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Slapping the cuffs on -- at home
Getting your blood pressure monitored outside your home can be inconvenient, even a little unnverving. For some people, just visiting a doctor's office is enough to raise their blood pressure (a condition called "white coat hypertension"). And sticking your arm into one of those big machines at your local drugstore and waiting for the cuff to tighten isn't always convenient. So for many, home testing is a convenient alternative. But be aware that home devices have to be used properly in order to give a correct reading. Carefully read the instructions that come with each kit. If your systolic blood pressure is 140 or above, or your diastolic pressure is 90 or above, and you have not been diagnosed with hypertension, you should inform your health care provider.
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A Common, and Dangerous, Condition
One in five Americans suffers from high blood pressure above 140/90 mm Hg. High blood pressure is a risk factor for many serious conditions, including:
- coronary heart disease
- kidney disease
- stroke
- congestive heart failure
- eye problems
It is often important for individuals with high blood pressure to monitor their condition on a daily or weekly basis. At-home monitoring of blood pressure can counteract "white coat hypertension," a documented phenomenon in which a patient's blood pressure increases because of the stress of being in a medical surrounding.
Types of Blood Pressure Monitors
Mechanical Devices
- relatively inexpensive
- resemble those used by health professionals
- require good hearing
- require the ability to squeeze the inflation bulb
- most accurate method of measuring blood pressure if the patient's hearing is good, and the patient is not hampered by arthritis or diminished hand strength
Electronic Monitors
- range from inexpensive to expensive
- easy to use
- quick
- differ in accuracy and reliability
- suggested for hearing-impaired individuals
- suggested for individuals with decreased hand strength or arthritis
- requires calibration at least yearly
- arm cuff models may be less convenient than wrist cuff models, but arm cuffs produce more accurate and consistent results
- generally less accurate and consistent than mechanical monitors
- cuffs that inflate automatically produce more accurate and consistent results than those that require manual inflation
Finger Cuff Monitors
- relatively expensive
- easy to use
- quick
- measure pressure from the finger, which is farther away from the heart than the wrist or arm
- produce highly variable readings
- are the least accurate of the three types
- some have been rated "unacceptable" by consumer groups
How to Choose a Blood Pressure Monitor
- Consult your healthcare provider for advice on which monitor would be best for you.
- Ask your healthcare provider or pharmacist about medical supply stores that carry a variety of monitors.
- Weigh each of the product's advantages and disadvantages and take into account your budget before making a purchase.
- Make sure that you are allowed to have a trial so if you find that the device does not suit you, you can return it with a full refund.
- Ask the manufacturer what kind of maintenance each device needs and how much replacement parts cost.
- Find out if your insurance will cover all or part of the cost of your at-home blood pressure monitor.
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Monitoring Your Blood Pressure
- Blood pressure monitors are used to chart the blood pressure of individuals for whom dangerously high blood pressure is a possibility.
- Blood pressure monitors can also be used to chart the effectiveness of drug treatment and lifestyle changes devised to treat high blood pressure.
How and What Do Blood Pressure Monitors Measure?
- Blood pressure monitors work by inflating a cuff around your arm, wrist, or finger.
- When the monitor begins to feel resistance on the part of your blood vessels against the pressure of the cuff, you will hear a thumping sound begin, and a number will be registered.
- This is your systolic pressure.
- The monitor then registers again when the thumping disappears.
- At this point the pressure of the cuff and the pressure of your blood are relatively equal.
- This is your diastolic pressure.
How Do These Machines Differ From the One at the Doctor's Office?
- Almost all healthcare practitioners use a manually inflated cuff and a stethoscope to measure blood pressure. The difference? Usually, healthcare practitioners are much more skilled at doing a blood pressure reading.
How to Use Mechanical Monitors
- Avoid caffeine, nicotine, and vigorous exercise at least 30 minutes prior to reading.
- Be seated.
- Stretch out your arm.
- Rest it on a surface so that the cuff is level with your heart.
- A pillow can help you prop up your arm to the appropriate height.
- Place the stethoscope in your ears and under the cuff.
- Make sure you can see the gauge.
- Inflate the cuff.
- Open the valve to slowly let air out of the cuff.
- Listen for the first thumping sounds. Record. This is your systolic pressure.
- The thumping will increase then suddenly decrease.
- Listen for the point at which you can no longer hear the thumping. Record. This is your diastolic pressure.
- Average three consecutive measurements for greater accuracy.
- This method is the most accurate method of measuring blood pressure only if the patient is not hampered by arthritis, diminished hand strength, or diminished hearing.
How to Use Electronic Monitors
- Avoid caffeine, nicotine, and vigorous exercise at least 30 minutes prior to reading.
- Be seated.
- Stretch out your arm.
- Rest it on a surface so that the cuff is level with your heart.
- A pillow can help you prop up your arm to the appropriate height.
- Most models provide diagrams that help you place the cuff in the correct position.
- If you have a self-inflating model, depress the button to initiate inflation.
- Wait until a reading is obtained.
How to Use Finger Cuff Monitors
- Avoid caffeine, nicotine, and vigorous exercise at least 30 minutes prior to reading.
- Be seated.
- Stretch out your arm.
- Rest it on a surface so that the cuff is level with your heart.
- A pillow can help you prop up your arm to the appropriate height.
- Place two fingers into the cuff.
- Wait until a reading is obtained.
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Be an Informed User
- Dangerously high blood pressure signals the need for immediate medical attention.
- When consulting your doctor about at-home blood pressure monitoring, make sure you understand what your individual level of "dangerously high" blood pressure is.
- Check the accuracy of your monitor by bringing it with you to the doctor's office so your healthcare provider can compare her or his results to those of your own device.
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Websites, Organizations & Manufacturers
Sources & Further Reading
Books
- 1. American Medical Association.The American Medical Association: Family Medical Guide. 3rd Ed. New York: Random House 1994.
- 2. Fauci, Anthony S. et al. Eds. Harrison's Principles of Internal Medicine, 14th ed. New York: MacGraw Hill 1998.
- 3. Segen, Joseph, and Joseph Stauffer.The Patient's Guide to Medical Tests: Everything you need to know about the tests your doctor prescribes. New York: Facts on File 1998.
- 4. Zaret, Barry L. Et al. The Yale University School of Medicine Patient's Guide to Medical Tests. New York: Houghton Mifflin 1997.
Find more books on health and wellness at  barnesandnoble.com.
Articles
- 1. Tien, Linda."For many, home is where the test is, but not all tests are created equal". Star Tribune; 8/13/1995.
- 2. MacDonald, Sue."Testing your health at home". Gannett News Service; 8/8/1996.
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