Step by Step Instructions to Check Your Blood Pressure at Home

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High blood pressure (hypertension) affects nearly half of adults in the U.S. That includes more than 1 in every 5 people under age 40 and 3 out of every 4 over the age of 60.

Managing high blood pressure can lower your risk of heart disease, stroke, kidney disease, and even dementia. But many people don't know that their blood pressure is high. And less than half of people with high blood pressure have it under control. That's why regular blood pressure checks are important.

In this article, we'll talk about why, when, and how to check your blood pressure at home. And we'll tell you what to do next if you get a high reading.

Why should you check your blood pressure at home?

Checking your blood pressure at home is obviously more convenient than going into a medical setting to have it done. It also allows you to check it more regularly. Home blood pressure readings can give you an accurate idea of how your blood pressure is doing over time, rather than at one point in time.

This is important in several different scenarios:

• You'll be able to tell how certain foods, stress, or other conditions affect your blood pressure.

• For people with hypertension, it can indicate how well your blood pressure medication is working.

• If you have low blood pressure (hypotension), it's a good idea to check your blood pressure regularly.

• Many people don't get accurate blood pressure readings in a medical office. As many as 30% of people have "white coat hypertension." That means that the stress of being in a medical office may drive the numbers up.

• Another 10% to 15% of people have normal blood pressure in the office but high blood pressure at home. This is called masked hypertension.

One study took a close look at how blood pressure affects the heart muscle. It found that checking your blood pressure regularly at home seemed to give a more accurate reading than office readings.

How to check your blood pressure at home

A few different types of blood pressure cuffs are available. But the most accurate blood pressure cuff for most people is an automatic upper arm cuff machine. Here's how to use it.

Find a comfortable place where you can sit quietly

Avoid exercise, smoking, or caffeine for 30 minutes prior, and empty your bladder if needed. Sit quietly for 5 minutes before checking your blood pressure.

Keep your back straight and supported

Use a straight backed chair, and not a sofa, if possible. Make sure you're leaning against the back of the chair to avoid getting numbers that are too high.

Rest your feet flat on the floor

Avoid crossing your legs. That's because crossing your legs can raise your blood pressure by an average of 10 points if you already have hypertension.

Roll up your sleeve

Blood pressure readings may be accurate even when the cuff is placed over a thin layer of clothing like a blouse or shirt. But thicker clothing (like a typical sweater) may add or subtract as much as 15 points. To be safe, it's best to use your bare arm.

Lay your arm on a flat surface at heart level

Your arm position should be at heart level. That's about the middle of your chest. This is important for a few reasons:

• If your arm is below heart level, your blood pressure reading can be as much as 10 points higher.

• If the arm is too high, you might get a falsely low reading.

• If you hold your arm up, the effort of holding it in position can raise your blood pressure reading. So it's best to rest your arm on a table.

Sit quietly

Don't chat or use your other arm to look at your phone, since that can raise your blood pressure by as much as 10 points. Take this opportunity to enjoy a few mindful moments instead.

Know your blood pressure cuff

Your blood pressure cuff will wrap around your upper arm, just above the elbow. Read the manufacturer's instructions, or watch their video. Your cuff may have markings on it that will help you place it correctly. Usually there's a button that you'll press to inflate the cuff. Wait until the indicator shows that the reading is complete before moving around or taking the cuff off.

Get a couple of readings

It can be helpful to get a couple of readings a minute or two apart. If there's a big difference, there could be a problem with your cuff. Or you may have just needed a little extra time to settle in. When in doubt, a third reading can be useful.

How often should you check your blood pressure?

If you have normal blood pressure, there's usually no need to check it at home regularly. But be sure to see your primary care provider yearly. Adults older than 40 years should get their blood pressure checked once a year.

If you have a high blood pressure reading in a medical setting, your healthcare professional may ask you to check your blood pressure at home. This usually means checking twice daily for 3 to 7 days. That way you'll know if it was just a single episode, or if you have hypertension. Checking at different times of the day will give you and your healthcare professional a better idea of how your blood pressure may vary.

If you do have hypertension, you may be asked to monitor your blood pressure a couple of times daily for a few weeks after starting or changing medications. Once your blood pressure is under control, the American Heart Association recommends checking it one to three times weekly. Check in with your healthcare professional for more personalized recommendations.

If you have hypotension, or low blood pressure, knowing your normal range can help your healthcare professional decide if there's a problem. By checking your blood pressure a couple of times daily for a week, you'll have a log of your usual numbers. It's also a good idea to check it when you feel dizzy or lightheaded, since those can be symptoms of low blood pressure.

What should you look for when taking your blood pressure?

Your home blood pressure cuff is a great tool that can help to keep you healthy. If you follow the steps above and use a cuff that fits you well (more below), current upper arm devices are quite accurate.

When you check your blood pressure, you'll get two numbers. The top number is your systolic reading and the bottom number is your diastolic pressure. Both of these numbers are important for determining whether you have hypertension.

• Normal: systolic below 120 and diastolic below 80

• Elevated: systolic 120-129 and diastolic below 80

• High (hypertension): systolic above 130 or diastolic above 80

• Low (hypotension): systolic below 90 and diastolic below 60

Should you keep a blood pressure journal?

Yes. A single high reading will not usually give you a diagnosis of hypertension. That's why it's helpful to keep track of your blood pressures. In your tracker or journal, make a note of the following:

• Date

• Time of day

• Any details about what was going on at the time

• Any new medications, over-the-counter medications or supplements

Take your blood pressure journal with you when you visit your healthcare professional. And of course, if you have unusually high or low readings, let them know. That way they can help you manage your blood pressure.

How do you buy a blood pressure cuff?

You can find a blood pressure cuff at most drugstores, big-box stores, and online.

Here are a few things to consider:

• The American Medical Association recommends getting one that has been tested for accuracy by the US Blood Pressure Validated Device Listing.

• The best type of blood pressure cuff measures blood pressure from your upper arm. Wrist and finger devices are not as accurate.

• When choosing a cuff, it's important to get one that fits your upper arm. If not, your reading will not be accurate. Measure around your upper arm before buying and know that you might need to order the right size for you online.

It can be a little confusing and overwhelming, and you don't want to waste your time or money. So when in doubt, ask your pharmacist or healthcare professional for help.

Frequently asked questions

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