The first time I ever bought a home blood pressure monitor; I opened the box and took a good look at my new toy. I was so happy to have a way to read and monitor my blood pressure anytime I wanted. I immediately unboxed it and took my blood pressure. I couldn’t wait. To this day I can remember the reading, it was 142 over 82.
Even though I thought my blood pressure was high prior to taking this reading, the reading confirmed it. Or did it? I failed to read the instructions or properly prepare myself to take that blood pressure reading. Maybe it was right, but I’ll never know because I didn’t read up on how to use a home blood pressure monitor the right way.
If you’re not using the home monitor the right way, it can result in inaccurate readings. This can give you a false sense of security when things are really not right. Or it can do the opposite and trick you into thinking you have high blood pressure when you don’t.
Therefore, I’m writing this blog post, so your chances of this happening to you is less. I’m going to tell you what you should do prior to taking your BP, the right times to take it and the proper technique.
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How To Use A Home Blood Pressure Monitor The Right Way
Yes folks, size does matter 😉 At least when it comes to the cuff size of your home monitor. Prior to buying one, make sure the cuff that comes with the blood pressure monitor is the correct size for your arm. Some monitors come with only one size cuff and others can be ordered with different size cuffs 1.
- If you’re unsure what size cuff you need, this is how to determine your arm size.
- Using a cloth measuring tape, wrap the tape around your upper arm, between the elbow and shoulder.
- Don’t flex your arm, just let it hang down relaxed.
- Wrap the tape evenly around the circumference and see how many inches your arm measures.
- To make sure you have the right measurement, take 3 measurements to check your accuracy.
Buying the correct size cuff is crucial. If the cuff is too small, it may be too tight and your blood pressure measurements may read higher than what your pressure actual is. If the cuff is too big, it will be too loose making your blood pressure measurements lower than the true reading.
The home monitor I recommend comes with a cuff that fits an arm between 8.75″ up to 16.5″. They sell smaller and larger cuffs if your arm doesn’t fit in that range. (see my home blood pressure monitor blog post and recommendation, right here)
Prior To Taking Your Blood Pressure
- Take your blood pressure readings the same time every day (resource). The best times are every morning or night. I prefer taking mine every morning before drinking my coffee. In addition, this is usually prior to experiencing the stresses of the day.
- Don’t do any activities that may raise your heart rate within 30 minutes of taking your BP. This includes exercise, smoking or drinking caffeinated beverages.
- Within 5 minutes of taking your blood pressure, have 5 minutes of quiet time.
- Empty your bladder before taking your blood pressure. A full bladder can cause stress and nervousness which may raise your blood pressure.
- Wear comfortable clothes and shirt, preferably with short sleeves. Do not place the blood pressure cuff over clothing.
- Sit in an upright chair and not slouched back like on a cushiony sofa. Keep your back straight and supported. I find a dining room chair is the best for this positioning.
- Keep your legs and feet uncrossed and your feet should be flat on the floor.
Taking Your Blood Pressure
- Slide a closed, loose cuff over your hand and up to your upper arm. Open the cuff more and resize it if needed to position it to your upper arm. The bottom of the cuff should be about 0.8″ to 1.2″ above the bend in your arm. The tube and artery marker on the cuff should be lined up with your inner arm and artery 2.
- Keeping the artery marker in place, tighten the cuff snugly around your arm, but not too tight. You should be able to insert 2 fingers between the cuff and your arm but not more.
- Keep the arm you will be using supported on a flat surface like an arm rest or a table.
- This step is crucial to using a home blood pressure monitor the right way. Keep the cuff at the same level as your heart. This is essential with any blood pressure monitor you might be using especially with a wrist monitor. Having the cuff positioned above heart level can result in a lower blood pressure reading. If the cuff is lower than heart level, it may result in the reading being higher. Most times if you are in the proper seated position with your arm supported as described above, your cuff will be at heart level.
- Now that you’ve done everything possible the right way, press the power button and get your reading. As the cuff inflates and your reading measures, stay still and remain relaxed.
- Take your BP measurement 3 times and jot down your results. Keeping track of your readings is important. Record your measurements manually with the time of day, or keep them stored electronically in the monitor or on your connected phone app. Every time you go in to see your doctor, take the BP readings with you.
- After you change something in treatment like medicine, nutrition or a lifestyle change, you’ll definitely want to start monitoring your BP daily. This is especially true after 2 weeks when you might see the change in treatment taking effect.
- If you have a physician appointment coming up and you haven’t been monitoring your BP, you’ll want to check it every day for a week. If you don’t have health insurance or you’re looking to change your plan, you can check out the best affordable plans right for you. Visit eHealth’s website.
- If you are getting high blood pressure numbers, remember a diagnosis of high blood pressure must be confirmed with a doctor.
- A single high reading of blood pressure is not a cause for alarm. If you do get a high reading, wait a few minutes and check it again. If your readings remain high, it will be a good idea to consult with your doctor.
- If you get a high BP reading higher than 180/120, wait five minutes and recheck it. If the next reading is just as high and you’re not experiencing any of the 6 symptoms below, call your doctor immediately and be guided by his advice. If your reading is over 180/120 and you have any of the following symptoms, call 911 3.
- Back pain
- Chest pain
- Shortness of breath
- Change in vision
- Weakness or numbness
- Difficulty breathing
- Even if you are using a home blood pressure monitor the right way, it’s never a substitute for regular physician check ups.
- If you’re taking medication for high blood pressure and your home monitoring indicates your BP readings are normal, don’t stop taking your medication without consulting with your doctor.
- Consistently check your blood pressure in the same arm. There can be a slight difference between arms, sometimes up to 10 mm Hg is normal 4. Sometimes it’s beneficial checking your blood pressure in both arms one right after the other. If there’s a difference more than 10 mm Hg, it can indicate a bigger problem such as a blocked artery, an increased risk of peripheral vascular disease or narrowing of the arteries.
- If you have a new device, always read your instruction manual prior to using it.
- Learn your new device including the settings, display and its features.
Factors That Cause You Not To Use Your Home Blood Pressure Monitor The Right Way
- Taking a reading in a cold room.
- Eating or drinking within 30 minutes of taking a measurement.
- Taking a bath, hot or cold, within 20 minutes of taking a measurement.
- Smoking before taking a measurement. Try not to smoke 30 minutes prior.
- The cuff position is too low or too high on the arm.
- The cuff is too loose or too tight.
- The cuff is applied over clothing, no matter how thin.
- The cuff is below or above heart level.
- Taking a BP measurement while moving, talking, watching TV or texting.
The circumference of your upper arm is larger than normal. This is usually cause by obesity. If the cuff does not fit properly and you have to wrap it too tight for it to fit, your readings are not going to be reliable.
Studies have shown that a cuff wrapped too tight can increase a person’s systolic BP measurement as much as 10 to 40 mm Hg 5. If this is the case, you can buy a larger and appropriate cuff for your upper arm measurement. If you can’t find one, then you may have to use a wrist monitor.
Your upper arm has a cone shape. The cuff will not wrap around a cone shaped arm properly. Check your other arm and see if it’s not con shaped or use a wrist monitor. Cuffs wrapped around a cone shaped arm can cause blood pressure discrepancies as much as 10 mm Hg.
Some people may have injuries or hand, arm or shoulder mobility limitations. This may make it impossible to use an upper arm monitor the right way. In this situation a wrist monitor would be more beneficial.
Can Wrist Home Blood Pressure Monitors Be Used The Right Way?
Yes, wrist home blood pressure monitors can be used the same way as an upper arm monitor. The tips and guidelines listed above work the same for wrist monitors. Even more so when it comes to the cuff being held at heart level 6.
I see many people taking their BP with a wrist cuff held down on their leg or somewhere in between but not at heart level. This error will most likely result in an inaccurate reading.
The easiest way to hold a wrist cuff at heart level is to start with your arm straight down on your side. Keeping your upper arm still, bend at the elbow raising your forearm up and across your chest until your wrist cuff is at heart level.
The wrist blood pressure monitor that I recommend has a sensor that tells you when the cuff is at heart level. You can check out my recommendation right here.
Is The Wrist Monitor As Accurate As An Upper Arm Cuff?
Wrist monitors are not as accurate as a traditional upper arm monitor. The American Heart Association does not recommend them. The blood vessels in the wrist are smaller and more close to the skin surface making the measurement less reliable.
Numerous studies indicate how the wrist monitors are not as accurate. One study published in the Journal of Clinical Hypertension showed that 33 percent of the people measured had differences equal or greater than 10 mm Hg 7.
Home Blood Pressure Monitors May Be Especially Useful For:
- Any person who has already been diagnosed with high blood pressure.
- Anyone who is starting a high blood pressure treatment to determine its effectiveness. In addition, anytime someone is changing their treatment.
- People who may be at a higher risk of high blood pressure or cardiovascular disease. Those risk factors include the following:
- Family History
- Bad habits such as excess alcohol and drugs
- High cholesterol
- Stress and anxiety
- Pregnant women, especially those that are already experiencing high blood pressure and/or preeclampsia. During pregnancy, changes in your blood pressure can be an early warning sign of preeclampsia 8.
- People who have white coat hypertension. This is when people are nervous and anxious at their doctor appointments and have high blood pressure only at their appointments and not at home. In addition, there could be stresses involved visiting a doctor like traffic, crowds or running late. This can increase your stress hormones, increase heart rate and temporary raise your blood pressure.
- Then there’s the opposite of white coat, which is “masked” hypertension. These people have high blood pressure only at home and not at the doctor’s office. This can be more dangerous because most of our time is spent out of the doctor’s office. The most common causes of masked hypertension are when people have highly stressed jobs or a stressful home situation. In this situation, people are more calm when they’re at the doctor.
How To Check Your Blood Pressure Monitor For Accuracy
Imagine following all the steps listed above to use your monitor the right way, but your BP monitor is not accurate. After being the perfect model for proper BP measurement, you’re getting false, inaccurate readings. This can be very discouraging and cause you more stress, which can raise your blood pressure. So, how do you find out if your home blood pressure monitor is accurate?
The answer is pretty simple, take it with you on your next doctor visit 9. Ask your doctor or nurse to take your blood pressure with your home monitor immediately after they check it with theirs. Both readings can be compared to check for accuracy.
To make sure your monitor stays accurate, bring it with you every 6 months or year to have it checked.
All new home blood pressure monitors sold in the United States are required to meet the Food and Drug Administration standards. The monitors undergo a formal validation process. However, even a device that has been validated may not give accurate readings in all patients.
Therefore, even a new monitor should be checked for accuracy. It’s a good idea to buy a new monitor just prior to a doctor visit so it can be checked almost immediately.
Can Home Blood Pressure Monitors Be Recalibrated?
Let’s say after checking your home blood pressure monitor at the doctor and you find out it’s not accurate. Whether it’s brand new or not you can have your monitor recalibrated. If it’s new, it’s still under warranty. Therefore, you can contact the company you bought it from or the company that manufactured it.
If it’s not new, it’s still best to contact the company that manufactured your monitor to have it recalibrated. If you have a Welch Allyn, the upper arm one that I recommend (see my blog post), they can recalibrate it, repair it and give you estimates.
You can visit their website and go to customer support, submit a repair and print out a packing slip with the appropriate information to send it to them.
If you have an Omron home blood pressure monitor, you can visit the website support page or call the following number (877) 216-1333.
Maintenance And Storage Of Your Home Blood Pressure Monitor
If you want to use your home blood pressure monitor the right way, proper maintenance and storage are essential. If these steps are not followed, it can result in a monitor that becomes inaccurate or broken.
- Store your home monitor and the components in a safe place that is clean and dry.
- Keep your monitor and components out of direct sunlight.
- Avoid shaking or dropping the monitor.
- Do not operate your monitor in dusty conditions.
- Do not attempt to repair or disassemble your monitor or components.
- You can unplug the air tube from the air jack and gently fold it into the arm cuff. Do not bend or crease the air tube excessively.
- Do not use abrasive or volatile cleaners. Never immerse the monitor or the components in water.
- Use a soft cloth to clean the entire unit.
- Clean the monitor only when necessary using 10% chlorine bleach/90% water solution. This is the same as a standard bleach wipe.
- To clean the cuff, wipe it with a soft, damp cloth. If needed, a neutral soap can be used.
Choosing A Home Blood Pressure Monitor
Purchasing the right home blood pressure monitor makes a big difference if you want to use it the right way. The American Heart Association recommends to use an automatic, cuff-style, upper arm monitor. In addition, the following guidelines are recommended:
- Wrist (watch like devices) and finger monitors are not recommended because they usually give less reliable readings.
- A cuff-style wrist monitor is only recommended when an upper arm monitor cannot be used.
- Choose a home monitor that has been validated. All monitors sold in the United States have been validated. It’s not worth the extra savings and risk buying a home monitor from abroad that may not be accurate.
- Always bring your new monitor to your next doctor’s visit to have it checked for accuracy.
How About A Sphygmomanometers?
Why not buy one of these, this is what the doctors and nurses use to measure blood pressure? Sphygmomanometers are manual monitors that involve pumping a rubber bulb to inflate the upper arm cuff.
A stethoscope is used to listen to your blood flow through the arteries as the pressure in the cuff is released. A round, numbered dial is watched for measurements when certain sounds are heard through the stethoscope.
A sphygmomanometer is very reliable but it’s usually not the best for someone taking their blood pressure alone at home. In addition, there is some training that’s involved to use a sphygmomanometer properly.
Some people have a medical background or home aides can use one. If this is the case, feel free to check out my recommended sphygmomanometers by clicking blood pressure products at the top of the website.
Read Next – More Home BP Monitor Articles!
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- National Center for Biotechnology Information: Blood pressure measurement: arm circumference and cuff size availability
- Harvard Health: Choosing and using a home blood pressure monitor
- American Heart Association: Monitoring Your Blood Pressure at Home
- National Center for Biotechnology Information: Accurate Blood Pressure Measurements and the Other Arm
- Harvard Health: Avoid these common blood pressure measuring mistakes
- American Heart Association Journals: Poor Reliability of Wrist Blood Pressure Self-Measurement at Home
- Wiley: Does “Hidden Undercuffing” Occur Among Obese Patients? Effect of Arm Sizes and Other Predictors of the Difference Between Wrist and Upper Arm Blood Pressures
- CDC: High Blood Pressure During Pregnancy
- Harvard Health: Some home blood pressure monitors aren’t accurate