How To Perform Blood Pressure Monitoring At Home

June 06, 2021

How To Perform Blood Pressure Monitoring At Home

Hypertension, or high blood pressure, has been classified as one of the most common and preventable causes of heart diseases. [1

According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of fatality for people living in the United States. In fact, for every 36 seconds, one person in the U.S. dies from heart disease. [2

Because hypertension is one risk factor for heart disease, it is crucial you manage your blood pressure well to preserve the health of your heart. [3] Fortunately, with the advancement of technology, you can now play a proactive role and take charge of your health by managing your blood pressure well. 

Home blood pressure monitoring is one of the most valuable and practical tools for both patients and physicians in managing and controlling high blood pressure. Unsurprisingly, there are multitudes of studies that prove the effectiveness of performing home blood pressure monitoring in helping patients achieve better outcomes. [11]

Of course, you need to understand how to accurately perform blood pressure monitoring at home and interpret the readings. There are several aspects related to this, and let’s explore them one by one!

The Importance Of Monitoring Your Blood Pressure At Home

Firstly, monitoring your blood pressure at home can help with early diagnosis, especially if you are at a higher risk of hypertension. 

Some of the risk factors for hypertension include: 

  • Family history: If someone you are closely related to, such as your parents, has hypertension, you are more likely to get it as well. [4
  • Race:African-Americans are more likely to develop hypertension, and the condition is usually more severe in African-Americans. [4
  • Age: As you age, you develop a higher risk of getting hypertension. [4
  • Chronic kidney disease (CKD):CKD can increase your blood pressure, and high blood pressure can worsen CKD. [5
  • Unhealthy diet:A diet high in sodium, salt, calories, saturated fats, and sugar will increase your risk of high blood pressure. [4

  • Lack of physical exercise:Physical activity is hugely beneficial for your heart’s health. Hence, a lack of physical exercise will predispose you to a higher risk of hypertension. [6
  • Excessive alcohol consumption:Regular and excessive alcohol consumption will raise your blood pressure via several proposed mechanisms. [7

  • Diabetes:High blood pressure is common among patients who have been diagnosed with diabetes. [8
  • Smoking:Smoking can make your arteries stiffer and damage them. Secondhand smokers are also predisposed to a higher risk of cardiovascular diseases. [4, 9

If you have any of these risk factors, performing blood pressure monitoring at home will be especially useful for you to detect increases in your blood pressure. Early interventions will help to reduce your blood pressure and prevent the development of cardiac disease. 

Hypertension is often labeled as a silent killer because there are no significant symptoms linked to it. In addition to that, it can increase the risk of heart attack, stroke, and heart failure, all of which may lead to fatal outcomes. [10]

Another benefit of monitoring your blood pressure at home is being able to track your treatment progress. This is a recommendation by the American Heart Association (AHA). Having a record of your readings will allow your doctor to make informed and necessary changes to your current treatment for better outcomes. [11

Lastly, monitoring your blood pressure at home will allow you to take charge of your health and encourage you to modify your lifestyle habits to bring your blood pressure down to healthy levels. 

Aspects To Consider When Choosing A Blood Pressure Machine

The AHA recommends the automatic, bicep (upper arm), and cuff-style blood pressure monitoring device as the best option in general. [11

Wrist and finger monitors produce less reliable results than the cuff-style upper arm blood pressure device. [11

Firstly, you should take into consideration the cuff size. If your arm is particularly larger or smaller than average, you may need to purchase a cuff separately, as most home monitoring devices will come with a medium-sized cuff. [12

The cuff should wrap around your upper arm comfortably and allow just enough space for you to slip two fingers underneath. [12

Some devices include features such as Bluetooth connection to link to your phone, internal memory to record your readings, and multiple-user features that allow records to be organized separately. Of course, machines with more features come at a higher cost, and you should select a device with consideration of your budget. 

Most importantly, it should be approved or validated. Check with your healthcare provider if you are unsure. [11

Factors That May Affect Your Blood Pressure Reading

Certain factors may affect the accuracy of your readings. [12

According to the American Medical Association, your reading may be 10-40 mm Hg higher if you place the cuff over your shirt’s sleeve instead of a bare arm. Besides that, having a full bladder or conversing while taking your measurement can add 10-15 mm Hg to your actual reading. [12

Additionally, if you do not support your arm and place it at the same level as your heart, this can put on an additional 10 mm Hg. Plus, being in the wrong posture, such as dangling your feet, not supporting your back, or crossing your legs, can tack on anywhere between 2-10 mm Hg. [12

Unsurprisingly, some people do get nervous when having their blood pressure taken. This situation is named the ‘white coat syndrome.’ 1 in 3 people who have a raised blood pressure reading at the doctor’s office may have readings residing at normal levels outside of it. [13

Finally, if you smoked, drank caffeinated drinks or alcohol, or exercised within thirty minutes of having your blood pressure taken, your reading may also be higher than usual. [13

How To Get An Accurate Reading 

If you wish to get reliable and accurate readings, there are a few things you should do. 

Firstly, if you smoked, drank caffeinated beverages, or performed some exercise in the last 30 minutes, wait until at least 30 minutes have elapsed before taking your reading. Preferably, don’t eat or drink anything at least 30 minutes before measuring your blood pressure. [11,13

Secondly, sit with the correct posture. Sit on a comfortable chair and ensure your back is straight and supported. It is best to sit and relax for at least 5 minutes before proceeding with the measurement. [11,13]

It would be best if you placed both of your feet flat on the ground with your legs uncrossed. Also, ensure your arm is resting flat on the table. Your upper arm should be at the same level as your heart. [11,13]

Next, place the cuff and wrap it over your upper arm. Use the same arm that your healthcare provider uses to measure your blood pressure. The cuff should go around your entire arm comfortably and be against your bare skin, not your sleeves. [11,13,14]

Remember to sit still and relax while measuring your blood pressure. If you talk, cough, sneeze or move around while doing so, you will need to restart and retake the reading. [11,13

Lastly, you should do a total of two to three readings at least one minute apart. All your readings may be recorded in a smartphone app, physical journal, or in the device itself. This allows you and your treating physician to track your readings. [11]

How Often To Measure Your Blood Pressure

How regularly you should measure your blood pressure depends on your condition. Consult your healthcare professional on how often you need to return for checkups and how often you should measure your blood pressure at home. [13

People diagnosed with hypertension may need to take their blood pressure readings more regularly than those with no diagnosed heart conditions. [13

Understanding Your Blood Pressure Readings

What Do The Numbers Mean? 

Blood pressure is measured as mmHg (millimeters of mercury). [15

Your blood pressure will be displayed on your device as two numbers. The first or top number represents your systolic blood pressure. This number is a measurement of how much pressure your blood exerts against the walls of your arteries each time your heart contracts. [15

The second or bottom number refers to your diastolic blood pressure, which measures how much pressure your blood exerts against the walls of your arteries each time your heart rests between beats. [15

What Do The Readings Mean?

Understanding what your readings mean can help you seek early medical advice and modify your lifestyle habits accordingly. 

  • Normal range: In general, the AHA states that blood pressure readingsless than 120/80 mm Hg are categorized as normal. This means that you are at a lower risk of heart diseases. To maintain your readings within this optimal range, practice an active lifestyle and heart-healthy diet. [16,17
  • Elevated range: Your blood pressure is considered elevated when readings constantly fall into the120-129 mm Hg systolic range and less than 80 mm Hg diastolic range. This is the pre-high blood pressure stage. You could develop hypertension, which is why it is crucial for you to modify certain habits and lifestyle practices to preserve the function of your heart. [16
  • Hypertension Stage 1: If your readings constantly fall between130-139 mm Hg systolic range and 80-89 mm Hg diastolic range, this is categorized as stage 1 hypertension. Your treating physician is likely to give you advice on changing your diet and lifestyle habits to bring your blood pressure down. They may also prescribe you some blood pressure-lowering medications if you are at a higher risk of heart diseases. [16
  • Hypertension Stage 2:You have stage 2 hypertension if your readings constantly land above the 140/90 mm Hg range. Your doctor will likely put you on medications to lower your blood pressure and, at the same time, advise you on how you can modify your lifestyle habits based on your situation. Take note that you may be put on two or more medications to decrease your blood pressure. [16

Let’s say you are currently on any medications for your blood pressure, and your readings have reduced and are now in the normal range. In this case, do not stop your medications abruptly without any prior medical advice. Instead, consult your treating healthcare provider to discuss your next steps. [18

When To See A Doctor 

When your blood pressure is out of the normal range, you may consult a healthcare professional to learn how you can manage your blood pressure. 

Let your treating physicians know what medications, supplements, and herbal remedies you currently take and if you have any other medical conditions. This information will help them select the most effective and safest treatment option for your case. [18

Another vital thing to remember is this. If your blood pressure abruptly surges above 180/120 mm Hg, wait for five minutes before measuring it again. Contact your healthcare provider immediately if your readings are still abnormally high after the repeated measurement. You might be experiencing a condition known as hypertensive crisis. [16

Say your readings are above 180/120 mm Hg, and you experience symptoms such as shortness of breath, numbness, weakness, chest pain, changes in your vision, or difficulty speaking. This is a medical emergency, and you should immediately call your emergency assistance hotline. Do not wait for your blood pressure to come down, as these symptoms suggest possible organ damage. [16


Monitoring your blood pressure at home is a practical and valuable method to alert you of any changes and help you detect patterns. It’s crucial to keep in mind that managing hypertension is a lifelong commitment, and there is no such thing as overnight success. [19

As part of your healthcare team, you play an essential role—partner up with your healthcare providers to treat your hypertension. Don’t hesitate to reach out to them should you have any doubts or queries. 

This article is a general guide and should not replace advice from your healthcare professional. 

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