If you’re being treated with medication for hypertension or being followed for borderline high blood pressure, it’s important to keep track of your blood pressure.
Hypertension, more commonly referred to as high blood pressure, is a prevalent condition in the U.S., with nearly 1 in 2 adults being affected by the condition. As a result, patients are tasked with periodically checking their own blood pressure at home. For those with “white coat hypertension,” a condition in which the anxiety of being in a clinical setting causes an individual’s blood pressure to increase, self-measuring your blood pressure in the comfort of your own home can produce more accurate readings.
But did you know that even the slightest change in arm position can skew the results?
“We are actually managing a lot of blood pressure from home. It’s important that patients know what their blood pressure is and that they know how to take it properly,” says Dr. Anjali Mahoney, chief medical officer of Venice Family Clinic in Los Angeles.
In an October 2024 study published in JAMA Internal Medicine, researchers conducted a randomized clinical trial evaluating the accuracy of blood pressure readings in three different common arm positions: with the arm supported on a desk, resting on the lap and hanging by the side. The results showed that having the arm on the lap or by the side led to higher blood pressure measurements, raising concern for experts as inaccurate readings can lead to more misdiagnoses and patients unnecessarily taking high blood pressure medications.
[Read: Foods for Hypertension.]
How to Properly Check Your Blood Pressure at Home
How you position your arm while taking your blood pressure reading can significantly affect its accuracy.
Here are the most current clinical guidelines to an accurate blood pressure reading:
1. Don’t eat, drink or exercise for 30 minutes
Avoid doing activities that may elevate your blood pressure, including eating, drinking and exercising for 30 minutes prior to your reading.
“People need to make sure they haven’t (had) any coffee, smoked a cigarette or gone on a run before they check their blood pressure,” Mahoney says.
This also includes taking any over-the-counter anti-inflammatory medications and decongestants, both of which can raise your blood pressure.
2. Use the bathroom beforehand
Make sure to empty your bladder before using the blood pressure monitor. Having a full bladder and holding your urine can increase your blood pressure.
3. Sit in a comfortable chair and relax
Find a chair that provides proper back support, and sit in it for at least 5 minutes before taking your blood pressure reading.
Because stress can raise your blood pressure, make sure you’re calm and relaxed, and don’t talk.
4. Keep your legs uncrossed and both feet flat on the ground
Crossing your legs at the knee restricts blood flow, which causes a slight increase in blood pressure. To avoid this, make sure you sit with your legs uncrossed with your back straight and both feet planted flat on the ground.
5. Rest your arm on a table
For the most accurate reading, place your arm on a table at the same level as your heart.
6. Place the cuff on your arm
Make sure the cuff is placed on bare skin rather than over a sleeve and positioned just above your elbow.
“The bottom of the cuff should be right at the bend of the elbow,” Mahoney says.
[READ: How to Spot the Signs of High Blood Pressure]
Picking a Home Blood Pressure Monitor
Here are some tips to help you choose an over-the-counter blood pressure monitor:
— Look for an arm cuff monitor. The American Heart Association and other experts recommend automatic blood pressure monitors that go around your upper arm. Wrist and finger monitors are not recommended, as they often show inaccurate readings.
— Choose the right cuff size. The cuff should be able to fit snugly around your arm. Measure the circumference of your upper arm and choose a blood pressure monitor that comes with a cuff in the appropriate size. There are four standard cuff sizes: small (20 to 25 centimeters), regular (25.1 to 32 centimeters), large (32.1 to 40 centimeters) and extra large (40.1 to 55 centimeters). A cuff that is too small or too loose will result in an inaccurate reading.
— Make sure the device is validated. The U.S. Blood Pressure Validated Device Listing, developed by the American Medical Association, features devices that have been evaluated for clinical accuracy. You can filter search results to view home monitors only.
— Bring it to your next doctor appointment. Once you’ve purchased your device, bring it with you to your next doctor appointment to have it checked by a health care professional, who can check it for accuracy by comparing it to the in-office monitor. After that, experts recommend bringing in their blood pressure monitor at least once a year.
For more guidance, refer to our pharmacists’ top picks for the best home blood pressure monitor.
Timing and Frequency
When self-checking your blood pressure, keep these timing tips in mind:
— Get into a routine for each sitting. Take three blood pressure checks in a row, and you can accept the last one or average the second and third one. This helps eliminate the concern that a lot of patients have about how high their blood pressure is.
— Consider time of day. Blood pressure is the highest in the morning. If you take blood pressure medication in the morning, it’s best to pick one or two times — either later in the morning or in the evening — to take your reading.
— Track your numbers. Keep a log of your blood pressure readings each time you take them. If your blood pressure monitor doesn’t already include a built-in memory to store your results, make sure to write down your readings in a notebook or printable tracker, such as this one by the American Heart Association.
— Follow your doctor’s recommendations on frequency. Make sure to follow your doctor’s guidance for how often to take your blood pressure reading.
[Read: Exercises for People With Hypertension]
How to Read Your Blood Pressure
There are two important numbers in a blood pressure reading:
— Systolic (top number). Your systolic blood pressure measures the highest blood pressure in your arteries when the heart is pumping blood.
— Diastolic (lower number). Your diastolic blood pressure measures the lowest blood pressure in your arteries when your heart is relaxed.
Preventative Care
If you’re healthy and have never had a problem with high blood pressure, you don’t necessarily have to invest in a home monitor. However, adults 18 and older should be medically screened for high blood pressure, at intervals depending on the factors below, according to the U.S. Preventive Services Task Force, an influential health panel of independent medical experts.
— Screening with an in-office blood pressure measurement is the initial USPSTF recommendation.
— Before starting treatment, the panel advises obtaining blood pressure measurements outside of the clinical setting for diagnostic confirmation. One way is for patients to wear a programmed portable device for 12 to 24 hours while going about their normal, day-to-day activities. Home blood pressure monitoring for a specified period is another alternative.
— Screening for hypertension every year for adults ages 40 and older and for all adults at increased risk for hypertension — this includes Black individuals, people with high-normal blood pressure and those with above-normal weight — is a “reasonable option,” according to the panel.
— Screening less frequently — every three to five years — as appropriate for adults ages 18 to 39 who are not at increased risk for hypertension, and who have a prior normal blood pressure reading, is also deemed reasonable.
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Home Blood Pressure Monitoring: How to Accurately Measure Your Blood Pressure originally appeared on usnews.com
Update 01/22/25: This story was published at an earlier date and has been updated with new information.
