How long should the nurse wait in between two blood pressure readings on the same arm?

‍Checking your blood pressure at home? When is the best time and how often should you take it?

You’ve made the decision to monitor your blood pressure at home. Congratulations! You have made a huge step toward taking control of your health and taking good care of your heart. Now the question is, what is the best way to do this? When you should check your blood pressure, how often and what affects the results, are all good questions. Here are some answers.

When Should I Check My Blood Pressure?

Our blood pressure fluctuates during the day, so when you start tracking your blood pressure, you should check it at different times of the day, about 5-6 times. Once you establish a routine of checking your blood pressure and have gained a better understanding of the numbers, you can begin checking it once or twice a day, at the same time each day.

If it has already been determined that you have high blood pressure, it is important to measure your blood pressure at roughly the same times each day. This will provide consistent readings less affected by other factors, and therefore show how well your medication and dosage are working.Getting into the habit of checking your blood pressure in the morning and again before bed is generally the best practice. For the A.M. reading, don’t take it immediately when you wake up; however, you should measure before breakfast or your morning coffee.

What If I’m Taking Medication? Does This Affect When I Should Check My Blood Pressure?

Yes. If taking high blood pressure medication, your blood pressure measurements should coincide with your doses. The best time to check it is before you take your medication. It is at this point that the level of medication in your body will be at its lowest. This is known as a trough value. Measuring your blood pressure before you take the next dose will demonstrate how well the medication has been working.

Another important variable to consider is symptoms. If you are experiencing a symptom of high blood pressure, it is a good idea to take a measurement then. Of course, if symptoms are severe, contact your doctor or seek immediate assistance.Common symptoms of high blood pressure include:

• Intense headaches
• Pounding in your chest, neck, or ears
• Irregular heartbeat
• Fatigue
• Vision problems
• Chest Pain
• Breathing issues

Measuring your blood pressure while experiencing these symptoms can help determine if high blood pressure is the cause. It is also possible that your medication has lowered your blood pressure too much. A blood pressure reading during symptoms can also help determine if an adjustment to your medication is needed, either in dosage or time of day it is taken.

What Else Is Important When Checking My Blood Pressure?

Many factors can influence your blood pressure reading. The following guidelines will help you get the best and most accurate results from your blood pressure monitoring.

Avoid Blood Pressure Spikers

Certain factors can increase your blood pressure. It is important to understand how these “spikers” affect your BP numbers. To learn their effect, check your BP before and after you experience each of the factors listed below. Once you know their effect, avoid these spikers before your daily checkup routine. This will prevent them from interrupting your baseline measurement and will allow you to see if your standard BP is stable. As you establish your BP routine, use the following guidelines to control spikes in your readings.

• Caffeine – Hold off on the morning cup of coffee before measuring your blood pressure. No caffeine for half an hour before measuring is best.
• Tobacco – If you can stop altogether, your heart will thank you. Otherwise, avoid for at least half an hour before you take a measurement.
• Exercise – Great to do, just wait until after you check your blood pressure. Avoid exercise for thirty minutes prior to blood pressure readings.
• Medication – For an accurate reading, you should have as little medication in your blood as possible.
• Food – Wait to eat until after you check your blood pressure.
• Alcohol – Avoid alcohol consumption for at least half an hour before checking your blood pressure.
• Cold Temperatures – Your heart will be working hard to keep you warm in an arctic blast. Get to a comfortable temperature before measuring.
• Full Bladder - A full bladder can cause a rise in blood pressure. So, make a restroom stop before you measure.

Choose A Good Machine

Myriad choices exist in today’s marketplace for home blood pressure monitoring devices. Not all are equal. Be sure to choose an FDA-approved device. Once you have selected a machine, it not a bad idea to take it in to your doctor’s office. Take your blood pressure reading in front of your physician,  nurse or PA so they can ensure you are using it properly. Have them to take an additional reading on their machine, to compare for accuracy.

Take the Proper Position for Reliable Blood Pressure ReadingsEnsure you are positioned correctly for accurate blood pressure readings. Put your feet on the floor and straighten your back with arms supported at heart level. Make sure your elbow is at about the same level as your heart.

Give yourself five minutes to rest quietly before slapping on the cuff. Because blood pressure can fluctuate, it’s a good idea to take at least two readings each time. Always use the same arm, as readings can fluctuate from arm to arm. Track all of the results. To make tracking easy, use an easy-to-use app (iOS, Android).

Why Does My Blood Pressure Vary Throughout The Day?

You may have heard the term circadian rhythm. If so, you know this is not a beat to keep on the dance floor. It is a biological cycle your body follows. As defined by the National Institute of General Medical Sciences, “Circadian rhythms are physical, mental and behavioral changes that follow a roughly 24-hour cycle, responding primarily to light and darkness in an organism's environment.” As your body cycles through this rhythm each day, responding to both internal and external stimuli, your blood pressure is affected.

The study of these important rhythms, known as chronobiology, was founded by Franz Halberg. His work in this field has helped identify abnormal rhythms in day-night blood pressure readings.Keeping the Beat of Blood PressureFollowing this chronobiological rhythm, your blood pressure is normally higher during the daytime and lower at night, during sleeping hours. Here’s the problem. People with high blood pressure often don’t experience this night time dip. This lack of a lowering of blood pressure at night is referred to as non-dipping.What’s the big deal? Heart attack and stroke have been found to be associated with non-dipping. Your blood pressure stays elevated, and your body is not in the relaxed state it should be during rest.

How Does My Circadian Rhythm Affect My Blood Pressure Medication?

Michael Smolensky, adjunct professor of biomedical engineering at the University of Texas, Ausin, reports, “"The body doesn't respond to medications in the same way at different times of the day. Some drugs are not as effective or as well tolerated if they're taken at the wrong biological time. It's not that they're not effective at all, but they're certainly much less effective."Studies on chronotherapy (medication scheduling) have found that taking high blood pressure medications before bedtime help with the non-dipping issue. This reduces your risk of heart attack and stroke by normalizing your daily blood pressure rhythm. Specifically, it has been reported that drugs called ACE inhibitors and ARBs are the most effective when taken at bedtime.

THE GIST

• Check your blood pressure 2x per day, morning and evening.
• If taking medication, align blood pressure readings with doses.
• Be aware of HBP symptoms, and take readings when they occur.
• Get the best readings by avoiding BP spikers, using a good machine, and testing properly.
• Realize your biological rhythms vary your blood pressure throughout the day.
• Apply chronobiology to decide when to take blood pressure medications.
• Use an easy-to-use app (iOS, Android) to track your daily blood pressure readings.

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How many times should blood pressure be taken on the same arm?