Posted February 17, 2025 by Israel Cajigas, M.D.
High blood pressure, or hypertension, can be a silent disease — without any warning signs or symptoms — and many people may not even realize they have it. But without treatment, high blood pressure can greatly increase your risk for a heart attack and stroke.
Monitoring your blood pressure is the only way to know if you have high blood pressure. That’s why it’s important to check it regularly — at every healthcare visit and between appointments at home — to be proactive about your health. Early intervention is key to improved outcomes.
Self-monitoring at home is especially important if you’ve been diagnosed with high blood pressure or other conditions that can elevate it. Your provider may recommend daily readings with a home monitor for a more complete understanding of your condition and risks, and to determine whether treatment is working or if adjustments need to be made.
Making sure you have an accurate reading is important. The first step in controlling your high blood pressure is knowing your numbers. A reading that’s too low can give you a false sense of security, while a reading too high may lead to treatment you don’t need.
What is a healthy blood pressure reading?
A blood pressure reading includes two numbers. The top is the systolic number and measures the pressure against your artery walls when your heart beats. The bottom number is the diastolic number, which measures the pressure between beats when your heart is at rest.
The American Heart Association breaks down healthy and unhealthy blood pressure ranges as follows:
- Normal: Less than 120/80 mm Hg
- Elevated: 120-129/80 mm Hg
- High blood pressure (Stage 1): 130-139/80-89 mm Hg
- High blood pressure (Stage 2): 140 or higher/90 or higher mm Hg
- High blood pressure (Stage 3): 180 or higher/120 or higher mm Hg
Stage 3 is referred to as a hypertensive crisis and immediate medical attention is necessary.
How often should I take a reading?
When you first start monitoring at home, your provider will likely recommend taking your blood pressure reading twice in the morning and twice in the evening every day. It’s best to take the readings at the same time each day and take multiple readings for a more accurate result because your blood pressure can fluctuate significantly, depending on exertion and stress.
What factors can affect an accurate blood pressure reading?
Many automated machines for home-based readings have made checking your blood pressure easier. However, there are factors that can slightly elevate your blood pressure and give you an inaccurate reading, such as:
- Drinking too much caffeine (a stimulant), such as coffee or tea, or alcohol
- Smoking
- Having a full bladder
- Crossing your legs
7 simple steps to an accurate blood pressure reading
To ensure an accurate blood pressure reading each time, follow these steps:
- 1. Avoid activity or substances that can raise your heart rate and blood pressure. Don’t drink caffeine, such as coffee, tea or soda, smoke or exercise at least 30 minutes beforehand.
2. Empty your bladder.
3. Find a quiet place without distractions. Sit upright with your back supported. Your feet should be flat on the floor and don’t cross your legs or ankles.
4. Rest your arm on a table with your elbow about heart height. Your palm should be facing up.
5. Place the cuff on your bare arm, and not over clothing. The cuff should fit properly and sit about a finger’s width above the crook of your elbow.
6. Sit quietly for about 5 minutes without distraction (i.e., no reading, watching TV or using electronics) before taking the measurement.
7. Take your measurement, while remaining silent and still. Then, record your blood pressure numbers and pulse displayed on your device.
After your first reading, wait about one minute and then repeat these steps. Average the two readings to get an accurate result. Keep a log of your results and bring it with you to your next appointment.
Did you get a high reading? Blood pressure fluctuates a lot. So, typically you don’t need to be concerned about one high reading. However, if the average is high for a few days or a week, contact your provider about your results.
Which home monitors are best?
The American Heart Association recommends using an automated device (automatically inflates and records the pressure) that has an upper arm cuff. Skip those with a wrist cuff or fingertip sensor, as they aren’t as reliable.
Also, it’s best to use a device that stores up to 30 blood pressure readings, if it doesn’t transmit results to your care team. This makes it easier to track your results over time and share the readings with your provider.
In addition, be sure to choose the correct cuff size — the inflatable part should completely cover at least 80% of your bare arm. If the cuff is too small, it can give an inaccurate high reading.
The American Medical Association offers a list of validated home monitors that meet its criteria.
Once you purchase a home monitor and about once a year thereafter, it’s a good idea to bring your device with you to compare its results against those taken by your provider to check your monitor’s accuracy.
Self-measuring is one of the easiest ways to monitor your heart health. But making sure you have an accurate reading is key to understanding your condition and risks, and ultimately, improving your health.
