Stephen J. Schueler, M.D.

Primary Hypertension Self Monitoring

If you have hypertension, it is important to become familiar with self-monitoring.

Self Monitoring

  • You should take your blood pressure at least once per week and record the results:
    • You may experience symptoms when your blood pressure is higher than usual.
    • You may experience symptoms when your blood pressure is lower than usual.
    • Notify your doctor for repeated blood pressure readings over 140/90.
    • Notify your doctor for repeated blood pressure readings that are 20 points higher than usual.
  • You should weigh yourself every day and record the results:
    • Notify your doctor if you gain more than 6 pounds over 1 week.
    • If you are overweight, your doctor can suggest a diet that can help you lose weight.

Taking your Blood Pressure
A number of devices are available for home blood pressure measurement. Digital blood pressure devices are easy to use: they automatically calculate the pulse and display the systolic and diastolic pressures. However, a simple blood pressure cuff with a stethoscope is the most accurate way to measure blood pressure.

Tips for Measuring an Accurate Blood Pressure
  • Remain seated or supine with the arm supported at heart level.
  • Do not smoking or ingest caffeine for 30 minutes prior to measurement.
  • Rest for 5 minutes before taking your blood pressure.
  • The blood pressure air bladder should nearly encircle the arm: persons with large arms may require an extra large adult cuff. Cuffs are usually marked to indicate the acceptable size range.
  • Apply cuff 1/2 inch above elbow crease.
  • Locate brachial pulse and place the stethoscope bell at this location.
  • With the valve closed, pump up cuff bulb to approximately 210 mm Hg, or a point where no sounds are heard through the stethoscope.
  • Open the valve slowly (2-3 mm Hg per second) and listen for the point where the tapping sounds are first heard. The corresponding reading on the dial is the systolic pressure. And then, listen for the point where the tapping sounds stop. The corresponding reading on the dial is the diastolic pressure.
  • Perform two more readings per session, separated by 5 minutes.
  • The blood pressure must be elevated during at least 3 separate sessions to diagnose hypertension.

Systolic Pressure Guideline for Adults
Systolic Blood PressureAssessment
Over 140-159Hypertension Stage 1
160 or higherHypertension Stage 2

Diastolic Pressure Guideline for Adults
Diastolic Blood PressureAssessment
Below 80Normal
90-99Hypertension Stage 1
100 or higherHypertension Stage 2

Continue to Primary Hypertension Stress

Last Updated: Dec 16, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Primary Hypertension References
  1. Aronow WS. Treatment of hypertension in the elderly. Geriatrics. 2008 Oct;63(10):21-5. Review. [18828653]
  2. Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004 Jan;22(1):11-9. [15106785]
  3. Then KL, Rankin JA. Hypertension: a review for clinicians. Nurs Clin North Am. 2004 Dec;39(4):793-814. [15561162]
  4. Toto RD. Hypertension and kidney literature review 2000. Clin Nephrol. 2002 Oct;58(4):253-9. [12400839]
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