How To Use A Blood Pressure Cuff At Home

There’s a reason high blood pressure is called the “silent killer:” It generally produces no symptoms. “In other words, a person may feel perfectly fine yet have dangerously elevated blood pressures,” says Ian Del Conde, M.D., a cardiologist and vascular medicine specialist at Baptist Health’s Miami Cardiac & Vascular Institute in Florida. “The only way to know that one’s blood pressure is normal is by measuring it.”

High blood pressure is very common: According to the Centers for Disease Control and Prevention (CDC), nearly half of adults in the U.S. have hypertension, and only one in four adults have it under control^[1]Estimated Hypertension Prevalence, Treatment, and Control Among US Adults. Million Hearts.hhs.gov. Accessed 7/15/2021. .

While your blood pressure is typically checked at routine doctor appointments, it may not give a complete picture.

“Blood pressure at the doctor’s office is only one point in time,” says Nieca Goldberg, M.D., medical director of NYU Women’s Heart Program and senior advisor of Women’s Health Strategy at NYU Langone Health in New York. “Some people have normal blood pressure at home and high blood pressure at the doctor’s office or normal at the doctor’s office and high blood pressure at home.”

This variance can be explained as “white coat hypertension,” the phenomenon of blood pressure rising at the doctor’s office, or “masked hypertension,” which occurs when your blood pressure is higher at home^[2]Franklin S, Thijs L, Hansen TW, O’Brien E, Staessen JA. White-Coat Hypertension. Hypertension. 2013;62:982-987. ^[3]Pickering T, Eguchi K, Kario K. Masked Hypertension: A Review. Hypertension Research. 2007;30(6):479-88. . Both situations are often stress-related, which is why it’s important to check your blood pressure often—especially if you’re at risk for hypertension, says Goldberg. Common risk factors for hypertension include physical inactivity, an unhealthy diet, obesity, diabetes, excessive alcohol consumption and tobacco use.

What Kind of Blood Pressure Cuff Should You Use?

Of the two types of at-home blood pressure cuffs—a wrist cuff and an upper arm cuff—experts generally recommend using an upper arm cuff because they are more accurate.

Experts also recommend opting for a digital blood pressure monitor over a manual one. “Automated electronic machines using an upper arm cuff are usually accurate,” says Dr. Del Conde. “If there is any question about their accuracy, they can be validated against a blood pressure machine at a doctor’s office.”

Using an upper arm blood pressure cuff might require practice, but once you get it down, it’s very simple. Follow the below steps suggested by Dr. Del Conde:

• Relax. Sit quietly and in an upright position for two to five minutes before checking your blood pressure.
• Keep your feet flat on the ground and your arm supported at heart level—on a table, for example.
• Place the machine on a table next to you so while you’re seated, you can keep your arm next to it comfortably.
• Wear the cuff over bare skin. Place it around your upper arm about one inch above the bend of your elbow. Secure the cuff tightly and evenly, but make sure you still have room to slide two fingers under the top edge of the cuff.
• Turn the power on.
• Press the start button to begin inflation. Automatic models inflate on their own and, once inflated, release air slowly.
• Look at the screen to get your blood pressure reading, separated into two numbers: your systolic and diastolic pressures.
• Write down your blood pressure reading so you can track it over time. The systolic pressure is listed before the diastolic pressure, so it should look something like 120/80 mmHg.

An upper arm cuff makes checking your blood pressure easy, but there are still some rules to follow to get the most accurate reading.

• Don’t smoke, exercise or drink caffeinated beverages for at least 30 minutes before taking your blood pressure.
• Avoid distractions and screens when taking your reading. Dr. Goldberg says you should be as relaxed as possible, which means no talking, texting, television, internet browsing or social media.
• Check your pressure in the morning and in the evening. “Blood pressure normally goes down at night, so if the evening reading is high, it may indicate that you have high blood pressure,” says Dr. Goldberg.
• Don’t stick to a strict schedule, though. Dr. Del Conde recommends checking your blood pressure at random times on a daily basis. “After two to three weeks, we should have a clear picture of what that person’s blood pressures are throughout the day,” he says.
• Ensure your cuff is the right size. “If it’s too tight, you’ll falsely elevate the blood pressure,” says Dr. Goldberg. “And a cuff that’s too big will give a falsely low blood pressure.” If you’re unsure about the size, bring your cuff to the doctor and they can advise you on how to find the right fit. In general, the cuff should be snug enough so it won’t slip off, but not so tight that it feels uncomfortable.
• Keep your machine in a spot where you always notice it. It’s easy to forget to check your blood pressure, especially when you first start doing it. Keep your monitor where you can’t miss it, such as in your bathroom or bedroom.

Blood pressure readings include two numbers. The top number is called the systolic blood pressure and it changes with every heartbeat, says Dr. Del Conde. “When the heart contracts and pumps extra blood into the circulatory system, the pressure increases. This increased pressure corresponds to the top number, or the systolic blood pressure.”

The bottom number is called the diastolic blood pressure. “When the heart is at rest and not contracting, the pressure that exists within the system is called the diastolic pressure,” says Dr. Del Conde.

A normal systolic blood pressure is less than 120 mmHg and a normal diastolic blood pressure is less than 80 mmHg, says Dr. Del Conde. So, your ideal blood pressure should be under 120/80 mmHg.

The CDC defines elevated blood pressure as 120/80 mmHg to 129/80 mmHg, stage 1 hypertension as greater than or equal to 130/80 mmHg and stage 2 hypertension as greater than or equal to 140/90 mmHg. Dr. Del Conde says to call your doctor if your blood pressure consistently reads higher than 140/90 mmHg.