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Blood Pressure Monitoring at Home
Not just for the doctor's office
High blood pressure, or hypertension, can be deadly. It is sometimes called the ‘silent killer’ because there are often no warning signs. Over time, if left untreated, high blood pressure can cause heart damage, kidney problems, and blindness that cannot be reversed. It can also lead to heart attack or stroke. The sooner high blood pressure is detected, the easier it is to reduce the damage it can do.
To measure blood pressure correctly:
- Begin by placing the monitor on a flat stable surface.
- Completely remove any bulky or tight fitting clothing from your arm. If your sleeve is rolled up, it must still be loose.
- Relax for five to 15 minutes to give your body a chance to slow down.
- Before putting on the arm cuff, sit comfortably with legs uncrossed, feet flat on the floor, and back supported by the back of the chair.
- The next step of positioning the cuff is very important. As you slide the cuff on, make sure the tube comes out of the cuff next to the inside of your elbow. This puts the cuff in the best position to give an accurate reading.
- The cuff should not be too tight. Two fingers should slide easily between the cuff and your skin underneath. It should also be one to two finger widths above the elbow. Check the picture to see how the cuff should be placed on your arm.
- Rest your forearm and hand flat on a table or firm support. The cuff should be at about the same level as your heart.
- Start the monitor. While the reading is being taken, breathe normally and relax your muscles. It is important to remain still and not talk. Moving and talking affect the way the machine reads your blood pressure and may give an inaccurate reading.
- Once the machine is done, record the result in a log book. If you are going to do a second test, wait at least five minutes before starting again.
Blood pressure often goes up and down over the course of a day. It can also be affected by other factors. One reading is not usually enough to diagnose high blood pressure. You may need to return to the doctor’s office several times to be certain.
Once high blood pressure has been diagnosed, you can make many changes in your life to help reduce it. By monitoring your own blood pressure at home, you can see for yourself whether the changes are helping. Your doctor may want you to bring these readings in to your next visit.
Which blood pressure monitor is best for me?
Doctors’ offices usually have either a mercury or aneroid type blood pressure monitor. Mercury blood pressure measuring devices are the standard against which all other monitors are measured. Aneroid devices are similar but do not contain mercury. To use either monitor you must have good eyesight and hearing, and be able to squeeze the bulb to inflate the cuff. Proper training is necessary to ensure readings are accurate and done consistently. Normally, mercury or aneroid devices are not the best choice for those who want to test their blood pressure at home.
By far the most popular type of monitor for home monitoring is the automatic digital blood pressure monitor. It does not contain mercury, is widely available, easy to use, and more durable than aneroid blood pressure monitors. However, there are drawbacks. Automatic monitors can cost more. Batteries or a plug-in adapter may be required. Though less delicate than mercury or aneroid devices, the mechanism inside can still be disrupted. If the monitor is inaccurate, it must be returned to the manufacturer to be reset.
When buying a home blood pressure monitor, try to find one that has been tested and validated. The Canadian Hypertension Society strongly recommends an automatic upper arm monitor that has met the standards of one of the following:
- the British Hypertension Society (BHS)
- the International Protocol (IP)
- or the Association for the Advancement of Medical Instrumentation (AAMI).
Check the Canadian Hypertension Society website at www.hypertension.ca to see which monitors are recommended. Before you buy, talk to an expert on home blood pressure monitors. You can then be sure that your monitor has been tested and validated. A pharmacist is an excellent resource.
One of the most common mistakes made is buying a monitor with an arm cuff that is the wrong size. If the cuff is too big or too small, your reading will not be accurate. To find your proper cuff size, measure around the midpoint of your bare arm between your shoulder and elbow, at the middle of your bicep. Compare this measurement with the recommendations on the blood pressure monitor’s package to see if the cuff is the correct size for your arm. Perhaps more than one person, such as you and your spouse, plan to use the monitor. If so, you may have to purchase another cuff in a different size. Do not use one monitor for a group of people unless the instructions specifically state it can be used for groups.
What options are available?
You may have difficulty deciding which blood pressure monitor is best for you. Many options are available on different monitors from various manufacturers. Memory functions can help those who either cannot or choose not to write in a logbook. Extra large or lighted displays can help people with poor eyesight. Formed arm cuffs that are easier to put on are also popular.
Some monitors have a bulb that allows you to inflate the arm cuff yourself. This reduces the cost of the machine and the drain on batteries, but can also lower accuracy. To be accurate, arm cuffs must be inflated 30 points higher than your blood pressure. If your blood pressure is higher than usual, you may not have pumped the monitor high enough to get an accurate reading. As these monitors cannot detect arrhythmia (irregular heartbeat), they are not good for people with this condition.
To simplify the process, many monitors have a pump that inflates the arm cuff for you. Some monitors automatically calculate how much to inflate the cuff, while others must be set beforehand. Ask for assistance from someone knowledgeable when you make your choice.
Irregular heart beats make it more difficult for automatic blood pressure monitors to accurately measure blood pressure. Some monitors have an arrhythmia detector. If your monitor has this feature and detects an irregular heartbeat, discuss this with your doctor.
After deciding which features are important to you, it is critical to ‘test drive’ a monitor before buying it.
- Take it out of the package and try on the arm cuff. Is it easy to put on? Does it fit properly?
- Is the number display large enough to read clearly?
- Do the instructions make sense?
- Do you know where the batteries go and where the plug-in adapter fits?
Make sure you are comfortable using the machine before you buy it.
What about finger or wrist monitors?
Wrist or finger blood pressure monitors, though more convenient, are not usually recommended. Wrist monitors must be in exactly the right place before they give an accurate reading. Finger monitors are generally not considered accurate enough to meet the standards.
Am I using the monitor properly?
Although blood pressure monitors have become easier to use, technique is very important to get an accurate reading. Being stressed, anxious, or excited will make blood pressure rise. Though unavoidable for many people, pain also increases blood pressure. Smoking, drinking alcohol, drinking caffeine, or exercising can all affect blood pressure if done within an hour of taking a reading.
Your blood pressure target
You and your doctor should decide what your target blood pressure should be. The target will depend on your current medical conditions, what medication you are on, and other factors. Ask your doctor how often you should take your blood pressure and what to do if your readings change significantly. If the readings at the doctor’s office and your monitor readings differ a lot, contact the store where you purchased the monitor or call the manufacturer. The monitor may need to be reset, or you may need a review on how to use it correctly.
Used properly, blood pressure monitors offer an excellent way to measure progress in controlling your blood pressure. Purchasing a quality product from an expert will ensure you get the right monitor for your needs.
FAMILY HEALTH is written with the assistance of |
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FAMILY HEALTH is written with the assistance of |
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