Home Monitoring for Blood Pressure
High blood pressure, or hypertension, is something that I commonly manage as a primary care physician. Most people know when they go see a doctor or even sometimes a dentist, they will have their blood pressure checked. More recently though, we are moving away from using these in office blood pressure readings to make a diagnosis of high blood pressure or manage medications.
This is because blood pressure is not a static number - it goes up and down over a 24 hour period based on many factors, such as your mood, what you had to eat or drink, what your activity level is, and even what time of day it is! When diagnosing and treating high blood pressure, we are ideally trying to gauge a person’s resting blood pressure. That can be hard to do if you only have one blood pressure reading every few months as you are rushed through a cold and clinical environment.
Now of course, with direct access primary care, visits are not rushed and I aim to make my office feel more like a relaxing spa than a clinical space. Still, the blood pressure reading that I take is just one point in time and not your typical home environment. So instead of relying on in office blood pressure readings, I find it’s much better to have patients check their blood pressure several days a week at home and record the readings to bring to the office visit.
I also encourage patients to bring their home blood pressure cuff to an appointment, so we can compare the automated reading with a manual reading to calibrate the cuff. Knowing how to correctly take a blood pressure at home is also essential to getting the most accurate readings possible. Here are some tips:
Sit comfortably with your legs uncrossed and feet flat on the floor for at least 5 minutes. Rest your arm on a counter or a table, about the level of your heart. Apply the blood pressure cuff and hit start as per your cuff’s instructions. Ignore the first reading that you get. Rather, wait 2 minutes and check again, recording this second reading instead. Note the time of day and anything you think might be relevant - how you are feeling, if you just ate, if you took any medication etc. Bring this record to your appointment and review with your doctor!
Having more data points like this will help you and your doctor determine the best treatment course to improve your blood pressure and thus lower your risk of cardiovascular disease!
