Checking your blood pressure at home is an important way to manage hypertension (high blood pressure). Regular monitoring can let you know if medication and lifestyle changes like exercise and cutting back on sodium are working. Or, if your numbers start to creep up, it can signal that it’s time to ask your doctor about adjusting your medication to bring your numbers back down. Best of all, measuring your blood pressure is fast and easy to do on your own. Self-monitoring empowers you to catch problems early, when they’re easier to treat.  

But if you’re new to taking your own blood pressure, it’s normal to feel a little nervous about getting it right. Having the proper equipment and knowing some simple tricks to get an accurate reading can help. Here’s what to do.  

Choose the right at-home blood pressure monitor 

Not all home monitors are equal. Devices that fit onto the wrist are not always accurate, says Martha Gulati, MD, division chief of cardiology at the University of Arizona College of Medicine. Blood pressure readings tend to be higher when taken with wrist monitors. The American Heart Association (AHA) advises against them.  

Instead, Dr. Gulati recommends a cuff-based monitor. Ranging from $20 to $150, these are the 2 most common types: 

• Manual cuffs: To use this monitor, wrap the cuff around your upper arm. Use a stethoscope on the inner side of your arm, just below the edge of the cuff, to listen to your pulse. Squeeze the attached bulb on the blood pressure monitor, quickly inflating the cuff to 180 millimeters of mercury (mm Hg). At this point, you will not be able to hear your pulse. Turn the knob on the pump toward you to let the air out steadily, at a rate of 3 mm Hg per second, until you hear your pulse return. Note the reading. That is your systolic pressure (the top number of your reading). When you can no longer hear a pulsing sound, note the reading again. That is your diastolic pressure (the bottom number). 
   
  This monitor is accurate, Dr. Gulati says, but only if used correctly. There is often a learning curve, and it can be difficult to use if you are hearing impaired or visually impaired. It’s also challenging if you can’t perform the hand movements with the coordination needed. In most cases, a digital cuff is much easier and just as accurate. 
   
• Digital cuffs: These range in price from about $50 to $150. That’s more expensive than a manual kit, which can be as little as $20. But digital cuffs are far easier to use. After you put on the cuff, you simply press a button and the device does the rest. Some newer models can wirelessly connect to a smartphone app and keep a record of all your readings. Some also provide charts, making it easy to spot positive and negative trends. 

(Have questions about checking your blood pressure? The fastest way to get answers is through Wellframe, the digital health management app that comes with your health plan. You can use Wellframe to connect to your care team or to search the library for trustworthy information written by medical experts. Log on or download Wellframe today.) 

Follow these steps for a better reading 

Blood pressure varies throughout the day. It can spike because of something you ate or because of sudden stress. Here’s how to take the most accurate reading possible, according to Dr. Gulati. 

1. Take the measurements at the same time every day. Common times are about half an hour after waking up in the morning and again sometime during the evening. Blood pressure has a daily pattern. It’s lowest when you’re sleeping and starts to rise a few hours before you wake up. It keeps rising during the day, peaking at midday. Then it starts to drop again in late afternoon. That’s why taking your blood pressure before and after this peak will give you the best reading. 
2. Avoid food, caffeine, tobacco, alcohol, and black licorice for at least 30 minutes before doing the measurements. These foods and beverages can cause your blood pressure to momentarily spike. 
3. Go to the bathroom first. A full bladder can raise blood pressure slightly, throwing off the reading. 
4. Sit up straight in a chair that has back support. Place both feet on the floor and relax for 5 minutes. Slightly bend the arm you’ll be using, since that keeps it more relaxed. Rest it on a table so that your upper arm is on the same level as your heart. If the arm hangs down, the reading may be lower and potentially inaccurate. 
5. Wrap the cuff around your bare arm (not over clothing), above the bend in your elbow. 
6. Stay still and quiet. Moving or talking can skew your results. 
7. Take 3 readings, each about 1 minute apart. This is an AHA recommendation, because the first reading tends to be higher. Do an average of all 3 readings. 
8. Record the results with the time and date.  

(Get help tracking your blood pressure numbers with Wellframe, your digital health management app. You can record your numbers and share the results with your care team so they can monitor your progress in real time. Log in or download the Wellframe app today.) 

Understand your numbers 

Your blood pressure is composed of 2 numbers: 

• Systolic (top number): the pressure in your arteries when your heart beats.   
• Diastolic (bottom number): the pressure in your arteries when your heart is resting between beats. 

Here’s what the numbers mean, according to recent American Heart Association guidelines. Your doctor may recommend lifestyle changes or medication to help control your blood pressure. 

Normal:  
Systolic: less than 120 
Diastolic: less than 80 

Elevated: 
Systolic: from 120 to 129 
Diastolic: less than 80 

High stage 1: 
Systolic: from 130 to 139 
Diastolic: from 80 to 89 

High stage 2: 
Systolic: at least 140 
Diastolic: at least 90 

Remember that your blood pressure changes throughout the day, so small variations are likely to occur. What you’re looking for during at-home readings is whether you start trending higher. Hypertension is diagnosed when your blood pressure is consistently high.  

Try these lifestyle tips to lower your blood pressure 

If your blood pressure is skewing a bit higher than you’d like, there are some science-backed ways to help bring it down: 

• Exercise regularly. Aim for about 150 minutes per week, or about 30 minutes, 5 times per week.      
• Eat a healthy diet. Include plenty of fruits, vegetables, and whole grains. 
• Reduce sodium. Even a modest reduction in sodium can lower blood pressure. 
• Limit alcohol. More than 1 drink per day can raise blood pressure. 
• Quit using tobacco products. Smoking cigarettes and using other tobacco products with nicotine increase blood pressure. 
• Reduce stress. Try deep breathing exercises, yoga, or just relaxing outdoors. 
• Focus on sleep quality. Create good bedtime habits, like limiting screen time and going to bed at the same time every night. This can help keep your blood pressure more regulated. 

(Ready to quit smoking? Don’t go it alone! You have access to a free smoking cessation program through your Wellframe app. Log in to learn more now.)  

Sometimes, these habits can be enough to get you back into a normal range. They’re also just good habits that boost your overall health.  

Continue taking your blood pressure daily while trying these changes. If you’re still getting slightly higher readings, check in with your doctor. But if your blood pressure is spiking much higher, get help sooner. Call 911 if your rising blood pressure comes with other symptoms like: 

• Chest pain. 
• Shortness of breath. 
• Changes in vision. 
• Back pain. 
• Numbness or weakness. 
• Difficulty speaking. 

Staying on track with your blood pressure in general is important for your health. Remember, there are no symptoms of high blood pressure, so it can be easy to miss. But with home monitoring, you can catch small changes and take action with your doctor before they cause bigger problems. 

SOURCES: 

[1] “Video: How to measure blood pressure using a manual monitor.” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/multimedia/how-to-measure-blood-pressure/vid-20084748. Accessed July 21, 2021.  

[2] Lopez-Jimenez F. “Blood pressure: Does it have a daily pattern?” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058115. Accessed July 21, 2021. 

[3] “10 ways to control high blood pressure without medication.” Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974. Accessed July 21, 2021.  

[4] “Hypertensive Crisis: When You Should Call 911 for High Blood Pressure.” American Heart Association, https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/hypertensive-crisis-when-you-should-call-911-for-high-blood-pressure. Accessed July 21, 2021.  

[5.] “High Blood Pressure.” American Family Physician, https://www.aafp.org/afp/2004/1015/p1542.html. Accessed August 4, 2021.