context: Follow your doctor's instructions for when and how often to check your blood pressure. Keep in mind that certain factors can cause blood pressure to temporarily rise. Blood pressure normally rises as a result of: Stress Smoking Cold temperatures Exercise Caffeine Certain drugs Avoid any of these factors that you can when taking your blood pressure. Also try measuring blood pressure at about the same time each day. Before taking your blood pressure: Find a quiet place. ( You will need to listen for your heartbeat.) Roll up the sleeve on your left arm or remove any tight-sleeved clothing, if needed. ( It's best to take blood pressure from the left arm, if possible.) Rest in a chair next to a table for five to 10 minutes. ( Your left arm should rest comfortably at heart level.) Sit up straight with your back against the chair, legs uncrossed. Rest your forearm on the table with the palm of your hand facing up. If you purchase a manual or digital blood pressure monitor, follow the instruction booklet carefully. The following steps provide an overview of how to take your blood pressure using either a manual or digital blood pressure monitor. 1. Locate your pulse Locate your pulse by lightly pressing your index and middle fingers slightly to the inside center of the bend of the elbow. Here you can feel the pulse of the brachial artery. If you cannot locate a pulse, place the head of the stethoscope (on a manual monitor) or the arm cuff (on a digital monitor) in the same general area. 2. Secure the cuff A. Thread the cuff end through the metal loop and slide the cuff onto your arm, making sure that the stethoscope head is over the artery. ( When using a manual monitor, the cuff may be marked with an arrow to show the location of the stethoscope head.) The lower edge of the cuff should be about 1 inch above the bend of your elbow. Use the Velcro wrap to make the cuff snug, but not too tight. B. Place the stethoscope in your ears. Tilt the earpiece slightly forward to get the best sound. 3. Inflate and deflate the cuff If you are using a manual monitor: A. Hold the pressure gauge in your left hand and the bulb in your right. B. Close the airflow valve on the bulb by turning the screw clockwise. C. Inflate the cuff by squeezing the bulb with your right hand. You may hear your pulse in the stethoscope. D. Watch the gauge. Keep inflating the cuff until the gauge reads about 30 points (mm Hg) above your expected systolic pressure. At this point, you should not hear your pulse in the stethoscope. E. Keeping your eyes on the gauge, slowly release the pressure in the cuff by opening the airflow valve counter clockwise. The gauge should fall only two to three points with each heartbeat. ( You may need to practice turning the valve slowly.) F. Listen carefully for the first pulse beat. As soon as you hear it, note the reading on the gauge. This reading is your systolic pressure. G. Continue to slowly deflate the cuff. H. Listen carefully until the sound disappears. As soon as you can no longer hear your pulse beat, note the reading on the gauge. This reading is your diastolic pressure. I. Allow the cuff to completely deflate. IMPORTANT: If you released the pressure too quickly or could not hear your pulse DO NOT inflate the cuff right away. Wait one minute before repeating the measurement. Start by reapplying the cuff. If you are using a digital monitor: A. Hold the bulb in your right hand. B. Press the power button. All display symbols should appear briefly, followed by a zero. This indicates that the monitor is ready. C. Inflate the cuff by squeezing the bulb with your right hand. If you have a monitor with automatic cuff inflation, press the start button. D. Watch the gauge. Keep inflating the cuff until the gauge reads about 30 points (mm Hg) above your expected systolic pressure. E. Sit quietly and watch the monitor. F. Pressure readings will be displayed on the screen. For some devices, values may appear on the left, then on the right. Most devices will also display your pulse rate. G. Wait for a long beep. This means that the measurement is complete. Note the pressures on the display screen. Systolic pressure appears on the left and diastolic pressure on the right. Your pulse rate may also be displayed in between or after this reading. H. Allow the cuff to deflate. IMPORTANT: If you did not get an accurate reading, DO NOT inflate the cuff right away. Wait one minute before repeating the measurement. Start by reapplying the cuff. 4. Record your blood pressure. Record the date, time, and systolic and diastolic pressures.