Features January 2014 Issue

Make the Most of a Home Blood Pressure Monitor

Here’s how to buy and use the right one for you.

If you have high blood pressure or heart failure, one of the smartest things you can do this new year is to buy a home blood pressure monitor. Research shows people who use home monitors regularly tend to keep their blood pressure under control more effectively.

Proper posture and arm position are among the keys to getting an accurate reading from a home BP monitor.

“The ability to measure your blood pressure between office visits can be very helpful if you need to watch your blood pressure carefully or are having trouble controlling it,” says Cleveland Clinic cardiologist Leslie Cho, MD.

The convenience of reading your blood pressure at home allows you to determine how well your antihypertension medications are working. You will also be alerted to unexpected rises in blood pressure from something as simple as taking an over-the-counter decongestant.

And if you’re trying to lower your blood pressure through weight loss, exercise and a low-sodium diet, watching it fall can be tremendous encouragement.

So here’s what you need to know to get the home blood pressure monitor that’s right for you and use it correctly.

What style is best?
Home blood pressure monitors are available in different styles. The manual arm monitor has a cuff that wraps around the arm, attaches with Velcro and is inflated by squeezing a bulb. In the automatic arm monitor, the cuff inflates automatically. The wrist monitor wraps around the wrist and inflates automatically.
The most accurate readings come from the manual arm monitor, says Dr. Cho.

“Unfortunately, most patients can’t use it properly. That’s why we generally recommend the automatic arm model,” she says.

If using an arm monitor, be sure the cuff fits. If it’s too tight or too loose, you won’t get accurate readings.

Before you go shopping, measure your arm where the cuff will be placed. Most blood pressure cuff packages say what size arms they will fit.

You can also ask the pharmacist if they have a demo model you can try.
Having a cuff that is too big or too small is not a problem for most people of average build, but it can become a problem if you are very thin or overweight. “If you are very large, you may need a wrist monitor, even though it’s the least accurate model,” says Dr. Cho.

Too many gadgets!
Blood pressure monitors do much more than simply read your blood pressure: They can store previous readings for one or two people, signal heart-rhythm abnormalities or sound an alarm if your blood pressure exceeds a certain number.

Do you really need all these features? “If you have atrial fibrillation, an arrhythmia detector could be important. Many people don’t feel this fast heart rhythm when it occurs, but nevertheless, it increases the risk of stroke,” says Dr. Cho.

“Memory might be helpful in keeping track of your blood pressure, but it isn’t necessary. Most people simply write down the numbers,” she says.

Get an accurate reading
It is important that you sit quietly for five minutes before checking your blood pressure, and that you measure it in your left arm or wrist. But according to Dr. Cho, it doesn’t matter what time of day you take your blood pressure, or whether you take it at the same time every day. The human body is dynamic, and blood pressure goes up and down.
“If your systolic pressure (the top number) is high, don’t panic. Take your blood pressure two more times in succession and take the average of all three readings. If it’s 180 mm Hg or more, call your doctor,” she advises.

Low blood pressure is another concern, especially in older people, since it increases the risk of dizziness and fainting. But the number at which this can occur varies among individuals. “In general, if it’s under 85 mm Hg, it’s probably too low,” says Dr. Cho. “Ideally, if you have no significant heart problems, your blood pressure should be about 150/90 mm Hg,” she says.

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