For many, being able to monitor blood pressure from home plays an important role in maintaining optimal health. Whether you’ve had high readings during a doctor’s visit or you’re experiencing symptoms of high blood pressure—there are many reasons you may want to test at home.  

For correct readings, it’s important to not only consider the accuracy of your blood pressure device but also understand the guidelines your doctor recommends for at-home testing. 

Benefits of testing blood pressure at home 

The American Heart Association recommends those with high blood pressure (hypertension) regularly monitor their blood pressure at home and schedule regular follow-up visits with a healthcare provider. Regular at-home monitoring is also recommended for those at increased -risk for high blood pressure, including:   

• People starting treatment for high blood pressure  

• Pregnant women with hypertension and/or preeclampsia 

• Individuals with risk factors for high blood pressure, such as obesity, high cholesterol, and diabetes 

At-home testing may provide more accurate results for those who experience white coat syndrome—a term used to describe a change in blood pressure due to anxiety and nervousness associated with seeing a doctor. 

Types of at-home blood pressure monitors  

There are two indirect blood pressure monitoring methods that are commonly used in consumer testing.  

Oscillatory Blood Pressure Monitors 

Oscillatory blood pressure devices provide automated blood pressure readings by measuring the vibrations in the arterial wall caused by blood flowing through an artery between systolic and diastolic pressures.  This method is used in most automated blood pressure monitors on the market today. In recent years, it’s become increasingly popular in healthcare clinics and for at-home testing. 

Auscultatory Blood Pressure Monitors

The auscultatory method uses a stethoscope and a sphygmomanometer (inflatable cuff and manometer) to manually determine blood pressure. This is often considered the traditional method of measuring blood pressure. However, the widespread ban of mercury sphygmomanometers and accuracy issues have resulted in a slow decline in its use. 

Are these blood pressure monitors accurate? 

Unfortunately, there has been some speculation regarding the accuracy of at-home blood pressure monitors  A recent study shows that clinicians can feel confident about the accuracy of consumer blood pressure devices if the devices are validated and less than 4 years old, but over the last several years standards were put in place to assess the accuracy of these devices. 

What accuracy credentials should you look for? 

Be sure to verify that your blood pressure monitor has the appropriate accuracy credentials. Some organizations with accuracy standards include the: 

• Food and Drug Administration (FDA) 

• European Society of Hypertension (ESH) 

• Association of the Advancement of Medical Instrumentation (AAMI)

• British Hypertension Society (BHS) 

• International Organization of Standardization (ISO)

Factors that can affect blood pressure results

When taking your blood pressure measurements at home, it’s important to remember that several factors can affect the accuracy of your results.  Some common factors that may affect your readings include: 

• Drinking caffeine before testing: Caffeine is a stimulant that increases activity in the brain and nervous system. In some people, caffeine consumption can temporarily increase blood pressure. For accurate measurements, we recommend avoiding caffeinated beverages at least 30 minutes before testing.  

• Smoking before testing: Smoking causes an immediate increase in blood pressure. It also increases the risk of developing chronic hypertension (high blood pressure). It is suggested that you not smoke for at least 30 minutes before your blood pressure test to ensure accurate measurements. 

• Exercising before testing: It’s normal for your blood pressure to be elevated immediately following a workout. In most cases, it should gradually return to normal within a few hours. Because of this, it’s important to wait at least 30 minutes after finishing a workout to take your blood pressure. 

• Testing with jackets or restrictive clothing: Wearing bulky or restrictive clothing can temporarily raise your blood pressure measurements. This includes tightly rolling your sleeves up while testing. For accurate results, consider wearing a short-sleeved shirt while taking your measurements.  

What to do when testing blood pressure at home 

• Record your BP readings at specific times of dayIt’s normal for your blood pressure to fluctuate throughout the day. It will typically be lowest when you are sleeping and then rise as the day progresses, peaking in the afternoon.For consistent readings, take measurements around the same time each day and after you have been sitting and relaxing for at least 5 minutes. Choose a time that works with your schedule and make testing part of your daily routine. It might also be beneficial to understand your daily blood pressure changes by testing many times throughout the day. 

• Make sure the device is the right fitWhen taking your blood pressure measurements, consider the following to ensure accurate results: 

• Cuff sizeA properly sized blood pressure cuff is important for accuracy. A cuff that’s too large or small can cause inaccurate measurements.  

• Arm cuff or wrist cuffUpper arm cuffs are more accurate than wrist cuffs; however, wrist cuffs may offer an alternative option for people who are unable to use the upper arm cuffs or who have limited arm or hand mobility.  

• Testing postureRest your arm at the level of your heart and sit comfortably with your legs and ankles uncrossed and your back supported.  

Discuss your blood pressure history with your doctor  

Learning your blood pressure values is just the first step. Regularly keeping track of can be an effective way to monitor your health, as well as prepare for your next visit with your doctor. Sharing these results with your care team can help you establish a treatment plan that’s right for you. These appointments provide the perfect opportunity to talk about your health concerns, receive guidance on lifestyle modifications, and discuss your overall health. Plus, your doctor will use these results to determine if your blood pressure falls within a healthy range. If you have questions about taking accurate readings at home, talk to a healthcare professional about your options.  

Heart disease is the leading cause of death in America. Every 36 seconds, another American dies from heart disease. Heart disease is the #1 killer of men in the United States. About 1 in every 4 American male deaths is from heart disease.

It is important for men to understand what heart disease is, the risk factors and symptoms, and how to prevent heart disease.  

What is heart disease? 

Heart disease refers to a group of more specific heart conditions, such as coronary heart disease (CHD) or coronary artery disease (CAD), arrhythmia, heart failure, and heart attacks. Coronary heart disease occurs when the arteries that supply blood to the heart and body become hard and narrow because of plaque buildup.   

This plaque is made up of substances like cholesterol and other fatty lipids in the body. This hardening and narrowing of the arteries are called atherosclerosis. When this plaque builds up, blood flow is restricted, leading to a decrease in the amount of oxygen that is supplied to the heart. Over time, this can lead to a heart attack.  

High blood pressure and heart disease

Having high and uncontrolled blood pressure can lead to heart disease. Over time, high blood pressure taxes the blood vessels and heart by making them do more work less efficiently. The friction and force that come from high blood pressure will do damage to the delicate tissues lining the arteries. Plaque forms along with these tiny tears and lesions. As more plaque builds up, the narrower the arteries become, raising blood pressure even more. It becomes a vicious cycle.   

Many people have no symptoms of high blood pressure until it is too late. It is important to regularly check your blood pressure to make sure it is within the healthy range.  

Why men are more prone to heart disease

Men have an elevated risk of heart disease. In 2013-2016, 47% of American men had high blood pressure or hypertension, which is a major risk factor for heart disease.   

Other risk factors for heart disease include being overweight or obese, having a poor diet, excessive alcohol use, physical inactivity, and having diabetes.  

Symptoms of heart disease  

The symptoms of heart disease can often be “silent,” and go undiagnosed until someone experiences the signs of a heart attack or arrhythmia. Symptoms of these events may include:  

• Chest pain or discomfort

• Pain in the upper back or neck  

• Heartburn or indigestion  

• Nausea or vomiting  

• Dizziness  

• Shortness of breath  

• Extreme fatigue  

• Palpitations or feelings of fluttering in the chest  

• Swelling in the feet, ankles, legs, neck, or abdomen  

It’s important to note that not all people who have heart disease experience signs or symptoms. Half of the men who died suddenly of coronary heart disease had no previous symptoms or warnings. 

Prevalence of heart disease in males

Heart disease impacts all males, but it tends to affect men of color even more. About 8% of non-Hispanic white men, 7.2% of black men, 6% of Hispanic men, and 4.8% of Asian men have CHD. Deaths from heart disease impact black Americans more than any other group. Nearly half of black women and 44% of black men have some form of heart disease. The incidence of high blood pressure in black Americans is the highest in the world.  

Even if you have no signs or symptoms of heart disease, you may still be at risk. This makes checking your risk factors, monitoring blood pressure, and working with your health team even more important. 

How can you lower your risk for heart disease?  

1. Check your BP: regular monitoring of your blood pressure will help you stay informed and in control of your blood pressure. If you suffer from high blood pressure, it may be helpful for you to keep a log of your blood pressure readings and take them to review with your doctor.  

2. Quit smoking: Smoking is known to increase blood pressure and can greatly increase your risk of heart disease.  

3. Check cholesterol and triglyceride levels: Work with your doctor to regularly check your cholesterol and triglyceride labs to make sure you stay within a healthy range.  

4. Eat healthy food: Eating a diet rich in fruits, vegetables, and whole grains has been tied to a lower risk of heart disease. Limit red meat, fried foods, high sodium foods, and sugary drinks and desserts.   

5. Stay active: Regular physical activity can help keep your blood pressure in check and keep your arteries relaxed and pliable. Find an exercise that you enjoy doing and aim to get about 30 minutes of exercise per day.  

6. Limit alcohol: Excess alcohol intake is tied to an increased risk of heart disease. Drink in moderation which means 1-2 drinks per day. An alcoholic drink is defined as a 12 oz beer, 5 oz wine, or 1.5 oz liquor or spirits.   

7. Lower stress: Too much stress can tax the heart and blood pressure even more. Find healthy ways of relaxing like taking a walk, reading a book, listening to calming music, or spending a few moments in quiet meditation or prayer each day.  

Men need to bear in mind their risk for heart disease and the associated risk factors. It’s advisable for men to keep their regular check-ups with their doctors, and complete the recommended labs. Checking your blood pressure regularly may also be beneficial, and those who struggle with high blood pressure or have a family history of hypertension may want to consider an at-home blood pressure monitor. 

Men should also eat a healthy low-sodium diet that limits red meat and sugar, only drink alcohol in moderation, get regular physical activity, and quit smoking. Practicing regular stress relief and getting a good night’s sleep is also part of a heart-healthy plan. 

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Laura Krebs-Holm, MS RD LD, is a licensed and registered dietitian in Austin, TX. She enjoys writing evidence-based articles about functional foods and nutrition. She loves to help people feel their best through a healthy lifestyle. 

Experiencing high blood pressure, or hypertension, during pregnancy can bring unique concerns for you and your baby. Living with a chronic condition like hypertension means that we need to place a major emphasis on prioritizing lifestyle factors to help control our blood pressure. Consider nutrition, exercise, and stress management as integral components of blood pressure management.  

**We recommend talking to a dietitian about specific nutrition changes to make a plan to lower blood pressure. Consult your healthcare professional regarding medications and other lifestyle interventions to help control elevated blood pressure.  

What is hypertension?

High blood pressure is also known as hypertension. Blood pressure is the force of blood pumping against the arteries and blood vessels. An increased force results in elevated pressure against the arterial walls. 

This phenomenon occurs when lifestyle factors impact our cardiovascular system and raise our blood pressure. Hypertension is correlated with sedentary behaviors, a diet high in calories and sodium, the incidence of obesity, and high-stress levels.  

During pregnancy, there are unique considerations for hypertension. Sometimes, hypertension in pregnancy cannot be prevented or avoided. However, there are lifestyle changes and medications that can be helpful in the management of hypertension. Hypertension may also increase challenges to conceiving and can have risks for you and the baby after conception.  

Hypertension is diagnosed with specific criteria, according to the AHA:  

Main types of hypertension during pregnancy

Hypertension in pregnancy likely will fall into one of three categories previously defined. It can range from benign and easily controlled to quite serious with increased medical risks. This makes monitoring blood pressure important to bring awareness and accountability to people’s health risks. 

The risks for hypertension in pregnancy include early delivery, decreased oxygen to the placenta, and potential heart disease. 

Let’s review the main types of hypertension in pregnancy.  

Chronic hypertension 

Chronic hypertension is a pre-existing condition known prior to pregnancy. Typically, if you are aware that your blood pressure is elevated before you become pregnant, your doctor will diagnose you with chronic hypertension.   

Use the diagnostic criteria above and work with your doctor to determine if you have chronic hypertension prior to getting pregnant. 

Gestational hypertension 

Gestational hypertension develops during pregnancy. Gestational hypertension is not preventable and generally returns to normal levels postpartum. However, your risk for later developing chronic hypertension is higher if you develop gestational hypertension. 

According to Mayo Clinic, gestational hypertension is diagnosed by the following criteria: 

• At least 20 weeks gestation 

• Blood pressure is greater than 140/90 on at least two occasions 

• Must be documented more than four hours apart 

• No other organ damage present  

Preeclampsia 

Of the three hypertension categories during pregnancy, preeclampsia is the most serious. Preeclampsia specifically develops after 20 weeks of pregnancy and is associated with a sharp spike in blood pressure levels.  

Preeclampsia presents with a few notable symptoms:

• sudden fluid swelling

• chronic headaches

• changes in vision

• nausea/vomiting

• weight gain.  

If you experience any of these symptoms, check in with your doctor right away.  

How to manage hypertension during your pregnancy

Managing blood pressure during pregnancy involves a holistic approach. You must consider both your unique lifestyle factors and medical needs. Your doctor may recommend changing your diet and exercise routine or discussing specific medications to help manage your blood pressure.  

Staying Active 

Physical activity before and during pregnancy can lower your risk for hypertension. One review study found that as little as 30 minutes of physical activity twice a week may lower the incidence of chronic hypertension and gestational hypertension. 

Consider moderate-intensity aerobic physical activity to decrease your risk or manage hypertension in pregnancy. Consult with your healthcare team about the appropriate amount of exercise for you.  

Healthy Nutrition 

Nutrition and blood pressure are highly connected. For chronic hypertension, the DASH diet has been the gold standard for nutrition management. This diet is high in fruits, vegetables, and whole grains and generally quite low in sodium and red meats.  

Recent research from the American Heart Association shows that the DASH diet may be most beneficial for women who have a high prior risk of developing gestational hypertensive disorders.  

Other healthy nutrition behaviors that can help manage blood pressure include eating a variety of fruits and vegetables, drinking enough fluids, and moderating sodium as directed by your healthcare team.  

Medications 

There are some blood pressure medications that are considered safe during pregnancy.  

However, ACE inhibitors, renin inhibitors, and angiotensin II receptor blockers are generally contraindicated during pregnancy.  

If you have been diagnosed with hypertension during pregnancy, talk with your provider to determine whether or not the medication is right for you. 

Lowering Your Risk for Hypertension when Pregnant 

There are some inherent risk factors for experiencing hypertension while pregnant.   

Firstly, a family history of hypertension or preeclampsia increases your risk as well. Unfortunately, there is nothing we can do about this risk.  

Secondly, other chronic conditions like diabetes may put you at an increased risk for elevated blood pressure while pregnant. Your healthcare provider should give you specific blood sugar targets to maintain while pregnant to improve your blood pressure risk as well.  

 You may not be able to completely prevent hypertension in pregnancy, but you can certainly decrease your risk for complications of hypertension by: 

• receiving early perinatal and medical care 

• logging your blood pressure at home as advised by your healthcare provider 

• managing your blood pressure with a healthy diet and physical activity 

Takeaway 

Hypertension while pregnant has become more common. . A combination of lifestyle factors and medical intervention are best suited to manage hypertension during gestation. With consistent blood pressure monitoring and good blood pressure control, you and your baby are more likely to stay healthy. If left untreated, the complications of high blood pressure increase health risks to both you and your baby. Work with your medical team to ensure you are engaging in healthy lifestyle factors to manage or prevent hypertension during your perinatal care.  

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Caroline is a women’s health Registered Dietitian and diabetes educator based in Northern Virginia. In her virtual private practice, she works with women to overcome the chronic yo-yo dieting cycle and find sustainable success with nutrition. You can connect with her via her website www.carolinethomason.com