Blood Pressure Monitoring and High Blood Pressure

Recording your blood pressure at home

There are three ways you can record your blood pressures.

• Send them in by text message (SMS) when prompted by our SMS reminder service (see Florence information at the bottom of this page). We prefer this approach as it has several advantages for both the practice and the patient. Video about Florence
• Write them down by Printing this blood pressure monitoring chart and recording your blood pressure readings according to the instructions. You can then post this to us or drop it into our letter box. The practice address is below.
• Fill in your readings on a computer spreadsheet: this blood pressure monitoring spreadsheet can be completed on your device and emailed to the practice.

The British Heart foundation also provides a 'how to' video to Managing your Blood Pressure at home: Managing your blood pressure at home

We encourage patients to purchase a suitable home Blood Pressure device for self management of their blood pressure monitoring. A list of suitable blood pressure monitors for home use is available here.

What is a normal blood pressure?

Blood pressure varies depending if the blood pressure is measured at home or at the medical practice. Blood pressure readings taken in the practice tend to be around 5mmHg higher than measurements taken at home. The difference is greater for some people.

Normal blood pressure is an average blood pressure reading of below 135/85 at home (140/90 in the practice). 

Hypertension is diagnosed when your blood pressure is an average of 135/85 or more at home (140/90 or more in the practice). Please read a bit more about High Blood Pressure:

• More information from Blood Pressure UK
• More information from Chest, Heart, Stroke Scotland.

I have hypertension. What should my blood pressure be?

Different people may have different targets for lowering their blood pressure.  

• Most patients with hypertension should aim for an average blood pressure of less than 135/85 or lower at home (140/90 in the practice).
• Patients with type 1 diabetes should usually aim for an average home blood pressure reading of 130/80 (135/85 in the practice).
• Patients with a history of significant kidney disease or stroke may be advised to aim for an average blood pressure 125/75 or lower (130/80 in the practice).
• Patients aged over 80, and those who are frail, with multiple medical conditions or a high risk of falls, should not aim for such intensive blood pressure lowering and should discuss this with their GP.

It is important for home blood pressure readings that an average of multiple readings is taken. The usual practice is to measure the blood pressure twice in the morning and twice in the afternoon for 2 weeks, and take an average of all the readings, excluding the first day's readings.

Florence text message reminders

We now offer our patients a service called Florence, which sends text message reminders and allows you to send your blood pressure readings back to the system via SMS (mobile phone text messages). It then collates the results over the set time period and sends a report to the practice at the end of the monitoring period.

Florence communicates by text messages to and from your mobile phone. It will work with any mobile phone or network able to send and receive text messages. All texts to and from Florence are free to you (even if your mobile phone says that you will be charged). Florence runs on a free to text short code, 64711.

To use this service, book an appointment with Leslie:

• If you have your own monitor, can download and read the information leaflet and Florence privacy notice can print and sign the Florence Opt In Form at home, you can book a telephone or video call appointment
• If you need to borrow a blood pressure monitor or need to come in to sign the consent form, then book a face-to-face appointment and we will go over it all with you

Using Florence to record your blood pressure

• Your healthcare professional will explain how often they wish you to record your blood
  pressure and how to use the monitor.
• Once you're signed up, you will receive text reminders from Flo to send in your readings at appropriate times.
• Your BP reading is two numbers, the pressure when the heart beats, and that in between beats. It is usually written for example as 130/85 mmHg.
• To send this by mobile phone, you need to reply with "BP and then the numbers, separated by a space. So to send the blood pressure 130/85, reply with the message: BP 130 85
• More information on using Florence to Help Monitor your Blood Pressure.

Receiving feedback from Florence on your blood pressure readings

If your blood pressure is lower or higher than expected, you may get a message from Florence advising you to consult your Shared Management Plan. Please see the attachments section below for this information. You should be sent a link to your plan by email or SMS or receive a printed copy of the plan when you are signed up to the service.

Possible issues with Florence

Some network providers may send a warning that texts will be charged at premium rates. It is a generic message that comes up for all short codes and doesn’t differentiate between those that charge or and those that are “free to text”. Please be assured 64711 is a FREE number. The texts are already paid for. There is a web site to check this out independently: www.phonepayplus.org.uk

It is also worth being aware that at least one network provider does not allow texts to be sent to 5 digit numbers at all - PlusNet, SMARTY, but there may be others.

In addition, some Android phones also warn that short codes can involve a charge and ask you to confirm whether you want to proceed with sending the message. If your Android phone gives you these warning messages, the next time you get the message select to "remember my choices" and then confirm that you wish for the message to be sent.

If you have difficulty sending texts to Florence:

- Check your own phone is not blocking 5 digit numbers in general, and 64711 in particular

- Contact your provider and ask them to unblock 64711