Ten tips for checking your blood pressure at home

Doctors are increasingly recommending that patients check their blood pressure at home to diagnose high blood pressure (hypertension) and make treatment decisions. Seeing the pattern of your blood pressure at home allows a doctor to make a more informed decision about treatment than a single test at the doctor’s office.

To ensure appropriate treatment, it’s important that you take appropriate steps when you monitor your blood pressure. Mistakes in your technique at home could misdirect the doctor to prescribe you too much, too little, or the wrong type of medication.

If you’ve been advised to monitor your blood pressure at home, follow these ten tips to ensure your data is accurate:

At your doctor’s visit:

1. Learn your numbers. Ask your doctor what your target blood pressure is. Targets can differ by as much as 20 points, depending on age and medical condition. Ask your doctor how often to check, and what results require an urgent call to the office, or a visit to the emergency room.
2. Bring your machine to the doctor at least once. The office can check your machine against office measurements. Make sure that your cuff size is correct: a cuff that’s too small will overestimate your pressure and a cuff too large will underestimate it.
3. Relax. It’s common for your blood pressure at the office to be higher than your results at home. This is called “white coat hypertension,” and is probably a result of the mild anxiety you may feel at the doctor’s office. That’s why doctors often recommend patients check their blood pressure at home. Doctors sometimes recommend further testing with another method, if available, for patients with white coat hypertension; this method is called ambulatory blood pressure monitoring.

At home:

4. Plan in advance. No smoking, caffeine or exertion 30 minutes before. Empty your bladder. Rest for 5-10 minutes before you start.
5. Know the correct body position.
   • Sit upright with your back supported and your feet on the floor. Don’t cross your legs or rest them on an ottoman.
   • Rest your arm at the level of your heart (for example, on pillows, books, or on a table). If your arm is too low—for example, lying in your lap–your results could overestimate your pressure.
6. Consistently measure either the right or left arm.
7. Stay still and quiet while the machine runs.
8. Repeat the cycle once.
9. If you get a high number, don’t panic. Expect some normal variations between days. Remember things like emotion, stress, exertion, or pain temporarily raise blood pressure, and this is not necessarily the same as poorly controlled blood pressure. Your blood pressure will typically be a little higher in the morning than the evening. Use your doctor’s guidelines to know what your action plan should be for high numbers.
10. Check your blood pressure regularly, if your doctor has recommended home monitoring.  Checking it only when you are feeling bad can be misleading. But, do not become overly obsessed with checking if your blood pressure is alright. Two to three times a week is usually sufficient, unless your doctor recommends otherwise. Light headedness may indicate your blood pressure is too low, so do check in that instance. Low blood pressure is a frequent problem for older patients leading to falls or other problems, so it is important to note when this happens. Record your numbers in a log with the date and time, and bring the log to your next doctor’s appointment.

This post was originally published on May 15, 2015

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