Home Monitoring of Blood pressure

American Heart Association recommends home monitoring for all people with high blood pressure to help the healthcare provider to determine whether treatments are working.

Before proceeding to the tips of measuring blood pressure at home, let us learn about some basics about blood pressure.

What is blood pressure?

Blood pressure is a measure of the force of blood flowing against the walls of the arteries. Blood pressure is expressed as a fraction of two numbers. The upper number is called the Systolic Blood Pressure and it is the highest pressure in a cardiac cycle. The lower number is called the Diastolic Blood Pressure and it is the lowest pressure in the cardiac cycle. BP is the commonly used abbreviation for blood pressure and the unit of blood pressure is mmHg which stands for millimetres mercury.

What is the normal value of blood pressure?

According to the latest guidelines of American College of Cardiology and American Heart Association, blood pressure below 120/80 mmHg is considered to be normal and blood pressure greater than or equal to 130/80 mmHg is called hypertension; but all other guidelines including European Society of Cardiology consider blood pressure greater than or equal to 140/90 mmHg as hypertension. Practically blood pressure reading lower than 90/60 mmHg is generally considered low blood pressure.

What factors influence blood pressure?

Many factors such as physical activity, anxiety, stress, hydration status, the time of day, climate etc, influence the blood pressure. Blood pressure has a daily pattern. Blood pressure is typically higher in the morning and lower in the afternoon and evening. It is lower in the summer and higher in the winter. There is also a normal variation in the blood pressure measured between both the arms with the dominant arm having slightly higher blood pressure up to 10 mmHg than the non-dominant arm.

What is the correct way to measure blood pressure at home?

Follow these directions while measuring blood pressure:

1. Avoid bathing, drinking alcohol or caffeine, smoking, exercising and eating for 30 minutes before taking a measurement.

2. Empty your bladder and take rest for at least 5 minutes before taking the measurement.

3. Avoid taking measurements during stressful times because stress raises blood pressure.

4. Take the measurements in a quiet place.

5. Be still, sit calmly and don't talk.

6. Sit with your back straight and supported (on a chair, rather than a sofa).

7. Your feet should be flat on the floor and your legs should not be crossed.

8. Your arm should be supported comfortably on a flat surface (such as a table) with the upper arm at heart level.

9. Make sure the bottom of the cuff is placed directly above the bend of the elbow.

10. Each time you measure, take at least two readings 1 min apart in the morning and evening before taking medications or meals.

11. Don't take the measurement over clothes. Remove tight-fitting clothing from your arm.

12. A single measurement does not provide an accurate indication of your true blood pressure. Take multiple readings and record the results.

13. Try to measure your blood pressure at the same time each day and in the same arm for consistency.

14. It is best to take the readings daily however 1 week after a change in medications and before your next appointment with doctor.

15. Use properly calibrated and validated instrument.

16. Use appropriate cuff size. Measure the circumference of your mid-arm in cm. The ideal length of the bladder cuff should be approximately 80% of your arm circumference. Too small or too large cuffs can provide wrong values.

Who may get benefitted with Home monitoring of blood pressure?

Home monitoring of blood pressure may be especially useful for:

Anyone diagnosed with high blood pressure

Individuals on medication to control blood pressure

People with risk factors for developing high blood pressure

Pregnant women experiencing conditions like pregnancy-induced hypertension and/or preeclampsia.

Evaluating potentially false high readings such as people who have high readings only at the doctor’s office known as “white coat” hypertension.

Note: If heart rhythm is irregular, automatic home blood pressure monitoring devices may not give accurate measurements.

What to do when you get a high or low blood pressure reading ?

· Do not panic with a single high or low reading. Measure your blood pressure a few more times and if it is still high then consult your doctor to know how to proceed further.

· If blood pressure reading exceeds 180/120 mm Hg on repeated measurements contact your doctor immediately because this may be a hypertensive crisis.

· Symptomatic very low blood pressure can be life-threatening in severe cases; so seek medical care immediately.

To conclude, home monitoring of blood pressure is essential but not a substitute for regular consultation visits to your physician. A diagnosis of high or low blood pressure must be always confirmed with a medical professional.