Wrist BP cuff
Home monitoring is appropriate for any patient with hypertension especially if you suspect “white coat” or resistant hypertension. It can confirm office BP’s my boost med adherence and improve control.
Choosing a monitor: Suggest a validated BP monitor with a memory (LifeSource, Omron, etc.). Recommend an automatic upper ARM monitor for most with a cuff where the inflatable rubber bladder encircles at least 80% of the arm. Wrist monitors aren’t as reliable as arm monitors. If a patient needs to use a wrist monitor, such as if a large arm cuff doesn’t fit, emphasize keeping their wrist still and at heart level during the test. Do NOT recommend finger cuffs as they’re notoriously inaccurate.
Proper Technique: In general, tell patients to check BP BEFORE taking BP meds and at least 30 minutes AFTER exercise, smoking or caffeine. Keep in mind that caffeine may not increase BP acutely in regular users. Encourage patients to sit first for about 5 minutes with their back supported, feet on the floor and legs uncrossed. Advise them to support their arm at heart level, avoid tight sleeves and to not talk. Suggest taking an average of 2 or 3 readings at least 1 minute apart. Recommend that patients compare their home BP monitor against a professional manual check, and recheck it annually.
Evaluating Results: First, suggest checking BP in the morning and evening over a weeks’ time or so to help guide decisions and assess efficacy of meds. Then, suggest checking BP once or twice a week to reinforce med adherence, or repeating the week-long process about every 3 months. Suggest taking both office AND verified home BPs’ into account before changing prescriptions.
How To Pick A Monitor
- An automatic arm cuff inflates on its own. This type may not work if you have an irregular heartbeat.
- A manual arm cuff displays readings automatically, but you must inflate the cuff by pumping a bulb.
- Wrist monitors are easy to use, but cost more than other monitors and can be slightly less consistent than arm cuffs. These are good if you have a larger arm that is ill fitting in an arm cuff
- Fingertip monitors are not as reliable as other types. Avoid these.
- Make sure you can read the display easily.
- With arm monitors, choose the correct size cuff for your arm.
**Ask your pharmacist to help you choose a reliable product. Good brands include; Omron and LifeSource.
What To Do BEFORE You Take Your Blood Pressure
- Wait at least half an hour after eating, smoking or exercising and a couple of hours after having caffeine to get the best reading.
- Sit quietly for at least five minutes before taking the reading.
- Sit up straight with feet flat on the floor and back supported. Do not cross your legs or ankles.
- Keep your upper arm at the level of your heart.
How To Take Your Blood Pressure
- Roll up your sleeve or remove any clothing with a tight sleeve.
- avoid talking while you take your blood pressure.
- If you’re using an arm cuff, rest your arm on the table with your palm up. If you’re using a wrist monitor, keep your wrist level with your heart.
- Take your blood pressure three times. Wait a few minutes between each measurement. Record the average of the three readings.
- It is important to check the blood pressure reading from your home machine with your health care provider at least once a year. Do this more often if the machine is dropped or if the blood pressure readings change suddenly.
What Blood Pressure Numbers Mean
Your blood pressure shows how hard your heart works to pump blood. The top number (systolic) is the pressure when the heart contracts. The bottom number (diastolic) is the pressure when the heart relaxes. People with high blood pressure have more heart attacks, strokes, kidney disease and blindness.
Normal blood pressure: 120/80 mmHg
Blood pressure goals:
Diabetic patients or patients with kidney disease: