May 22, 2008 -- You know your blood pressure, right?
Most people have their blood pressure checked at the doctor's office or the
pharmacy. But if yours is high or borderline high, if you are in your 70s or
older, or if you have diabetes or kidney disease, you
may want to start checking your blood pressure at home. That's according to a
new statement issued by the American Heart Association and two other
Because blood pressure can vary so much, the groups advise that it's more
accurate to check your own levels every day or so, instead of at a doctor's
office every few months.
"High blood pressure is notoriously difficult to treat. ... Many
patients fail to reach target levels despite treatment," Thomas Pickering,
MD, DPhil, assistant professor of medicine at Columbia University, says in a
Pickering says "studies show home monitoring can help" track blood
pressure levels in the same way that blood sugar monitors help people with
diabetes track their blood sugar levels.
Sometimes, home blood pressure monitoring can show that there is actually no
blood pressure problem at all. Studies have shown that between 10% and 20% of
patients diagnosed with high blood pressure in a doctor's office actually have
what is called "white coat hypertension." That means their blood
pressures are normal but rise only when in a hospital or doctor's office.
At-Home Blood Pressure Monitoring
Who should monitor blood pressure levels at home?
People with high blood pressure or suspected high blood pressure
People with diabetes
People over age 70
People with kidney disease
Here are some guidelines to follow when measuring your blood pressure at
Do not smoke or take caffeine 30 minutes before measuring.
Rest for five minutes.
Keep your arm at heart level, support your back, and keep your feet flat on
If you are right-handed, put the device on your left arm (and vice versa),
or consistently take the measurement in the arm with the higher pressures.
Take two to three measurements in the morning and two to three in the
evening every day and keep a log of your readings.
For long-term monitoring, checking your levels daily for one week every
three months should suffice.
Your target blood pressure goal should be 135/85, or 130/80 if you have
diabetes, heart disease, or chronic kidney
Buying a Blood Pressure Monitor
Getting a home blood pressure device:
The devices can be purchased for less than $100.
Buy an oscillometric monitor (these are mostly automatic monitors that
display blood pressure readings on a screen) with a well-fitting upper-arm
Wrist monitors are not recommended.
Once you have purchased the monitor, bring it with you to your next clinic
visit so you can check your technique and the accuracy of your monitor.
The groups recommend only buying devices that meet the standards set by
either the Association for the Advancement of Medical Instrumentation (AAMI) or
the British Hypertension Society (BHS).
In prepared statements, Pickering says he hopes the recommendations will
prompt people to use home monitors and usher in a "new era in patient and
doctor partnerships," adding "it really does depend on the patients
remembering to change their lifestyles or remembering to take their
The recommendations are from the American Heart Association, American
Society of Hypertension, and the Preventive Cardiovascular Nurses'
"Call to Action on Use and Reimbursement for Home Blood Pressure
Monitoring. A Joint Scientific Statement from the American Heart Association,
American Society of Hypertension, and Preventive Cardiovascular Nurses
Association." DOI: 10.1161/HYPERTENSIONAHA.107.189010