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American Heart Association News
Knowing your blood pressure is a basic part of good health. But monitoring it at home can get complicated.
“It sounds easy – you buy a device, smack the cuff on your upper arm and push a button, right? It’s not so easy,” said Dr. Daichi Shimbo, co-director of the Columbia Hypertension Center in New York.
High blood pressure is a common condition in adults that’s associated with “really bad consequences,” such as heart attacks, strokes and dementia, Shimbo said. To diagnose and track it, doctors often ask people to check it at home. But even professionals can get tripped up on the proper procedures for home blood pressure monitoring.
Here’s help with some of the basics.
What exactly do those numbers mean?
The top number in a reading measures systolic pressure, the force against artery walls when the heart beats. The bottom number, diastolic pressure, measures that same force between beats.
Dr. Karen Margolis, senior research investigator at HealthPartners Institute in Minneapolis, puts it this way: “The top number is when your heart is squeezing. The bottom number is when your heart is relaxing.” If you’re using a stethoscope, where a heartbeat sounds like “lub-dub,” the “lub” is the squeeze, and the “dub” is the relaxing.
The American Heart Association and American College of Cardiology recognize five categories of blood pressure in adults. A reading of less than 120/80 is considered normal.
Where do I start?
Margolis and Shimbo agreed that proper self-monitoring of blood pressure starts with a validated device. Both co-authored a 2020 policy statement from the AHA and American Medical Association about home blood pressure monitoring.
To find a validated device, start with the AMA website validatebp.org. An international consortium also lists validated devices at stridebp.org.
What kind of device should I use?
Upper arm cuff devices are preferred over wrist devices, according to the AHA/AMA report.
And cuff size matters. A “universal” cuff will work for most people, she said, but if you have a very slender or large arm, you’ll need an alternate.
Cuffless devices, including smartwatches, sound cool, Shimbo said. But few have been validated, so he considers them “not ready for primetime.”
How do I prepare for a measurement?
This is “surprisingly hard,” Margolis acknowledged. Before taking a reading, you should avoid caffeine. Don’t exercise for 30 minutes beforehand. If you smoke, don’t smoke. Go to the bathroom. “Ideally, you want to wait until 30 minutes after you’ve had a meal.”
Then sit quietly without any distractions for five minutes.