How Often Should You Check Your Own Blood Pressure?

A patient’s blood pressure readings can vary significantly between doctor’s visits, according to new research from millions of appointments.

While this doesn’t matter for everyone, it poses a challenge to patients and providers working to manage high blood pressure.

A research article published in the April issue of the journal Circulation analyzed data from 7.7 million outpatient blood pressure readings taken between January 2014 and October 2018 at the Yale New Haven Health System. The authors reported that over the course of roughly 13 visits, a patient’s systolic blood pressure—the top number of a blood pressure reading—could vary by 10 points between consecutive visits.

Their findings led researchers to question if certain patients may need to monitor blood pressure at home to help guide their treatment plan.

“We know that the doctor’s office isn’t a place where people spend a lot of time,” Joseph Ebinger, MD, associate director of the coronary intensive care unit at Cedars-Sinai in Los Angels, told Verywell. Ebinger was not involved in the study. “Just being in a medical environment can increase their blood pressure for some folks. We see this classic rise at the doctor’s office, with a slow decline when they go home.”

Why Does Your Blood Pressure Read Differently at the Doctor?

It’s important to recognize that your blood pressure reading at the doctor’s office may not reflect your daily blood pressure.

“An office blood pressure measurement is just a snapshot at one point in the day,” Yuan Lu, ScD, lead study author and assistant professor at the Yale School of Medicine in New Haven, Connecticut, told Verywell. “For instance, there will be differences between measuring in the morning and evening. A one-time reading doesn’t reflect how the blood pressure changes throughout the day.”

Several factors can cause your blood pressure to rise or fall daily, and make a difference in the reading you get at the doctor’s office: 

• Blood vessels expand and contract with warmer or colder conditions, which may cause a difference in blood pressure. Sitting in a cold waiting room could also cause your blood pressure to rise.
• If you take medication for blood pressure, your reading may also vary based on the time of day you took your medicine.
• Rushing to get to your doctor’s office and feeling stressed when you arrive can elevate your blood pressure reading.
• Improper blood pressure cuff size or placement may cause your reading to be inaccurate.
• Some patients experience “white coat syndrome,” a temporary elevation in their blood pressure due to anxiety around visiting their doctor.
  

Who Should Check Their Blood Pressure at Home, and How Often?

Only some people need to regularly check their blood pressure at home, including patients diagnosed with high blood pressure and whose blood pressure is slightly elevated.

Lu also recommends elderly adults and anyone with risk factors that predispose them to heart disease, including a family history of high blood pressure or a previous history of heart disease, check their blood pressure at home.

Patients who are new to home blood pressure testing should check their blood pressure a few times daily for about a week. But too much monitoring could cause anxiety in some patients, which could elevate their blood pressure. After they have the process down, both Lu and Ebinger recommend testing once daily at the same time each day.

“When we have people monitor their blood pressure at home, we hope to get a better sense of what their blood pressure is doing,” Ebinger said.

How to Get an Accurate Blood Pressure Reading at Home

You’ll need a blood pressure monitor in order to take your own blood pressure. According to Ebinger, there are a few steps to follow for getting an accurate reading at home:

• Empty your bladder and rest for 5 minutes before checking your blood pressure.
• Sit with your feet on the floor, your legs uncrossed, and your arm at the level of your heart.
  
• Correct cuff placement around the arm is essential to getting an accurate reading, so ask your doctor or nurse for guidance before beginning home monitoring. Most home blood pressure cuffs come with markings to aid in proper placement, so be sure to look closely at the instructions.
• Avoid distractions such as stimulating television programs or sporting events.
• Rest at least one to two minutes between blood pressure readings, and take the higher result.
• Check your blood pressure at a consistent time of day. High blood pressure, or hypertension, can have major consequences on the body

Most home blood pressure monitors you can purchase in a pharmacy are reliable. Still, for extra assurance, Ebinger recommends cross referencing your device with Validate BP, an independent review committee that certifies home blood pressure monitors for accuracy.

What Are the Risks of High Blood Pressure?

High blood pressure, or hypertension, can have major consequences on the body, so getting an accurate sense of your blood pressure is critical to properly treating the condition.

“High blood pressure is the number one risk factor for cardiovascular disease, and cardiovascular disease is the number one cause of death in the U.S.,” Lu said. “When it’s not super high, you may not have any symptoms. People just ignore it, or think, ‘Why do I need to take medication if I have no symptoms?’ But it can contribute to organ damage in the brain, heart, and kidney, leading to stroke, heart attack, heart failure, and kidney failure.”

How to Get Your Blood Pressure Under Control

Lifestyle changes are the first line of treatment for hypertension. Reducing salt in your diet, getting regular exercise, and managing your stress are all strategies you can implement to lower your blood pressure.

For some patients, lifestyle modifications alone will not control their hypertension. These individuals will need medication. Working with a provider to find the right drug and dose is vital.

“Patients may stop taking their blood pressure medication because they don’t feel any side effects from their hypertension. But blood pressure meds need to be taken continuously,” Lu said.

If you have any side effects or concerns about your medication, speak with your provider. You may be able to find a different drug or dosage that works better for you.

“We’ve known for a long time that elevated blood pressure is a prevalent but highly modifiable risk factor for heart disease,” Ebinger said. “The more we focus on controlling blood pressure, the better outcomes we will see.”