Never Too Late - July 2022

Healthy Living

Monitoring Blood Pressure at Home (continued from previous page)

Cuffless devices, including smartwatches, sound cool, Shimbo said. But few have been validated, so he considers them "not ready for primetime." How do I prepare for a measurement? This is "surprisingly hard," Margolis acknowledged. Before taking a reading, you should avoid caffeine. Don't exercise for 30 minutes beforehand. If you smoke, don't smoke. Go to the bathroom. "Ideally, you want to wait until 30 minutes after you've had a meal." Then sit quietly without any distractions for five minutes, Margolis said. "And when I say no distraction, I mean don't watch TV. Don't listen to a podcast. Don't read a book. Definitely don't read the newspaper or listen to the news." What else is important? According to guidelines from the AHA and ACC, sit in a chair that supports your back. Keep your feet flat on the ground. Don't cross your legs. Position and support your upper bare arm at heart level. Keep your palm up and your arm muscles relaxed. Don't talk. Take two readings at least one minute apart. Not following these steps can throw a reading off significantly. A reading taken over clothing, for example, can be off by 5 to 50 points. Does timing matter? Blood pressure tends to be highest in the morning, decreases through the day and is lowest during sleep. To account for that,

when diagnosing high blood pressure, you'll be asked to take two readings in the morning and two in the evening over the course of a week. "I would follow the advice of your doctor for how often to monitor," Margolis said. For example, people whose readings are consistently normal wouldn't need to check so often. What if the reading doesn't match what's in the office? That's one of the things home monitoring hypertension," which is when readings are high in a doctor's office but not outside the office. Others experience "masked hypertension," where readings are normal in a doctor's office but high outside the office. Put another way – a reading in a doctor's office will say what your blood pressure was during the brief time you're in the exam room, Shimbo said. "But you spend all of your life outside the doctor's office. Don't you want to know what your blood pressure is in the real world?" is looking for, Shimbo said. Some people get "white coat American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. If you have questions or comments about this story, please email By Michael Merschel, American Heart Association News American Heart Association News CONSUMER NEWS

The American Heart Association and American College of Cardiology recognize five categories of blood pressure in adults. A reading of less than 120/80 is considered normal. Where do I start? Margolis and Shimbo agreed that proper self-monitoring of blood pressure starts with a validated device. Both co-authored a 2020 policy statement from the AHA and American Medical Association about home blood pressure monitoring. Many devices tout Food and Drug Administration clearance. But the FDA does not validate the accuracy of devices it clears to be sold on the market, Shimbo said. To find a validated device, start with the AMA website An international consortium also lists validated devices at What kind of device should I use? Upper arm cuff devices are preferred over wrist devices, according to the AHA/AMA report. "I just find them really difficult to use," Margolis said of the wrist devices. "They're touchy. Your arm has to be in exactly the right position." Still, people with medical issues that preclude compressing the arteries of both upper arms might need a wrist device, she said. And cuff size matters. A "universal" cuff will work for most people, she said, but if you have a very slender or large arm, you'll need an alternate.

Page 18 | July 2022, Never Too Late

Pima Council on Aging

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