Blood Pressure Monitor Buying Guide

    Blood Pressure Monitor Buying Guide

    High blood pressure—known as the silent killer—has no obvious symptoms, yet as many as half of Americans have the condition, according to the Centers for Disease Control and Prevention. But just 24 percent of those people have the condition under control. Hypertension can increase your risk of heart attack, stroke, kidney disease, and a number of other serious health problems.

    The American College of Cardiology and the American Heart Association (AHA) consider hypertension to be when a person’s systolic (top) blood pressure measurement is 130 mmHg or higher, and diastolic (bottom) is 80 mmHg or higher.

    But when it comes to keeping track of these important numbers, an occasional blood pressure check at a doctor’s office of your blood pressure might not be giving you the full picture, experts say. “Blood pressure varies a lot during the day,” says Beverly Green, MD, MPH, senior investigator and family physician at the Kaiser Permanente Washington Health Research Institute and Kaiser Permanente Washington in Seattle. “A single good blood pressure measurement . . . may not be enough information.”

    Why Monitor at Home?

    Research shows that home blood pressure monitoring can help people with hypertension keep their condition under control. A 2010 analysis from the independent Cochrane Collaboration, for example, found that self-monitoring led to lower numbers in both systolic (top) and diastolic (bottom) blood pressure. And some research suggests that using a home blood pressure monitor may help people with uncontrolled hypertension get their numbers under control.

    For some, monitoring at home can be useful for diagnosing hypertension in the first place. Some people experience “white coat hypertension,” blood pressure that’s high during a medical checkup but normal at home. The reasons aren’t completely clear, but one popular theory is that anxiety about being in a doctor’s office or other healthcare setting may cause blood pressure to temporarily spike, according to Aldo Peixoto, MD, professor of medicine at the Yale School of Medicine in New Haven, Conn., and co-director of the Hypertension Program at the Yale New Haven Hospital Heart and Vascular Center. So a series of readings over the course of a week or so can give you and your doctor information to determine whether there is a problem.

    The opposite effect, known as “masked hypertension,” can also occur—some people have normal blood pressure readings at the doctor’s office but high blood pressure most of the rest of the time. (It’s even less clear why this happens, Peixoto says.)

    For those who are just starting to take medications to lower blood pressure, monitoring at home can help determine how well the therapy is working. It can also be useful for people experiencing pregnancy-induced hypertension, or preeclampsia, according to the AHA.

    Note: People with atrial fibrillation or other arrhythmias might not be good candidates for home monitoring. Before you purchase a device, talk with your doctor about whether you would benefit from using one.

    Types of Home Monitors

    Home blood pressure monitors come with an arm cuff or a wrist cuff. When narrowing your choice, make sure to consider performance, features, and price.

    Arm Monitors

    Arm Monitors

    These monitors automatically inflate the cuff and display readings. Most have “risk category indicators” that will flag high readings. Some models allow you to download results to a computer, making it easy to share the information with your doctor.

    Pros: Some models have multiple user memories, allowing more than one person in your household to monitor and record their blood pressure. Arm monitors tend to be more accurate in our tests.

    Cons: Correct fit of the arm cuff is essential. If it’s too tight or loose, you may get inaccurate readings. Often, the units are bulky or not portable, and they’re often not as comfortable as wrist monitors.

    Blood Pressure Monitors Ratings
    Wrist Monitors

    Wrist Monitors

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

    Pros: They’re compact, lightweight, and portable. They’re usually more comfortable than arm monitors.

    Cons: Pressure measurements taken at the wrist are extremely sensitive to body position. Both wrist and arm cuffs should be positioned at heart level for an accurate reading; this is more difficult to get right with a wrist cuff.

    Blood Pressure Monitors Ratings

    How to Buy the Best Blood Pressure Monitor for You

    Pick a top-scoring model that has the features you need and that will make testing easiest for you. For example, some models allow you to store readings for more than one user. All the models we recommend earn Excellent ratings for accuracy, but there are other factors to consider, too. Follow these tips to help you select the best blood pressure monitor for you.

    Check the Fit
    Make sure the blood pressure monitor you choose has a cuff that fits the circumference of your upper arm or wrist. (Use a tape measure to be certain.) Using a cuff that’s the wrong size can result in inaccurate readings. Most of the arm models we tested have two cuffs or a cuff that can be adjusted to fit most people. Wrist models also fit most people.

    Consider Cost
    The recommended models in the ratings (available to members) were priced from $40 to $100. But shop around. And find out whether your insurance covers blood pressure monitors.

    Choose One That’s Easy to Use
    The display on the monitor should be easy to read. The buttons should be large and intuitive. The directions for using the cuff and operating the monitor should be clear.

    Select the Features You Need
    There are many features to look for when selecting a blood pressure monitor. Here are some to consider: an irregular-heartbeat detector, a risk-category indicator, multiple user memories, multiple cuffs, memory download capability, a large-digit display, and a data-averaging function. For more details, check the specs section of our ratings.

    How We Test

    We rate blood pressure monitors based on their difference from a reference model. Our testing methods are patterned after, but are not identical to, the U.S. ANSI/AAMI/ISO 81060-2:2013, British Hypertension Society, and European Society of Hypertension (revised in 2010) standards. For simplicity, in our ratings tables we generally show summarized results of our tests. For example, the displayed result for accuracy is a composite of the tests based on the three standards mentioned above.

    Using Your Home Monitor Properly

    Take the blood pressure monitor you’ve purchased to your doctor’s office, so your care team can make sure you’re using it correctly and test whether its results are the same as the office monitor’s. The AHA recommends doing this once a year to make sure your device is still working properly and getting accurate readings. And note that even the best home blood pressure monitor can still give inaccurate readings if it’s used improperly. The following tips from the AHA can help.

    • Don’t smoke, drink any caffeine, or exercise for at least 30 minutes before you measure your blood pressure.

    • Use the bathroom and then rest quietly for 5 minutes before taking a reading.

    • Don’t talk during the rest period or while you take a reading.

    • Wrap the cuff around your bare arm, without any clothes between the cuff and your skin. (And don’t roll up your shirtsleeves, which could constrict your arm.)

    • Sit on a sturdy chair with a supportive back (not a sofa), with your feet flat on the floor. Your arms should rest on a flat surface. The cuff of the device, whether it’s on your arm or your wrist, should be at the same level as your heart.

    • Take readings at the same time every day—such as morning and evening—for whatever time period your doctor advises. And each time you sit down to take your blood pressure, you should take two or three readings, 1 minute apart. Record your results and take them to your next appointment.