Healthcare is changing. Clinicians struggle more and more to offer all they know they should to improve health within the five-or-six minutes allotted in conventional medicine. Gathering sufficient information, coming up with a plan, and instituting that safely is a real challenge. Support staff are being cut back to save healthcare dollars and more is being delegated back to the client, such as monitoring of blood pressures at home. Virtual visits during the pandemic made these more pertinent as well, even for pregnant mommas, and to be honest, we know that just coming into the office can cause enough anxiety to raise your blood pressure, so readings from home are often more accurate.
If you have already been diagnosed with hypertension, or elevated blood pressures, then knowing how to obtain these readings at home can empower you to better understand your body, its response to its environment, and monitor its improvement or progression with your chosen treatment plan. The American College of Cardiology and the American Heart Association encourages anyone diagnosed with elevated blood pressures to take their blood pressures twice in the morning and twice at bedtime for a week prior to each clinic visit. They also encourage individuals to bring in their monitors to their provider's office each year so they can help validate their accuracy.
Do you know how to get an accurate blood pressure reading?
There really is a bit of a procedure here, in that small circumstances can really change your reading. As I mentioned, noise and activity can raise your blood pressure, so give yourself just a moment to sit down and take a deep breath before taking a reading. Automatic blood pressure cuffs are great, but read the directions because most of them have their own very specific directions, like having the monitor turned to the inside of your wrist and raising your arm up above your heart. Cuffs can be put on upside down, and many times they are too small, which will falsely elevate your reading.
The heart pumps its blood into your body from its left side so the right side of the body has to work to get all this dispersed blood back into your heart from the right side. This effort increases your pressure a smidge, so the right arm blood pressure reading can reflect this. For this reason, I consistently get blood pressure readings in the left arm. Find your own routine and stick with it. If you have had lymph nodes removed under your arm, you'll want to avoid that arm and certainly there are other reasons to choose one side over the other that your practitioner may have already made you aware.
Once you have grounded yourself and settled in, feet flat on the floor, then sit quietly after you hit start. Don't have conversation with others in the room. Try to relax. These readings are variable, or modulate a bit, so if you were to repeat it in five minutes, you'll find a slightly different reading. What we want to understand is more of what your baseline would look like, so taking blood pressures at random times of the day, even the night, under different circumstances can be helpful.
Has your clinician offered a 24 hour blood pressure monitor to better evaluate your pressures and guide treatment?
When I am working with a client who is newly diagnosed with hypertension, or elevated blood pressure, or I am considering altering their medication regimen a bit, I'll suggest we do a 24 to 48 home blood pressure monitor. This will automatically obtain a blood pressure every thirty minutes through the day and every hour as you sleep. I've found this data to be incredibly helpful in appreciating how high blood pressures climb for any particular client, and how often they are high through the day, even if they stay high at night. This helps guide my treatment so that I am adequately dosing them, but also not offering more than necessary.
Bakris, G., Ali, W., & Parati, G. (2019). ACC/AHA versus ESC/ESH on hypertension guidelines. Journal of the American College of Cardiology, 73(23), 3018-3026. https://doi.org/10.1016/j.jacc.2019.03.507