Should You Be Using a Blood Pressure Monitor

New research suggests that home monitoring may help some people control high blood pressure.

More than 100 million Americans have high blood pressure, according to the American Heart Association (AHA), but only about half of them have it under control.

Now preliminary research suggests that adopting a simple step—home blood pressure monitoring—can improve that outlook, helping many more people with uncontrolled hypertension get it under control.

When high blood pressure is not controlled, patients are at a high risk for heart attack, brain aneurysm, or stroke. And although previous studies have shown that a home blood pressure monitor can be very effective, only about a third of people with hypertension check their blood pressure at home at least once a month, according to the Centers for Disease Control and Prevention.

“The average physician is trying to see a patient every 10 to 15 minutes, so there’s barely time to go over medication, let alone talk about home blood pressure monitoring,” explains Roy Champion, M.Sc., B.S.N., a clinical quality nurse at Scott and White Health Plan in Temple, Texas, who presented the new research at an AHA conference.

Here, what you need to know about the new findings, and what to consider if you’re thinking about trying to monitor your own blood pressure at home.

What the New Research Found
The researchers provided free home blood pressure monitors—along with monitoring reminders and resources for taking and tracking readings—to 2,550 adults with uncontrolled hypertension, and followed the patients’ progress between December 2016 and June 2017.

By the third office visit, more than two-thirds (which was nearly 67 percent) of patients had their blood pressure under control. An even larger share of patients still had their blood pressure under control by the end of 2018.

Who Needs a Blood Pressure Monitor?
Although groups like the AHA and the American College of Cardiology have long recommended home blood pressure monitoring for patients with hypertension, it hasn’t caught on the way other simple self-testing strategies, like checking blood sugar at home for type 2 diabetes, have, notes Luke Laffin, M.D., a preventative cardiologist at the Cleveland Clinic.

This may be because it’s time consuming, and the monitors themselves, which aren’t covered by insurance, can be expensive. They don't have to be: Consumer Reports has recommended models for as little as $29. Participants in the new study also had fewer doctor’s visits and lower ER and medication costs after regularly using a home monitor, according to Champion.

While anyone who has hypertension should consider a home monitor, says Laffin, it’s particularly important for the following groups of patients:
• Anyone starting high blood pressure medications, to make sure that they are on the right dose.
• Patients with other, coexisting conditions such as type 2 diabetes or kidney disease.
• Pregnant women who are developing signs of pregnancy-induced hypertension or pre-eclampsia.
• People who have had high or borderline readings in the doctor’s office, but need to confirm that they have true hypertension.
• People who may have “white-coat hypertension," a condition where their blood pressure is normal at home but elevated when they’re nervous at a doctor’s office. 

How to Check Your Own Blood Pressure
A few precautions can help ensure that you’re getting the most accurate reading:
• Try to take your blood pressure at the same time every day. Levels are usually lowest first thing in the morning and rise steadily throughout the day.
• Don’t exercise, smoke, or consume caffeine for at least an hour before.
• Stay quiet. Talking can raise your blood pressure.
• Go to the bathroom right before, since a full bladder can raise your systolic pressure by as much as 15 points and your diastolic by 10 points.
• Make sure your feet are flat on the floor, legs uncrossed, and cuff at heart level.
• Put the cuff on bare skin, since putting it over clothes can raise your systolic pressure by up to 50 mmHg.