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Apr 07, 2025

Aging for Amateurs: Take control of your blood pressure

Accurate blood pressure measurements are key to helping providers assess health. Getting a good blood pressure monitor and doing this at home can help providers, as well. Blood pressure measurement is

Accurate blood pressure measurements are key to helping providers assess health. Getting a good blood pressure monitor and doing this at home can help providers, as well.

Blood pressure measurement is a very important part of recognizing and treating hypertension, or high blood pressure. Last month, I wrote about problems with blood pressure measurement that happen in your doctor’s office or clinic. You can help your physician or nurse practitioner take better care of you by also measuring your blood pressure at home.

An accurate home blood pressure monitor is the first requirement.

Blood pressure can be measured at the finger, wrist, upper arm, ankle and toes, but the most accurate measurements come from the upper arm. So that is where it should be measured unless there is a very good reason that it can’t be done there, such as a rash, a tumor or recent surgery on that part of your body. Since most of us have two arms, we can use the other if one is not available.

There are many manufacturers of blood pressure monitors and they vary in proven accuracy. Omron monitors have the longest record of consistent performance and durability. They aren’t the cheapest, but they have the highest level of accuracy and also good warranties.

Everything that can go wrong with measuring your blood pressure in your doctor’s office can go wrong at home, too. (See the Aging for Amateurs column for March 3 for those details.) The manuals that come with the monitors have detailed instructions. Read these instructions carefully and follow them.

One of the most important directions refers to the position of the cuff on the upper arm. There is a small dot on the outside of the cuff. The cuff should be placed a half inch above the elbow with the dot over the inside of the upper arm, at the groove between the muscle and the bone. I haven’t looked at all brands of cuffs, so I don’t know if all have the dot, but every one has the groove between the muscle and bone.

Blood pressure varies during the day. In general, blood pressure is lowest in the morning, before activity begins, and is highest in the afternoon or evening between 4 and 8 o’clock. I want to know when my patients' blood pressure is highest, so I suggest that they measure their blood pressure between 4 p.m. and 8 p.m.

One of the nice things about having a home monitor is that you can measure your blood pressure anytime you feel like it. When you don’t feel well, it is good information to share with your health care provider.

Because persistently elevated blood pressure is bad for the heart and brain, it is good to think about other causes in addition to the most common one, which is primary or essential hypertension. That’s what persistently elevated blood pressure is called when we don’t know exactly what’s causing it.

Sleep apnea often causes hypertension that is hard to resolve unless the underlying problem is treated. The repeated stresses caused by frequent periods of apnea and disturbed sleep that occurs due to apnea result in elevated blood pressure.

Poor sleep not related to apnea can also result in hypertension. People that don’t get six to eight hours of uninterrupted sleep a night are at risk.

Air pollution, both fine particulates produced by burning and auto emissions and coarse particulates from dusty roads and construction sites, is associated with higher levels of blood pressure. High levels of noise from aircraft and auto traffic also are associated with elevated blood pressure.

Our Western diet, with low amounts of fruits and vegetables and higher intake of sodium, especially in highly processed foods, push blood pressures up. Alcohol consumption, even at one drink per day levels, can elevate blood pressure.

Man was not meant to live alone. Low levels of social interaction put us in the “flight or fight” mode and are associated with elevated blood pressure.

Regular use of common over-the-counter medications, such as non-steroidal anti-inflammatory drugs like ibuprofen and naprosyn, acetaminophen and decongestants can cause elevated blood pressure

And don’t forget two other lifestyle-related diseases — smoking and obesity — both can increase blood pressure.

For better health, know what your blood pressure numbers are; take your blood pressure medications; and stay active, such as at least 30 minutes a day of walking.

Dr. William M. Simpson is a retired Family Medicine physician and emeritus professor at the Medical University of South Carolina.