How to Choose a Home Blood Pressure Monitor

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Having your blood pressure (BP) measured is a routine part of visiting your doctor. However, it's also easy to measure your BP at home. The good news is that home BP readings, when done properly, are a more accurate predictor of cardiovascular risk than BP readings measured in the medical office. In addition, home BP recordings can also predict progression of kidney disease and functional decline in older people. They have several advantages over recordings taken at the doctor’s office, including a large number of measurements, low cost and easy implementation. However, to obtain useful data, it is essential to have a validated device and perform the measurement correctly. You should consider measuring your BP at home if:

  • You have a known high BP problem (hypertension). Home BP measurements will help determine if your treatment is effective. If your office BP is greater than or equal to 130/85 mm Hg, your doctor will probably consider an out-of-office measurement.
  • You or your doctor suspect that you may have white coat hypertension, defined as high BP in the medical office, but normal BP at home.
  • You or your doctor suspect that you may have masked hypertension, defined as normal BP in the medical office, but high BP at home.

BP monitors for home use come in many different styles. In general, the American Heart Association recommends that you use an automatic BP monitor with a cuff that fits around your upper arm.

Automatic vs Manual

The traditional, manual method of measuring BP requires you to inflate the cuff by squeezing a bulb and listen to how the pulse changes as the cuff deflates. This is a technical and complex skill. Fortunately, automatic BP monitors make the task much easier. At the push of a button, the cuff will inflate and measure your BP as it slowly deflates.

Note: Measuring BP with an automatic machine may not be accurate if you have atrial fibrillationAsk your doctor for advice in this situation.

Location of BP Cuff

The most accurate and reliable way to measure BP is to use a cuff that goes around your upper arm, or bicep area, above the elbow.

It may be convenient to use a machine that measures BP at your wrist or finger because you don’t have to roll up your sleeve. However, BP readings with these machines are particularly sensitive to the position of your wrist and finger. And the smaller arteries in your wrist and finger (compared to your upper arm) also make the BP readings less accurate.

Therefore, wrist and finger monitors are not recommended unless no other alternative is available.

Size of BP Cuff

Make sure the cuff fits properly. If the cuff is too small (too tight around your arm), the BP measurement will be falsely elevated. If the cuff is too large (too loose), the BP measurement will be falsely low. Usually the BP monitor will come with instructions to determine if the cuff is the correct size for you.

Record and Send BP Readings

Most BP cuffs with a digital display will record several weeks of your BP readings. Make sure that you don't lose these readings as the memory clears. Write them down or plug the monitor into your computer or smartphone. If the service is available, send your BP readings directly to your health care provider. It is important for your doctor to calculate the average of multiple BP values taken over a period of time. Therefore, many experts recommend keeping a home blood pressure diary. A recent study led by Professor James Sharman from the University of Tasmania, Australia, showed that if at least 30 percent of the last 10 home systolic blood pressure readings greater than or equal to 135 mm Hg, the patient is likely to have an uncontrolled blood pressure. Although this is just a rough estimate, physicians could use it to quickly assess entries from home BP diaries.

Validated Monitors

Consult this rating of upper arm BP monitors and choose one that is specifically recommended. The up-to-date data information is provided by the dabl® Educational Trust, a not-for-profit educational organization that has many experts on blood pressure measurements on their advisory board.

Body Positioning

Your body position affects your blood pressure. no matter which type of monitor you are using.

There are key points to remember before and during BP measurement.

Before you measure your BP:

  • Don't smoke, drink caffeinated or alcoholic beverages, or exercise within 30 minutes before measuring your BP.
  • Empty your bladder.
  • Rest quietly for 5 minutes before measuring BP.

When measuring your blood pressure:

  • Sit in a chair with your back supported and feet flat on the ground.
  • Do not cross your legs or ankles.
  • Support your arm on a table so that your upper arm (bicep) is even with your heart. Don’t let your arm dangle at your side, and don’t raise it too high.
  • Turn your palm facing up.
  • Place the BP cuff around your bare upper arm, one inch above the crease of your elbow.
  • Press the start button on the monitor. The cuff will automatically inflate and read your BP as it deflates.
  • Take two or three readings, one minute apart.

It's also a good idea to check your BP monitor against the one in your doctor's office to see if there is a difference in the readings.

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