Getting the most out of home blood pressure monitoring

Articles: Getting the most out of home blood pressure monitoring

Posted by admin on Tuesday, May 11, 2004 - 06:53 AM

The doctor's office isn't the only place to get your blood pressure checked. With a little training and the right equipment, you can do it yourself at home.
In fact, home blood pressure monitoring is an important part of managing high blood pressure. Home monitoring can help you keep closer tabs on your blood pressure, show if medication is working, and even alert you and your doctors to potential health complications. Because blood pressure monitors are available widely and without a prescription, home monitoring is becoming increasingly popular. However, if you use a device that's inaccurate or use it improperly, you can do yourself more harm than good. Learning more about home blood pressure monitoring can help you stick with it, avoid the potential pitfalls and even stay healthier. Why do home monitoring? Monitoring your blood pressure at home offers several benefits: Tracking your treatment. Self-monitoring provides vital information between visits to your doctor. The only way to know whether your lifestyle changes or your medications are working is to check your blood pressure regularly. Keeping track of changes can help you and your health care team make decisions about your ongoing treatment strategy, such as adjusting dosages or changing medications. Encouraging better control. Taking your own blood pressure measurements can help give you a stronger sense of responsibility for your health. When you're an active participant in your own health care, you may be more motivated to better control your blood pressure with an improved diet, physical activity and proper medication use. Cutting costs. Home monitoring may cut down on the number of visits you must make to the doctor or clinic. That can reduce your overall health care costs, lower your travel expenses, and save in lost wages. In addition, home monitoring can sometimes help in cases where diagnosing high blood pressure is difficult. Your doctor may suspect, for instance, that your blood pressure is high only when it's measured in a medical office — a condition called white coat hypertension. Monitoring blood pressure at home, where anxiety won't cause those spikes, can help determine if you have true high blood pressure or simply white coat hypertension. High blood pressure Home monitoring may also help when the opposite occurs — your blood pressure seems fine at the doctor's office but is elevated at home. This kind of high blood pressure, sometimes called masked hypertension, is more common in women and those with potentially life-threatening cardiovascular risk factors, such as obesity, high blood cholesterol and high blood sugar. Not everyone is able to perform blood pressure self-measurements, though. If you have an irregular heartbeat, for instance, home monitors might not provide accurate readings. In some cases, your physical condition may dictate what type of monitor you can use, or whether you can use one at home at all. If you're extremely obese, you may not find an arm cuff large enough to fit, but you may be able to use a wrist monitor. If you have hearing loss, a monitor with a digital display may be suitable. Talk to your doctor, nurse or other health care professional about whether home monitoring is a good option for you. Keep in mind that a family member or friend who is properly trained may be able to take blood pressure measurements for you. Types of home monitors Today, scores of blood pressure monitors are available in pharmacies, medical supply stores and even on the Internet. They all have the same basic components, with an inflatable cuff or strap, a gauge for readouts and sometimes a stethoscope, depending on the model. The cuff consists of an inner layer, or bladder, made of rubber that fills with air and squeezes your arm. The cuff's outer layer is generally made of nylon and has a fastener to hold the cuff in place. The stethoscope that comes with some models is used to listen to the sounds your blood makes as it flows through the brachial artery in the crook of your elbow. There are three basic types of home blood pressure monitors: Manual devices. Manual blood pressure monitors consist of a stethoscope and an inflatable arm cuff connected by a rubber tube to a gauge that records the pressure. To use these monitors, you must manually inflate the cuff around your arm by pumping a bulb at one end of the tube. You must also manually check your blood pressure with a stethoscope — listening for certain arterial blood sounds — and calculate your own heart rate. These devices include mercury column monitors, which are being phased out of use, and aneroid monitors. Automatic devices. These monitors, commonly called electronic or digital monitors, consist of a cuff and a gauge that records the pressure. The cuff automatically inflates at the touch of a button. These devices automatically calculate heart rate and measure your blood pressure by assessing arterial blood flow. Digital monitors can be fitted on the upper arm, wrist or finger. Arm devices are the most accurate. Avoid devices that claim to measure blood pressure in your finger, because they're not accurate. Semiautomatic devices. These monitors are a hybrid of manual and automatic blood pressure monitors. They require you to manually inflate the arm cuff but they automatically measure blood pressure and heart rate. These are generally less expensive than automatic devices, but they may be difficult to use if you have physical limitations, such as arthritis in your hands. Each type has pros and cons. Talk over the choices with your doctor or nurse so you pick the one that's best for your situation. And what about those free blood pressure machines in malls, pharmacies and super stores? Don't rely on them for an accurate reading. Chances are, you haven't prepared properly for the test, such as resting first or not eating. And many of these machines aren't routinely checked for accuracy and haven't been validated. Features to consider Not only are a variety of home monitors available, but the features they have also vary widely, from bare-bones manual models to top-of-the-line fully automated devices that allow you to send data to your doctor's office through the phone lines. Here are some general features to consider when choosing a blood pressure monitor: Cuff size. Monitors have different sized cuffs to fit different sized arms or wrists. You must get a size that fits properly or the blood pressure measurement will be inaccurate. Ask your doctor or nurse about the cuff size you need. Display. The display that shows the blood pressure reading comes in various sizes. Be sure to get one with numbers you can easily read. Stethoscope. If you get a monitor with a stethoscope, you must be able to clearly hear the sounds through it. You also must know how to interpret those sounds — something your doctor or nurse can teach you. Validation. Check with your doctor or the manufacturer to see if the monitor has been certified as validated, which helps ensure that it'll give an accurate reading. Cost. Your health insurance may not cover the cost of a home blood pressure monitor. Prices can vary from as little as $25 for manual monitors to well over $100 for automatic devices that come enhanced with memory and electronic printout ability. Tips for accurate use No matter what type of home blood pressure monitor you choose, proper use requires some practice and training. Take the device to your doctor or nurse or seek out a class at a local medical facility to make sure the one you've chosen is the best fit for you and to learn how to use the monitor accurately and keep it calibrated. VIDEO How to monitor your own blood pressure How to monitor your blood pressure at home. << ENLARGE You can also follow these tips to help ensure accuracy when you measure your blood pressure at home: Before using a monitor for the first time, have your doctor or nurse check its accuracy against the office model. And show them how you use the device so that they can see if you're doing it properly. Take your blood pressure at consistent times, such as in the morning and in the evening. Use the same arm whenever you take your blood pressure. Note that many digital monitors are meant for use only on the left arm. Don't measure your blood pressure immediately after you wake in the morning. Wait an hour or so. If you exercise after waking, take your blood pressure before exercising. Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a measurement. Go to the bathroom first. A full bladder can increase blood pressure slightly. Sit quietly for three to five minutes before taking a measurement. Sit in a comfortable position with your legs and ankles uncrossed and your back supported against a chair. Rest your arm, raised to the level of your heart, on a table, desk or chair arm. You may need to place a pillow or cushion under your arm to elevate it high enough. Don't talk while taking your blood pressure. Place the cuff on bare skin, not over clothing. Rolling up a sleeve until it tightens around your arm can result in an inaccurate reading, so you may need to slip your arm out of the sleeve. Take a repeat reading two to three minutes after the first one to check accuracy. If your monitor doesn't automatically log blood pressure readings or heart rates, write them down in your own log. Take the monitor to your medical office annually to be calibrated. If you drop the device or damage it, take it in to be checked before using it again, as it may no longer work properly. Blood pressure taken at home is usually slightly lower than that taken in a medical office, typically by about five points. For instance, a reading at home of 135/80 millimeters of mercury (mm Hg) is about the same as 140/90 at the doctor's office. Talk to your doctor about what your home blood pressure goal is. If you have diabetes, chronic kidney disease or cardiovascular disease, you may need a goal lower than that of someone without these conditions. Blood pressure varies throughout the day, and readings are often a little higher in the morning. But contact your doctor if you have any usual or persistent increases in your blood pressure. And talk to your doctor or nurse about what reading should prompt an immediate call to the medical office. In addition, if your home reading shows that your blood pressure is higher than normal and you experience any physical symptoms, such as severe headache, chest pain, numbness or tingling in the face or limbs, contact your medical office immediately or seek emergency treatment. Blood pressure: Can it vary between arms? Blood pressure: Why is it lower in the morning? Long-term payoffs If your blood pressure is well controlled, you may need to check it at home only a few days each month. If you're just starting home monitoring, if you're making any changes in your medications or other treatment, or if you have another health problem, such as diabetes, you may need more frequent monitoring. Home blood pressure monitoring is not a substitute for visits to your doctor. Even if you get normal readings, don't stop or change your medications or alter your diet without talking to your doctor first. Monitoring your blood pressure at home doesn't have to be complicated or inconvenient. You might even find that you enjoy tracking your readings and that home monitoring gives you more control over your condition. And in the long run, you may risk fewer complications related to high blood pressure and enjoy a healthier life.

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