Self-Measured Blood Pressure (SMBP) Monitoring

Strong scientific evidence shows that self-measured blood pressure (SMBP) monitoring, also known as home blood pressure monitoring, plus clinical support helps people with hypertension lower their blood pressure.

SMBP monitoring is the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere. SMBP requires the use of a home blood pressure measurement device by the patient to measure blood pressure at different points in time.

SMBP plus clinical support can improve access to care and quality of care for people with hypertension while making blood pressure control more convenient and accessible across the population. Clinical support includes regular one-on-one counseling, web-based or telephonic support tools, and educational classes.

AHA Recommendation

The American Heart Association recommends home monitoring for all people with high blood pressure to help the health care professional determine whether treatments are working. Home monitoring (self-measured blood pressure) is not a substitute for regular visits to your physician. If you have been prescribed medication to lower your blood pressure, don't stop taking your medication without consulting your doctor, even if your blood pressure readings are in the normal range during home monitoring.

Choosing a home blood pressure monitor

The American Heart Association recommends an automatic, cuff-style, bicep (upper-arm) monitor.

• Wrist and finger monitors are not recommended because they yield less reliable readings.
• Choose a monitor that has been validated.
• When selecting a blood pressure monitor for a senior, pregnant woman or child, make sure it is validated for these conditions.
• Make sure the cuff fits — measure around your upper arm and choose a monitor that comes with the correct size cuff.

Once you’ve purchased your monitor, bring it to your next appointment

Have your doctor check to see that you are using it correctly and getting the same results as the equipment in the office. Plan to bring your monitor in once a year to make sure the readings are accurate.

Home blood pressure monitoring may be especially useful for:

• Anyone diagnosed with high blood pressure (HBP or hypertension).
• Individuals starting high blood pressure treatment to determine its effectiveness.
• People requiring closer monitoring, especially individuals with risk factors for high blood pressure and/or conditions related to high blood pressure.
• Pregnant women, experiencing pregnancy-induced hypertension and/or preeclampsia.
• Evaluating potentially false readings, like:
  • People who only have high readings at the doctor’ s office (“white coat” hypertension).
  • People who only have high readings at home but not at the doctor’ s office (“masked” hypertension).
• NOTE: People with atrial fibrillation or other arrhythmias may not be good candidates for home monitoring because electronic home blood pressure devices may not be able to give accurate measurements. Ask your doctor to recommend a monitoring method that works for you.

Left-arm vs. right-arm blood pressure

Several studies have been done to determine what is a normal variation between right and left arm. In general, any difference of 10 mm Hg or less is considered normal and is not a cause for concern.

Why keep a blood pressure journal?

One blood pressure measurement is like a snapshot. It only tells what your blood pressure is at that moment. A record of readings taken over time provides a “time-lapse” picture of your blood pressure that can help you partner with your physician to ensure that your treatments to lower high blood pressure (HBP or hypertension) are working.