It’s not uncommon for patients to have normal blood pressure readings at home but high blood pressure readings at their doctor appointments. This can be very frustrating for hypertensive patients, especially those who are diligent about keeping their high blood pressure under control.
Patients often are nervous about what their blood pressure will be when it’s measured at their doctor’s office, and that anxiety causes their blood pressure to go up. It’s known as “white coat hypertension,” and it’s particularly common among elderly patients.
For that reason, I encourage my patients who take hypertension medication to monitor their blood pressure numbers at home.
Five tips for at-home blood pressure monitoring
Measuring your blood pressure at home is easy, and providing your doctor with a sheet of blood pressure readings gives a fuller picture than a single reading in the office once every three months.
- Relax: Measure your blood pressure when you are relaxed, not when you’re running late or on the go.
- Proper timing: Blood pressure is often highest early in the morning – 5 a.m. or 6 a.m. – so choose another time to take it.
- Be consistent: Take your blood pressure at the same time of day. Discuss with your health care provider how often you should measure your blood pressure.
- Average your readings: Hypertension specialists recommend taking three readings and then averaging the last two for the most accurate measurement.
- Know the recommendations: Ask your doctor what is a safe target blood pressure for you.
Blood pressure machines are widely available for purchase at drug stores and online, and many machines keep track of the measurements for you. Measuring your blood pressure at home can help you work with your physician to keep your blood pressure within a “normal” range between appointments.
I recommend that my patients purchase a blood pressure monitor with an arm cuff as opposed to a wrist cuff to get the most precise readings. It’s a good idea to bring your machine along to your appointments to make sure the readings you get at home are accurate.
What’s a ‘normal’ blood pressure?
For most patients, a “normal” blood pressure reading is less than 120 for systolic (the top number in the reading, which measures when your heart is contracting) and less than 80 for diastolic (the bottom number, when your heart is relaxed).
At the doctor’s office, a systolic measurement of 120 to 139 and a diastolic of 80 to 89 are considered prehypertension for most patients. Anything above 140/90 is considered hypertension.
Away from the doctor’s office, a reading above 135/85 is considered to be high – often, people are more relaxed during readings that don’t occur at the doctor’s office.
Aside from white coat hypertension, other factors can cause your blood pressure to read higher at the doctor’s office. When a patient has to use the restroom, his/her blood pressure can increase slightly. Likewise, if a patient has to walk up a flight of stairs to reach the doctor’s office or is frustrated by a long wait to see the physician, his/her blood pressure may increase.
Consider monitoring your blood pressure at home if you’re concerned that your regular check-ups don’t provide an accurate view of your blood pressure.
If your at-home readings are higher than your target range, request an appointment with your doctor to make sure you’re measuring correctly at home, and to rule out another health condition.