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How Can I Accurately Measure My Blood Pressure at Home
From the winter 2013 issue of the Scleroderma Voice
Follow these steps to accurately measure and monitor your blood pressure at home.7,11,13
Ask your clinician if you need a regular adult or large adult upper arm cuff, or possibly an upper arm cuff that self-adjusts to your mid-arm circumference. You will need a regular adult cuff if your mid-arm circumference is less than 13 inches (33 cm), but a large adult or self-adjusting cuff if 13-17 inches (33-43 cm). Wrist cuffs are less accurate and should be used only if mid-arm circumference is greater than 17 inches (43 cm).
Purchase only electronic oscillometric devices (EODs) that have been validated for accuracy by one or more international protocols. An up-to-date listing of validated cuffs is available at www.hypertension.ca/devices-endorsed-by-hypertension-canada-dpi. If possible, purchase an EOD that stores BP measurements to bring to your clinician. EODs that automatically measure and then average three BPs at one-minute intervals may be especially convenient. Also, have your upper arm EOD confirmed for accuracy as compared to your clinician’s office aneroid or mercury device.
You must prepare for a home BP measurement just as you would at an office visit.
Take your BP in the morning before breakfast and medication and again in the evening between 6 and 9 p.m. for three 3 straight days. At each measurement session, take your BP two to three times at one-minute intervals and average the results. Since readings from the first day are often higher and unstable, discard readings from the first day and average readings from the last two days.13,14 This approach to home BP measurement maximizes reproducibility and provides the best estimate of your usual or true BP.
Communicate your home BP results to your clinician at an office visit or by telephone or email. Goal home BP for most patients is below 135/85 mmHg (corresponding to an office BP below 140/90 mmHg) and for patients with diabetes or chronic kidney disease, probably below 130/80 mmHg (corresponding to an office BP below 130/80 mmHg).13,15
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16. Quinn RR, Hemmelgarn BR, Padwal RS, Myers MG, Cloutier L, Bolli P, et al. The 2010 Canadian Hypertension Education Program recommendations for the management of hypertension: part I - blood pressure measurement, diagnosis and assessment of risk. Can J Cardiol;26(5):241-8.