Blood pressure readings from the doctor’s office don’t paint the whole picture.
You hop on your bathroom scale regularly to check your weight. You check your fridge weekly before you head to the market. You may even check your pedometer every couple hours to make sure you’re on track for your 10,000 steps a day. You do a lot to keep track of your health, but there’s one thing you may be forgetting: your blood pressure.
“It’s important for patients to test their blood pressure at home,” says Michelle Weisfelner Bloom, MD, cardiologist at Stony Brook University Medical Center. “It allows them to see their numbers, and by seeing their numbers they feel more inclined to be compliant, meaning take their medications.”
Knowing your blood pressure numbers is incredibly important, whether you have high blood pressure or not. For one thing, hypertension is often called the “silent killer,” because most patients don’t feel any symptoms of high blood pressure, says Rachel Bond, MD, a cardiologist at Lenox Hill Hospital. High blood pressure is also one of the major risk factors for cardiovascular disease.
Why It’s Important to Check Blood Pressure Often
When you’re getting your blood pressure checked at the doctor’s office, the reading you see is only part of the picture. “Just because your blood pressure is high at the doctor’s office, does not necessarily mean you have high blood pressure,” says Satjit Bhusri, MD, a cardiologist at Lenox Hill Hospital in New York City.
It’s normal for your blood pressure to fluctuate throughout the day, even if your blood pressure is at a healthy level. Your blood pressure may rise when you’re stressed, during exercise, or after your morning cup of coffee, and then fall again when you’re at rest.
Cardiologists have special names for these type of situations. If you get an elevated blood pressure reading at your doctor’s office, but outside the office your blood pressure is normal, cardiologists call that “white coat hypertension.” On the other end of the spectrum, some patients might have a normal reading at the doctor, but have high blood pressure in their regular life, which is called “masked hypertension.”
That’s why cardiologists need multiple readings from different times a day to paint your entire blood pressure picture. “Once we get the numbers we put it together then we can see where your body truly stands and whether or not you have essential hypertension,” says Dr. Bhusri.
Tips for Checking Your Blood Pressure at Home
If you have high blood pressure, your doctor may recommend that you check your blood pressure levels regularly, both at the doctor’s office and at home. Take note of these essential tips for checking your blood pressure at home, and be sure to avoid these common blood pressure reading mistakes.
- Buy a blood pressure monitor, but ask your doctor for help first. Before you head to the store, ask your doctor what blood pressure monitors he or she recommends, says Dr. Bloom. “It can be very, very overwhelming when you walk into the pharmacy. In general we try to stay away from the finger monitors or the wrist monitors because we find that they’re not as accurate,” she says.
- Check your blood pressure at least twice a day. “The first blood pressure reading should be first thing in the morning, it’s going to be your lowest,” says Dr. Bond. “As you go through the course of the day, stress comes on, you’re walking, you’re exercising, your blood pressure should probably get a little bit higher.”
- Before you check your blood pressure, check your situation. “You want to make sure when you’re testing your blood pressure, you’re in a situation where you’re not going to get falsely elevated readings,” says Dr. Bloom. If you just ran a mile, had a shot of espresso, or got in a heated argument with your significant other, you might want to hold off until you’re calmer, she says.
- Don’t mess with your blood pressure medication regimen. Dr. Bhusri says his patients will sometimes skip taking their blood pressure medication if they get a low reading, or take more if their blood pressure is high. Not good. “That’s not the way blood pressure works. Blood pressure medications are not as-needed medications,” says Dr. Bhusri. Stick to the medication schedule prescribed by your doctor, no matter what your home BP reading says.
Remember: “Don’t be afraid of the numbers you get. We’re not treating a number, we’re just getting a number to get data,” says Dr. Bhusri. Recording and reporting your blood pressure numbers helps your doctor determine the next course of action to help you manage your blood pressure, like a medication adjustment or making more lifestyle changes to lower your blood pressure.
Dr. Bond is a cardiologist and associate director of the Women's Heart Health Program at Northwell Health, Lenox Hill Hospital and an assistant professor of cardiology at Hofstra Northwell School of Medicine.Satjit Bhusri
Dr. Bhusri is an attending cardiologist at the Lenox Hill Heart & Vascular Institute and an assistant professor of cardiology at Hofstra Northwell School of Medicine.Michelle Weisfelner Bloom
Dr. Bloom is an associate professor of medicine at Stony Brook University Medical Center, a fellow of the American College of Cardiology, and a fellow of the Heart Failure Society of America.
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It's important for our patients to
test your blood pressure at home,
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mainly because it allows
them to see their numbers.
00:00:07,691 --> 00:00:11,055
And by seeing their numbers they
feel more inclined to be compliant,
00:00:11,055 --> 00:00:12,738
meaning take their medications.
00:00:12,738 --> 00:00:17,451
00:00:17,451 --> 00:00:21,173
So just because your blood pressure
is high at the doctor's office does not
00:00:21,173 --> 00:00:23,680
necessarily mean you
have high blood pressure.
00:00:23,680 --> 00:00:27,420
We need continuous readings,
readings from different times of the day.
00:00:27,420 --> 00:00:31,470
Once we get the numbers,
we put it together, then we can see where
00:00:31,470 --> 00:00:35,630
your body truly stands and whether or
not you have essential hypertension.
00:00:35,630 --> 00:00:39,140
There are certain situations where
we don't get the whole picture when
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a patient's sitting in our office.
00:00:40,860 --> 00:00:43,440
That's something called
00:00:43,440 --> 00:00:46,900
meaning that in my office the blood
pressure can look fine but in reality,
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in their regular life,
the blood pressure's really high.
00:00:49,240 --> 00:00:50,740
On the opposite end of the spectrum,
00:00:50,740 --> 00:00:53,490
there's something called
white coat hypertension.
00:00:53,490 --> 00:00:56,260
White coat hypertension
is stage fright.
00:00:56,260 --> 00:01:00,450
Really, your blood pressure is elevated
when you're in the doctor's office, but
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outside the doctor's office,
your blood pressure is normal.
00:01:02,800 --> 00:01:07,500
So I normally encourage them to
buy a blood pressure monitor, and
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when they do buy it,
they bring it into the office.
00:01:09,780 --> 00:01:12,870
When we check it in the office,
it's gonna be a manual blood pressure,
00:01:12,870 --> 00:01:15,520
meaning that we're checking
it with a cuff and
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we're inflating it, whereas the ones
at home are normally electronic.
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If the blood pressure monitor,
when you bring it into the office,
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is very similar to the readings we're
getting, the likelihood is it's accurate.
00:01:26,710 --> 00:01:29,910
I think it's really important to
speak to your doctor because there
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are many different monitors out
there that you can choose from.
00:01:32,750 --> 00:01:36,020
It can be very, very overwhelming
when you walk into the pharmacy.
00:01:36,020 --> 00:01:39,100
In general, we try to stay away
from the finger monitors or
00:01:39,100 --> 00:01:42,880
the wrist monitors because we find
that they're not as accurate.
00:01:42,880 --> 00:01:46,630
I typically suggest that they check
their blood pressure probably twice a day.
00:01:46,630 --> 00:01:49,470
The first blood pressure reading, which
should be first thing in the morning,
00:01:49,470 --> 00:01:51,030
is likely gonna be your lowest.
00:01:51,030 --> 00:01:55,440
And then as you go through the course of
the day, stress comes on, you're walking,
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you're exercising, your blood pressure
should probably get a little bit higher.
00:01:59,040 --> 00:02:02,320
So you want to make sure that when
you're testing your blood pressure,
00:02:02,320 --> 00:02:06,740
you're in a situation where you're not
going to get falsely elevated readings.
00:02:06,740 --> 00:02:09,990
You don't want to do your blood
pressure right after you ran a mile.
00:02:09,990 --> 00:02:14,400
You don't want to do your blood pressure
right after you had a huge cup of coffee.
00:02:14,400 --> 00:02:17,560
You don't want to do your blood pressure
after you had a fight with your boyfriend
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over the phone.
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You want to be in a situation
where you're calm and collected.
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You can sit for a few minutes,
you can set your arm up on the table.
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I have patients that come in and say,
well, I didn't take my blood pressure
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medication because my blood
pressure this morning was too low.
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Or patients who say, I took double
my blood pressure medication because
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last night my blood pressure was too high.
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That's not the way blood pressure works.
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Blood pressure medications
are not as needed medications.
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Do not be afraid of the numbers you get.
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We're not treating the number,
we're just getting a number to get data.
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Just think of it as more information for
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me to help adjust their lifestyle or
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Measuring High Blood Pressure. Atlanta, GA. Centers for Disease Control and Prevention. (Accessed on January 31, 2021 at https://www.cdc.gov/bloodpressure/measure.htm)Get Your Blood Pressure Checked. Bethesda, MD. U.S. Department of Health and Human Services, HealthFinder.gov. (Accessed on January 31, 2021 at https://healthfinder.gov/HealthTopics/Category/doctor-visits/screening-tests/get-your-blood-pressure-checked)