Checking blood pressure at home has been shown to be consistent with ambulatory blood pressure monitoring and, in some case, more accurate than measuring blood pressure in the clinical setting. 1–4
Jung et al. tested the reliability of home blood pressure monitoring devices.1 A total of 212 people using home automated upper-arm blood pressure devices were included in the study. Participants’ devices were categorized as validated if they were recommended on dabl Educational Trust and British Hypertension Society websites. 85.4 % of the validated devices were accurate (within 5 mm Hg) when compared with a mercury sphygmomanometer.
The 2017 American College of Cardiology and American Heart Association (AHA) guidelines for the management of hypertension recommend the use of home monitoring to maximize blood pressure control efforts.5 The guidelines acknowledge the relationship between office readings, ambulatory monitoring, and home devices remains unsettled, but agree that home blood pressure monitoring is a practical approach to improve blood pressure control. They recommend the following procedures be in place when using home devices:
- Patient training under medical supervision
- Use of validated automated devices
- Proper cuff size should be confirmed
- Verification that left-right differences are insignificant
The AHA recommends home monitoring of blood pressure. The familiar setting of home, the convenience of checking at home, and the frequency with which the readings can be done improves overall accuracy. Wrist or finger blood pressure monitors are not recommended.
Best practice for measuring blood pressure at home involves the following parameters:
- Make sure the cuff fits by measuring around your upper arm and matching the measurement with the package instructions.
- Stop smoking, drinking caffeinated beverages, and exercising 30 minutes prior to measuring; rest for 5 minutes before measuring.
- Sit with your legs uncrossed and your back supported. Your arm that is being measured should be at heart level.
- The bottom of the cuff should be just above the bend of the elbow. Don’t put the cuff over your clothes.
- Measure twice a day in the beginning and at the same time every day. Bring the results to the doctor whenever you go.
- Know your numbers. A single high reading may not be an emergency. Talk with your doctor so you know when to call for guidance.
References
- Jung MH, Kim GH, Kim JH, et al. Reliability of home blood pressure monitoring: In the context of validation and accuracy. Blood Press Monit 2015; 20 (4): 215-220.
- Peixoto AJ. Practical aspects of home and ambulatory blood pressure monitoring. Methodist Debakey Cardiovasc J 2015; 11 (4): 214–218.
- Stergiou GS, Ntineri A. The optimal schedule for self-home blood pressure monitoring. J Hypertens 2015; 33 (4): 693-697.
- Stergiou GS, Kollias A, Zeniodi M, Karpettas N, Ntineri A. Home blood pressure monitoring: Primary role in hypertension management. Curr Hypertens Rep 2014; 16 (8).
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPMACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2017; 71 (19): e127-e248.
