Checking blood pressure on Wrist

One look at the national statistics for high blood pressure (hypertension) may be enough to make your own pressure rise: According to the Centers for Disease Control and Prevention (CDC), about one out of three U.S. adults—31.3%—has high blood pressure. The condition is a major risk factor for heart disease, stroke, congestive heart failure, and kidney disease, which are among the leading causes of death in the U.S. High blood pressure affects people of all ages and ethnic backgrounds. And most ominously, you can have it for years or decades without any symptoms.

Fortunately, high blood pressure is easy to detect and you can monitor it at home. A blood pressure monitor is a relatively inexpensive investment that can have a tremendous impact on your health. Home monitoring is extremely important if you know you have hypertension, pre-hypertension, or other risk factors for heart disease and stroke. Home monitoring also helps clarify cases of “white coat hypertension, ” in which your blood pressure is only elevated in the presence of a doctor. And even if you think you have normal blood pressure, home monitoring allows you to participate proactively in the management of your health. Armed with data and self-awareness, you can go to your primary care provider to discuss the best treatment options for you.

Here are some answers to commonly-asked questions about home BP monitoring:

What type of monitor should I get?
We recommend a digital, fully-automated unit such as the Omron HEM-712C, available at drug and grocery stores or online for around $40. All you have to do is put the cuff on your arm, press a button, and wait for the results to appear on the screen. Aneroid monitors—the kind with a gauge and a rubber bulb you squeeze with your hand-are trickier to use and require more instruction and practice, and are only slightly more accurate. If you have one of these, your best bet is to bring it in at your next visit and we’ll be happy to give you a quick lesson!

No matter which monitor you get, be sure the cuff fits your arm properly. It should be just snug enough to stay on your arm when deflated—no tighter. The wrong size cuff will produce inaccurate measurements. Your pharmacist can help determine which cuff size you need.

We also recommend bringing your monitor to our office once a year so we can verify its accuracy.

What about those finger and wrist monitors?
Measurements taken with finger and wrist blood pressure monitors are less accurate because they can be affected by body movement, position, and even temperature. Your best bet is to stick with the tried-and-true arm monitors.

How should I prepare to check my blood pressure?

• Relax. Sit in a comfortable position, with your legs uncrossed and feet on the floor, for at least five minutes beforehand. Take slow breaths and maybe even close your eyes during the measurement.
• Avoid food, caffeine, alcohol, or tobacco products for 30 minutes prior to measuring.
• Place your arm in front of your body on an armrest or table, with the middle of your biceps muscle at chest level. Use the same arm every time you measure.
• How often should I check my blood pressure?

You and your doctor should determine the best monitoring frequency, but here are some general guidelines:
If you are just starting to track your blood pressure, we recommend taking several measurements per day to help you understand your normal daily variations.

• If your pressure is normal, measuring once a month is usually sufficient.
• If you have high blood pressure and you’re monitoring the effectiveness of your treatment regimen, check your pressure at least once a week, ideally at the same time of day.
• If you change medications or doses, you should check your pressure daily, both before and a few hours after taking your medications, until you and your provider are confident that your pressure is under control.

What do the numbers mean?
A blood pressure measurement consists of two numbers separated by a slash, for example 120/80 mmHg. (Note: “mmHg” refers to millimeters of mercury, just like an old thermometer or barometer).

The first number—the systolic pressure—is the peak pressure generated in your arteries with each beat of your heart. This should be 120 mmHg or lower. The second number—the diastolic pressure—is the pressure in your arteries between each beat, when the heart is at rest. This should be 80 mmHg or lower.

If your systolic pressure exceeds 140 or your diastolic pressure exceeds 90, you have high blood pressure. If your numbers are somewhere in-between, then you have “pre-hypertension.” In either case, you should discuss the results with your provider.

Automated blood pressure monitors will also report a third number: your heart rate (aka pulse), which is ideally 60 beats per minute (bpm) or less when you’re at rest.