The following factsheet has been developed to help understand the importance of monitoring blood pressure in people affected by MSA. It also helps support decision making in choosing a suitable blood pressure monitor and offers information about recording blood pressure.
Why monitor your own blood pressure?
- Low blood pressure can be a particular feature of MSA.
- Low blood pressure puts you at risk of falls and feeling unwell.
- Some medications (such as Parkinson’s disease medications) can lower blood pressure.
- Blood pressure will alter throughout the day and is also linked to various activities. It can be helpful to see what factors affect it.
- Blood pressure may be different at home than when visiting a neurologist or GP.
- You can see for yourself how your medication is working.
- Studies have shown that people who monitor their own blood pressure are more likely to make positive lifestyle changes to assist with blood pressure control.
Low blood pressure symptoms
If you are experiencing low blood pressure you may have one or some of the following symptoms:
- Dizziness
- Feeling light-headed or muddled
- Headaches
- Blurred vision
- Shoulder and neck pain – known as coat hanger pain
- Lower back pain
- Buttock pain
- Chest pain
- Feeling weak and tired
- Fainting or having blackouts.
If you do suddenly experience these symptoms, you need to take prompt action:
- Sit or lie down
- Elevate your legs if possible
- If the above is not possible, try bending over and pressing on your lower abdomen
- Drink two 500ml glasses of water.
If improvement doesn’t happen after 20 minutes call 111 for advice or 999 if the person stops breathing.
Our factsheet on Postural or Orthostatic Hypotension, which is a sudden drop in blood pressure, is available from our office or on our website. It explains how to reduce the risk of experiencing sudden episodes and offers further information on daily management strategies. For a copy of this please contact the MSA Trust, details can be found at the end of this factsheet.
How to choose a blood pressure monitor
A wide range of machines exist for measuring your blood pressure at home. It is essential that you choose a machine that has been clinically validated. This means the machine has been tested and certified by the British Hypertension Society to give more accurate and consistent measurements.
Clinically validated machines can be bought from leading chemists and the Blood Pressure Association. The British Hypertension Society have lists of validated machines (details are at the end of this factsheet). You should avoid buying a blood pressure monitor from an unknown supplier.
Choosing a machine that records blood pressure on your upper arm produces the most accurate and consistent results. Those that take readings from your wrist or finger are not as accurate. Upper arm machines come with a cuff that you wrap around your upper arm. To get an accurate blood pressure reading it is essential that you choose the right size cuff.
To find out your cuff size, measure around your upper arm at the midpoint between your shoulder and elbow, and choose your cuff size from the chart below:
| Upper Arm Blood Pressure Monitor cuff sizes | ||
| Measurement (cm) | Measurement (inches) | Cuff size |
| 18-22 cm | 7.1-8.7” | Small |
| 22-32 cm | 8.8-12.8” | Medium |
| 32-45 cm | 12.8-18” | Large |
Most home blood pressure monitors will come with a medium-sized cuff. You may have to order a different-sized cuff separately.
Machines will vary in price. You may find a memory facility helpful which can store the readings for you. You should write the results in a diary or notebook and record the date and time you took the recordings to show your Neurologist or GP.
Remember: Consistent and accurate readings are essential in monitoring blood pressure. Choose a machine that is the right size for the upper arm and is a British Hypertension Society clinically validated machine.
How to record your blood pressure
Blood pressure is measured using two numbers. The first number, called systolic blood pressure, measures the pressure in your blood vessels when your heart beats. The second number, called diastolic blood pressure, measures the pressure in your blood vessels when your heart rests between beats. If the measurement reads 120 systolic and 80 diastolic, this equates as “120 over 80” and is written as 120/80 mmHg.
When recording your blood pressure there is some good practice to follow and some things to avoid. The following tips will help you prepare and take a blood pressure reading to ensure the most accurate results.
Preparation:
- Rest for five minutes before taking a recording.
- Wear short sleeved or loose-fitting clothes to ensure easier access to your arm.
- Use the same arm for each recording. Use whichever arm is easiest and most comfortable for you and note which arm it is when you record the reading (it may be slightly higher on the left arm).
- Ideally you should sit with your arm resting on a table.
Performing the test:
- Your arm should be relaxed, not tense.
- Make sure your arm is supported and is at the same level as your heart. You may need to rest your arm on a cushion or pillow to achieve this.
- Put the cuff around your upper arm following the instructions with the machine.
- Remain still whilst taking the recording.
- Take three readings whilst sitting and work out the average. Write this down and mark it ‘sitting’.
- Stand for three minutes (aided if necessary) and take three more readings and work out the average. Write this down and mark it ‘standing’
- You can record the readings, either in a notebook or in the memory of your machine if you prefer.
Some daily activities will affect the blood pressure reading, so it is best to avoid taking a reading if:
- you need to use the toilet
- you have just eaten a large meal
- you have drunk caffeine or been smoking within the past 30 minutes.
General tips
The following information will help you maximise the benefit of recording your blood pressure. Blood pressure will be different at various times of the day. It is therefore important that you conduct the monitoring at the same time each day. By taking the readings at the same time of day it shows a comparison of what your blood pressure is doing over a period of time.
- Don’t round your readings up or down, you need to keep accurate details to give to your doctor or nurse. Don’t worry if you get a one-off reading that is very low, do a further reading on another day.
- Record which medicines you take and at what time of day you take them. This will help your doctor understand if any of the medicines are affecting your blood pressure.
- Try not to take readings too often as it can cause a lot of anxiety which may affect your blood pressure levels. Generally, once or twice a week will be fine. Note the time of day you take the readings, as that will be helpful too.
24-hour monitoring
Sometimes your doctor may want you to have 24-hour monitoring of your blood pressure. If this is the case, they will arrange for you to have a blood pressure machine fitted at your local hospital or at your GP surgery. It is a small device fitted to a belt around your body and attached to a cuff around your upper arm. You carry on with your normal daily activities and even sleep whilst the machine records your blood pressure. You will not be able to bath, shower or swim whilst the machine is in place. You will be asked to keep a diary of what you were doing throughout the day whilst the machine was taking recordings. You then remove the machine and return it to the hospital where they retrieve all the recordings and send the results to your doctor.
Helpful contacts
Blood Pressure UK – http://www.bloodpressureuk.org/Home
British and Irish Hypertension Society – https://bihs.org.uk/
If you have any questions or concerns regarding your blood pressure, you can contact your MSA Health Care Specialist at The MSA Trust.
