Routine screenings are important for health. Advice from a cardiologist on screenings, home monitoring, and interpreting the results
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Nearly half of all adults in the U.S have high blood pressure. “High blood pressure (also called hypertension) puts you at risk of many life-threatening problems,” says Rachel Goodman, MD, Chief Cardiology Fellow at Tufts Medical Center. According to the Centers for Disease Control and Prevention, hypertension contributed to over 664,000 deaths in the United States in 2023.
The Pressure Is On
When your heart contracts, it pushes blood out of its chambers into the blood vessels. This puts pressure on the vessel walls, stretching them. When the heart relaxes, this pressure is released. “Hypertension occurs when there is increased force and pressure in your blood vessels,” says Goodman. This is usually caused by a stiffening of the vessels, making it less likely they can expand in response to the increased blood flow. The two numbers in a blood pressure reading represent the amount of pressure on the blood vessel walls during heart contraction (the top number, or systolic pressure) and during relaxation (the bottom number, or diastolic pressure).
Measure Up
“Having your blood pressure measured regularly allows your healthcare provider to diagnose hypertension so it can be treated,” says Goodman, “thereby decreasing your risk of developing conditions like stroke, heart attack, heart failure, and kidney disease.”
Healthy individuals without a diagnosis of hypertension should have their blood pressure checked annually. Individuals who have a diagnosis of hypertension should measure and record their blood pressures at home as directed. “This allows your healthcare provider to assess trends and make careful adjustments of medications if needed,” says Goodman. Along with the time and readings, Goodman recommends noting the timing of readings with respect to when you took your blood pressure medications.
Since high blood pressure is almost always symptomless, it is unlikely you will be aware it is quietly damaging your blood vessels and your health. Be sure to monitor your blood pressure as recommended and follow your healthcare provider’s advice for treating hypertension if you have it.
Home Monitoring Tips
If you have high blood pressure, your health care provider will most likely recommend you take your blood pressure daily at home. Make sure you are getting accurate blood pressure readings by paying attention to the following:
Monitor style: The American Heart Association (AHA) recommends an automatic, cuff-style, upper arm monitor. Wrist or finger monitors are less reliable.
Cuff size: If the cuff that wraps around your arm is the wrong size, your blood pressure reading could be off. The cuffs come in four sizes: small (8 to 10 inches), regular (10 to 12.8 inches), large (12.8 to 16 inches), and extra-large (16 to 22 inches).
In one study, the blood pressure reading for people with small arms was lower using a regular cuff than a small-sized cuff. For people who need a large cuff, a regular cuff gave a higher reading. And for those who required an extra-large cuff, the smaller cuff measured blood pressure as nearly 20 points higher than the appropriately sized cuff. Whether your blood pressure is being measured at home or by your health care provider, make sure the cuff is the right size for your arm.
Validation: Before buying a monitor for home use, make sure it is validated for accuracy by visiting validatebp.org. A study found that only 16% of the upper arm cuff devices being sold in the U.S. had been validated. Take your monitor with you to a checkup once a year to make sure the readings are accurate.
Proper procedure: The AHA recommends taking your blood pressure at the same time(s) every day for best results. They also suggest the following:
- Don’t smoke, drink caffeinated beverages, or exercise within 30 minutes before taking your blood pressure.
- Sit quietly for at least five minutes before measuring. You can use either arm, but make sure the cuff goes on your skin, not over clothing.
- Sit with your back straight and supported, feet flat on the floor with your arm resting on a flat surface, upper arm level with your heart
- Take two readings one minute apart and record the results (if your monitor does not store them for you).
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