Many healthy behaviors (stopping smoking, eating better, getting active, and losing weight) do not require any input from a health care professional. Health care professionals can help patients live longer and healthier lives with more aggressive blood pressure, cholesterol and blood sugar control. Patients can check their blood pressures at home and the Health Care Remotely can track blood pressures without a face-to-face visit and adjust medications as needed. This page walks through the different steps to set up home blood pressure measurements with our practice.

Get the right blood pressure cuff for you

Measure the distance around your upper arm halfway between your shoulder and elbow. Most cuffs are listed in centimeters instead of inches.

Choose a validated blood pressure cuff. There are at least two groups (US Blood Pressure Validated Device Listing and Stride BP) that use international standards to verify blood pressure machine accuracy. The A&D Medical Essential Blood Pressure Monitor (UA-651) is approved by both groups, accommodates nearly every arm size and, as of November 2022, costs about $41 on Amazon.

Tips for getting an accurate blood pressure reading

• Empty your bladder.
• Sit in a chair where your back and feet are supported.
• Keep your legs uncrossed.
• Wrap the cuff around a bare arm (placing the cuff over clothing can falsely elevate the reading).
• Support the arm at heart level (e.g., keep it resting on a desk).
• Do not have a conversation while the cuff is working.
• When you take your blood pressure, write down the systolic blood pressure (top number), the diastolic blood pressure (bottom number), the arm you took your blood pressure, the date and time of the blood pressure measurement.

After one measurement, wait one to three minutes and take a second measurement.

Initial monitoring schedule

• If we decide that you might benefit from blood pressure monitoring, we would like you to record four blood pressure measurements a day for seven days: twice in the morning and twice in the evening. The two readings in the morning and evening should be taken at least one minute apart.
• Email the blood pressure measurements to clinical@hcremotely.com or enter them within the practice portal.

Goal blood pressure by home monitor

• For patients under age 60, the goal systolic blood pressure by home monitor is less than 125 mm Hg.
• For patients 60 and older with chronic kidney disease, coronary artery disease, diabetes OR peripheral vascular disease, the goal systolic blood pressure by home monitor is less than 135 mm Hg.
• For patients 60 and older without chronic kidney disease, coronary artery disease, diabetes OR peripheral vascular disease, the goal systolic blood pressure by home monitor is less than 145 mm Hg.

Expected Interactions with Health Care Remotely based on your blood pressure measurements

If any systolic blood pressure reading is 171 mm Hg or higher	Contact Health Care Remotely within one business day
If the systolic blood pressures range between systolic blood pressure above goal and 170 mm Hg	Health Care Remotely will contact you within three business days of you sending the measurements to the practice
If the systolic blood pressures range between 100 and goal blood pressure,	Your blood pressure is well-controlled and no further interaction with Health Care Remotely is required.
If any systolic blood pressure is less than 100 mm Hg,	Contact Health Care Remotely within one business day

Monitoring schedule after the first set of measurements

If you have just had your blood pressure medications adjusted, please check your blood pressure twice a day (two measurements each time) once a week.

If your blood pressure is at goal, please check your blood pressure once a month. On that day, check your blood pressure twice in the morning and twice in the evening. If your blood pressure rises above your goal for two months in a row, the Health Care Remotely team will try to determine what adjustments might be needed to bring your blood pressure back to goal.*

*There are no evidence-based recommendations on how often one should check their blood pressure at home. The largest trial of self-monitored blood pressure published in 2018 had patients measure their blood pressure twice in the morning (at least one minute apart) and twice in the evening (at least one minute apart) every day the first week of every month over a year. A 2020 policy statement by the American Heart Association and American Medical Association suggested patients checking their blood pressure four times (twice in the morning and twice in evening) for a week initially. Once a patient’s blood pressure is controlled, the two groups suggest monitoring one’s blood pressure one to three days a week.

Health Care Remotely believes that monitoring blood pressure on a monthly basis is more likely to encourage patients to check their blood pressure regularly rather than expect patients to check their blood pressure at a frequency that is not feasible (e.g., three days a week).