HOME BP MONITORING – DOs AND DON’Ts

Why is Blood pressure monitoring at home is important?

  1. To make sure blood pressure is maintained normal and to keep an eye on the blood pressure in individuals whose medications or dose of medications for hypertension are changed, lifestyle changes are made, recently.
  2. It is important to make a note of all the BP readings in an app/a book, as a single reading of blood pressure doesn’t warrant diagnosis of hypertension or a need of medication unless, it is consistantly high.
  3. To avoid biased blood pressure readings as many people may get anxious, stressed at the doctor’s clinic leading to false high blood pressure called white coat hypertension.
  4. To avoid frequent visits to the doctor for checking blood pressure.
  5. If one feels dizzy, lightheaded after waking up from bed/ on standing from sitting position, it is best to check blood pressure on standing and sitting position as well to check if there is a decrease in BP on standing.

Pre-requisites for blood pressure recording:

  1. Avoid smoking, food, alcohol intake, exercises, caffeinated drinks such as coffee, tea, aerated drinks, etc. at least 30 minutes before measuring blood pressure.
  2. Empty bladder before taking the blood pressure reading as full bladder may rise blood pressure.
  3. Sitting in a comfortable position, staying calm and relaxed for at least 5 minutes before measuring the blood pressure is important to get an accurate reading.
  4. Sitting straight with a back rest, with feet flat on the surface of floor (without cross-legged) and resting the elbow and forearm flat on a cushion/a pillow with upper arm at the heart level is also important.
  5. The cuff of the BP apparatus should cover at least 80% of the upper arm with its lower part placed just above the elbow crease.
  6. Do not tie the cuff too tight or too loose to get accurate reading.
  7. The cuff should be tied over arm but not over sleeve/clothing to avoid false readings of BP. If the sleeve is too tight when folded up, it may be best to remove the sleeve off arm.
  8. The readings should be taken only at the same time every day, ideally in the morning (not immediately after waking up) before breakfast and in the evening.
  9. At least two readings of blood pressure should be taken about 2-3 minutes apart to get accurate measurement.
  10. BP from both arms should be measured at least once in a while
  11. Do not talk, do not make a fist but keep the hand and arms relaxed while BP is being measured.
  12. Make sure the cuff is of right size of the arm while buying the BP apparatus.
  13. Make sure the BP apparatus that is going to be used at home and the procedure of measuring BP by self is correct by practicing once before the treating doctor.
  14. Start measuring blood pressure every day at least after 2 weeks of starting a new dose or a new medication for hypertension and at least 1 week before next appointment with the doctor.

References:

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20047889

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/KnowYourNumbers/Monitoring-Your-Blood-Pressure-at-Home_UCM_301874_Article.jsp#.Wx-hoYozbDd

https://www.health.harvard.edu/heart-health/tips-to-measure-your-blood-pressure-correctly

https://doctor.ndtv.com/living-healthy/world-hypertension-day-2017-dos-and-donts-of-checking-blood-pressure-at-home-1698016

https://www.aafp.org/afp/2005/1001/p1391.html

-Dr. Divya Teja Pasupuleti

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