This process can be carried out through contact with the local distributor of the device. Intermittent servicing (eg every three years) to check device condition and accuracy is generally recommended, and devices should be serviced or replaced if the accuracy is questionable. 4 A validated wrist device may be a reasonable option in patients with a large arm circumference that is beyond the maximum cuff range. 9 Wrist and finger cuff monitors are less likely to have passed validation testing and should be avoided. A cuff that is too small will overestimate BP and a cuff that is too large will underestimate BP. An appropriately sized cuff that fits the arm within the appropriate range indicated on the cuff must be used. Inaccurate recording of home BP using patient diaries 6–8 is a problem that can be circumvented by using BP devices with memory storage or telemonitoring, if feasible. Standardised method on how to measure home blood pressure 4 A list of validated devices can be found at (Figure 1).įigure 1.
Device validity should be tested in the patient population intended for its use. The BP device should be validated, automated, preferably with memory storage, and used with a correctly sized upper arm cuff. Standardised measurement of home BP What type of BP device to use? This topic is extensively addressed in several international guidelines, 2–4 including an Australian consensus statement 5 in which evidence is provided to show that home BP monitoring offers advantages beyond clinic BP measurement in terms of: It is beyond the scope of this paper to provide a detailed rationale for using home BP monitoring in general practice.
Pragmatic resources for ease of clinical implementation are also provided. The purpose of this article is to provide a practical summary guide for Australian healthcare professionals and their patients on how to measure home BP using a standardised, evidence-based protocol. A standardised approach to measuring home BP is recommended to help minimise error. Home BP monitoring is already in widespread use, 1 but many factors can affect the reliability of BP readings. While 24-hour ambulatory BP monitoring is the gold standard method to assess BP control, it is not always practical to use this in general practice. Home blood pressure (BP) monitoring, the self-measurement of BP in the home, away from a medical environment, provides a greater number of BP readings that are more reliable for assessment of true underlying BP than clinic BP measurement.
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