Home blood pressure monitoring is an important component of managing high blood pressure, and is recommended by the American Heart Association, the American Society for Hypertension and other medical organizations. Taking a manual blood pressure reading is a simple yet significant task. With a few special tools and basic knowledge, just about anyone can learn to take a manual blood pressure measurement. Important steps in the process include using the proper equipment, preparing for the measurement and knowing how to conduct the reading.
You need only 3 items to perform a manual blood pressure measurement:
-- A blood pressure cuff.
-- A blood pressure gauge with hand-held inflation bulb.
-- A stethoscope.
It's important to have the correct size cuff. If it's too large or small, the blood pressure reading might be inaccurate. The cuff should have a 2:1 length-to-width ratio -- meaning the width is approximately 40 percent of the upper arm circumference and the length is at least 80 percent. If you have questions about the proper cuff size, talk with your healthcare provider.
Many things can cause temporary blood pressure fluctuations, so it's important to prepare before a reading to get an accurate measurement. Preparation includes:
-- Refrain from smoking, exercising and consuming caffeine for at least 30 minutes before the check.
-- Remove restrictive clothing from the upper arm.
-- Sit quietly with legs uncrossed and feet flat on the floor in a chair with back support for at least 5 minutes.
-- Sit next to a table or other flat surface to support the arm being used for the blood pressure measurement, such that the upper arm remains relaxed next to the chest at about heart level.
For most adults, either upper arm can be used. Secure the cuff about an inch above the crease of the elbow. Lightly place the stethoscope’s flat surface just below the lower edge of the cuff in the crease of the elbow, slightly off center toward the body.
Taking the Reading
To take the blood pressure reading:
-- Place the stethoscope ear pieces in your ears, oriented so they are pointing forward. You should be able to hear rhythmic pulsations.
-- Twist the pressure valve closed and inflate the cuff by repeatedly squeezing the bulb.
-- Inflate the cuff until you no longer hear the pulsations, then inflate approximately 30 mmHg more.
-- While looking at the gauge, slowly open the valve and listen for the return of the rhythmic pulsations. Note at what number the first sound is heard. This is the systolic blood pressure, the top number of the reading.
-- Continue allowing the cuff to deflate until the pulsations stop completely. Note the pressure at which the sounds disappear. This is the diastolic blood pressure, the bottom number of the reading.
-- Once the pulsations have not been heard for at least 10 mmHg, stop the reading.
For optimum accuracy, repeat each step on the same arm, waiting at least 1 minute between readings. Record all results with the date and time.
Warnings and Precautions
Normal blood pressure in adults is less than 120/80 mmHg. For people being treated for high blood pressure, the doctor will advise about the target blood pressure and when to call if home readings are off-target.
Extremely high blood pressure can indicate serious or even life-threatening health concerns. For a blood pressure reading of 180/110 mmHg or higher, seek emergency medical care. Other warning signs of extremely high blood pressure include a severe headache or anxiety, shortness of breath or an uncontrolled nose bleed.
A sudden drop in blood pressure can also indicate a serious health concern. Medical attention is needed as soon as possible if blood pressure readings are low and accompanied by symptoms such as dizziness, lightheadedness, nausea, paleness and/or cold, clammy skin.
- National Heart, Lung, and Blood Institute: Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
- American Family Physician: New AHA Recommendations for Blood Pressure Measurement
- Circulation: Miscuffing: Inappropriate Blood Pressure Cuff Application
- American Journal of Pharmaceutical Education: Simulation-Based Learning to Teach Blood Pressure Assessment to Doctor of Pharmacy Students
- British Medical Journal: Recommendations on Blood Pressure Measurement
- Circulation: Heart Disease and Stroke Statistics—2014 Update
- Hypertension: Recommendations for Blood Pressure Measurements in Humans and Experimental Animals