Blood pressure measured at home correctly gives you accurate information. If done incorrectly, can have scary numbers. As an anesthesia doctor, I measure blood pressure multiple times a day and I will share my experience here so you can measure at home like a pro!
Let’s jump right into it.
What type of blood pressure machine should I use?
There are three major types of blood pressure apparatus.
Manual using mercury sphygmomanometer
Manual aneroid type
Automated blood pressure machines
The principles behind all this are similar. Although mercury ones are used in many parts of the world, they are not in use anymore in developed countries. The aneroid ones have a round dial and require the use of a stethoscope for measuring blood pressure. The third type automated does not require a stethoscope and appears to be the most common in recent times.
Where is the blood pressure measured?
The blood pressure is typically measured at the level of the brachial artery at the level of the elbow joint. If you see the below picture of my hand, the red lines are the arteries and the blue lines are the veins. The arteries carry blood with oxygen away from the heart and the veins carry blood towards the heart.
If you do not place the rubber tubing on the red line, you can get the wrong blood pressure reading.
How do I know where the brachial artery is?
Try this out. You can also check how it’s done by clicking the video below. Bend your left hand at the elbow. You can take your 3 fingers on the right hand and put them on the side of the arm that is close to the body. This is also called the medial side. Now open your hand and you should feel a pulse here. It may be difficult on the first attempt, keep trying today and the next few days while you are watching TV or whenever you are relaxing. Once you do it a few times you will nail it. You will know next time how to check blood pressure even without looking for it.
Check this link for a video on youtube: How to measure your blood pressure at home like a pro! By Anesthesia Doctor
Want a quick tutorial?
Check this 30-second video
What are the steps in measuring blood pressure at home?
- Turn on the blood pressure apparatus
- Make sure the batteries and connections are good
- Wrap this around your arm like this with this plastic tubing going down where the red line is.
- Sit on a dining table chair
- Place your hand on the dining table or on your lap
- Keep your hand relaxed.
- With this seating position, the cuff will be at the level of the heart
- Wait for 2-3 minutes and relax. Stress can increase blood pressure
- Press the on button and wait for the blood pressure to read
- As the cuff inflates, you may feel a tingling sensation in the arm
- As the cuff deflates, it will record the blood pressure
What should I do if I cannot sit straight?
If you are unable to sit straight or you are measuring someone who is bedridden, you can measure lying down. Following this, the ideal thing to do is to continue measuring in the same arm/leg and in the same position.
Where should the blood pressure cuff be at?
The blood pressure cuff should be at the level of the heart. If the cuff is higher than the heart level, then the blood pressure will be falsely low and vice versa (lower than the heart level will falsely increase blood pressure).
How should the blood pressure cuff be placed?
The blood pressure cuff should be at the level of the heart. The cuff should be wrapped tightly around the arm enough to let one or two-finger pass beneath the cuff.
What precautions to take prior to measuring blood pressure at home?
- Use the bathroom
- Do not drink anything with caffeine (coffee, tea, or soda) 30 minutes to 60 minutes before measuring as this can falsely increase the blood pressure
- Do not measure as soon as you wake up in the morning
- Relax prior to measuring
- If you get a high reading, don’t panic. Take 3 readings and average it.
Why is my blood pressure different whenever I measure it?
Blood pressure is a physiologic variable. The body is constantly functioning and hence the numbers will not be perfectly the same. There are normal ups and lows that could happen during the day and also with activity. For example, with exercise the heart rate and blood pressure will go up and then comes back down to baseline after a period of rest.
Hence, measuring the blood pressure at the same time on the same arm will give more accurate measurements.
Can the blood pressure readings be inaccurate?
Unlikely but possible. If you think it is inaccurate, then check the connections and retry. If you think it is still inaccurate, then you can double-check this on a family member whom you think has normal blood pressure.
What are the blood pressure numbers shown on the machine?
There are three numbers. The highest is the systolic blood pressure and the lowest number is the Diastolic blood pressure. The middle number is the mean blood pressure.
The systolic blood pressure indicates how much pressure your blood is exerting against your artery walls as your heartbeats. The diastolic blood pressure tells you how much pressure your blood is exerting when your heart is resting in between beats. The mean blood pressure is used by Doctors for many different health conditions. For the purpose of measuring blood pressure at home, focusing on systolic and diastolic blood pressure is generally sufficient.
Maintaining a log (noting blood pressure values in a book or a smartphone app) will help you keep a track of it.
How many times should I measure blood pressure at home?
It is ideal to measure 3 times in one setting and take the average of it. Some situations where you want to measure it 3 times are
- If you take medicines for high blood pressure
- Risk factors for high blood pressure like a family member having high blood pressure
Does the blood pressure cuff size matter?
Yes, it definitely does.
If a cuff is to be used on someone who is obese or has big arms then you need a bigger-sized cuff. Same for using for children. You will need a smaller-sized cuff. If the cuff size is wrong the blood pressure readings can be wrong.
What is a correct-sized blood pressure cuff?
If you look at the cuff, there are two measurements with the cuff. The width should be 40% of your arm length. The arm length is actually measured between the bony prominence here on the shoulder which is called the acromion and the bony process here called the olecranon on a bone called ulna.
The length of the cuff should be enough to encircle the whole arm with just a little extra. It should not go around the arm twice as this can happen if I put the same cuff on a child. This is not correct. Also, if you put this same cuff on a person with a big arm then can you imagine this won’t circle enough. So, this is how you decide on the size. You don’t have to make it so complicated. If you get an adult-sized cuff this should be sufficient for most people, and you don’t have to routinely measure the width and length of the cuff.
Can you measure blood pressure at home on top of clothes?
Ideally, it should be measured directly on the arm. If you cannot do this then you can do this on a thin cloth but not a sweater or a jacket. You should take it out. Since you are doing this at home, you can do this in your privacy.
What is normal blood pressure?
Normal blood pressure is 120/80 mm Hg. It is very rare to see this perfect number on any individual.
The American College of Cardiology and the American Heart Association defines high blood pressure as a number above 130/80 mmHg. So, the top number if it is 130 or more and the bottom number 80 or more is considered high blood pressure.
What happens if blood pressure is high?
High blood pressure also known as hypertension causes many health problems. This increases the risk of
- Heart problems like heart attack
- Brain damage like stroke
- Kidney problems
- Eye damage
- Sexual Dysfunction
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