6. HBPM should be used to evaluate the response to any blood-pressure-lowering treatment. HBPM may help you adhere to your treatment, since you are more actively involved.
7. The target HBPM goal for most people is below 135/85 mm Hg. It is below 140/80 mm Hg for people with diabetes. (For tips on lowering blood pressure, click here.)
8. HBPM is useful for elderly people because of the increased variability in blood pressure that comes with age, and because older individuals have a higher incidence of white-coat hypertension.
9. HBPM is valuable for people with diabetes, in whom blood pressure control is of paramount importance for prevention of diabetes-related complications.
10. HBPM is valuable in other populations such as pregnant women and people with kidney disease.
11. HBPM has the potential to improve quality of care while reducing costs and should therefore be reimbursed by health insurance providers. Home blood pressure monitors typically cost between $50 and $120. Some insurance companies will reimburse you for a blood pressure monitor; many will not. If you have insurance, ask before purchasing one. You may need to get a prescription or complete other paperwork. If your insurance doesn’t cover a home blood pressure monitor, buy one yourself if at all possible.
Getting an accurate reading
How you go about taking your blood pressure at home matters; you must do it right to get an accurate reading:
- Purchase and use an accurate oscillometric blood pressure monitor. (Your doctor, diabetes educator, or pharmacist should be able to help you select an accurate monitor.)
- Monitor your blood pressure within an hour of waking up and at bedtime, or when recommended by your health-care provider.
- Make sure the cuff is the correct size for your arm. (See “Finding Your Cuff Size.”)
- Apply the cuff correctly, following the manufacturer’s instructions.
- Remove all clothing from the arm you will be using.
- Avoid eating, drinking alcohol or caffeine, using tobacco, exercising, or bathing for at least 30 minutes before taking a measurement.
- Rest for at least 5 minutes before taking your blood pressure.
- When taking a measurement, sit in a straight-backed chair with your feet uncrossed, flat on the floor.
- Keep your arm at heart level, resting your forearm on a table.
- Do not talk during blood pressure monitoring.
- Take two to three readings, waiting at least one minute between readings, then average the three. Most automatic blood pressure monitors will do this for you.
- Record your readings, either by hand or electronically. Make sure to include the date and time. (Some home monitors come with software that lets you upload stored readings to your computer using a cable.)
- Write down any information that may be relevant to your blood pressure, such as when you took your medicine, whether you missed your medicine, whether you have a headache or feel light-headed, or whether you feel great.
- Bring your numbers with you when you visit your health-care provider, and find out if there is a particular time when you should call your numbers in between visits.
Make it automatic
It may seem like monitoring both your blood glucose and your blood pressure is a lot to do, and it is. But you can make it easier by keeping your supplies together and doing both measurements at the same time. It may help to designate a particular place to keep your monitoring equipment, such as by your computer or at your kitchen table. When you wake up in the morning, go to the bathroom and wash your hands, then sit down, relax for a few minutes (maybe while watching TV, checking your e-mail, or reading), and check your blood glucose and blood pressure. Taking care of your diabetes is a great way to start your day!