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Do you monitor your blood pressure? More importantly, are you measuring it correctly?

This article focuses on how to measure your blood pressure (BP) accurately. A number of people presenting at the doctors have white coat hypertension (higher BP readings in front of a health professional then readings taken at home) and surprisingly, this phenomenon can be a marker for chronic inflammation. (increased risk of future hypertension and poor sugar control/diabetes).[i],[ii] On the flipside, one can also have ‘masked hypertension’ where the reading is actually normal but the true reading is much higher. My own BP averages 110/80mmHg however embarrassingly peaked to 120/70mmHg in front of my cardiologist.

The gold standard to figuring out your true reading is the 24 hour blood pressure monitor (otherwise known as ambulatory blood pressure) as it measures your BP over time.[iii],[iv] It also captures your night BP patterns that some argue are a stronger predictor of heart disease than daytime readings.[v] Home blood pressure monitor comes a close second followed by readings taken at the doctors.

Blood pressure is the force put on the walls of your blood vessels. Blood pressure is measured as two numbers, such as 120/80. The top number indicates systolic blood pressure; the pressure in the arteries as the heart pumps out blood during each beat. 

The lower number indicates diastolic blood pressure; the pressure as the heart relaxes before the next beat.

Why is high blood pressure an issue?

Here’s the issue: long term high pressure can cause long term damage resulting in heart attacks, stroke, kidney damage and more.

By keeping an eye on our blood pressure, we can monitor how our blood vessels are doing over time, with hypertension signalling underlying inflammation and a trajectory to chronic disease. Most guidelines recommend a BP target of < 120/80 mmHg and to treat when this increases north of 130/85 mmHg. An average home BP of ≥ 135/85 mmHg is a threshold for the diagnosis of hypertension. Check with your doctor for your individual target.

Here’s the thing, BP measures can change depending on the setting (e.g. who is taking the reading) and time of day.

Here’s the solution:

  1. Wear a sleeveless top when preparing for a measurement
  2. Keep arm at the same level as your heart
  3. Avoid talking (and even crossing your feet) while measuring
  4. Avoid caffeine/smoking 30 minutes before measurement
  5. Buy a machine that has been approved for accuracy (validated). See list of validated monitors here. If you already have an electronic sphygmomanometer, bring it to your next visit to the doctors/pharmacist and check how it compares to the professionals

3 tips to monitor blood pressure

And here’s how I recommend measuring blood pressure with my clients[vi][vii]

  • Before each measurement, rest 5 minutes. Sit down with feet flat on the floor, legs uncrossed.
  • Take BP twice daily around the same time each day (usually before food and medicines e.g. before breakfast and dinner) for a minimum of 5 days.
  • Take 2 readings each time, one minute apart but only record the 2nd reading

I am a big fan of self-monitoring one’s blood pressure: it’s readily available, easy to apply and can provide some useful information about your health. If there’s any request for topics on health, please feel free to comment below.

For other articles on preventative health, you can read my 10 steps series to boost your immune system here.

References:


[i] Fujiwara, T., Matsumoto, C., Asayama, K. et al. Are the cardiovascular outcomes of participants with white-coat hypertension poor compared to those of participants with normotension? A systemic review and meta-analysis. Hypertens Res 42, 825–833 (2019). https://doi.org/10.1038/s41440-019-0254-2

[ii] Omboni S. A working definition of white-coat hypertension must include nocturnal blood pressure [published online ahead of print, 2018 Jul 15]. J Clin Hypertens (Greenwich). 2018;20(8):1183-1186. doi:10.1111/jch.13355

[iii] Huang, Q. F., Yang, W. Y., Asayama, K., Zhang, Z. Y., Thijs, L., Li, Y., & Staessen, J. A. (2021). Ambulatory blood pressure monitoring to diagnose and manage hypertension. Hypertension77(2), 254-264.

[iv] McGrath BP. Home monitoring of blood pressure. Aust Prescr 2015; 38:16-9. https://doi.org/10.18773/austprescr.2015.005

[v] Hansen, T. W., Li, Y., Boggia, J., Thijs, L., Richart, T., & Staessen, J. A. (2011). Predictive role of the nighttime blood pressure. Hypertension57(1), 3-10.

[vi] Sharman JE, Howes F, Head GA, et al. How to measure home blood pressure: Recommendations for healthcare professionals and patients. Aust Fam Physician. 2016;45(1):31-34.

[vii] McGrath BP. Home monitoring of blood pressure. Aust Prescr 2015; 38:16-9. https://doi.org/10.18773/austprescr.2015.005

Author

  • Therese Pharmacist Health Coach Podcaster The Enlightened Pharmacist

    Therese is a consultant pharmacist, evidence-based health and wellness researcher, health coach and self-confessed wellbeing addict. As the host of The Enlightened Pharmacist podcast and webinar series, Therese regularly presents group workshops and seminars, and has a practice working with patients one-to-one who have improved their health outcomes for the long term. Having experienced chronic health issues herself, Therese understands that the struggle with maintaining health and wellness is real. She has spent countless hours with patients facing chronic conditions including kidney disease, fatty liver disease, obesity, high blood pressure, stroke, metabolic syndrome, respiratory issues and more. Inspired by the success her patients have experienced, Therese has created this workshop to share the effective strategies and shortcuts she uses to help people understand and implement every day, so you can reclaim your health with confidence. Therese is on a mission to help 10,000 individuals reclaim their health for the long term - you too can be part of her revolution.

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