Do you have trouble with inconsistent blood pressure readings?

[isisdave]

I recently attended my annual cardiology visit. I know my systolic BP has been up to 130, measured on my wrist meter. The nurse first announced 160/90 (and this was following the correct protocol, waiting 5 minutes, etc.) and then a few minutes later 150/80.

I had brought my wrist unit, and it said 131/72. Twice.

They're sure they're right, and they probably are. I couldn't find my old arm cuff monitor, which used to agree quite closely with the wrist one, so I bought another. It's even weirder. If I take three measurements a few minutes apart without moving my arm, I can get 132, 145, and 122. I did notice with the arm monitor that it's important to get the "index" right in the middle of the arm; otherwise it reads high. But it can read high anyway. Or low ...

The wrist monitor is sensitive to height. It needs to be at "heart level." So I usually perform the "Hail Caesar" salute to get the right elevation, then straighten my arm. It's more consistent, but like 20 mmHg less than the nurse gets.

I'm going back in a week to evaluate a new med. I'm taking both monitors. I find it disappointing that the 21st century has brought us immunotherapy and similar high-tech advances, but something as basic -- and important -- as blood pressure is still difficult to measure.

Does anyone have any experience to share about at-home measurements, either vs professional or about consistency? Or suggestions for positioning either your wrist or the cuff?

 

[Panina]

I recently attended my annual cardiology visit. I know my systolic BP has been up to 130, measured on my wrist meter. The nurse first announced 160/90 (and this was following the correct protocol, waiting 5 minutes, etc.) and then a few minutes later 150/80.

I had brought my wrist unit, and it said 131/72. Twice.

They're sure they're right, and they probably are. I couldn't find my old arm cuff monitor, which used to agree quite closely with the wrist one, so I bought another. It's even weirder. If I take three measurements a few minutes apart without moving my arm, I can get 132, 145, and 122. I did notice with the arm monitor that it's important to get the "index" right in the middle of the arm; otherwise it reads high. But it can read high anyway. Or low ...

The wrist monitor is sensitive to height. It needs to be at "heart level." So I usually perform the "Hail Caesar" salute to get the right elevation, then straighten my arm. It's more consistent, but like 20 mmHg less than the nurse gets.

I'm going back in a week to evaluate a new med. I'm taking both monitors. I find it disappointing that the 21st century has brought us immunotherapy and similar high-tech advances, but something as basic -- and important -- as blood pressure is still difficult to measure.

Does anyone have any experience to share about at-home measurements, either vs professional or about consistency? Or suggestions for positioning either your wrist or the cuff?

I find wrist machines never work on me. Being you had it with you at the doctors you probably have the same problem as me.

I tried many wrist and arm ones and found the Omron evolv to be spot on with the doctors readings.

Evolv® Wireless Upper Arm Blood Pressure Monitor

This one-piece upper arm blood pressure monitor utilizes our exclusive Advanced Accuracy algorithm to measure more data points & reduce interference.

omronhealthcare.com

 

[clifffaith]

Dentist used a wrist monitor on me two weeks ago when I was finally ready for the final tooth implant. 120/80 was the reading and I was immediately able to tell her no way that was correct. So they switched to a cuff style and the 140 over something was more like it. However everyone else in the office got the same reading wrist and arm when they tested. Our home cuff style machine gives different answers, so we tend to take it three times and use the middle reading.

 

[turkel]

You should be sitting, feet planted in front of you ( no crossed ankles) arm at the level of you heart and no talking when you take your blood pressure.

White coat syndrome truly happens. If your nervous in any way or in pain your blood pressure will be effected.

Cuff size also matters.

 

[bogey21]

I'm not sure it is the monitor. With me I think it is my heart. I use an Omron and take my blood pressure 3 times a day. One time it may be 117 over 67; another it may be 135 over 90 and the third time it might be 120 over 80. Usually the lowest is first thing in the morning and the highest around 7 pm right before I take my medication. It has been like this for many years (I'll be 85 in April) so I'm used to it. Maybe my A-fib has something to do with it. My pulse rate jumps around also. My Cardiologist tells me not to worry as long as it (my pulse rate) stays between 60 and 100...

 

[WinniWoman]

I think this is fairly normal and why blood pressure readings should really be taken several times to be more precise.

 

[Passepartout]

Maybe it's your anxiety over taking multiple BP's?

 

[WVBaker]

Multiple things can cause a reading to be different.

Medications and the time they are taken. Certain foods and when eaten. Your stress level at the time it's taken and even the time of day you take it can cause a different reading.

Don't rely on any one reading, either good or bad. You'll need to average the readings over the course of the day.

I've always used a Omron cuff machine as recommended by my doctor. It takes three readings each time used and averages those numbers for the final reading at that time.

 

[isisdave]

Thanks for the input. Passepartout, not anxiety (it's not high enough for that), just annoyance. And why would it go up and THEN down? Grrr.

Most of your observations were about the accuracy and repeatability of home observations. I'm fine with that, but I still end up with an average that's 130 when the nurse says 150.

Bingo on the protocol -- I always do that. https://www.health.harvard.edu/heart-health/tips-to-measure-your-blood-pressure-correctly

The part that is often not mentioned is that you should sit still at that table for at least 5 minutes before testing. I asked my doctor how long it takes for a person's BP to return to baseline after walking in from the waiting room, enduring the Scale of Shame, and marching to the exam room. He didn't know! Turns out there's like one study that says 90% of people will be at baseline after 5 minutes. But I require 7.

 

[artringwald]

To be consistent, I take mine with an arm cuff first thing in the morning, before coffee. Readings are pretty close from day to day. I took my monitor to the doctor once, and got very close to the same readings they did, but my measurements in their office are very inconsistent. I'd try to sit still before they take it and do deep breathing relaxation for awhile.