Choosing the right home blood pressure monitor
If you've been diagnosed with high blood pressure (hypertension) or pre-hypertension, or if you have risk factors for high blood pressure, your healthcare provider may recommend that you monitor your blood pressure at home. Home monitoring can help you track your treatment if you're taking blood pressure medicine as well as help you keep an eye on your blood pressure between doctor visits. But with all of the different kinds of blood pressure monitors available, how do you know which ones are reliable?
Ask your healthcare provider for advice in selecting and using a home monitor. When it's time to go shopping, keep these tips in mind:
* Choose an automatic, cuff-style, bicep (upper am) monitor. Automatic monitors are easier to use and don't require a stethoscope. You just put the cuff on your upper arm, press a button and your rate will appear on a digital screen. The AHA recommends upper arm monitors because they are more reliable than wrist and finger monitors.
* Make sure the monitor is validated. Before you buy, check to see if the monitor you're interested in has been tested and approved by the Association for the Advancement of Medical Instrumentation, the British Hypertension Society and the International Protocol for the Validation of Automated BP Measuring Devices. A list of validated monitors is available at dableducational.org/sphygmomanometers/recommended_cat.html.
* Check that the monitor is suitable for any special needs. If you're older, pregnant or buying the monitor for a child, make sure it's validated for these conditions.
* Get the right cuff size. Adults and children with small arms or adults with large arms may need special-sized cuffs. Measure around your upper arm and see if the cuff that comes with the monitor is the right size. If not, you can buy a special-sized cuff from a pharmacy or medical supply company.
* Check the display size. Make sure the display that shows your blood pressure measurement is clear and easy to read.
* See if your health insurance will cover the cost. Blood pressure monitors can vary in price from $25 for a manual one to over $150 for an automatic device. Some insurance providers will reimburse you for the cost of a home blood pressure monitor; call your insurance company to find out.
Once you purchase a monitor, ask your healthcare provider to check the monitor before you use it and then once a year to make sure you're getting accurate readings. Once you're ready to use the monitor, follow the directions in the instruction booklet carefully. Don't smoke, drink caffeinated beverages or do any physical activity for 30 minutes before taking a measurement. Sit up straight with your feet on the floor and support your arm on a flat surface (such as a table). With your upper arm at heart level, take two or three readings one minute apart and record all three. Some monitors will store your readings in their memory. If yours doesn't have this feature, record your readings on paper or use an online tracking device—you can find one at heart360.org.
Your healthcare provider will tell you what range your blood pressure should be in. Contact him or her if your readings aren't within that range.
Life's Simple 7 in a Nutshell
Cardiovascular health encompasses two basic components: ideal health behaviors and ideal health factors.
The behaviors include not smoking, maintaining a healthy weight, meeting or exceeding AHA recommendations for physical activity and eating a healthy diet.
The health factors include blood pressure, fasting blood glucose and total cholesterol levels that are within the AHA's recommended range—preferably without needing medication to keep them there.
Modest lifestyle or behavioral changes can move you in the right direction. And those who make behavioral changes before developing any serious health risks can look forward to a better quality of life and moving toward excellent heart health.
Stop them before they start
According to recent studies, smoking and use of other tobacco products usually begin in adolescence—more than 80% of adults who smoke started before they turned 18. Every day in the United States, about 3,450 kids between the ages of 12 and 17 smoke their first cigarette, and 850 become daily cigarette smokers. And once they start, it's hard to stop. So how can you prevent your kids from smoking in the first place?
First, set a good example. If you smoke, quit! Studies have shown that kids who have a parent who smokes are more likely to smoke and be heavier smokers at an earlier age. Tell your kids how hard it is to quit. Don't allow anyone to smoke in the house—this sends a strong message that smoking is undesirable. If you maintain a smoke-free home, kids are less likely to smoke.
Provide your kids with the facts they need about how harmful smoking is. Emphasize the effects of smoking on physical appearance—kids, especially teens, are particularly aware of how they look. Tell them that smoking causes yellow teeth, bad breath, smelly clothes, and early facial wrinkles. Show them how cigarette ads are designed to manipulate them. Talk to your kids about the false ideas of glamour, maturity, and coolness that ads portray.
Be open and talk to your kids about the reality of smoking, but don't be judgmental or make them fear punishment. Avoid lecturing, threats and intimidation. Ask them what they find appealing about smoking, and really listen to what they have to say. Some kids think smoking makes them feel rebellious or independent. Applaud their good choices and talk about the consequences of bad choices. Explain how smoking affects the daily life of those who choose to smoke and how expensive it is. Calculate the weekly, monthly or yearly cost of smoking a pack a day; compare the costs with that of electronic devices and clothes.
Remind kids that smokeless tobacco, clove cigarettes, candy-flavored cigarettes and hookah smoking are just as dangerous and addictive as cigarettes, no matter what they may have heard to the contrary. Provide guidance on how to deal with peer pressure and to refuse cigarettes. Remind them of the seriousness of addiction—kids tend to assume that bad things only happen to other people. Explain the long-term consequences, such as cancer, heart attack and stroke. Provide examples of family members, neighbors or celebrities who've become ill or died as a result of smoking.
Even though you may think otherwise, kids do listen to what their parents have to say. Just make sure you say it with respect for their thoughts—and say it often! With your guidance, you can help your kids make the right choices to keep them smoke-free and healthy.
Is high cholesterol inherited?
We all know that high cholesterol is associated with eating foods that are high in saturated fats such as red meats, butter and cream. If you watch what you eat and cut back on these fatty animal products, it's possible to keep your cholesterol at a healthy level. But did you know that your genes also play an important role in the amount of cholesterol in your blood?
Sometimes it's not what you eat that's increasing your cholesterol levels but what you've inherited. Some people find it difficult to lower their cholesterol levels no matter how carefully they manage their diet. This is usually due to a genetic abnormality that causes the body to produce excess cholesterol, no matter what you eat. Two inherited conditions, familial (“runs in families”) hypercholesterolemia and familial hyperlipidemia, can cause high levels of cholesterol to occur naturally in the body and lead to early heart disease. Hypercholesterolemia increases the level of cholesterol in the blood. It's the most common condition—about one in 500 people have it. Hyperlipidemia increases the level of fat in your blood, which in turn increases the level of cholesterol. This condition is more common in families that have a history of high cholesterol. Both of these inherited conditions can be dangerous if they're not taken care of and can lead to heart attack, stroke and hardening of the arteries.
Having a genetic predisposition to high cholesterol doesn't mean you can't control it, however. While most people with high cholesterol can bring their levels down by cutting back on fatty foods, maintaining a healthy weight and regularly exercising, those with inherited types need to work a bit harder. Restricting fat and cholesterol in your diet is important—you'll have to cut out saturated fats, as cholesterol and saturated fats are usually found in the same foods. Limiting total calories per day and increasing the amounts of fruits and vegetables you eat is important too. Your healthcare provider will help you choose the best eating plan for your condition.
Following a regular physical activity program can help get your cholesterol levels down. Most people with inherited types of high cholesterol are also given prescription medications. These may include fibrates, which lower fat levels in the blood; statins, which lower cholesterol levels; and bile acid sequestrants, which remove cholesterol from the body. You may have to take more than one. Your healthcare provider will decide which will work best for you.
If your healthcare provider determines that you have one of the inherited conditions, follow his or her plans for a healthy eating plan, a regular physical activity program and medication regimen. With a little extra work, you'll be able to keep your cholesterol at a healthy level and avoid serious heart problems in the future.
Does where you gain weight matter?
We all know that gaining weight isn't good for our health—but did you know that where we gain weight counts, too? You've probably seen body composition examples of people who are shaped like “pears” (most of their weight gain is in the hips and thighs) or “apples” (most of their weight gain is in the abdomen). Unfortunately, when it comes to fat distribution, apples aren't the healthy choice.
Studies have shown that fat that builds up in the abdominal area can be more dangerous than fat that builds up in the hips and thighs. About 90% of all body fat is subcutaneous, meaning it lies just beneath your skin. Fat that builds up around your abdomen is visceral, which means it lies beneath the abdominal wall. Subcutaneous fat produces beneficial molecules, such as the hormone leptin, which acts on the brain to suppress appetite and burn stored fat. Visceral fat, on the other hand, produces molecules that have been implicated in dangerous health conditions such as cardiovascular disease, dementia, asthma, diabetes, high cholesterol, breast cancer and colon cancer.
If you look in the mirror and see an apple instead of a pear, don't despair. The good news is that the visceral fat on your abdomen responds more efficiently to healthy eating and exercise than the subcutaneous fat you find on your hips and thighs. Aim for regular moderate-intensity physical activity, such as brisk walking, for 150 minutes per week along with resistance training, lifting weights and a healthy eating plan to take a bite out of that apple and help whittle your waistline.
Keep cholesterol in check with physical activity
Eating right is an important part of getting your cholesterol to a healthy level. Keeping saturated fats at a minimum and increasing your intake of fruits and vegetables and whole grain, high-fiber foods can certainly help, but that's not all. Physical activity is just as important in keeping those levels where they need to be.
Studies have shown that physical activity stimulates enzymes that help move cholesterol from the blood to the liver, where it is excreted. Most cholesterol disorders respond to the amount of exercise rather than specific types. So the more you exercise, the more cholesterol leaves your body. Physical activity also increases the size of protein particles that carry cholesterol through the blood, making it harder for cholesterol to land in small places like the linings of the heart and blood vessels.
Remember that regular physical activity doesn't have to mean going to the gym every day. Try to fit physical activity into your daily life in short bursts—briskly walking the dog, cleaning the kitchen, raking leaves or taking the stairs instead of the elevator can add up to at least 30 minutes of activity a day. Combine heart-healthy eating with regular physical activity to keep your cholesterol levels where they need to be.
Life's Simple 7¯ Assessment
To understand the steps you may need to take to improve heart health and quality of life, visit heart.org/mylifecheck
Track your blood pressure at home
Use the AHA's online blood pressure tracking tools at heart360.org
Keep your kids smoke-free
Get tips on preventing your kids from smoking at tobaccofreekids.org
Get physically active
For ideas on how to incorporate physical activity into your life, visit startwalkingnow.org
Body Mass Index Calculator
© 2012 American Heart Association, Inc.