Should I Start a Blood Pressure Log?by Nicole Van Hoey, PharmD Health Professional
High blood pressure is a concern for at least 75 million Americans. New guidance suggests that a blood pressure level of less than 140/90 mmHg is appropriate for most adults. A true diagnosis of high blood pressure, or hypertension, doesn’t rely on just one measurement, though. Instead, a pattern of high levels is needed.
It can be hard for health professionals to tell if your blood pressure is high regularly, or only during doctor visits. Some reasons that your blood pressure could be higher during an appointment include
white coat syndrome (associated with anxiety in the doctor’s office)
climbing the stairs to get to the office
having appointments after a big meal or gym class
stress about other health problems being discussed
When your blood pressure seems too high in the office, or when you are recovering from a heart procedure, your doctor may ask you to check your own blood pressure at home and share results at the next office visit.
Home blood pressure basics
If you are asked to take your blood pressure at home, you should receive some basic instructions about
what type of monitor to get (bicep and wrist cuffs are most common)
how to use it (especially where to place the strap, how long to stay still, without talking, with feet flat on the ground)
when to use it (after 5 minutes of rest, not directly after a big meal, after—not before—you use the bathroom or smoke)
It’s okay to use the same machine every day at a pharmacy if you have to, but it’s better to have a home machine if you can afford one. That way, your doctor can check to see if your machine gives the same reading as his before you start to use it, and you can be more relaxed when you use it.
You might wonder why your blood pressure monitor can’t save the readings to share with your doctor. Although some electronic monitors can save the last reading or two, most home monitors don’t reliably keep an electronic diary, and anything saved cannot be printed or emailed to share. Advances on the horizon do include monitors that connect with apps; until those are commonplace, keeping a blood pressure log up-to-date is up to you.
What’s in a blood pressure log?
At its most basic, a blood pressure log or diary is just a list of the day, time, and measured blood pressure. Ideally, a log also will include other relevant information, like
sitting or standing position
arm or wrist used
a comment box for notes about eating, physical activity, or medication use before measurement
The idea of a paper diary to record health information is not new; a recording notebook is an affordable and easy way to keep track of your own blood pressure every day. New technology apps make it even easier for doctors—and you—to spot trends, look at pressure changes over time, and more. An electronic log can associate blood pressure with salt intake, weight, chest pain, and medication use, for example.
How do I choose and use an electronic log?
The simplest jump from a paper diary to an electronic record is a spreadsheet on your laptop or tablet that lets you type, instead of write, your daily measurements. But this isn’t your only electronic option. Apple, Android, and Kindle all have free blood pressure diary apps, and their portability makes it easier than ever to share data and keep up on self care. The Android Blood Pressure Diary by e-werest, for example, keeps the week’s history on a home page and can show graphs and statistics by time of day, too. Conversely, the Blood Pressure Log – My Diary app developed by a doctor uses a large keypad in the app, includes a spot to record pulse, and graphs systolic and diastolic numbers in two separate curves. This app also includes a free user manual on its website.
All apps allow basic recording of the systolic and diastolic pressure, but each app offers slightly different displays, storage and export options, and amount of detail. It might take a few tries to find the one that best fits your needs or that is easiest for you to use. You have the flexibility to choose between apps that do any combination of the following:
Auto-select standard options, like always seated
Enter weight and other basic stats
Graph your measurements over a week, month, or personalized date range
Show when your reading reflects prehypertension or a stage of actual hypertension
Sharing the log with your doctor
Another characteristic that differs between apps is the way the information is shared. Some apps can export number measurements from dates you choose into a spreadsheet format (see my example spreadsheet). Others allow you to view and save graphs that show blood pressure spikes in PDF form, or see the number of times your measurements were in a too-high zone, as in-color pictures. Many apps allow you to email these files to yourself or directly to your doctor.
Like apps you might already compare for fun, such as music streamers or photo editors, apps to track your blood pressure can be as individualized and flexible as you want. These apps, though, can help your doctor improve your health, too.