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Should you use an at-home blood pressure monitor? Cardiologists weigh in

Monitoring your blood pressure at home can help you get more accurate readings and monitor your progress.
/ Source: TODAY

Getting your blood pressure taken at the doctor's office is about as standard as medicine gets. But experts are urging some patients to also monitor their blood pressure at home. And more of us should probably be keeping tabs on that than we might realize.

Nearly 48% of adults in the U.S. have high blood pressure (hypertension), which adds up to about 128 million people, according to the Centers for Disease Control and Prevention.

And anyone with hypertension or who's been told by a doctor that their blood pressure is elevated could benefit from self-monitoring, Dr. Alexander Blood, cardiologist and critical care specialist at Brigham and Women’s Hospital, tells TODAY.com.

"For anyone who's diagnosed with hypertension, it's important to be able to track blood pressure readings at home in between visits," Yvonne Commodore-Mensah, Ph.D., a cardiovascular nurse epidemiologist and spokesperson for the American Heart Association, tells TODAY.com.

That's because it's common for your blood pressure reading in the doctor's office to be different from readings you take at home, says Commodore-Mensah, who is also an associate professor at the Johns Hopkins Schools of Nursing and Public Health.

For instance, sometimes people may be anxious in the office and have a higher than normal reading, a phenomenon known as white coat hypertension. These patients can "benefit quite a bit from home monitoring," Blood says, because they may be able to reduce or even completely stop taking medications if home monitoring shows them to be unnecessary.

Other people find that their blood pressure readings are lower in the office, which may lead to a condition called masked hypertension.

That's why "home readings are actually considered to be more reflective of an individual's true blood pressure," Commodore-Mensah says. And having that data can help clinicians make the right decisions about medication and other treatments for that patient, she adds.

Is it worth having a blood pressure monitor at home?

If you have high or elevated blood pressure, then yes, it's worth having a blood pressure monitor at home, experts tell TODAY.com. The American Heart Association also recommends that everyone with high blood pressure monitor their blood pressure at home.

In particular, the AHA says home monitoring can be especially beneficial for patients just starting treatment for hypertension, people with certain other risk factors related to high blood pressure, people experiencing certain pregnancy-related blood pressure conditions (such as preeclampsia) and people who might be having false high or low readings at the doctor’s office.

Home monitoring isn't meant to replace getting regular readings from your doctor, but to help ensure that they're getting as full and accurate a picture of your blood pressure as possible.

But, in reality, research published in 2022 in JAMA Network Open suggests that less than half of people (48%) aged 50 to 80 with hypertension or other health conditions related to high blood pressure are actually using home monitoring devices. Other research shows the rate may be even lower for younger patients, around 43%.

Part of the issue is that doctors don't always recommend the devices to begin with. In the JAMA Network Open study, for example, more than a third of participants reported that their doctor didn't suggest they use a home blood pressure monitor. And even if patients are monitoring their blood pressure at home, they may not share that data with their doctor.

For others, the cost may be a barrier as health insurance plans don't always cover home blood pressure monitoring devices, Commodore-Mensah says. That may differ from state to state, she says, noting that her state of Maryland passed legislation requiring Medicaid to cover the cost of home cuffs for recipients with uncontrolled high blood pressure. That bill took effect at the beginning of 2023.

Which blood pressure monitor is best for home use?

When you're ready to start self-monitoring your blood pressure, the first step is to choose a validated device, meaning the device has been tested for accuracy, Commodore-Mensah says.

"Not all blood pressure devices are created equal," she adds.

Before picking a device, the experts recommend that you check validatebp.org, a site maintained by the American Medical Association that lists validated blood pressure devices.

Validated devices generally cost around $80, Commodore-Mensah says. If the cost of a device is an issue and insurance won't cover it, you can use funds from a health savings account, check in with local clinics that may be offering devices or opt for a more affordable cuff that "may not have all the bells and whistles," like Bluetooth connectivity, she explains.

How do I know if my blood pressure monitor is accurate?

If you purchased a validated at-home blood pressure monitor, that means it's been tested and should be accurate when used correctly.

Once you have your own blood pressure cuff, your doctor will likely "recommend (you) bring that cuff into (your) next appointment so we can actually confirm and validate that there's been adequate calibration of the cuff," Blood says. "Then we can feel really comfortable about the numbers we're seeing at home."

When it comes time to take your readings, make sure to follow the AHA's guidelines so that you get accurate results. For instance, you should avoid drinking caffeine or exercising within 30 minutes of measuring your blood pressure. You should also take care to empty your bladder and take five minutes to sit and relax before measuring, the AHA says.

Of course, it's important to keep track of your readings and share them with your doctor so the two of you can make informed decisions about your treatment options. Some people may choose to just write them down by hand, fill out a sheet given to them by their doctor or use a smartphone app, the experts say.

Some blood pressure monitors can send these remote readings directly to a health care provider, says Blood, whose recent research shows this can be particularly helpful for patients who don't have adequate access to in-person care.

What if measuring your blood pressure makes you nervous?

If you find that keeping track of your readings makes you anxious, you're not alone. For some people, "seeing the numbers on a regular basis leads to this vicious cycle of over-measuring," Blood says.

But Blood reiterates that you don't need to take your readings more often than your doctor tells you to, which is usually just 12 times a month. That could just be checking your blood pressure twice in the morning and twice in the evening (with readings one minute apart) for three days, Commodore-Mensah says.

"Most people don't need to check their blood pressure every single day for the rest of their lives," Commodore-Mensah says. With those 12 readings a month, that's "enough to understand the trends in an individual's blood pressure readings," she says.

You can do more if you want, but if it’s causing more stress, then you can leave it be. And if you do find that monitoring your blood pressure this much is leading to anxiety, that's worth bringing up to your doctor, Commodore-Mensah says.

What to look for when taking your own blood pressure readings

If you're using a blood pressure device at home to monitor the effects of medication or lifestyle changes, you should start to see positive changes in your readings quickly — within a week or two at most, Commodore-Mensah says.

But the benefits aren't just about seeing the numbers improve. For many patients, being able to keep track of their blood pressure helps them "feel empowered and that this is an opportunity that allows them to take control of their condition," Commodore-Mensah says.

Blood agrees: "Asking for blood pressure monitors makes most people feel better about having some control, being in the loop and feeling knowledgeable about their medical condition," he says.