Home monitoring

Ambulatory blood pressure devices that take readings every half hour throughout the day and night have been used for identifying and mitigating measurement problems like white-coat hypertension. Except for periods during sleep, home monitoring could be used for these purposes instead of ambulatory blood pressure monitoring. Home monitoring may also be used to improve hypertension management and to monitor the effects of lifestyle changes and medication related to BP. Compared to ambulatory blood pressure measurements, home monitoring has been found to be an effective and lower cost alternative.

Aside from the white coat effect, BP readings outside of a clinical setting are usually slightly lower in the majority of people. The studies that looked into the risks from hypertension and the benefits of lowering BP in affected patients were based on readings in a clinical environment.

When measuring BP, an accurate reading requires that one not drink coffee, smoke cigarettes, or engage in strenuous exercise for 30 minutes before taking the reading. A full bladder may have a small effect on BP readings, so if the urge to urinate exists, one should do so before the reading. For 5 minutes before the reading, one should sit upright in a chair with one's feet flat on the floor and with limbs uncrossed. The BP cuff should always be against bare skin, as readings taken over a shirt sleeve are less accurate. During the reading, the arm that is used should be relaxed and kept at heart level, for example by resting it on a table.

Since BP varies throughout the day, measurements intended to monitor changes over longer time frames should be taken at the same time of day to ensure that the readings are comparable. Suitable times are:

• immediately after awakening (before washing/dressing and taking breakfast/drink), while the body is still resting,
• immediately after finishing work.

Automatic self-contained BP monitors are available at reasonable prices, some of which are capable of Korotkoff's measurement in addition to oscillometric methods, enabling irregular heartbeat patients to accurately measure their blood pressure at home.