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Measuring your blood pressure at home
Information fact sheet provided by the Blood Pressure Association
Many people with high blood pressure measure their blood pressure
at home, in between visits to their doctor or nurse. Some people
may also be asked by their doctor or nurse to take measurements
at home for a short period of time to find out whether they have
high blood pressure or not.
There is a wide range of blood pressure monitors available to buy
and choosing the right one is important to make sure you get accurate
readings. It is also important that you know how to take readings,
what to do with the results and what might affect the readings.
First
Aid Warehouse and Medisave
are online UK distributors of a wide range of medical equipment
to both medical professionals and individual home users including
automatic digital blood pressure
monitors. They consistently score high on excellent value prices
and high quality service. They stock makes and machines that the
British Hypertension Society recommend - accurate monitors for home
use and regularly include promotions with their sales.
Why do people monitor their blood pressure at home?
Some people are asked by their doctor or nurse to measure their
blood pressure at home for a short period of time, usually two weeks,
to find out what it is like away from the surgery or clinic. Sometimes
your blood pressure is only raised when taken in a clinical or medical
environment, such as your doctor’s surgery. This is called
white coat hypertension and can be caused by feeling anxious, or
by being in a busy or noisy environment. This can affect readings
by as much as 30mmHg (systolic readings).
Blood pressure readings taken at home are often lower than those
taken at a doctor’s surgery, whether a doctor or a nurse takes
them. Readings taken away from the clinic are now seen to give a
more accurate picture of your blood pressure.
To be sure that you have high blood pressure your doctor needs
more than one reading, and home measurements can be a good way of
finding out what your blood pressure is like when you are relaxed
and going about your daily life. The other way of doing this is
by having 24-hour (ambulatory) blood pressure monitoring done.
Monitoring blood pressure over a period of time at home can also
provide your doctor or nurse with more information about how well
your treatment is working and how you respond to medications. Home
blood pressure monitoring can also be useful for people who have
high blood pressure and who are taking medications as it can mean
that you are able to cut down on the number of visits to your surgery
for checks.
Many people enjoy measuring their own blood pressure and monitoring
their condition because it helps them to feel in control of their
high blood pressure and health, and involves them in making decisions
about their treatment.
Is monitoring my blood pressure at home the right thing for me?
Most people feel more in control of their condition if they take
and monitor their blood pressure at home. Once they are familiar
with how to take their readings and are comfortable doing so, they
make it part of their daily routine. Doing so helps to show that
their medicines and lifestyle changes are working and they understand
much more about their condition. However, taking readings at home
is not for everyone. It makes some people more anxious. If this
happens, talk to your doctor and see if you are taking the readings
too frequently or if you should stop doing so. Generally speaking,
it is not necessary in the long term to take readings more than
once a week unless your doctor has specifically asked you to do
so.
There are a few physical conditions that can make monitoring at
home difficult. If you have an irregular heart rate, such as atrial
fibrillation, then you may not be able to get a good reading –
a digital machine may read ‘error’. If you have difficulty
bending or moving your arms you may find putting on the cuff and
taking a reading without help difficult. If you have lymphoedema,
or have had a lymphectomy, then you should not have a blood pressure
reading taken on the affected arm, as the pressure can cause or
make lymphoedema worse.
Before you buy a blood pressure monitor
Talk to your doctor or your nurse about monitoring at home. Many
health professionals actively encourage people with high blood pressure
to take and then monitor their readings themselves. You can discuss
how often you need to take readings and what contact you should
have with the surgery while monitoring your blood pressure. You
can work together to ensure you are well informed and that your
blood pressure is being treated effectively. A few doctors may be
unhappy about you monitoring at home. If this is the case, talk
to them about your reasons for wanting to monitor at home.
Work out some guidelines with your doctor or nurse. Agree how often
you should take your readings and at what time of day, as well as
when you need to go back to the surgery. For example if your readings
go above a certain level, how and when will you let your doctor
or nurse know.
Choosing a blood pressure monitor
Machines for measuring your blood pressure are not available on
the NHS so you will have to buy your own. They range in price from
about £30 to £150. Most people who measure at home
use an automatic or semi-automatic machine. These are simple to
use and will often store your readings in their memory and provide
you with a printout. Automatic machines inflate and deflate the
cuff for you. With semi-automatic machines you will need to inflate
the cuff by hand.
Having a consistently accurate reading that you can trust is important,
not only for you when you are testing at home but also for your
health professional. Inaccurate readings can lead to misdiagnosis,
and can mean the difference between having treatment or not. Therefore
the first priority when buying a monitor is to choose one that you
know is accurate. So:
· Choose a machine that measures from the top of the arm,
rather than the wrist or the finger. Finger monitors will not give
accurate readings and wrist monitors are also less likely than upper
arm monitors to give an accurate reading.
· Choose a monitor that has passed independent testing for
accuracy. When you look at blood pressure machines, you should find
they carry a “CE” marking on their packaging. However,
although monitors marked with “CE” show that they have
undergone some testing, this is not a reflection of their accuracy.
The British Hypertension Society (BHS) has therefore compiled a
list of accurate monitors as a guide for home users. The monitors
on this list have been independently tested to a protocol set by
the British Hypertension Society or the European Society of Hypertension,
and have been found to be accurate. The BHS list is compiled from
research papers and not direct testing, but you may find it a useful
guide when you buy a monitor. All the monitors on this list measure
blood pressure from the upper arm (upper arm monitor).
This list is regularly updated, so do check the web site for the
latest information. Most machines on the BHS list of approved
machines for clinical and home use are available from First Aid
Warehouse. They supply both medical professionals and home users
and offer very competitive prices and special promotionsUsing the
right size of cuff is important for an accurate reading. Four out
of every five people are able to use the standard size cuff that
comes with the monitor and get an accurate reading. However, some
people have very thin or very large arms and a standard size cuff
may produce inaccurate readings. If the cuff is too small the reading
may be falsely high and if it is too big the reading may be falsely
low. If you have any doubts, ask the manufacturer of your monitor
about the cuff sizes they have available and check with your doctor
or nurse that you are using the right one.
It is now possible to buy monitors that connect to your computer
to allow you to use a computer programme to record readings. A and
D instruments also make a version of the UA-767, for use by people
who are visually impaired, which ‘talks’ to you.
Taking blood pressure readings
When and how often should I take readings?
When and how often you take readings will depend on your blood
pressure. Some people may need to take a number of readings over
a short period of time, others will need to take a reading once
a week. Your doctor or nurse will be able to advise you. If you
take readings less than once a week you may be likely to forget,
so try and make your readings part of your routine. A few people
find that there is a difference between readings taken on days when
they work and days when they do not, so try taking readings during
these times as well.
When you first start taking readings at home discount the first
day’s measurements. They may not be accurate because you are
unfamiliar with the monitor and could be anxious. It is useful to
take readings at the same time of day so that you are consistent
and are comparing ‘like with like’.
Which arm should I use?
There can be a difference between the readings on each arm. When
you first use the monitor take a reading on both the left and right
arm and then in future use whichever arm gives you the higher reading.
Always use the same arm for readings. If you find that the difference
between the readings on either arm is greater than 20mmHg systolic
(top number) or 10mmHg diastolic (bottom number) talk to you doctor
or nurse about your readings.
How do I take a reading?
· Wear a short sleeved T-shirt or loose fitting clothing
so that the sleeve can be rolled up comfortably
· Before taking readings rest for five minutes. You should
be sitting down, preferably at a desk or a table, in a quiet place,
with your arm resting on a firm surface. It is very important that
your arm is supported so that the cuff around the arm is at the
same level as your heart. You may need to support your arm with
books to make sure it is at the correct height. Ensure that the
arm is totally relaxed and not tensed
· The deflated cuff needs to be tight, but not too tight.
You should be able to insert two fingers between it and the skin
· If you are using a machine that needs you to set the systolic
level for the cuff inflation, choose a setting that is at least
20mmHg above your last reading. For example, if your last systolic
reading was 153, set the machine to inflate to 180.
· Start the machine – keep still and silent whilst
the reading is taken. Moving and talking can affect the reading
· Take two or three readings each about two minutes apart.
If you take two readings disregard the first and use the second,
if you take three readings disregard the first and take an average
of the second and third
· Some people find that when they take two or three readings
the first is always highest and then the readings become lower each
time they take them. If this is the case keep taking readings until
they level out and then use this as your reading
· Record the reading either in the memory of the machine
or on computer or paper. Make sure you keep accurate records –
some people are tempted to round the numbers up or down, or to record
a lower blood pressure. This can affect your treatment and therefore
your long-term risk of stroke and heart attack. Also record any
medications you have taken and when, and any other information such
as whether you have just eaten or exercised
What is my ideal level of blood pressure?
The aim of treatment for high blood pressure is to reduce it, when
measured by your doctor or nurse, to below 140/85mmHg. When it is
measured in a clinic, particularly by a doctor or nurse, it may
be higher than when you are more relaxed at home. It is therefore
important that with home measurements they should at least be below
140/85mmHg and preferably below 130/80mmHg. This can be hard to
achieve for some people and your doctor or nurse may set you a different
target.
What do I do if my blood pressure readings start to go up?
As blood pressure varies in everybody by quite a large amount,
you may get unexpected ‘one off’ high readings, so always
repeat the measurement again at another time. However, if you find
that on repeated measurement your blood pressure over a period of
time is higher than usual go and see your doctor or nurse, taking
details of the measurements with you. The important readings are
the averages over a period of time and not individual readings.
Is there anything that might affect my blood pressure readings?
There are several factors that can make your blood pressure rise
temporarily; exercise, alcohol, caffeine, tobacco, a full bladder,
talking, anxiety, excitement and pain are just a few. It is worth
recording what you have been doing before a reading, as it will
act as a guide for you and your doctor or nurse.
First Aid Warehouse and Medisave are online UK distributors of
a wide range of medical equipment to both medical professionals
and individual home users including automatic digital blood pressure
monitors. They consistently score high on excellent value prices
and high quality service. They stock makes and machines that the
British Hypertension Society recommend - accurate monitors for home
use and regularly include promotions with their sales.
Details of blood pressure
monitors suitable for home use, compiled by the British Hypertension
Society are available on their Web site you may find it a useful
guide when you buy a blood pressure monitor. All of the monitors
on this list are digital upper arm monitors and have been through
independent testing shown in research to be accurate and are currently
available.
Click here to access
the current British Hypertension Society list of Automatic Digital
Blood Pressure Devices for Home use
The Blood Pressure Association is represented on government committees
to extend and update the standards used to measure the accuracy
of blood pressure monitors available to the general consumer. The
Blood Pressure Association is working with the Medical Devices Agency
(part of the Department of Health), and British Standards Institute
to try and ensure that all home medical equipment including blood
pressure monitors are tested for accuracy.
I provided database support and maintained the Web site for the
Blood Pressure Association
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