Home Blood Pressure Test

Blood Pressure Test, Home

How It Is Done

Specific instructions

When you first get a blood pressure monitor, take it to your doctor's office to make sure it is working right. Have your health professional take your blood pressure and then compare that result with your own device. Ask your health professional to watch you use your monitor to make sure that you are using it correctly. It is a good idea to have your monitor checked every year.

The size of the blood pressure cuff and where you place the cuff on your arm can change your blood pressure readings. If the cuff is too small or too large, the measurements will not be accurate. As a general rule, the inflatable part of the cuff needs to be at least as long as the widest place around your upper arm. Hospital and medical supply stores generally carry many cuff sizes and can help make sure that your cuff fits you.

Your blood pressure in your right arm may be higher or lower than the blood pressure in your left arm. For this reason, try to use the same arm for every reading. Blood pressure readings also rise and fall at different times during the day. They are usually highest in the morning and lowest in the evening.

The instructions for using blood pressure monitors vary depending upon the type of blood pressure monitor you choose. Here are the general guidelines:

• Take your blood pressure while you are sitting down and feel comfortable and relaxed. Try not to move or talk while you are measuring your blood pressure.
• Sit with your arm slightly bent and resting comfortably on a table so that your upper arm is on the same level as your heart.
• Place the blood pressure cuff on the skin of your upper arm. You may have to roll up your sleeve, remove your arm from the sleeve, or take your shirt off.

Manual blood pressure monitors

Sit with your arm slightly bent and resting comfortably on a table so that your upper arm is on the same level as your heart. Expose your upper arm by rolling up your sleeve but not so tightly as to constrict blood flow. If you are unable to roll up your sleeve, remove your arm from the sleeve or take off your shirt. Wrap the blood pressure cuff snugly around your upper arm so that the lower edge of the cuff is about 2.5 cm (1 in.) above the bend of your elbow. A large artery (called the brachial artery) is located slightly above the inside of your elbow. You can check its location by feeling for a pulse in the artery with the fingers of your other hand.

If you are using a stethoscope, place the earpieces in your ears and the bell of the stethoscope over the artery, just below the cuff. The stethoscope should not rub on the cuff or your clothing, since this may cause noises that can make your pulse hard to hear. If you are using a cuff with a built-in stethoscope bell, be sure the part of the cuff with the stethoscope is positioned just over the artery. The accuracy of a blood pressure recording depends on the correct positioning of the stethoscope over the artery. You may want to have another person who can use a stethoscope properly help you take your blood pressure.

Close the valve on the rubber inflating bulb. Squeeze the bulb rapidly with your opposite hand to inflate the cuff until the dial or column of mercury reads about 30 mm Hg higher than your usual systolic pressure. (If you don't know your usual pressure, inflate the cuff to 210 mm Hg or until the pulse at your wrist disappears.) The pressure in the cuff will stop all blood flow within the artery temporarily.

Now open the pressure valve just slightly by twisting or pressing the valve on the bulb. The pressure should fall gradually at about 2 to 3 mm Hg per second. Some blood pressure devices have a valve that automatically controls this rate. As you watch the pressure slowly fall, note the level on the dial at which you first start to hear a pulsing or tapping sound through the stethoscope. The sound is caused by the blood starting to move through the closed artery. This is your systolic blood pressure. If you have trouble hearing the start of your pulse through the stethoscope, you can check your systolic blood pressure by noting the level on the dial when you are able to feel the pulse at your wrist once again.

Continue letting the air out slowly. The sounds will become muffled and will finally disappear. Note the pressure when the sounds completely disappear. This is your diastolic blood pressure. Finally, let out all the remaining air to relieve the pressure on your arm.

Be sure to write your numbers in your log book, along with the date and time.

Electronic blood pressure monitors

For electronic models, press the on/off button on the electronic monitor and wait until the ready-to-measure "heart" symbol appears next to zero in the display window. Then press the start button. The cuff will inflate automatically to approximately 180 mm Hg (unless the monitor determines that you require a higher value). It then begins to deflate automatically, and the numbers on the screen will begin to drop. When the measurement is complete, the heart symbol stops flashing and your blood pressure and pulse readings are displayed alternately.

All blood pressure monitors

At first it is a good idea to take your blood pressure 3 times in a row, 5 or 10 minutes apart. As you get more comfortable taking your own blood pressure, you will only need to measure it once or twice each time.

Check your blood pressure cuff frequently to see that the rubber tubing, bulb, valves, and cuff are in good condition. Even a small hole or crack in the tubing can lead to inaccurate results.

To help develop your skills, see:

Monitoring your blood pressure at home.

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Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated: June 23, 2006
Medical Review:	Adam Husney, MD - Family Medicine Caroline S. Rhoads, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology Robert A. Kloner, MD, PhD - Cardiology
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