II. Indications

  1. White-Coat Hypertension
  2. Refractory Hypertension
  3. Antihypertensive Compliance

III. Types: Home monitors

  1. Automatic arm cuffs monitors
    1. Most accurate
  2. Manual arm monitors
  3. Wrist monitors
    1. Most convenient but least accurate
    2. Not recommended unless large arm is unable to fit in arm cuff
    3. If wrist cuffs must be used, during measurement, keep the wrist still at heart level
  4. Avoid finger cuffs
    1. Most inaccurate of all devices

IV. Preparations: Blood Pressure Monitors

  1. U.S. Blood Pressure Validated Devices
    1. https://www.validatebp.org/
  2. General
    1. Arm cuffs are preferred for most consistent accuracy (see above)
    2. Omron has consistently been top in Consumer Reports reviews since I started looking at this in 2003
      1. Omron has also been the manufacturer behind other brands (e.g. Walmart's ReliOn BP cuff)
  3. Best arm cuff monitors Consumer Reports (2014) - preferred method
    1. CVS Premium BP3MV1-3WCVS ($66)
    2. Omron 10 Series BP785 ($100)
  4. Best wrist monitors by Consumer Reports (2014)
    1. Wrist cuffs are not recommended (less accurate) - see above
    2. Omron 7 Series BP652 wrist monitor ($70)
    3. Rite Aid Automatic RC210 ($50)

V. Preparations: Calibration

  1. See BP Examination for determining cuff size
  2. Patient should bring Blood Pressure cuff to clinic annually to check against a manual Blood Pressure

VI. Technique

  1. Keep arm supported at heart level
  2. Sit with back supported and feet flat on floor
  3. Rest for 5 minutes before checking Blood Pressure
  4. Take the average of 3 readings at 1 minute apart
  5. Avoid checking Blood Pressure within 30 minutes of Exercise, Caffeine or Tobacco

VII. Protocol: Blood Pressure logs

  1. Start by logging Blood Pressures morning and night for one week
  2. Repeat Blood Pressure check weekly (or repeat a one week log every 6-12 months)
  3. Consider more intensive monitoring before and during antihypertensive management changes

VIII. References

  1. (2014) Consumer Reports, accessed online 2/11/2015
  2. (2008) Presc Lett 15(3):14
  3. (2015) Presc Lett 22(2):11-2

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