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High blood pressure, or hypertension, is a major risk factor for heart disease, stroke, kidney failure and early death. It’s common, affecting about one in three adults. Untreated high blood pressure is also one of the leading causes of death worldwide. It is estimated that there are 700 million untreated patients with hypertension globally. Fortunately, there are many ways to manage your blood pressure. Working with your physician to monitor and manage your blood pressure can help you reduce your risk of serious complications from hypertension. There are several types of monitoring options including home BP monitors, office monitors and 24-hour ambulatory monitors with and without a cuff. There are pros and cons to each type of monitoring, so let’s take a closer look at what each option has to offer.
Home Blood Pressure Monitoring
Home blood pressure monitoring is the most common and simplest type of blood pressure monitoring. It’s also the least expensive option. Blood pressure monitors can be purchased over-the-counter at most pharmacies, drug stores and online retailers. 2 large manufacturers are Omron and Withings. They are easy to use and provide accurate results if they are used properly! Some blood pressure monitors can be paired with a smartphone app for even easier results recording. There are a few important points to keep in mind when using a home blood pressure monitor:
- You should use the same monitor and the same spot on your arm to take your blood pressure readings every time.
- It’s important to take your blood pressure in a quiet environment without distractions with an empty bladder.
- Sit quietly for 5 minutes before taking it.
- You should take your blood pressure at the same time every day, ideally morning and evening.
- Keep a diary to show your doctor.
Office Blood Pressure Monitoring
Office blood pressure monitoring is done in a doctor’s office or clinic setting by either a doctor or a nurse. You may have your blood pressure checked here once a week, or once a month. Depending on the type of model used, each visit lasts between five and 15 minutes. There are a few different types of monitor models used in doctor’s offices. Some monitors use an inflatable cuff to measure your blood pressure while others use oscillometric technology. Drawbacks are that patients often get stressed when visiting their doctor and this can falsely elevate your blood pressure. A condition called “white coat hypertension”. High blood pressure should not be diagnosed on a single office measurement. It usually needs repeated on at least 3 occasions.
24 Hour Blood Pressure Monitoring
24-hour ambulatory blood pressure monitoring is the gold-standard for the diagnosis of hypertension. It requires you to wear a blood pressure monitor for 24 hours straight. This is a cuff with a small box that attaches to your waist band. The cuff inflates every 10-15 minutes day and night to give an accurate profile of your BP over a full day and night. This type of monitoring is useful to detect white coat hypertension.
Cuffless Blood Pressure Monitoring
Recently a new type of blood pressure monitor has come on to the market. They are not yet widely available. They measure your blood pressure without a cuff using an optical device at your wrist. One example of this is the Aktiia device. They require calibration with a cuff at the start of the reading and then they read almost continuously. These are available as clinical grade 24 hour monitors or consumer grade devices worn like a smart watch. There is no doubt they are the most convenient way to measure blood pressure.
Frequently Asked Questions
- Does blood pressure ever go down? Yes. Your blood pressure will go down slightly when you’re at rest, sleeping or sitting down. It will also drop when you’re in a warm environment.
- Is high blood pressure dangerous? Yes. High blood pressure can lead to stroke, heart disease and kidney disease. It’s also one of the leading risk factors for death.
- Can blood pressure be too low? Yes. If your blood pressure drops too low, it can cause fainting, dizziness, blurred vision and confusion.
Blood pressure monitoring is essential to diagnose high blood pressure. In addition, it is used to monitor your pressure over time, because blood pressure tends to go up as you get older. If you don’t have your blood pressure monitored regularly, you might not notice a change in your blood pressure until it’s too late. As with any health intervention, it’s important to pay attention to the type of monitoring device you use. Some devices are better than others, and some will provide more accurate readings than others. Not all blood pressure monitors are created equal. Depending on your individual needs, you’ll want to choose a device that fits your lifestyle and provides you with accurate results. From home blood pressure monitors to cuffed and cuffless 24-hour monitoring devices, there’s a device for every type of user.
Dr Michael MacDonald is a heart doctor and cardiologist working in Singapore.