How To Monitor Blood Pressure At Home

Hypertension usually develops without symptom, therefore, it is called “silent killer”. The higher the blood pressure, the greater chance of getting heart attack, heart failure, stroke, kidney disease etc. Hence, it is important to identify high blood pressure early for early interventions in order to prevent end organ damages and even death.

Hypertension is defined as persistent elevation of systolic blood pressure of 140mmHg or greater and/ or diastolic blood pressure of 90mmHg or greater, taken at least 2 times at 2 different occasions.

The table below shows the classification of clinic blood pressure levels in adults :

Classification	Systolic blood pressure (mmHg)		Diastolic blood pressure (mmHg)
Optimal	< 120	and	< 80
Normal	120 - 129	and/ or	80 - 84
At risk	130 - 139	and/ or	85 - 89
Stage 1 hypertension	140 - 159	and/ or	90 - 99
Stage 2 hypertension	160 - 179	and/ or	100 - 109
Stage 3 hypertension	>= 180	and/ or	>= 110
Isolated systolic hypertension	>= 140	and	< 90

However, the criteria of blood pressure reading to define hypertension is different for clinic blood pressure and home blood pressure.

The criteria to define hypertension using clinic blood pressure is systolic blood pressure of 140mmHg or greater and/ or diastolic blood pressure of 90mmHg or greater, whereas the criteria to define hypertension using home blood pressure is systolic blood pressure of 135mmHg or greater and/ or diastolic blood pressure of 85mmHg or greater.

Why you should monitor blood pressure at home?

Regular home blood pressure monitoring is the most effective way to detect changes in blood pressure early. It is a practical way to keep yourself healthy, especially if you are on treatment for hypertension or if you are trying to prevent hypertension. If blood pressure monitoring at home is done correctly, it can give you and your doctor a clearer picture than occasional clinic readings.

In fact, blood pressure fluctuates throughout the day. Some people also experience “white coat hypertension,” where readings spike in a medical setting only. Therefore, home blood pressure monitoring can help to track your blood pressure trends over time, evaluate how lifestyle changes or medications are working and detect early warning signs before complications develop.

However, it is important to know the correct methods to measure blood pressure at home to avoid getting wrong readings which cause wrong interpretations.

Choosing the right blood pressure monitor :

You need to have a proper blood pressure electronic device. Select an automatic upper-arm blood pressure monitor.
Other devices that measure blood pressure in the fingers or wrists are not recommended.
Choose the device that is clinically validated.
Use a correct bladder cuff size around your arm.
Correct blood pressure bladder cuff size means :
The bladder length should encircle at least 80% of the circumference whilst the width should be at least 40% of the circumference of the arm. It is because small cuff size will give a falsely high blood pressure reading whereas too big a cuff size will give a falsely low blood pressure reading.
Follow manufacturer’s instructions for setup and maintenance.

Best time to check blood pressure for accurate results :

Blood pressure should be done around the same time once in the morning (before taking medicine if you are on treatment) and once in the evening before meal.

If unsure, consider a dietitian consultation near you for personalised advice.

How to prepare before taking your blood pressure reading?

You need to refrain yourself from smoking, eating, caffeine intake or exercise for at least 30 minutes before checking blood pressure.
Avoid having full urinary bladder before checking blood pressure.
You need to be seated for at least 1 minute in a quiet room.
You need to stop talking and in a relaxed condition.

Proper sitting position and technique for accurate measurement :

Sit with your back and arm supported (your arm is resting on the table) with legs uncrossed.
After that, remember to use the correct bladder cuff size around your arm and placed your arm at heart level (on the table).
Start the blood pressure device and remain still and silent.
Record the systolic and diastolic blood pressure, pulse rate, date and time.
Wait for at least 1 minute then take a second reading because two blood pressure readings should be taken at each time, at least 1 minute apart.

How to record and track your blood pressure readings over time?

Check your blood pressure for at least 3 days (ideally 7 days).
Record all the readings for future reference or show it to doctor.
In fact, blood pressure readings measured on the first monitoring day should be disregarded. The remaining blood pressure measurements (at least 3 days) are calculated for an average reading.
If the mean home systolic blood pressure is more than 135 mmHg and/or diastolic blood pressure is more than 85 mmHg, then you need to consult a doctor because it is considered elevated for home blood pressure monitoring.

Tips for maintaining healthy blood pressure :

Eating balanced diet which is rich of fruits, vegetables and grains.
Reduce salt intake.
Avoid alcohol intake.
Stop smoking.
Regular exercise.
Manage stress.
Weight reduction.
Compliant to medicines and follow up.

Everyone should check blood pressure regularly because hypertension is a very common disease worldwide and also in Malaysia. This is especially important for those at higher risk of developing hypertension such as those who have family history of hypertension, people who are overweight or obese, smokers, people who have other co-morbid conditions such as diabetes or dyslipidemia or kidney disease, and also elderly population.

As home blood pressure monitoring is a simple, accurate and cost effective way to detect high blood pressure and prevent possible complications from hypertension, hence, everyone should learn the proper technique of self-home blood pressure monitoring and start monitor blood pressure at home in order to lead a healthier and happier life.

References :

CLINICAL PRACTICE GUIDELINES, Management of Hypertension, 5TH EDITION (2018), Ministry of Health Malaysia, Malaysian Society of Hypertension, Academy of Medicine of Malaysia.

By :

Dr Lim Jye Wey

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Bangsar South

03 2241 3610

012 234 3610

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03 8658 3688

011 2721 3620

How To Monitor Blood Pressure At Home

Table of Contents

Why you should monitor blood pressure at home?

Choosing the right blood pressure monitor :

Best time to check blood pressure for accurate results :

How to prepare before taking your blood pressure reading?

Proper sitting position and technique for accurate measurement :

How to record and track your blood pressure readings over time?

Tips for maintaining healthy blood pressure :

Bangsar South

03 2241 3610

012 234 3610

Cheras South

03 8658 3688

011 2721 3620

How To Monitor Blood Pressure At Home

Table of Contents

Why you should monitor blood pressure at home?

Choosing the right blood pressure monitor :​

Best time to check blood pressure for accurate results :

How to prepare before taking your blood pressure reading?

Proper sitting position and technique for accurate measurement :

How to record and track your blood pressure readings over time?

Tips for maintaining healthy blood pressure :

Choosing the right blood pressure monitor :