Heart Smart Living
Heart Smart Living

Cardiologist, author, and heart health expert Dr. Sarah Samaan offers advice on how to live a heart smart life.

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Home Blood Pressure Monitoring

A great investment in your health.

When you visit your doctor, it’s nearly a sure bet that you’ll have your blood pressure measured.  A high blood pressure reading usually means that you have hypertension, but sometimes the problem is all in your head. The term “white coat hypertension” refers to someone whose blood pressure is perfectly normal until they step into the doctor’s examining room. At that moment, tension rises and a type of performance anxiety sets in, boosting levels of adrenaline in a typical “fight or flight” reaction.

Sometimes what gets labeled “white coat hypertension” is actually just poor measuring technique. To get an accurate reading, you should sit quietly, your feet resting on the ground, for a good five minutes. The cuff should fit properly (usually there are size guides printed on the cuff to indicate if the fit is correct), and your arm should be at about the level of your heart. If this procedure is not followed, it is reasonable to ask for a repeat measurement before any decisions or conclusions are made.

Unless the blood pressure is dangerously high, it’s best to have at least three separate readings on different days before diagnosing hypertension. Ideally, you should have five or six readings. That’s where a home blood pressure cuff can make all the difference. A recent Veteran’s Administration study, published in the June 21, 2011 edition of the Annals of Internal Medicine, found a nearly 10 point difference in home blood pressures when compared to those measured in the clinic.

When you’re scouting for a home blood pressure machine, look for one that measures the pressure in the upper arm. Wrist and finger cuffs are notoriously inaccurate. If you’re overweight or obese, or you have exceptionally muscled arms, you may need a large cuff. Very thin people sometimes need a pediatric cuff. You can choose either a manual or a digital machine. The manual machines are a little cheaper, but may be a bit more difficult to use.

If you need to monitor your blood pressure at home, ask your doctor for a prescription. Often the cost will be reimbursed by your insurance if it is medically indicated. Alternatively, you may be able to use your Flexible Spending plan or Health Savings Account to pay for the device.

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Tags: High Blood Pressure

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About the Author


Dr. Samaan is an acclaimed cardiologist, writer, and heart health educator.