How can I measure my blood pressure at home? Tips and advice

Regularly checking your blood pressure at home is an important part of managing hypertension and helping your care providers find out if treatment is working. 

Why should I monitor my blood pressure at home?^1,2 

Self-measurement of blood pressure at home provides information regarding the “true” blood pressure values of a given patient, for example, values free of a significant “white coat” effect or of the so-called “alarm reaction” which artificially increases blood pressure values and may act as a confounder in the diagnosis of hypertension. 

It is worth noting that normal blood pressure values for office, home, and 24-hour ambulatory readings vary. Indeed, according to the European Society of Hypertension (ESH)/European Society of Cardiology (ESC) Guidelines, normal systolic and diastolic blood pressure values should be as follows: 

• Office or clinic: 140/90 mm Hg 

• Home: 135/85 mm Hg 

• 24-hour ambulatory: Below 130/80 mm Hg 

Furthermore, home blood pressure measurement: 

• Obtains information on blood pressure behavior in daily life
• Helps with early diagnosis 
• Helps track your treatment
• Encourages better control

Not everyone can track blood pressure at home. For those with irregular heartbeats, home blood pressure monitors might not give the correct reading. 

How do I choose my blood pressure monitor?^1-3

Most pharmacies, medical supply stores, and some websites sell home blood pressure monitors. It is important to know how to find a good home blood pressure monitor and how to use it correctly. Experts generally recommend an automatic or electronic device. 

Blood pressure monitors generally have the same basic parts: 

• Inflatable cuff: its inner layer fills with air and squeezes the arm, and its outer layer has a fastener to hold the cuff in place. The device figures out the heart rate and blood flow by measuring the changes in the motion of the artery as the blood flows through while the cuff deflates.  

• Gauge for readouts: some blood pressure monitors can take several readings and report the averages. 

When choosing a blood pressure monitor, here are the features to consider: 

• Cuff size. Having a properly fitting cuff is important. Cuffs that fit poorly will not give accurate blood pressure measurements. Wrist and finger monitors are not recommended as they give less reliable readings. Some people with large arms may not have access to a well-fitting upper arm cuff at home. If so, measuring blood pressure at the wrist or lower arm may be okay if used as directed and checked against measurements taken in your health care professional's office.  

• Display. The display showing blood pressure measurements should be clear and easy to read. 

• Cost. Prices vary. Ask your health insurance provider if your policy covers the cost of a home blood pressure monitor. 

The European Society of Cardiology recommends: 

• The use of validated equipment

• Semiautomatic rather than mercury sphygmomanometric devices

How can I measure my blood pressure at home?^1-4 

Once you have purchased your blood pressure monitor, take it to your next appointment with your health care professional, to check if you are using it correctly and getting the same results as the equipment in the office. It is important to make sure your home monitor is accurate and that you have the correct cuff size and fit. A cuff that is the incorrect size will cause an inaccurate blood pressure reading. 

When preparing to take your blood pressure: 

• Plan ahead: do not smoke, drink caffeinated beverages or alcohol, and exercise within 30 minutes before taking your blood pressure. Empty your bladder first. A full bladder can increase blood pressure slightly. 

• Do not measure your blood pressure right after you wake up: you can prepare for the day, but do not eat breakfast or take medicine before measuring your blood pressure. 

• Do not take the measurement over clothes: remove the clothing over the arm that will be used to measure blood pressure and place the cuff on bare skin. 

• Use either arm: usually there is no substantial difference between readings on them. If you notice that one arm shows a higher reading than the other, use the arm with the higher reading. 

• Be still: allow at least 5 minutes of quiet rest before measurements. Do not talk, use the phone, or think about stressful things. Rest your arm comfortably on a flat surface at heart level and relax your hand and arm. Relax, breathe normally, and do not talk during the test. 
• Sit correctly: sit with your back straight and supported on an upright chair with a back such as a dining chair, rather than a sofa. Your feet should be flat on the floor. Do not cross your legs and ankles. The middle of the cuff should be placed on the upper arm at heart level. 
• Measure at the same time every day: talk with your health care professional about how often to take your blood pressure. 
• Take multiple readings and record the results: each time you measure, take at least 2 readings 1 minute apart, preferentially in the morning before taking medications, and in the evening before going to bed. 
• Record all the results: if your monitor has built-in memory to store your readings, take it with you to your medical appointments. Some monitors may also let you upload your readings to a secure website.  

How should I use my blood pressure readings?³ 

A single high reading is not an immediate cause for alarm. If you get a reading that is higher than normal, take your blood pressure a second time. Write down the results of both measurements. Check with your health care professional to see if there is a health concern or whether there may be problems with your monitor. 

If your blood pressure readings are suddenly higher than 180/120 mm Hg, wait at least 1 minute and test again. If your readings are still exceedingly high, contact your health care professional immediately. You could be having a hypertensive crisis. 

Call the emergency services if your blood pressure is higher than 180/120 mm Hg and if you are having new signs or symptoms that may include: 

• Chest pain 

• Shortness of breath 

• Back pain 

• Numbness 

• Weakness 

• Change in vision 

• Difficulty speaking

• Confusion 

• Dizziness 

• Vomiting 

Why and how should I track my blood pressure readings?^2,3 

A record of readings taken over time provides a complete picture of your blood pressure. This can help you collaborate with your doctor to make sure that your treatments to reduce your blood pressure are working. 

Some people use a notebook to record their blood pressure readings. If you have an electronic personal health record, you might choose to record your information using a computer or mobile device. This gives you the choice of sharing your readings with your health care team and family members. Some blood pressure monitors upload this data automatically. 

It is worth noting that home blood pressure monitoring is not a substitute for medical visits. Home blood pressure monitors might not always be correct. Even if you get readings that are typical for you, do not stop or change your medicine or your diet without talking to your care team first. However, if continued home monitoring shows that your blood pressure is under control, you might be able to make fewer medical visits.