How to correctly monitor your blood pressure at home

Home blood pressure monitoring provides valuable information for you and your doctor about your risk of heart disease and stroke and can help guide treatment if you have high blood pressure. While it is not uncommon for a doctor to request that a patient check his or her blood pressure at home, it is very important for the patient to understand how to use a home blood pressure monitor properly in order to obtain accurate readings. Below, I summarize important recommendations from the American Heart Association about home blood pressure monitoring.

Choice of blood pressure monitoring device

The American Heart Association recommends that patients use blood pressure monitoring devices that have been validated through a review process that includes peer-reviewed publications showing they have met using internationally accepted protocols to ensure clinical accuracy. Many home blood pressure monitors that are commercially available have not undergone this review process. To help patients identify validated devices, several organizations are now maintaining websites that list these devices:

  • Stride BP, a joint initiative from the European Society of Hypertension, the International Society of Hypertension and the World Hypertension League
  • Validate BP, funded by the American Medical Association to the National Opinion Research Center at the University of Chicago
  • dabl Educational Trust

It is also important to note that upper arm blood pressure monitors are preferred over wrist devices because wrist devices require exact positioning of the wrist at heart level, which is often done incorrectly.

Preparation and Positioning

Before checking blood pressure, you should avoid caffeine, exercise and smoking for at least 30 minutes before measurement. You should also empty your bladder. When you are ready to check your blood pressure, you should sit in a chair with your feet flat on the floor (uncrossed) and with your back supported. You should be seated for 5 minutes without talking or moving around before recording your blood pressure and during the measurement. Your arm should be supported on a desk or flat surface with your upper arm at the level of your heart. You place the cuff on your bare upper arm, making sure the bottom of the cuff is directly above the bend of your elbow.

 Monitoring Schedule

The American Heart Association recommends that you take two measurements taken at least one minute apart in the morning and evening (4 readings per day) ideally for 7 days, but for at least a minimum of 3 days. The average of all readings should be calculated to assess blood pressure. While it is preferred to take these readings over consecutive days, readings taken on non-consecutive days can also be taken.  You may want to repeat this protocol every few weeks, or if a new treatment is prescribed. If your blood pressure remains stable for several months, monitoring less frequently may be reasonable.

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