Slides

There are two types of BP measurement strategies that can be used at home:

Ambulatory BP monitoring — a noninvasive, fully automated technique in which BP is recorded over an extended period of time. A BP cuff is placed around the upper arm and left in place for about 24 hours. A connected monitor records BP, usually every 15 to 20 minutes while awake and every 20 to 30 minutes while asleep. This approach is expensive; it requires a technologist to program the machine, fit it on the patient, remove it, and download the results and a physician to interpret the results. Additionally, recording BP over an extended period may interfere with the patient’s daily activities and sleep. Ambulatory BP monitoring, therefore, is mainly used to diagnose white coat or masked hypertension or to monitor patients whose BP is hard to control or is highly variable.

Self-measured BP (SMBP) monitoring — regular measurement by the patient (or a companion) of his or her own BP. Readings can be stored and taken to the doctor’s office or transmitted electronically. SMBP measurements can be obtained from the upper arm, wrist, fingers, or lower extremity. However, experts recommend the use of upper arm devices because of their greater accuracy. Patients can measure their own BP and provide written lists of readings to their health care provider at office visits. Newer SMBP devices can automatically store readings, and some are equipped to electronically transmit readings to a health care provider. SMBP is used to aid diagnosis in patients suspected of having white coat or masked hypertension, and to prevent over-treatment in patients with orthostatic BP changes or hypotensive episodes associated with medication.