Ask the doctors: Daily blood pressure checks increase data
Q: I was surprised to learn that two of my friends (we are in our mid-40s) take their blood pressure every day. They both say their doctors think it's a good way to get ahead of potential problems. Do you know if these kinds of at-home readings are reliable?
A: Not only are blood pressure readings taken at home considered to be reliable, but for many adults, they are recommended.
Leading health authorities endorse the practice, such as the American Heart Association, the American College of Cardiology and the Centers for Disease Control and Prevention. As your friends have noted, performing regular blood pressure checks creates a continuous pool of valuable data. It also helps avoid the so-called white coat hypertension, which is when stress and anxiety at a medical exam yield artificially high readings.
Blood pressure is a measure of the force that blood exerts on the walls of the arteries. When that force remains too high over time, it can strain the heart, damage blood vessels and increase the risk of cardiovascular and kidney disease and stroke.
Readings consist of two numbers, and are written one over the other. The top number, known as systolic pressure, is the force produced when the heart contracts. The bottom number is the pressure on the artery walls while the heart is at rest. This is diastolic pressure. (Think “d for down.”)
Our blood pressure changes throughout the day. Physical activity, salt intake and stimulants, such as caffeine or tobacco, affect blood pressure. It’s also affected by alcohol use, medications, emotions, stress and even the food we eat.
To get an accurate blood pressure profile, you need multiple readings. Proper technique and a good monitor are also important. You can find a list of validated home monitors at validateBP.org. Your doctor can also guide you.
To get an accurate blood pressure reading, wait at least 30 minutes after exercising, ingesting caffeine or using tobacco. Empty your bladder first, as that can affect results. Position the blood pressure cuff above the bend of the inner elbow with the air tubes centered. Adjust it so it's firmly in place without being tight. You should be able to slip a fingertip beneath the top of the cuff.
Sit quietly with your back supported. Rest your arm at the level of your heart. Put both feet flat on the floor. Sit quietly for two to three minutes without your phone, TV, conversations or other distractions.
When you’re ready, press the start button. You will feel the cuff inflate, go still for a moment and then gradually deflate. Breathe normally and remain relaxed as the device completes its cycle. When the machine finishes, your blood pressure reading will appear on the screen.
Over the course of a week, with multiple readings, you'll get a more detailed picture than a single reading can offer. A reading below 120/80 is considered normal. Blood pressure of 130/80 or higher falls into the range of hypertension. If your readings are consistently high or low, it's a good idea to review the results with your doctor.
• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.
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