Welcome to this week's waffle, which was inspired by a recent catch up Dr Tom had with some medical school chums. Off-duty medical students have always been renowned for their hearty carousing. Those same individuals reuniting 30+ years later had, inevitably, 'for one night and one night only' reverted to type, gamely sampling alcoholic innovations such as 'little Guinesses' and pink tequila, only to wake the next morning with what we might euphemistically term 'some regrets'...
It was in that context that Tom felt compelled to remark on the resilience of one of his contemporaries whom he observed returning from a hearty morning jog, whilst he (Tom) was still at the 'searching listlessly for analgesia' stage. When quizzed on his motivation, his friend (who left the medical profession many decades ago) replied that he had blood pressure concerns. Unable to resist, Tom dug deeper and it turns out that this gentleman had been in a pharmacy a few weeks before, queuing up for a prescription after a particularly broken night with his primary school aged sick son. There was a BP machine in the building and an offer to check, which he accepted, only to be somewhat shocked to see "160 over something or other"**, and thus he had concluded that he had an issue with his blood pressure. (**text book 'normal' blood pressure is 120/80)
Now of course there were several factors indicating that this was not the right moment for Tom to launch in to a full consultation (the alka seltzer not yet being fully dissolved being a key one) but he felt bound nevertheless in a very informal way to raise doubts as to the safety of this diagnosis. Because the way to assess whether you have an underlying blood pressure issue is by taking 'resting' readings. That is to say after you have been sitting calmly, without significant stimulation for at least 5 minutes. Certainly not when you are rushing around trying to get meds for your sick son, on the back of about 2 interrupted hours of sleep.
Further more, GPs would interpret isolated high readings taken in clinic with some caution, due to 'white coat' syndrome. This is when the heightened anxiety some people feel in medical settings gives rise to elevated readings that are not a true reflection of the underlying situation. But this should still not detract from the fact that undiagnosed hypertension is second only to smoking as a risk factor in heart attack or stroke- so we absolutely want to keep an eye on this- let's just make sure we are gathering data in the right way!
Read on for a definitive guide to taking home blood pressure readings with an Omron blood pressure monitor. You can also download this handy template to record your readings. and if after this you have any concerns, please don't wait- book in with one of our doctors to address the root causes, and/or suggest treatment as appropriate.
Before the measurement
Rest quietly for at least 5 minutes before taking your blood pressure.
Empty your bladder beforehand; a full bladder can affect readings.
Avoid caffeine, smoking, exercise or eating a large meal for at least 30 minutes prior.
Proper sitting position
Sit in a chair with your back supported and feet flat on the floor.
Do not cross your legs.
Keep your arm supported at heart level (e.g.on a table).
Place the cuff on bare skin, about 1 inch above the elbow.
How to take the reading
Use a validated upper arm blood pressure monitor (e.g. Omron)
Ensure the cuff is snug and positioned correctly
Take 2 readings, spaced 1–2 minutes apart
Do not talk or move during the measurement
Measure at the same time each day, ideally morning (before medications or meals) and either afternoon or evening
Tracking tips
Always use the same arm for consistency.
Focus on long-term trends, not isolated readings
We recommend taking a week’s worth of readings unless your doctor has advised a different protocol and then if the average is above 135/85 please see your doctor for further guidance.
When to contact a doctor
If your systolic (top number) is ≥180 or diastolic (bottom number) is ≥120, wait 5 minutes and retake. If still high, seek immediate medical attention.
If you notice a consistent increase in your blood pressure, share your log with your healthcare provider.