When should you measure your blood pressure?

High blood pressure is rarely noticed, but it is a constant threat. It can only be detected by routinely measuring blood pressure. If high blood pressure has been detected, it is even more important to keep an eye on the readings by measuring them regularly. But how often is this advisable, and when are the right times to do so?

High blood pressure can cause strokes, heart attacks, and damage to the kidneys and eyes. However, high blood pressure can be reduced. Measures include losing excess weight, increasing physical activity, eating a low-salt diet, and strictly cutting down on or even giving up alcohol and smoking. If needed, tablets can lower blood pressure. The success of these measures can only be checked by measuring blood pressure.

According to the guidelines of the German Hypertension League, the European Society of Hypertension (ESH), and the European Society of Cardiology (ESC), you should measure your blood pressure in the morning and evening. We recommend sitting on the edge of the bed with your back supported for 5 minutes immediately after waking up and then measuring your blood pressure. In the evening, please measure it immediately before going to bed. Again, remain seated on the edge of the bed for 5 minutes and then measure your blood pressure before lying down. Take two measurements 1 to 2 minutes apart and please record both measurements.

In addition to the measurement schedule described in the guidelines, your doctor may of course consider further measurements at other times necessary. In this case, please follow the instructions agreed with your doctor.

Regular blood pressure monitoring at home, together with measurements at the doctor's office, helps guide hypertension treatment. This reduces risks because extreme spikes are detected in time. Measuring at home also lets patients link how they feel to their blood pressure. Constantly high blood pressure is often barely noticed in daily life, but during blood pressure spikes there can be symptoms such as headaches, tiredness, nausea, and even nosebleeds. Another advantage of regular blood pressure monitoring is that patients can see differences between their own readings and those taken in the doctor's office. Initial errors when first measuring at home are completely normal. The doctor can provide advice on this. However, such errors are not the only reason for discrepancies between readings at the doctor's office and at home. Some patients have what is known as "white-coat hypertension." Their blood pressure readings are elevated only at the doctor's office. The opposite is masked hypertension. These people have normal blood pressure readings at the doctor's office, but elevated readings at home. If this is suspected, automated monitoring over 24 hours using a portable blood pressure monitor is usually performed. The device records blood pressure readings every 15 to 30 minutes, including at night.

Ambulatory long-term blood pressure monitoring-that is, as described, using a portable device to record continuously-is essential for the accurate diagnosis of elevated blood pressure readings. The large number of measurements allows the doctor to draw reliable conclusions. This enables the doctor to determine the patient's true blood pressure level. Blood pressure fluctuations and blood pressure variability can only be captured in this way. Another important piece of information is the nighttime drop in blood pressure, which should normally occur. Long-term measurements are also used for follow-up. Since medications are often prescribed after high blood pressure is diagnosed, long-term monitoring is used to check their effectiveness. If necessary, treatment is changed to a different drug and/or additional measures are taken. When using medication, it is also important to detect and prevent periods of very low blood pressure. This can also be dangerous because of the risk of falling during fainting episodes. Devices for ambulatory long-term monitoring are normally provided by doctors.

If the device is used correctly, blood pressure can be measured reliably, but there are a few rules. It goes without saying that the measurement must be taken before you take blood pressure-lowering medication. Before measuring, allow about five minutes of rest. The measurement point must be at heart level. Always use the arm that shows the higher blood pressure reading. The cuff must not be too small; otherwise, it will show systolic (upper) readings that are too low and diastolic (lower) readings that are too high. The cuff should cover two thirds of the upper arm and be large enough to fit even a very muscular upper arm. The device description always states the upper-arm or wrist circumference for which the cuff is suitable. Please measure this if necessary.

Wearing a thin shirt on the arm does not affect the measurement. However, follow the instructions in your device manual. Thicker clothing should be removed. Rolling up the sleeve is only acceptable for very loose garments, because folding tighter sleeves can restrict blood flow and thus distort the measurement. According to the guidelines, measure twice at an interval of one to two minutes.

We hope you found the article helpful. Accurate measurements are essential for good blood pressure control. Our app Tensana can help with that. Clear instructions walk you through taking measurements according to current guidelines. The app can also remind you if you wish. These features are fully available in the free version as well. Get the free app now.

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