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Blood pressure monitors

Blood pressure monitor buying guide

Last updated: March 2015

Getting started

For people with borderline or high blood pressure, home testing with the best blood pressure monitor is more important than ever. Recent research shows that an average of several readings over time provides the most reliable measurement. Home testing is essential for taking multiple readings and can actually be more accurate than the results you get at a doctor's office.

Our experts say that good candidates for at-home monitoring include:

  • Seniors, whose blood pressure can vary.
  • People who experience "white-coat hypertension," a spike in blood pressure when they are tested in a doctor's office or hospital; and
  • People with diabetes, for whom tight blood pressure control is important.

How we tested

Our most recent tests (see Ratings, available to subscribers) of blood pressure monitors found many that are worth recommending.

Staff members assessed each model for comfort. Our testers compared the readings from those devices with readings taken with a mercury sphygmomanometer, often used in medical settings, to rate accuracy. A sensory panel evaluated how easy it was to use each monitor.

Check the fit

For arm models, make sure the blood pressure monitor you choose has a cuff that fits the circumference of your upper arm. Using a cuff that's the wrong size can result in a bad reading. Most models we tested have two cuffs or a cuff that adjusts to fit most people. Wrist models also adjust to fit most people.

Available features

An irregular-heartbeat detector checks for arrhythmias and other abnormalities. (We did not test those features.) A risk-category indicator tells you whether your blood pressure is in the high range. Multiple-user memory allows two or more users to save readings.

Cost

The recommended models in the Ratings (both are available to subscribers) were priced from $40 to $80, but shop around. And check to see whether a monitor is covered by insurance.

Ease of use

Make sure that the display on the monitor is easy to read and understand and that the buttons are big enough. The directions for applying the cuff and operating the monitor should be clear.

How to choose

Pick a top-scoring model that has features that will make testing easier for you, such as the ability of more than one user to store readings. Blood pressure monitors may be available at a discount, and some insurance plans may provide coverage for them. Check with your provider.

Accuracy

All of our recommended models (available to subscribers) were rated Excellent for accuracy.

Types

Automatic arm monitors

This type automatically inflates the cuff and displays the readings.

Wrist monitors

These convenient monitors are fully automatic, but may be less accurate than arm monitors.

What's high blood pressure?

Blood pressure is measured as two numbers, one over the other--for example, 120 over 80 millimeters of mercury (mm Hg). The systolic, or top, number reflects the pressure in the arteries when the heart is pumping. The diastolic, or bottom, number reflects the pressure between heartbeats. An elevation in either or both of those numbers constitutes hypertension. Optimal blood pressure is a systolic of less than 120 mm Hg and a diastolic of less than 80 mm Hg. Borderline high blood pressure is a systolic of 120 to 139 mm Hg and a diastolic of 80 to 89 mm Hg. And hypertension is a systolic of 140 or more mm Hg and a diastolic of 90 or more mm HG.

How to lower your blood pressure

Studies have conclusively shown that changes in lifestyle can reduce blood pressure substantially. Other research has clarified which medications work best for which people. Here is what you can do:

Diet and exercise

Lose excess weight. Eat a diet high in fruits, vegetables, whole grains, and low-fat or no-fat dairy products and low in salt. Limit your alcohol intake, and quit smoking. Do aerobic exercise regularly. Strength training can help, too. Consider stress-reducing techniques such as yoga, meditation, and cognitive-behavioral therapy.

Pain-relieving nonsteroidal anti-inflammatory drugs

Limit the use of NSAIDS such as ibuprofen (Advil, Motrin, and generics) and naproxen (Aleve and generics), as well as the COX-2 drug celecoxib (Celebrex).

Sleep apnea

This breathing disorder, common in heavy snorers, increases blood pressure. See a sleep specialist if you've already tried losing weight, sleeping on your side, and avoiding alcohol and sleeping pills.

Medicate, if necessary

If after three or four months changes in lifestyle fail to reduce blood pressure sufficiently, your doctor may need to prescribe medication. Diuretics, the oldest and least expensive type of antihypertensive drug, are best for most people with uncomplicated hypertension, particularly those with only an elevated systolic reading.

Beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin-receptor blockers (ARBs) are good options for people with certain additional disorders. Alpha-blockers and calcium-channel blockers should generally be reserved for people who don't respond to or can't tolerate other drugs. Note that evidence has suggested that ACE inhibitors, beta-blockers, and ARBs may be less effective in African-Americans.

How to check your blood pressure

Most people with hypertension should use a home monitor regularly. So should many people with prehypertension--particularly if they have other risk factors for heart disease. In general, you should check pressure at least twice a week at about the same time of day, and as often as twice a day if the hypertension isn't well controlled or if the treatment has changed. Here is how to get the most accurate results:

  • Wait at least a half-hour after eating, drinking beverages with caffeine, smoking, or exercising before you test.
  • Remove clothing or jewelry that interferes with placement of the cuff. If necessary, empty your bladder before testing.
  • Sit in a comfortable chair with a back for support, and relax for at least 5 minutes before testing. Keep your feet flat on the floor. Don't talk, move, or cross your legs.
  • With an arm monitor, adjust the cuff as directed by the product's manufacturer. The monitor's instructions should explain the proper positioning.
  • Rest your arm on a table so that the cuff is at the same height as your heart. For wrist monitors, instructions normally direct you to place your wrist at the level of your heart.
  • Do your initial tests on both arms. If the readings differ by more than a few points, check with your physician. If not, just use the more comfortable side.
  • Take two readings about 1 or 2 minutes apart. Typically, the second reading will be lower. If the results differ by more than 5 points, take a third reading and average the results. Some automatic monitors will average three closely spaced readings automatically.
   

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