The American Heart Association has clearly stated that blood pressure measurement is one of the “least accurate” measurements performed. Today we’ll talk about how to accurately measure blood pressure at home. Blood pressure monitors have international standards Mercury column sphygmomanometers will be phased out, so electronic sphygmomanometers have become the main tool for monitoring blood pressure. There are two main types of electronic sphygmomanometers for home use: one is arm type and the other is wrist type. The Chinese Working Group on Blood Pressure Measurement recommends the use of an upper-arm electronic sphygmomanometer certified to international standards for measurement. The main international standards for sphygmomanometer certification are the European Society of Hypertension (ESH), the British Hypertension Society (BHS) and the American Association for the Advancement of Medical Devices (AAMI) standards. China recommends the use of ESH standards, and every six months to calibrate the sphygmomanometer. Cuff selection is important It is currently believed that the length of the cuff airbag should cover 80% of the upper arm circumference and the width should be at least 40% of the upper arm circumference. The lower edge of the cuff is 2-3 cm above the elbow fossa, and we can choose a different type of cuff depending on the circumference of our arm. In obese individuals with overly thick upper arms, the cuff can be placed on the upper forearm to measure the radial artery blood pressure when a suitable cuff is not available. If neither the right nor the left upper arm is suitable for blood pressure measurement, consider using the lower extremity. The cuff is tied to the lower leg and the ankle blood pressure is measured. If the cuff is too loose, the measured systolic and diastolic blood pressures rise slightly; if the cuff is too tight, the systolic and diastolic blood pressures both fall, and the tighter the cuff, the more pronounced the fall, but mainly the systolic blood pressure. The cuff is generally considered to be the right amount of tightness when it can fit two fingers. Time and posture are important The Chinese expert consensus on home blood pressure monitoring recommends that measurements should be taken 2-3 times a day in the morning (after waking up) and in the evening (before going to bed), with an interval of 1 min. Patients who are first diagnosed, early in treatment or those who have been treated but whose blood pressure has not yet reached the standard or is unstable should be measured continuously for 5-7 d before the visit; when blood pressure is well controlled, measurements should be taken once a week. Morning blood pressure measurements are best taken after urination, before breakfast and before taking medication. In the evening, blood pressure should preferably be measured after dinner, after bathing, after taking medication, and before going to bed. Do not smoke or drink stimulating foods such as coffee and tea within 30 minutes before the measurement. Rest in a seated position on a chair with a backrest for at least 5 min before starting the blood pressure measurement. When measuring blood pressure, place the upper arm with the cuff on the table at the same level as the heart, with both legs relaxed and on the ground. Also note these: 1. If the back is not resting or the feet are not on the ground, the systolic blood pressure will be 5-15 mmHg higher than it actually is; 2. Crossing the feet will be 5-8 mmHg higher; 3. Taking the blood pressure without resting for 3-5 min will be 10-20 mmHg higher; 4. If the patient is talking when the blood pressure is measured, it will be 10-15 mmHg higher; 5. If there is difficulty breathing, the blood pressure If the patient’s bladder is full, the blood pressure will be 10-15mmHg higher; 7. If there is pain, the blood pressure will be 10-30mmHg higher. Should I wear clothes for blood pressure measurement? The Chinese Working Group on Blood Pressure Measurement requires that the upper arm be exposed to measure blood pressure. In the daily blood pressure measurement work, especially in the low temperature measurement environment and in the autumn and winter season, many people use the clothed method for blood pressure measurement, is this feasible? Some studies have shown that the effect of the clothed method of measurement on blood pressure is not statistically significant when compared with the standard method of measurement (P>0.05). However, it is required that the thickness of the undergarment is <0.5 cm and that the sleeves are not tight. This can avoid the increase of blood pressure caused by cold and chill, and more mainly can avoid the trouble of rolling up the sleeves directly in order to reduce the trouble of undressing, which can cause the cuff to tighten the artery of the upper arm and make the blood pressure too high. Left arm or right arm? Which is more accurate? It is recommended that the blood pressure of the right and left upper arms (at the brachial artery) be measured for the first time, with the side with the higher blood pressure being the upper extremity for blood pressure measurement. In a normal person, the right brachial artery originates from the first major branch of the aortic arch, the innominate artery, while the left brachial artery originates from the third branch, the left subclavian artery. Therefore, generally speaking, the blood pressure of the right upper extremity is about 10 mm Hg higher than that of the left upper extremity. If the difference in blood pressure (systolic pressure) between the left and right upper arms is greater than 20 mm Hg, it is highly suggestive of aortic arch narrowing and upper extremity artery occlusion, and it is recommended to measure the blood pressure values of the extremities. Insist on home blood pressure measurement Home blood pressure measurement is important for a comprehensive grasp of blood pressure, not only for the diagnosis of white coat hypertension, occult hypertension, but also to monitor the blood pressure control and prognosis of hypertensive patients. However, for patients with rapid atrial fibrillation and frequent premature beats, the electronic blood pressure monitor will not be able to accurately measure blood pressure. Patients with mental anxiety, depression and disorders or those who like to change their treatment regimen without permission and those whose emotions can affect their blood pressure are also not suitable for home self-measurement of blood pressure.