How to Monitor Your Blood Pressure at Home and When to Call Your Doctor

Nearly half of American adults have high blood pressure. Among people over 60, that number climbs to about two-thirds. High blood pressure is sometimes called “the silent killer” because it usually has no symptoms until something serious happens, like a heart attack or stroke.

Home blood pressure monitoring is one of the best tools you have to catch problems early, track your treatment, and keep your doctor informed between visits. The American Heart Association and the American Medical Association both recommend it for anyone with high blood pressure or at risk for it.

Here is everything you need to know to do it right.

Choosing the Right Monitor

Not all blood pressure monitors are created equal. Here is what to look for:

Get an upper-arm cuff monitor. Wrist monitors and finger monitors are less accurate. The upper-arm style is the gold standard for home use.

Check for validation. Look for monitors that have been tested and approved by a recognized organization. The Association for the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society both certify monitors. Your pharmacist can help you find a validated model.

Make sure the cuff fits. This is the most common mistake people make. Cuffs come in different sizes. Measure around the middle of your upper arm. Most standard cuffs fit arms 9 to 13 inches around. If your arm is larger, you need a large or extra-large cuff. A cuff that is too small will give falsely high readings. A cuff that is too big will give falsely low readings.

Budget options work fine. You do not need the most expensive monitor. Reliable upper-arm monitors cost between $40 and $80. Some Medicare Advantage plans and supplemental insurance policies cover the cost. Ask your plan.

Popular validated models include:

Omron Silver (BP5250)
Omron Gold (BP5350)
Withings BPM Connect
A&D Medical UA-651

How to Take an Accurate Reading

Small details make a big difference in blood pressure readings. Follow these steps every time:

1. Sit quietly for five minutes first. Do not rush in from walking the dog and immediately strap on the cuff. Sit in a chair with your feet flat on the floor and your back supported. Rest for five full minutes before you start.

2. Skip caffeine and exercise beforehand. Do not drink coffee, tea, or soda for 30 minutes before your reading. Do not exercise for 30 minutes before. Both can temporarily raise your blood pressure.

3. Empty your bladder. A full bladder can raise your systolic reading by 10 to 15 points.

4. Sit correctly. Sit with your back against the chair. Do not cross your legs. Place your feet flat on the floor.

5. Position your arm right. Rest your arm on a table or armrest so your upper arm is at heart level. Your arm should be relaxed, not tensed. Roll up your sleeve so the cuff sits on bare skin, not over clothing.

6. Place the cuff correctly. The bottom edge of the cuff should sit about one inch above the bend of your elbow. The tube should run down the center of your inner arm. Most cuffs have an arrow or marker that should line up with your brachial artery (the inside of your elbow crease).

7. Do not talk. Talking during a reading can raise your numbers by 10 points or more. Stay still and quiet while the monitor works.

8. Take two readings. Wait one to two minutes between readings. Record both numbers. If they are very different (more than 10 points apart), take a third reading.

Understanding Your Numbers

Blood pressure is recorded as two numbers: systolic (top number) over diastolic (bottom number). Both matter.

Category	Systolic	Diastolic
Normal	Below 120	Below 80
Elevated	120-129	Below 80
High Blood Pressure Stage 1	130-139	80-89
High Blood Pressure Stage 2	140 or higher	90 or higher
Hypertensive Crisis	Higher than 180	Higher than 120

Systolic (the top number) measures the pressure in your arteries when your heart beats. Diastolic (the bottom number) measures the pressure between beats.

For most adults over 60, doctors focus more on the systolic number because it tends to rise with age and is a stronger predictor of heart disease and stroke.

A note about home vs. office readings: Home readings are usually 5 to 10 points lower than what you see in the doctor’s office. This is normal. Many people have “white coat hypertension,” meaning their blood pressure goes up from the stress of being in a medical setting. Home monitoring gives a more accurate picture of your true blood pressure.

When and How Often to Check

The American Heart Association recommends this schedule:

If you have high blood pressure or are starting a new medication: Check twice a day for the first two weeks. Take one reading in the morning before medications and one in the evening.
After the first two weeks: Check at least a few times per week at different times of day.
Before a doctor’s visit: Check daily for one week before your appointment. Bring the log with you.

Keep a log. Write down every reading with the date, time, and which arm you used. Many monitors store readings automatically, but a written log is useful to share with your doctor. You can also use a free app like the AHA’s Blood Pressure Tracker.

When to Call Your Doctor

Most blood pressure changes happen slowly over weeks and months. But some situations need quick attention:

Call your doctor’s office (same day or next day) if:

Your readings are consistently above 140/90 for several days
Your readings have jumped significantly from your usual numbers (for example, your normal is 125/80 and now you are seeing 155/95)
You are having side effects from your blood pressure medication (dizziness, fatigue, cough, swelling)
Your readings are consistently below 90/60, especially if you feel lightheaded

Call 911 or go to the emergency room if:

Your reading is above 180/120 AND you have symptoms like chest pain, shortness of breath, vision changes, severe headache, numbness, or difficulty speaking
You have any symptoms of a stroke (sudden face drooping, arm weakness, speech difficulty)

A reading above 180/120 without symptoms is still urgent but may not need an ER visit. Call your doctor immediately for guidance. Do not wait until the next business day.

Common Mistakes That Throw Off Your Numbers

Even careful people make these errors:

Talking or watching TV during the reading (can add 10+ points)
Crossing your legs (can add 5 to 8 points)
Cuff over clothing (can add 5 to 50 points, depending on thickness)
Arm hanging at your side instead of supported at heart level (can add 10 points)
Using the wrong cuff size (too small adds 2 to 10 points)
Checking right after coffee, a meal, or exercise (can add 10 to 20 points)

These errors almost always make your reading higher than it truly is. If your numbers seem surprisingly high, review this list and try again in 30 minutes with correct technique.

Talking to Your Doctor About Your Numbers

Bring your blood pressure log to every doctor visit. This gives your doctor a much better picture than a single office reading.

Good questions to ask your doctor:

“What is my blood pressure target?”
“Should I adjust my medications based on these home readings?”
“Is my home monitor accurate?” (Your doctor can compare your home reading with their office equipment.)
“Are there lifestyle changes I should try before adding medication?”

If your doctor prescribes blood pressure medication, home monitoring helps you see whether it is working. Most medications take two to four weeks to reach full effect. Keep checking regularly and report back.

Lifestyle Steps That Lower Blood Pressure

Along with monitoring, these changes can bring your numbers down:

Reduce sodium to less than 2,300 mg per day (about one teaspoon of salt). For even better results, aim for 1,500 mg.
Walk 30 minutes a day most days of the week
Lose weight if you are overweight. Even 10 pounds can make a difference.
Limit alcohol to one drink per day for women, two for men
Eat more potassium-rich foods like bananas, sweet potatoes, and spinach
Manage stress through deep breathing, meditation, or activities you enjoy

These steps can lower your systolic blood pressure by 5 to 15 points each. Combined, they can sometimes replace or reduce the need for medication.

The Bottom Line

Home blood pressure monitoring is simple, affordable, and could save your life. It gives you and your doctor better information than occasional office visits alone. Get a validated upper-arm monitor, learn the correct technique, and check regularly.

Your blood pressure tells a story about your heart health. Pay attention to it.

Reported by Sarah Thornton with additional research from the SeniorDaily editorial team. For corrections or updates, please contact us.