Q. You mentioned previous that you would discuss the various medications that are used to help lower blood pressure. But first, can you review the best technique for taking my blood pressure?
A. Absolutely. Let’s continue our review of blood pressure by describing how to get the most accurate blood pressure. If you are questioning the best technique, you likely have a home blood pressure monitor that allows you the freedom and capability to take it at any time. That makes it very convenient, providing you do actually use it and it is not collecting dust somewhere in your home. For those of you who do not have a home blood pressure monitor and are wondering if you should invest in one, considering our last column when we discussed that hypertension or high blood pressure is also termed as “the silent killer”. It just might be worthwhile for you to keep an eye on your blood pressure at home to ensure it continues to be well managed. Some of you might be getting your blood pressure checked regularly by your health care provider and therefore it may not be necessary for you to have your own personal monitor.
On the other hand, some people are finding that the blood pressure readings taken at a medical clinic are very different to what they get at home. Are you familiar with White Coat Syndrome? This is an abnormally high blood pressure measurement in a medical environment with or without feelings of anxiety. Due to that phenomenon, many people purchase a blood pressure monitor to use at home to see what their blood pressure truly is when they are relaxed in their own home environment.
When deciding to measure your blood pressure at home, there are small improper blood pressure techniques that each lend themselves to errors of 5 to 10 mmHg which can lead to improper treatment decisions. Even though the home blood pressure monitors have been around for decades and are simple and easy to use, we want to ensure you are getting a reliable measurement each time you take your blood pressure. Otherwise, what is the sense in checking it? We know your time is precious and valuable so it is importatnt to make the most out of your practice of monitoring your blood pressure.
When you are sitting down to take your blood pressure, it is usual practice to take more than one reading at a time, at least 1 to 3 minutes apart, and to record the average of those values and to measure your blood pressure twice a day. Keep in mind that our blood pressure does vary during the day and tends to be higher in the morning for most of us. Therefore, it is recommended to check your blood pressure at various times in the day. We don’t expect you to be married to your monitor and check it constantly. You can get an accurate picture by changing up your chosen two times each day to see how you’re your heart is performing at these various times.
There is a proper technique to measuring your blood pressure and by not following these steps you may artificially affect your blood pressure. Yes, that’s right; it is not as easy as slapping on the cuff and pressing the start button. Keep reading to learn more and prevent incorrect blood pressure readings from happening.
· Active listening while BP is measured can increase your systolic pressure by 10mm Hg. It is recommended to sit comfortably in a quiet place for 5 to 10 minutes in a chair with back support and legs/ankles uncrossed (crossed legs can increase BP) prior to taking your reading. It is important to not talk during this time as this has shown to affect your blood pressure. Even actively listening to others can have the same effect so try to look for that quiet area of your home. Not only that, but having a radio or television on in the background can have the same effect, especially if you have a news station on!
· Using an unsupported arm can increase your systolic pressure by 10mm Hg. Your arm should be resting on a table or arm chair and it should be at the level of your heart; use a pillow to raise it to heart level if needed. Sit up straight with your back supported by the back of the chair and your feet on the floor (remember to not cross those legs or ankles!). It is also important to use the same arm each time when measuring BP. It is customary to use your non-dominant arm unless you have been told otherwise.
· A blood pressure reading on a full bladder can increase systolic pressure by >10mm Hg. It is best to empty the bladder before settling down to take a blood pressure reading to ensure accuracy.
· A measurement taken over clothing or tight clothing rolled up over the arm can produce false values. It is best to use the cuff on your bare arm. Very light clothing may be worn under the cuff but the arm should be removed from most clothing rather than rolling the sleeve up the arm. This rolling of the sleeve produces a tightening of the vessels in the arm and will give an inaccurate reading.
· Smoking or eating within 30 minutes can increase your systolic pressure by 6 to 20mm Hg. Any food, caffeine, tobacco and alcohol should be avoided within 30 minutes of measuring BP. If you wish to take a first morning reading, it is best if you don’t take it right out of bed. Rather, get up and void your bladder and take time to get dressed but take it before breakfast and medications. If you exercise first thing in the morning, take your reading before exercising.
· Use a blood pressure monitor with a properly fitted cuff. An improperly fitted cuff can give you an inaccurate reading as well so be sure to get fitted prior to buying your own monitor. It just takes a few minutes to be measured. As well, the lower edge of the cuff should be 3cm above your elbow crease. The tubing should be at the bottom so that it is closest to your hand and in line with your large artery that runs along the inside of your forearm towards the palm side of your baby finger.
Who knew there was so much to learn about something as simple as taking a blood pressure reading. With the above tips and tricks, you can stay on top of your blood pressure health.
For more information on this or any other health related topic, contact your pharmacist.
