How to Measure Blood Pressure at Home

Your blood pressure reflects the impact of your physiology and psychology on heart. It varies at rest, work, exercise and sleep.

Measuring Blood Pressure, either at doctor's office or at home is often the first way to know whether you have hypertension or not. It is also an important way to monitor it and check the efficacy of medical or Ayurvedic treatment of hypretension.

We need to take readings at 2 to 3 different times a day to see if blood pressure is persistently raised at rest.

Blood Pressure Reading:

The blood pressure monitor (Sphygmomanometer) is broadly of two types.

One which is primarily used by doctors or healthcare providers where stethoscope is used along with cuff. (Auscultatory Method)

Second are common in household, which are battery operated, and inflate and deflate the cuff themselves and gives you Systolic (Upper) BP, Diastolic (Lower) BP and Pulse Rate reading on the small screen. They might have a memory of past readings as well. (Oscillometric Method)

The reading has a range of accuracy…e.g. Pulse Rate can be plus 5 or minus 5. Blood Pressure reading can be plus 3 or minus 3 of the reading.

When Should You Take Reading?

You should be in normal resting condition. If you have walked or came from outside, wait for 5 to 10 minutes before measuring BP.

It is better to take the reading at least 2 times of the day - morning and evening. Write down the time as well besides the reading.

When you are taking the reading, take 2nd reading 2 minutes apart and note it down as well. It is a must at least initially. Your exact reading is generally the average of at least 2 or 3 consecutive reading, each 2 minutes apart.

22nd May

Morning: 9:30 AM 144/88 PR 79 138 / 90 PR 81

Evening: 7:30 PM 140/90 PR 82 144 / 78 PR 78

Appropriate Cuff Placement:

1. Be quiet for 5 minutes before taking reading.
2. Find a comfortable place to sit. Work desk or dining table are good.
3. Place your hand stretched on the table, palm up, arm on the table, even with your heart.
4. Your arm should be bare or only one thin layer of clothing like shirt. No Sweater or Jersey or Coat.
5. It is recommended that the cuff should be wrapped around the upper arm with the midline of the bladder (tube) placed over midline of front side of arm).
6. The Cuff should snugly fit, It shouldn’t be loose or tight. You should be able to insert only one finger.
7. The lower edge of cuff should be one finger or two fingers above the fold of arm.
8. Press Start. The Cuff will inflate and deflate. Don’t move or talk during this time.
9. Record the reading displayed on the display.
10. After 2 minutes, take another reading and record it as well.

The Right Size of Cuff Matters:

The use of appropriate size of Cuff is a must. It shouldn’t be smaller or larger than required.

The Circumference of Arm is the deciding factor for choosing the Right size of Cuff. The 2nd factor is length of arm. The 3rd Factor is conical or cylindrical size of arm.

Take a tape and ask someone to help with 2 measurements.

Arm Length: From Shoulder to Elbow. Divide by 2. It will give you mid arm level.

Mid Arm Circumference: Measure the periphery at mid arm level. And use the table below…

Problems with Using Inappropriate Cuff:

There is a high probability that you will get a faulty reading by 10 mm Hg or more.

Undercuffing - use of too narrow or too short bladders gives you a higher than actual reading of BP. There is dange of overdiagnosis of hypertension.

Conversely, Overcuffing - use of too wide or too long bladders will give you reading lower than actual. Here, you will have hypertension but your readings will be normal.

The recommendations of the American Heart Association are mainly based on the 40% × 80% rule. In other words, the bladder inside the cuff should have at least a 40% width and an 80% length of arm circumference.

Reference: J Clin Hypertens (Greenwich). 2018 Jul; 20(7): 1100–1103. PMID: 30003699

Take Home Points:

1. Measurement of Blood Pressure properly at Home is key for its effective management and checking the efficacy of treatment or preventive protocols.
2. Follow the Steps about when and how to measure blood pressure.
3. Select the appropriate size of Cuff for Blood Pressure Monitor.
4. If you are hypertensive, initially record Blood Pressure at least 2 times consecutively at 2 minutes interal to arrive at correct / average reading.
5. And take at least 2 readings at different times of the day, until treatment or preventive measures give stability.