New high blood pressure guidelines: Think your blood pressure is fine? Think again
'It's An Inaccurate Reading': Expert Says 'the Majority' Of Doctor's Offices Are Taking Your Blood Pressure Wrong
'The amount of times I had mine measured incorrectly is insane.'
Posted on September 12 2024 7:00 pm CDT
A self-described medical assistant instructor has gone viral on TikTok after claiming the "majority" of doctor's offices are taking your blood pressure wrong. In the TikTok, which amassed 387,200 views as of this writing, user @favorite_ma_instructor detailed five rules for checking blood pressure that she says doctor's offices aren't following.
"In order to accurately take a patient's blood pressure, they need to be sitting, resting for at least five minutes—which means, if you were sitting in the waiting room for however long, and then you get up, and you walk from the waiting room to the back, and then you sit in a chair, you are no longer sitting for five minutes," she said.
She then said patients should have their feet flat on the floor. She also claimed the reading must be taken at least 30 minutes after a patient's last meal.
Fourthly, she added, "Your patient is supposed to be sitting with their back rested against something. So, if your patient is sitting on one of our beds and they're sitting up … their back isn't really being supported, so it's an inaccurate reading."
Her fifth and final claim was, "A lot of people have high blood pressure just walking into a provider's office due to white coat syndrome. This does not mean that this patient has high blood pressure. It just means that something surrounding them, something that's happening, has instilled a little bit of fear or anxiety, and during that moment, it causes a spike in their blood pressure."
@favorite_ma_instructor Now there are several other factors that are involved when it comes to obtaining an accurate blood pressure such as the size of the cuff that is being used. #b#bloodpressureb#bloodpressurecheckm#medicalassistantm#medicalassistantlifem#medicalassistantsoftiktokm#medicalassistantstudent ♬ original sound – Medical Assistant Instructor Are these claims true?According to the United Kingdom's National Health Service (NHS), "white coat syndrome" is a real issue that affects blood pressure readings in doctor's offices. The NHS website also verifies the five-minute rule, adding that "this period of rest allows the body to relax and stabilize, ensuring a more accurate portrayal of the individual's blood pressure."
Furthermore, the American Heart Association notes that "dangling feet" and an "unsupported back" can "throw off a blood pressure reading and classify a patient as having high blood pressure when they don't."
As for eating beforehand, Healthline confirms people should wait at least 30 minutes after eating before measuring their blood pressure. It states this is because the digestion process can temporarily lower blood pressure.
In the TikTok comments, viewers shared their own experiences with white coat syndrome and inaccurate blood pressure readings. "I have white coat syndrome BAD and my BP is always at like stroke levels every time I go to the doctor," one claimed. "My at-home readings are always very normal."
Another shared, "The amount of times I had mine measured incorrectly is insane. They aren't even lining up the cuff correctly."
"I told my doctors office this and they wrote 'patient blames office for her high BP' in my chart," a third said.
The TikToker didn't immediately respond to the Daily Dot's request for comment via TikTok comment.
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The Best Blood Pressure Monitors To Have At Home, According To Cardiologists
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There are many reasons to keep a blood pressure monitor at home, the main one being that high blood pressure (also known as hypertension) frequently has no symptoms and can easily go undetected, explains Karishma Patwa, M.D., cardiologist at Manhattan Cardiology in New York City. "People may not be aware they have high blood pressure until they suffer a significant health consequence, like a heart attack or stroke." Monitoring blood pressure on your own, therefore, could quite literally be life-saving.
Meet the Experts: Karishma Patwa, M.D., cardiologist at Manhattan Cardiology in New York City, Ernst von Schwarz, M.D., a Los Angeles-based cardiologist and author of The Secrets of Immortality, and Katie E. Golden, M.D., board-certified emergency medical physician and medical editor at GoodRx.
Plus, measuring blood pressure at home helps you and your doctor get a better understanding of your levels, as an anxiety-induced phenomenon called "white coat syndrome" is often responsible for elevated numbers during office visits, explains Ernst von Schwarz, M.D., a Los Angeles-based cardiologist and author of The Secrets of Immortality. "More readings mean more accuracy," adds Dr. Patwa. "Blood pressure can change throughout the course of the day. Home monitoring allows for multiple readings at different times, providing a more accurate picture."
From there, the insights can help you adjust your lifestyle to maintain healthy levels, as factors like stress, exercise, and diet all have an impact. So, whether or not you've been diagnosed with hypertension, if you don't already monitor your blood pressure at home, now is a good time to start.
Below, experts recommend the best blood pressure monitors for use at home and on-the-go.
Platinum Blood Pressure MonitorThe experts we spoke to all recommend taking multiple readings consistently to identify trends in your levels over time. This device makes it easy by taking three consecutive readings in two minutes of wear for the best possible accuracy, and it also stores readings, allowing you to compare data between days and signaling when your average is off. You can read all its health data on the Omron app and easily share the monitor with a partner or family member, as it will hold information for two separate users.
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Platinum Blood Pressure Monitor
amazon.Com
$84.00
Omron Track Smart Upper Arm Blood Pressure MonitorIf you're someone who's always on-the-go and can't be bothered with charging an at-home monitor, this battery-powered one has all the basic functions without the need to plug it in all the time. Its simple, minimal buttons make it easy to use, and app connectivity offers a deeper dive into your data, which includes flagging of any irregular heart rhythm that may arise. Dr. Patwa recommends iHealth as a reputable brand for at-home blood pressure monitors.
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Track Smart Upper Arm Blood Pressure Monitor
amazon.Com
$39.99
iHealth Blood Pressure MonitorDr. Patwa recommends this monitor and so do its 20,000-plus five-star raters on Amazon. It's small enough to easily travel with, and can run on batteries or be plugged in to save power. "I have tried many monitors. Most were large and more expensive. This is accurate, saves data, has lighted screen which is great for night use, [and is] very easy to set up," one users raves. "Worth more than I paid."
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Blood Pressure Monitor
walmart.Com
$39.95
Greater Goods BM67 Upper Arm Blood Pressure MonitorGreat for the whole family, this simple monitor stores up to 30 measures at a time for four users. It also features app connectivity, and simple color risk indicator graphics that make interpreting each reading a breeze. Amazon reviewers particularly love the large numbers and well-lit display, "and most important it is accurate," one adds.
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BM67 Upper Arm Blood Pressure Monitor
walmart.Com
$68.12
Beurer Blood Pressure MonitorFor a reasonable price, this monitor is battery-powered for portability, and features a large display screen for optimal visibility. In addition to checking and storing blood pressure levels, it also detects irregular heartbeats and it only takes the push of one button to get a reading started. One Amazon shopper wrote, "I have had several of these types of products and always struggle with finding my pulse or pressure. This one finds it, gives indication and is accurate. It has an incredible data tracking, with charts and trends to send to doctors to print to take with you if needed."
Shop Now
Blood Pressure Monitor
walmart.Com
$39.99
Meraw Blood Pressure MonitorIt takes 30 seconds to get an accurate reading from this monitor, that comes calibrated and ready-to-use right out of the box. The basic design and multiple user compatibility make it ideal for family use, and a color-coded key makes it easy to interpret your levels. "I definitely recommend, especially for the price," a reviewer writes.
Shop Now
Blood Pressure Monitor
amazon.Com
$19.99
Aile Silver Blood Pressure MonitorIf you don't want to splurge for the Omron Platinum but would like most of its perks, the Omron Silver is the next best thing. It also averages your readings and alerts you when they're off, and it's known for its accuracy thanks to its multiple data points and 360-degree cuff inflation. It also offers app connectivity which is compatible with Alexa-enabled devices.
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Silver Blood Pressure Monitor
amazon.Com
$56.00
Omron Complete Wireless Upper Arm Blood Pressure + EKG MonitorThis Omron monitor is a blood pressure and EKG monitor in one, which therein tracks systolic and diastolic blood pressures, pulse, atrial Fibrillation, tachycardia, bradycardia, and sinus rhythm. The device requires the use of your smart phone—which connects it to the Omron Connect app, where all of your data is stored. The trends the app identifies can help you take detailed health information to your doctor and aid in diagnoses. Plus, the app offers heart health-related advice and information.
Shop Now
Complete Wireless Upper Arm Blood Pressure + EKG Monitor
amazon.Com
$130.41
Omron Neo Wireless Blood Pressure MonitorMost blood pressure monitors come in two pieces—the cuff and the display. This one, however, combines them with a sleek, thin screen attached to a cuff for convenience, portability, and ease of use. Your readings are delivered straight to the screen itself and the compatible app, where an unlimited number of readings can be stored and analyzed.
Shop Now
Neo Wireless Blood Pressure Monitor
amazon.Com
$79.99
iHealth How to choose the best blood pressure monitorConsider cuff size: Although most are similar, not all cuffs are created equal, and you want to make sure to get one that fits your arm well for accurate readings. A cuff that's too tight or too lose can throw them off.
Decide on complexity: How fancy of a monitor are you looking for? There are simple models that give you basic stats on-screen and high-tech versions that track all kinds of metrics, stored in a mobile app. "What's most important is that it is simple to use, and you are comfortable and confident in using it," says Golden.
Consult your doctor: If you're unsure about the type of blood pressure monitor to buy, or if you're ever concerned about the accuracy of your specific cuff, Golden recommends seeking advice from your doctor and even bringing your chosen cuff along to a check-up. "You can compare the measurements from your home monitor with the monitor at the office or pharmacy," she says, to determine how well it works.
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How does a blood pressure monitor work?To understand blood pressure monitors, you have to understand blood pressure, which is "a measure of how hard your blood pushes against your artery walls as it circulates throughout your body," explains Golden. A blood pressure reading includes two numbers: systolic pressure (the top number of a reading), and diastolic pressure (the bottom number).
The systolic pressure is the pressure in the arteries when the heart is pumping and blood is moving, she adds, and the diastolic pressure is the pressure in the arteries when the heart is relaxed and filling up with blood, which is why it's always a lower number. "Think of it like a wave at the beach. The systolic pressure is like the wave crashing forward onto the shore," Golden says. "The diastolic pressure is like the water receding back into the ocean to prepare for the next wave."
Blood pressure monitors are pretty simple by design. An arm cuff is connected to an air pump, and "when the pump is activated, the cuff inflates until it can sense it has reached a high enough pressure to temporarily stop blood flow," says Golden. "As the cuff deflates, it measures the pressure at which your blood starts flowing again (systolic pressure), and when the blood vessel remains open in between heartbeats (diastolic pressure)."According to the American Heart Association, a normal reading for an average, healthy person is below 120/80, but that "normal" can vary from person to person, Golden adds, "depending on their other medical conditions and health status."
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Types of blood pressure monitorsThere are two main types of blood pressure monitors:
Manual: The model you've likely seen at a doctors appointment, manual monitors feature a cuff that is placed around the upper arm and a squeezable bulb that manually pumps air into the cuff. As air is gradually let out of the cuff, a stethoscope is used to listen for sounds of blood flow, Patwa explains.
Automatic: Most at-home monitors are automatic because they're easier to use. They work with the use of a sensor, which measures blood pressure and detects blood flow. "The cuff is automatically inflated by the monitor, and a digital reading is generated from the sensor," Patwa says.
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How accurate are blood pressure monitors for home use?Dr. Von Schwarz says at-home blood pressure monitors work "relatively well as long as the heart rhythm is regular." Still, he recommends taking two to three measurements at a time to ensure accuracy and reproducibility.
Golden adds that finger and wrist monitors are less reliable. "Take your blood pressure when you are at rest, sitting down, and in a quiet place," she recommends. "It's best not to take your blood pressure right after exercise, drinking a cup of coffee, or even after a stressful event or moment. And for those taking blood pressure medication, you should wait at least an hour after taking the medication before testing your blood pressure to get an accurate reading."
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How we chose the best blood pressure monitorWe spoke to doctors and cardiologists Katie E. Golden, M.D., board-certified emergency medical physician and medical editor at GoodRx, Karishma Patwa, M.D., cardiologist at Manhattan Cardiology in New York City, and Ernst von Schwarz, M.D., a Los Angeles-based cardiologist and author of The Secrets of Immortality for their recommendations and expert input. We also consulted customer reviews to narrow down the best picks.
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Why Home Blood Pressure Monitoring Could Save Lives
A recent study published in the American Journal of Preventive Medicine reveals that increasing the use of home blood pressure monitoring among U.S. Adults with hypertension could significantly reduce cardiovascular disease and result in long-term healthcare savings.
The findings suggest that home monitoring could help address health disparities, particularly benefiting racial and ethnic minorities and people living in rural areas by reducing heart attacks and strokes.
According to Yan Li, Ph.D., Professor at the School of Public Health, Shanghai Jiao Tong University School of Medicine, "Our study is among the first to assess the potential health and economic impact of adopting home blood pressure monitoring among American adults with hypertension.
We found that it facilitates early detection, timely intervention, and prevention of complications, leading to improved control and better health outcomes."
The study revealed that shifting from traditional clinic-based care to home blood pressure monitoring could lower the number of heart attacks (myocardial infarctions) by 4.9% and strokes by 3.8% over the next 20 years.
Certain groups—such as non-Hispanic Black individuals, women, and rural residents—could see more significant reductions in cardiovascular events and higher healthcare cost savings compared to non-Hispanic White individuals, men, and urban residents.
These findings suggest that home monitoring could play a role in reducing health disparities by improving access to effective hypertension management.
Greater Impact in Rural Areas and Long-Term Savings
In rural areas, where hypertension and access to healthcare are particularly pressing issues, home blood pressure monitoring could have an even greater impact.
The study projects that for every one million people, 21,278 fewer heart attacks would occur among rural residents, compared to 11,012 fewer heart attacks in urban populations.
The economic benefits are also substantial. Based on data from the Medical Expenditure Panel Survey (MEPS), researchers estimate that home blood pressure monitoring could save an average of 4.4% per person in healthcare costs annually, with savings totaling around $7,794 per person over a 20-year period.
These savings would come from fewer cardiovascular events and reduced hospital visits, making home monitoring a cost-effective intervention.
Challenges of Traditional Clinic Monitoring
Hypertension, defined as systolic blood pressure over 130 mmHg or diastolic blood pressure over 80 mmHg (or being on medication for it), is a leading cause of heart disease and stroke in the U.S. Despite its significant impact on public health, traditional clinic-based blood pressure monitoring has notable limitations.
Patients typically visit the clinic infrequently, and their blood pressure readings can be affected by factors such as "white coat" syndrome, where blood pressure is elevated in a medical setting, or "masked" hypertension, where it appears normal in the clinic but is higher outside.
Home blood pressure monitoring addresses these challenges by providing more consistent, accurate readings over time, leading to better management of hypertension.
Despite its effectiveness, home monitoring is not yet widely adopted in the U.S. Due to inadequate insurance coverage, limited investment in preventive services, and insufficient promotion by healthcare providers.
Pandemic-Driven Change and Future Potential
The disruptions caused by the COVID-19 pandemic have brought more attention to home blood pressure monitoring. Between 2020 and 2022, as many patients avoided in-person clinic visits, home monitoring became a more viable option for managing chronic conditions like hypertension.
With nearly half of all U.S. Adults affected by high blood pressure, the study's co-lead investigator, Donglan Zhang, Ph.D., from New York University Long Island School of Medicine, emphasized the importance of expanding home monitoring.
"Home blood pressure monitoring empowers patients to take a more active role in managing their chronic conditions. Our findings provide compelling evidence for healthcare systems and payers to support the broader implementation of this intervention."
By encouraging the widespread adoption of home monitoring, the study suggests that healthcare systems can improve outcomes for millions of Americans, particularly those in underserved communities, while reducing the overall burden of cardiovascular disease and healthcare costs.
If you care about blood pressure, please read studies about unhealthy habits that could increase high blood pressure risk, and people with severe high blood pressure should reduce coffee intake.
For more information about blood pressure, please see recent studies that early time-restricted eating could help improve blood pressure, and results showing plant-based foods could benefit people with high blood pressure.
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