“Elevated blood pressure” is defined by the the American College of Cardiology/American Heart Association (ACC/AHA) Clinical Practice Guidelines  as above 120 mmHg systolic or above 80 mmHg diastolic (120/80). “Hypertension” is defined as blood pressure (BP) above 130/80. The diagnosis of high blood pressure should be based on both clinic and home readings, since they may be different due to the phenomena of white coat and masked hypertension. White coat hypertension refers to blood pressure readings that are elevated in the clinic but normal at home. According to UpToDate :
Conversely masked hypertension refers to normal clinic but elevated home readings. Also, blood pressure should be measured throughout the day and night, since readings may differ significantly by time of day. Whereas the normal 24-hour mean blood pressure is below 125/75, the normal daytime awake mean is below 130/80, and nighttime asleep mean below 110/65 . Furthermore, BP should be measured periodically in both arms to ensure they are approximately equal. BP should also be measured standing as well as sitting in the elderly and in people with dizziness, since BP may fall significantly with standing.
Each individual patient should discuss their appropriate BP target with their healthcare provider, because the target may vary depending on a patient’s age and medical condition.
The most convenient method to take a BP reading is to use an oscillometric instrument. According to an American Heart Association scientific statement :
The most accurate method to diagnosis hypertension is ambulatory blood pressure monitoring (ABPM). This is performed by equipment that automatically measures blood pressure every 15-20 minutes throughout the day and night. However, this equipment is expensive and not widely available.
A reasonable alternative to ambulatory blood pressure monitoring is home blood pressure readings
Home BP monitoring results should be periodically sent to and reviewed by a healthcare provider.
The Omron 10 Series BP 786N blood pressure monitor has received the best rating from Consumer Reports in 2018 , which judged it excellent for accuracy and convenience, and very good for comfort. Wirecutter also found that the Omron 10 Series monitor was the most accurate and comfortable . Besides measuring BP, this monitor has an irregular heartbeat detector and includes a one-size-fits-most cuff. BP readings are stored in memory, can be blue-toothed to your phone, and sent to your physician for review.
1. Whelton PK, Carey RM, Aronow WS, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018; 71: 313.
3. Muntner P, Shimbo D. Measurement of Blood Pressure in Humans. Downloaded from http://ahajournals.org on March 4, 2019
4. Ohkubo T, Imai Y, Tsuji I et al. Home blood pressure measurement has a stronger predictive power for mortality than does screening blood pressure measurement: a population-based observation in Ohasama, Japan. J Hypertens 1998. 16(7): 971.
5. Rickerby J. The role of home blood pressure measurement in managing hypertension: an evidence-based review. J Human Hypertension 2002: 16, 469.
Disclaimer: Since healthcare is complicated and personal, you should discuss these topics with your healthcare provider before applying this information to your own health. This website does not intend to diagnose or treat any disease or medical condition. Its only purpose is to assist people to monitor their health at home under the supervision of their healthcare provider.