Measuring Your Blood Pressure at Home

 Home monitoring, as well as reducing the need for frequent face to face medical appointments, can be very useful, for several reasons: 

  • To give a picture of what your blood pressure is like as you go about your daily life
  • To see if your blood pressure is higher in the clinic than it is at home
  • To see for yourself how your treatment is working for you i.e. are lifestyle changes or medicationhaving any effect on your blood pressure
  • It can help with early diagnosis of high blood pressure, as blood pressure measured at a clinicsetting is done occasionally
  • To alert you/your GP to unexpected changes in your readings, helping them to make changes to oradjust your medication
  • To help pick out ‘white coat effect’ – where the thought of a doctor or nurse measuring yourblood pressure, even though you know you have raised blood pressure and may even be ontreatment, will still raise it even high

Is measuring blood pressure at home for you?

Measuring blood pressure at home can be very useful and is now an important part of managing high blood pressure, but it is not for everyone. Some people become more anxious when they start measuring at home and end up taking readings far too often. If you feel anxious you can discuss this with your doctor or nurse first. Before you decide to try measuring your blood pressure at home, ask yourself: is this going to make me feel more relaxed or more worried?

Blood pressure monitors

 You may already have a blood pressure monitor, you may be supplied a monitor by your GPpractice or you may be encouraged to buy a validated BP monitor.

  • If a monitor is supplied by your GP practice or you already have a monitor, please do not buy areplacement without first discussing it with your healthcare professional. There are some medicalconditions such as irregular heartbeat that mean a particular type of monitor is required.
  • A list of clinically validated home blood pressure monitors can be obtained from the British andIrish Hypertension Society (www.bihsoc.org) or by contacting the Blood Pressure UK helpline on020 7882 6218.

Choosing the right monitor for you

If you are purchasing your own BP monitor it is important to be sure that the monitor you choose is the right one for you; there are a wide range of home monitors available.

Choose the right type of monitor
There are many kinds of blood pressure monitor, but it is easiest to use a monitor that is fully automatic. Choose one that measures your blood pressure at your upper arm, rather than your wrist or finger. Upper arm monitors usually give the most accurate and consistent results.
Make sure your monitor is accurate

Make sure that the monitor you choose has been ‘clinically validated’ for accuracy. This means that it has gone through a series of tests to make sure it gives results that you and your doctor can trust. A list of clinically validated home blood pressure monitors can be obtained from the British and Irish Hypertension Society (www.bihsoc.org) or by contacting the Blood Pressure UK helpline on: 020 7882 6218.

Make sure you have the right cuff size

An upper-arm monitor will come with a cuff that you need to wrap around your arm. If you use a cuff that is the wrong size for you, your reading will not be correct. Measure around your upper arm at the midpoint between your shoulder and elbow and check the information for the individual monitor regarding the cuff size you require. Most monitors will come with a medium sized cuff. You may have to order a different sized cuff separately. Please note that cuff sizes may vary slightly according to manufacturer.

Choose a monitor to suit your budget
Blood pressure monitors can vary in price from £30-£150. This usually depends on the number of extra features that a monitor has, like a built-in memory for example. All you need to measure your blood pressure correctly is a clinically validated monitor, and a pen and paper to record your readings. Extra features can be helpful, but they are not necessary, and you do not have to buy expensive machines.
Keep your monitor up to date
It is recommended that you change your monitor every five years to ensure that it gives you accurate results.

When to measure your own blood pressure

When and how often you take readings will depend on your blood pressure. Your doctor or nurse will advise you on this. In most cases, initially, you will be asked to take at least two BP readings twice daily(morning and evening) ideally for 4 consecutive days or as advised by your doctor.

How to measure your own blood pressure

There are a few simple steps that you can follow to be sure that you get an accurate measurement.

Before you take a reading

  • 1
    Many things can make your blood pressure rise for a short time. Make sure you do not need to use the toilet, and that you have not just eaten a big meal. Do not measure your blood pressure within 30 minutes of drinking caffeine or smoking, or immediately after exercise or drinking alcohol.
  • 2
    Wear loose-fitting clothes like a short-sleeved t-shirt so that you can push your sleeve up comfortably.
  • 3
    Always use the same arm for readings, as each arm will give you a slightly different reading. If possible, use the arm that your doctor or nurse uses when measuring your blood pressure.
  • 4
    Before you take your readings, rest for a few minutes. You should be sitting down in a quiet place, preferably at a desk or table, with your arm resting, palm up, on a firm surface and your feet flat on the floor.
  • 5
    Make sure your arm is supported and that the cuff around your arm is at the same level as your heart. You may need to support your arm with a cushion to be sure it is at the correct height. Your arm should be relaxed, not tensed.

Taking your reading

  • 1
    Put the cuff on following the instructions that come with your monitor. You may have been asked to monitor for an irregular heartbeat as well as BP monitoring. If so, you will have been provided with a BP monitor that can detect this. Refer to your BP monitor instructions for details on how to use this feature on your BP monitor.
  • 2
    Make sure you are relaxed and comfortable. If you are anxious or uncomfortable, this will make your blood pressure rise temporarily.
  • 3
    When you are taking your reading, keep still and silent. Moving and talking can affect your reading.
  • 4
    Take two or three readings, each about two minutes apart. Some people find that their first reading is much higher than the next readings. If this is the case for you, keep taking readings until they level out and stop falling, then use this as your reading.
  • 5
    Record two readings, either in the memory of your BP monitor or on computer or paper. We have included a sample record sheet at the end of this leaflet, which you can use. If you are monitoring for an irregular heartbeat, record each time the monitor indicates an irregular heartbeat has been detected (refer to your BP monitor instructions for details on how this will appear on the monitor screen).

Do not round your measurements up or down, just write down the number that comes up on the monitor – If you do not keep accurate records of your blood pressure, this may affect the treatment you receive. e.g. if your blood pressure is 127/84 do not round to 130/80-90. 

If the monitor shows an error code read the manufacturer’s instruction booklet and follow the advice. If the error code is not related to a monitor issue and keeps occurring, inform your GP practice of the code in the usual way.

What should my blood pressure be

Normal or healthy blood pressure readings measured at home should usually (unless your doctor advises differently) be less than:

  • 135/85 mmHg if you are under 80 years old
  • 145/85 mmHg if you are over 80 years old

Do not be alarmed if you get an unexpected high reading – A one-off reading may be nothing to worry about. Measure your blood pressure again at another time, but if you find that it continues to be high after a period, contact your doctor or nurse.

Important: If you record two or more BP readings in a row, over 170/115mmHg (a top reading of over 170 or a bottom reading of more than 115), you should contact your GP practice the same day. If your GP practice is closed ring 111 for advice.

Do not check your blood pressure too often or you may become worried or stressed about small changes in your reading – This can raise your blood pressure temporarily. Worrying about your blood pressure reading may make it higher.

What to do with your blood pressure measurements

All readings, along with your name and date of birth, should be documented and then submitted via our Blood Pressure Form

Following submission of readings your healthcare team will contact you to discuss your BP management plan and next steps with regards monitoring.

Further Information

For further information on Home Blood Pressure Monitoring please see the following resources:

1. The British Heart Foundation (BHF)

Manage your blood pressure at home hub – a new hub website to help measure and manage blood pressure at home during the pandemic. In particular:

2. Blood Pressure UK: www.bloodpressureuk.org/

3. Stroke Association: www.stroke.org.uk/what-is-stroke/

4. Bradford Healthy Hearts: www.bradfordshealthyhearts.co.uk/