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Understanding Blood Pressure Readings with Blood Pressure Monitor

Reading Time: 12 minutes

High blood pressure is often called the “silent killer”.  Why is that? According to Singapore’s Health Promotion Board, many people with high blood pressure may not know they have it. Often the signs and symptoms are misunderstood or ignored.

Not only does it harm you directly, but it is also the onset of other critical illness as well.

High blood pressure (HBP, or hypertension) has no obvious symptoms to indicate that something is wrong. When left untreated, the damage that high blood pressure does to your circulatory system is a significant factor to heart attack, stroke and other health threats.

The best ways to protect yourself are being aware of the risks involved and making small changes in your diet and daily activities.

What is blood pressure?

Blood pressure refers to the force of the body’s blood pushing against the inner walls of the blood vessels, especially the arteries. Each time the heart contracts, it pumps blood into the arteries. Blood pressure monitor measures your blood pressure.

Most of us are worried about high blood pressure and needs to monitor to keep our blood pressure in check. A minority of the population has blood pressure that is too low and may need different medications.

High blood pressure is one of the top medical illness in Singapore as well as the United States of America. Singaporeans, Americans, are all victims of modern society’s diet problems, where we have excess salt, sugar, and fats.

Who are People at Risk of Having High Blood Pressure?

If you have high blood pressure, you are not alone. Heart.org stated that nearly half of American adults have high blood pressure (many don’t even know they have it.) According to everydayhealth.com, monitoring blood pressure periodically is a good health practice for anyone, but it’s especially important for:

  • Anyone at risk for high blood pressureor related conditions
  • Anyone diagnosed with high blood pressure/hypertension
  • Anyone currently being treated for high blood pressure/hypertension (to evaluate the effectiveness of their medication)
  • Following up on (potentially) false readings
  • Pregnant women with preeclampsia or hypertension

 

What is the ideal normal blood pressure?

The ideal normal blood pressure should be below 120/80 mmHg and above 90/60 mmHg.

You have high blood pressure if you are above 120/80 mmHG. You have low blood pressure if you have readings below 90/60 mmHg.

Your blood pressure doesn’t stay constant throughout the day. It is lowest when you’re sleeping, and rises when you get up and start moving about. It can also go up when you are excited, nervous or physically active. Systolic pressure refers to the blood pressure in the arteries that results when your heart contracts or beats, pushing blood out. When your heart relaxes between beats, blood pressure in the arteries falls. This is the diastolic pressure.

About High Blood Pressure

What is high blood pressure (or hypertension)?

135 / 80 mmHg is the medical limit in Singapore for high blood pressure.

If the systolic blood pressure is greater than 135 mmHg, and the diastolic blood pressure greater than 80 mmHg, you are considered diagnosed with high blood pressure.

High blood pressure can results in stroke, heart attack, kidney failures, dementia, and various serious medical conditions.

How to read your blood pressure reading?

Blood pressure is typically recorded as 2 numbers, typically presented as a ratio like this in all blood pressure monitor:

How to read Blood Pressure reading

Systolic

The top number (the higher of the two numbers shown) measures the pressure in the arteries when the heart beats (which is when the heart muscle contracts).

Diastolic

The bottom number (the lower of the two numbers) measures the pressure in the arteries between heartbeats (that is when the heart muscle is resting between beats and refilling with blood).

Blood Pressure Chart

Blood Pressure Chart

A healthy blood pressure reading should be lower than 120/80 mmHg. Normal blood pressure is less than 120 mmHg systolic and 80 mmHg diastolic (see blood pressure chart), and may vary from 90/60mmHg to 120/80mmHg in a healthy young woman. A blood pressure of 140/90 mmHg or higher indicates high blood pressure.

Blood Pressure Level Categories

Categories for Blood Pressure Levels

Categories for Blood Pressure Levels

Know Your Blood Pressure Number

At what number you are considered having high blood pressure? This table below can show you.

The five blood pressure ranges widely used by Americans or Singaporeans are:-

  • Normal BP

120/80mm Hg is the benchmark for normal blood pressure. If your numbers are within this range, your blood pressure is ideal. Continue to be active daily, have a balanced diet with plenty of vegetables and nuts. Keep up the good work for a healthy body!

  • Elevated BP

120-129 / 80 mm Hg systolic/diastolic – at this range, your blood pressure reading is considered elevated. This is considered the zone just before you are diagnosed with medical high blood pressure (hypertension). The good news is you are not considered in danger zone yet, so do exercise regularly, and have less red meat, less processed food. A great exercise regime with plenty of vegetables, nuts and seeds can help to bring you down from “elevated”.

  • Hypertension Stage 1

130-139 systolic / 80-89 mm Hg diastolic. This is when you are diagnosed with hypertension Stage 1. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular diseases (ASCVD), such as heart attack or stroke.

It is important that you adopt lifestyle changes, such as cutting back on alcohol, cigarettes, oily food or red meat. Exercising regularly is a great step forward.

  • Hypertension Stage 2

Higher than 140 systolic / 90 mm Hg diastolic is considered Hypertension Stage 2. The doctor will usually prescribe medications to manage your blood pressure and insist on lifestyle changes. As with stage 1, simple steps is to cut down on alcohol, smoking, red meat, and oily food.

  • Hypertensive crisis

Higher than 180/120mm Hg. This requires medical attention. Do consult your doctor. If you are taking this reading at home with a home BPM, do sit down and rest for 5-10 minutes and test again to verify this abnormally high reading.

If your readings are still unusually high, contact your doctor immediately. You could be experiencing a hypertensive crisis.

If your blood pressure is higher than 180/120 mm Hg and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision or difficulty speaking, do not wait to see if your pressure comes down on its own. Call 995 for Singapore ambulance services.

How Do You Manage Your Blood Pressure?

There is no specific “cure” for hypertension but there is medication to manage and reduce your risks. You should also adopt lifestyle changes to improve your conditions. It does not need to be drastic changes such as quitting alcohol or smoking completely (though that will help a lot!) but small steps such as reducing alcohol, eating less fried stuff, cutting your smoking by a little daily.

All these small steps do not reduce your enjoyment of life but do help with your blood pressure. And small steps help to add up and leads to bigger steps.

Exercise Pedal SeniorCare

Exercise Daily!

A better BP will lead to a reduction of odds of striking heart disease, stroke, kidney disease etc.

Adjust your lifestyle for healthy blood pressure:

  • Relax, chill and have more leisure to cut down on stress
  • Enjoy daily physical activity, like daily walks or sports.
  • A balanced diet full of vegetables, nuts, and seeds
  • Reduce drinking of beer, wine, spirits and etc.
  • Quit smoking or at least cut down on number of cigarettes
  • Take your medication regularly.

 

What Food to Eat if you have High Blood Pressure?

For people with high blood pressure, you can consider a heart-healthy diet:-

  • Vegetables
  • Fruits
  • Whole grains (wholegrain bread instead of white bread)
  • low-fat dairy products (cheese, milk, etc)
  • Poultry (chicken, duck etc)
  • Fish and seafood
  • Beans and peas
  • Nuts and Seeds

Low Glycemic Foods

You should not eat these foods that will lead to hypertension:

  • sweet food
  • sugar-sweetened beverages such as sweetened tea or coffee
  • salty food (such as potato chips)
  • Red meats.

 

Blood Pressure Monitors for Home / Office uses

Anyone can measure your own blood pressure at home with a digital blood pressure monitor that can be purchased at pharmacies, health care stores etc. Read the instructions carefully. You may wish to calibrate your reading with your family doctor. However, that is usually not needed as almost all commercial units come calibrated.

The proper time to take the measurement is when you are at rest. Please refrain from any physical activities 30 minutes before each measurement. These will help to ensure the accuracy of your reading:

  • Sit in a comfortable position
  • Place your LEFT arm, raised to the level of your heart, on a table or desk, and sit still (take note that the left arm is preferred as your heart is positioned at the left-center of your body)
  • Wrap the cuff of the blood pressure monitor smoothly and snugly around the upper part of your bare arm

How to Use Blood Pressure Monitor at Home?

Singapore’s Health Promotion Board recommends home monitoring for all people with high blood pressure to help the healthcare provider determine whether treatments are working. Home monitoring (self-measured blood pressure) is not a substitute for regular visits to your physician. If you have been prescribed medication to lower your blood pressure, don’t stop taking your medication without consulting your doctor, even if your blood pressure readings are in the normal range during home monitoring.

Do take note of these when taking your blood pressure readings

  • Be still and calm.

No caffeinated drinks, no smoking nor exercising 30 minutes before taking your readings. Do visit the toilet 30 minutes before the readings and have a calm, quiet and relaxing seat for about 5 minutes just before measuring.

  • Sit correctly. 

Sit with your back straight and supported (on a chair, rather than a sofa). Do not cross your legs and lay your feet flat on the floor. Your arm should be supported on a flat table, with the upper arm at heart level. Make sure the bottom of the cuff is placed directly above the bend of the elbow.

Check your monitor’s instructions for graphic instructions, or refer to the youtube video below.

  • Measure at a similar time every day.

As our body changes from morning to night, you should take the readings at similar timing each day so that comparing these readings over days and weeks can be more consistent.  Do take readings just before starting treatment or lifestyle changes, and monitor for 2 weeks.

  • Take multiple readings and record the results.

You should take two or three readings one minute apart and record the results on paper or digitally. If your blood pressure monitor has built-in memory to store your readings, take it with you to your appointments. Some monitors may also allow you to upload your readings records too.

  • Don’t take the measurement over clothes.

Do not take blood pressure readings with the cuff over your clothing (such as sleeves of your shirt) because the extra cloth will act as a barrier. The reading will be less accurate.

Why is my blood pressure fluctuating? Is my BPM faulty?

Researchers from the “Center for Health Research and Rural Advocacy at Geisinger Health System” in Pennsylvania have found that time of day and time of year can influence blood pressure readings by as much as 40%. Not a surprise if your blood pressure varies more than 20mm within the same day.

Your blood pressure varies throughout the day

it is normal for your blood pressure to vary throughout the day and night. It also varies depending on the environment where you measure your blood pressure. Many things, such as stress levels, food or drink intake, activity levels, even time of day can all affect a person’s blood pressure reading at any given time. In fact, there are published studies that show a given person’s blood pressure can change by up to 20mm within a day, based on activity levels, food/drink intake, stress, etc.

Your BP fluctuates with emotions and physical activities

Doctors have also found that blood pressure also fluctuates with physical activity and emotional state, it would be better if you can measure your blood pressure at the same time every day, under resting conditions and on more than one occasion. This will allow the results to be comparable easier.

Do not worry about any single measurement. Do take measurements every day, at around the same time, and observe one’s own blood pressure trend. This will allows you to understand your daily fluctuation cycle & many other factors.

Do not be alarmed if your blood pressure machines seem erratic.

Firstly, Do make sure you read the instructions thoroughly. If need to, you can refer to some Youtube clips.

 

Do make sure your blood pressure machine is from a trusted brand. Most of the highly reputed brands of blood pressure machines are established brand names from Japan or Europe.

Secondly, ensure that the products you bought are from an Authorised Dealers, beware of fakes. Authorized Dealers means that you can have peace of mind as any errors can be solved by re-calibrating by the brand staff in their customer service offices.

Which Arm to Measure Blood Pressure? Right or Left?

The short summary is both arms are fine as the difference is not significant. Though many doctors prefer the left arm as it is nearer to your heart which is located at your left side of the chest.

The difference between the right or left arm is not significant, however, if you do measure a difference of more than 10 mm Hg for either your top number (systolic pressure) or the bottom number (diastolic), there may be an issue in one of the arms. It could be blocked arteries in the arms, diabetes or other health problem.

If this difference is significant and persists, do check with a doctor.

Wrist vs Upper Arm Cuff’s Blood Pressure Monitor, Which One is Better?

Upper arm cuff is more accurate than wrist monitors.

However, wrist blood pressure monitors can be accurate if used correctly. Upper arm cuff is easier to handle correctly, while wrist devices are more difficult to use therefore the more inaccurate results.

Wrist Monitors: Wrist must be the same level as arm

When taking your blood pressure with a wrist monitor, your arm and wrist must be at heart level. If not, it will be less accurate.

Blood pressure measurements taken at the wrist are usually higher and less accurate than those taken at your upper arm. That’s because the wrist arteries are narrower and not as deep under your skin as those of the upper arm.

Who should use Wrist monitors?

There are some people for which measuring blood pressure at the wrist presents an advantage:

  • people who are so obese that an arm cuff cannot be properly wrapped around their arm. (however we do think a large arm cuff will be better)
    HEM-RML31 LARGE CUFF

    HEM-RML31 LARGE CUFF

  • people with a large arm or find blood pressure measurements painful.
  • Women who have undergone breast cancer surgery.

If you are not the above, please stick to normal upper arm cuff blood pressure monitors for ease of using and better accuracy.

Bring your wrist monitor if you visit a doctor

It’s common for blood pressure readings taken at home on any type of monitor to be different from those taken at your doctor’s office.

If you have a wrist monitor, it’s a good idea to take your monitor to a doctor’s appointment. Your doctor can then check your blood pressure with both a standard upper arm monitor and a wrist monitor in the correct position in the same arm to check your wrist blood pressure monitor’s accuracy.

Also, make sure to use a proper authentic brand for your health.

Bottom line: Do use upper cuff arm monitor if possible for great accuracy.

 

What is The Most Accurate Blood Pressure Monitor recommended for Home Use?

We have reviewed many brands, such as Tensoval Mobil, Rossmax, Omron and other brands.

According to medicalnewstoday.com, Omron is one of the most established brands on the home blood pressure (BP) monitor market.  Omron is one of the first names doctors recommend to patients who are considering purchasing their own BP monitor, which would seem to justify their “#1 Doctor Recommended Brand” strapline.

To take a reading, all the user need do is attach the cuff to their upper arm and hit the big, blue button. As well as displaying your blood pressure, the machine will display stats on your pulse and even identify whether you have an irregular heartbeat.

Why Omron is recommended for the Best Blood Pressure Monitor?

One of the biggest reasons is doctors in Singapore tend to prefer Omron for its accuracy and ease-of-use. Most hospitals do use their higher grade products and doctors find the home monitors close to the hospital grade.

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Doctors use high grade medical devices

 

Omron is both crowned for having the Best Overall and Best Bluetooth’s features. Omron’s reputation for high-quality, reasonably-priced, and accurate products has made it an established leader in the home blood pressure monitor category for decades.

Its 10 Series Upper Arm Blood Pressure Monitor continues the tradition of excellence. This monitor earns a best overall ranking for its excellent features, performance, ease of use, and overall value.

 

Comparison of different Omron models of blood pressure monitors- functions and capabilities

There are many large global brands like Omron, Rossmax, Tenosoval Mobile etc.

One of the most reliable global brand worldwide is Omron Healthcare, and Omron provides blood pressure monitors to hospitals, clinics and sells to the general public as well. Due to a huge variety of models, many consumers may be confused about different models.

Comparisons of different models for Omron Blood Pressure Monitors

Comparisons of different models for Omron Blood Pressure Monitors

 

We noted recently there are many made-in-China blood pressure monitors, given that Taobao, Ezbuy, Lazada makes it easy for us to buy foreign Chinese goods. Unfortunately, the quality is sub-par and not monitored by Singapore’s HSA (Health Science Agency)

Do note that there are many merchants are parallel importing blood pressure monitors with no government approvals. Hence, they are not responsible for minor defects and quality lapses. Only authorized dealers have warranty coverage and calibration offers to re-calibrate your blood pressure monitors. These are the reason why the government regulates the import and sales of blood pressure monitors.

UPDATE: As of Jan 2019, Omron has discontinued many older blood pressure monitors models. You may want to get the latest and most value-for-money model from established blood pressure monitors from Authorised dealers in Singapore.

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    Omron HEM-6121 Wrist Blood Pressure Monitor

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    OMRON HEM-7121 Upper Arm Cuff Blood Pressure Monitor (5 Years Warranty)

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    Omron HEM-7130 Upper Arm Cuff Blood Pressure Monitor (5 Years Warranty)

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    Omron HEM-7211 Blood Pressure Monitor Upper Arm

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    Omron HEM-7322 Upper Arm Blood Pressure Monitor

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    Omron HEM-JPN2 Upper Arm Cuff Blood Pressure Monitor

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