Dossier: Healthy heart

How to take your blood pressure correctly

In the long term, high blood pressure endangers the heart and blood vessels. So it’s all the more important to be aware of your values. It’s easy when you have a monitor at home – if you choose the right one and avoid common mistakes.

Text: Stefan Schweiger; photo: iStock

Experts like Professor Isabella Sudano call high blood pressure the “silent killer”, because you can’t see hypertension and don’t notice the symptoms for a long time. “However, the consequences can be fatal in the long term,” explains Sudano, senior attending physician in the Department of Cardiology at University Hospital Zurich. “High blood pressure damages the blood vessels and the heart”. In Switzerland, it is estimated that around one in four adults are affected by hypertension. And many don’t even know they have it.

When blood vessels harden and thicken, it can lead to arteriosclerosis, which in turn can cause cardiac insufficiency or cardiac arrhythmia. It sounds dramatic – and it is. High blood pressure increases the risk of a heart attack or stroke.

How often should you take your blood pressure?

Blood pressure is a key indicator of your heart health. Everyone should be aware of their blood pressure and measure it regularly – either at the doctor’s practice or at home. How often is regular enough? From the age of 18, it varies from person to person.

  • If you don’t have high blood pressure and have no genetic predisposition, once a year is sufficient.
  • If someone in your family has high blood pressure, you should take the measurement once a month.
  • If you’ve been newly diagnosed with high blood pressure, you should take the measurement every day for two to three weeks until the drug therapy works well.
  • If your high blood pressure therapy is well adjusted? Talk to your doctor, but at least once a month.

Which monitors are suitable for measuring blood pressure at home?

It’s good to take your blood pressure regularly at home, but only if you have an accurate device. The measurement taken at the doctor’s practice is, of course, the most reliable. “However, good appliances for use at home don’t lag far behind these days, provided they are clinically tested and certified,” says Sudano. For example, ESH validation from the European Society of Hypertension or the seal of approval of the Deutsche Hochdruckliga (German hypertension league). Only devices that measure reliably are awarded these official seals. A CE mark on the device does not offer the same guarantee.

Should you take the measurement at your wrist or upper arm? It is most important that the cuff sits comfortably and is positioned at heart height. “Neither position is better than the other,” says Sudano. “Upper arm cuffs are often harder to put on properly. But they are automatically positioned at the right height by the heart.” Positioning is a typical source of error with a wrist cuff: the arm has to be bent and placed on the table so that it is not too far away from the heart.

Avoid typical errors when taking blood pressure

Before measuring

To ensure that the values can be compared with each other, it is important to always measure at the same time if possible. Sudano recommends that you measure your blood pressure before breakfast, before taking medication, before your first coffee, before your first cigarette and while seated and at rest. This often only comes after five minutes of doing nothing. During the day, you should not have exercised, drunk coffee or alcohol or smoked for at least half an hour before taking the measurement. Should you roll your sleeve up? It’s best to take off your top.

During the measurement

When taking the measurement, don’t move, talk or touch the device. The first time, you should take the measurement on both arms. Then always use the arm that shows the higher values.

After measuring

Wait a few minutes, then measure again. Is there a big difference between the two measurements? Then take the measurement again and calculate the mean value from the second and third measurements. It doesn’t matter whether you note the values on paper or use a dedicated app. If the values deviate from the average and you have a suspicion as to why this might be the case, you should make a note of this. State-of-the-art devices that transfer the values directly to an app and evaluate them clearly are handy. However, if you use an app, you should make sure that data protection is guaranteed.

What is blood pressure?

For blood to flow around the body, the blood vessels require a specific amount of pressure, which is generated by the heart beat. A person’s blood pressure depends on the width of the vessels, the volume of blood and the rate at which the heart pumps blood through the body. The upper, systolic blood pressure shows the pressure inside the artery when the heart contracts and pumps blood through the body. The lower, diastolic value shows the pressure in the arteries when the heart rests between beats.

And there is such a thing as “white coat syndrome”, which is when a person’s blood pressure is fine at home, but shoots up at the doctor’s surgery, probably as a result of nervousness or anxiety. A 24-hour continuous measurement can rule out such distortions.