How To Take Your Blood Pressure At Home

After sprinting across the parking lot, you make it into your physician’s office just in time for your doctor's appointment. You chat with the nurse as she escorts you back to the exam room. You start to feel the effects of that cup of coffee you had and regret not having stopped at the restroom first. The nurse wraps the blood pressure cuff around your upper arm, and you try to relax. She pumps up the cuff tourniquet-tight, places her stethoscope in the crook of your arm and releases the air gradually, listening for that mysterious moment.

Afterwards, she removes the cuff with that typical velcro rip, saying, “Well, it’s a little high.”

How can that be? You’ve watched your salt, started exercising—even lost a few pounds! And the reading you took yesterday with your home monitor hovered near that desired 120/80 mark.

Take heart—you’re not alone. Contrary to what you may think, going by the blood pressure reading you get in your doctor’s office may not be as helpful as you think.

Maintaining a normal blood pressure is basic to our best heart health. By avoiding or minimizing hypertension, we reduce the stress on our arteries and heart muscle. But high blood pressure tends to have no symptoms, which makes it important to track your blood pressure and work with your doctor on keeping it at a healthy level, especially as we age.

Are Home Blood Pressure Monitors Accurate?

Home monitors make regular tracking possible, but how helpful and accurate are they, really? As it turns out, very much.

The American Heart Association recommends that all people with high blood pressure track it at home using an at-home blood pressure monitor. Upper arm cuff devices are preferred over wrist monitors, the AHA says.

“We tend to think the blood pressure monitors in the doctor’s office are more sophisticated, more accurate than home monitors,” said Derrick Plahn, DO, a cardiologist with Indiana Heart Physicians, a Franciscan Physician Network practice in Indianapolis, Greencastle and Greensburg. “But the problem is, you don’t live at the doctor’s office.”

No White Coat Hypertension At Home

Depending on the reason for your doctor's visit, you may be experiencing temporary anxiety. In addition, about one in three patients have what is called “white coat hypertension,” meaning just seeing the doctor or being in the office can raise the blood pressure.

But of all the factors that can temporarily affect your blood pressure reading, a home monitor itself is probably not one of them. There are several excellent, easy-to-use home monitors available, said Dr. Plahn, and he encourages all of his patients to have a home blood pressure monitor and use it regularly.

“You are more apt to get more accurate blood pressure readings at home than at the office because home is your normal environment. As physicians, we’ve learned to rely more on home readings that those taken in our office,” said Dr. Plahn.

Making Home Blood Pressure Checks A Routine

Paul Jones, MD, medical director for Franciscan Health Cardiovascular Services in South Suburban Chicago, recommends that people weigh themselves and measure their blood pressure as part of their daily routine, using his own example: “I have a blood pressure machine by my toothbrush and my razor, so when I get up in the morning and go to shave and brush my teeth, I check my pressure, too,” he said.

“You shouldn’t wait until your doctor makes a diagnosis that you have an elevated blood pressure,” Dr. Jones added. “If you see your blood pressure going up, you can go to the doctor and say, ‘Hey, I’ve got a problem. Can you help me?’”

Likewise, regularly stepping on the scale can help control obesity, a key to preventing diabetes.

“Obesity breeds diabetes,” Dr. Jones said.

9 Tips For Monitoring Blood Pressure At Home

When checking your blood pressure, follow these guidelines as closely as possible—ignoring one or more may affect your reading, whether you’re at home or in the doctor’s office.

• Empty your bladder
• Don’t have a conversation
• Support back and feet—sit in a chair with your feet flat on the ground
• Support arm at heart level by placing it on the arm of a chair or a tabletop
• Keep legs uncrossed and feet flat on the ground.
• Use the correct monitor cuff size
• Place cuff on bare arm, not over a shirt or sweater
• Position and support your upper bare arm at heart level. Keep your palm up and your arm muscles relaxed. 
• Don't talk during the test.

“Also, don’t take your blood pressure when you’re angry or upset, for obvious reasons,” said Dr. Plahn. “And take it before you eat a meal or drink your coffee, tea, or other beverage with caffeine.”

Take two blood pressure readings at least one minute apart.

Not following these steps can throw a reading off significantly. A blood pressure reading taken over clothing, for example, can be off by 5 to 50 points.

Blood pressure tends to be highest in the morning, decreases through the day and is lowest during sleep. To account for that, when diagnosing high blood pressure, you may be asked to take two readings in the morning and two in the evening over the course of a week.

Buying A Home Blood Pressure Monitor

When buying a blood pressure monitor to use at home, decide first what features you want, such as how many reading you want stored on the unit and for how if more than one person will be using it. Many home devices also track pulse rate, and more advance models can even track irregularities in heartbeat, if that is a health concern as well.

Buy the right model and size. Arm cuff models tend to be more accurate than wrist models, especially for older patients, but it’s important to get one with the correct cuff size, especially if you have slender or large arms. In general, if the circumference of your upper arm is more than 17 inches or is smaller than 8.7 inches, look for a monitor with an extra-large cuff or a highly rated wrist monitor.

Take your home monitor to the doctor’s office to compare readings and calibrate to the office models.