Monitor Blood Pressure at Home to Prevent Misdiagnosis


Does this situation sound familiar to you?

It’s time for your annual wellness exam. The nurse calls you back, weighs you, checks your temperature, and takes your blood pressure.

Then you hear the dreaded words…“Hmmm, your blood pressure is a little high.”

“I suppose I am a little anxious about this appointment,” you reply, knowing you’re about to undergo a blood draw despite your fear of needles, while sitting naked in a paper gown.

We call this nervous surge in blood pressure at the doctor’s office “white coat syndrome.” This phenomenon affects up to 20 percent of the population. Not surprisingly, it presents a bit of a challenge for doctors. Accurately diagnosing and treating serious conditions like high blood pressure (hypertension) couldn’t be more important.

Hypertension is so dangerous because it can damage the arteries that deliver blood from your heart to the rest of your body. Blood pressure (the force of blood pushing against the walls of your arteries) rises and falls throughout the day. This is normal. But if the force exerted on your arteries stays high for too long, microscopic tears develop in the artery walls.

The tears ultimately turn into scar tissue, providing the perfect lodging place for fat, cholesterol, and other particles—collectively called plaque. And, as this plaque builds up on your artery walls, it narrows the amount of room for your blood to pass through, forcing your heart to work harder to circulate oxygen-rich blood, raising your risk of heart disease and stroke.

About 67 million US adults have hypertension. Millions more don’t even know they have it because, unlike most diseases, high blood pressure presents zero symptoms.

So here we have a life-threatening condition that affects at least one in three Americans, many of whom are unaware. On top of that, 20 percent may be improperly diagnosed with hypertension when all they’re really experiencing is nerves.

The problems of potential underdiagnosis and misdiagnosis are widespread. But there’s a very simple solution.

Be your own doctor

Having an accurate account of your blood pressure over time is the first line of defense in preventing heart attack, stroke, and even death. And the only way to accomplish that is to monitor your blood pressure at home.

The conclusion of a study published last month says it all: Clinical blood pressure measurements alone are not specific or sensitive enough to be used as the main tool in diagnosing or treating hypertension.

Another study found that home monitoring helps confirm cases of white coat syndrome and masked hypertension (the opposite of white coat, when readings in clinical settings are normal, but high elsewhere). Home monitoring is also a better predictor of potential heart issues. The researchers stated that home blood pressure monitoring should have a primary role in diagnosis and treatment of hypertension.

Why? Well, having your blood pressure taken at your doctor’s office is merely a snapshot of what’s going on in your arteries at that very specific moment in time. But home monitoring provides a longer-term view and offers a much clearer picture of your blood pressure fluctuations over time.

Steps to Successful At-Home Monitoring

I recommend home monitoring to anyone who has (or is at risk for) high blood pressure and heart disease. That way they can gauge how effectively their prevention or treatment program is working. I even tell people who have perfectly normal blood pressure that it doesn’t hurt to measure themselves every once in a while. (You can usually do this at your local pharmacy.) Knowing where you stand puts you in much greater control of your health.

Here are some tips to assure the most accurate readings at home.

  • Buy an automatic monitor that goes around your upper arm (as opposed to your wrist or finger), and make sure the cuff fits properly. (Insurance may fully or partially cover a monitor; check with your provider.)
  • Before your first use, have your doctor or nurse check to make sure you are using it properly. Also test your monitor’s accuracy by having your doctor take a reading, then do a self-reading.
  • Take your blood pressure twice a day—morning and evening. At each reading, take two to three measurements (spaced about one minute apart) to make sure they are similar.
  • Thirty minutes prior to measuring, avoid caffeine, alcohol, tobacco, and exercise. Also be sure you have an empty bladder.
  • Position your left arm properly by resting it on the table or chair arm at heart level. Place the cuff on your bare skin, not on top of clothing.
  • Don’t talk or think about stressful situations during the readings.
  • If your monitor doesn’t record your readings automatically, be sure to log them.
  • Sit quietly and calmly for at least three to four minutes beforehand. Make sure to leave your legs and ankles uncrossed before and during the reading.

Treating Hypertension Naturally

For high blood pressure, treatment should always start with lifestyle changes and nutritional supplements. Eliminating sugar and reducing sodium, losing weight, exercising, avoiding tobacco products, managing stress, and getting checked for sleep apnea, thyroid issues and other causes of hypertension can go a long way in reducing blood pressure.

Nutrients that support healthy blood pressure include nattokinase (an enzyme derived from natto, a fermented soybean product), omega-3 essential fatty acids, grape seed extract, garlic, and hawthorn extract.

If you have hypertension, I suggest trying these before turning to pharmaceutical blood pressure medications. You’ll more likely than not see results without any of the nasty side effects of drugs.


Last Updated: February 15, 2019
Originally Published: January 23, 2015