MEASURING BLOOD PRESSURE

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I have access to a calibrated BP machine in my doctors but I can get no advice on how to come up with an overall measurement which is meaningful. I have been told variously to take two measures and take the lowest whereas my chemist said take three and average the last two. I even created a wonderful spreadsheet to work everything out. In summary I can get no definitive advice which encourages me to take my BP in the knowledge of never being able to establish what my overall BP average is and whether it is acceptable, So what is the definitive advice about taking BP measurements over say a week and how should it be interpreted . Should it be an average over the whole day or just solely mornings /evenings or what

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  • Posted

    Firstly, I'm not a doctor or a nurse but this is how I understand it. Blood pressure (BP) varies depending on the time of day. It's normally lower first thing in the morning and higher in the evening. Before you take your BP sit and rest for 3 to 5 minutes. Take it 3 times and note the lowest. Rest for 3 minutes in between each test to allow your veins/arteries to resume their natural position. Don't talk or move your arm during the tests. Keep it simple.

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  • Posted

    Providing you follow the guidelines you will get a more accurate BP record than what you would get from your Doc or Nurse if you take control at home with BP measurements. First off, that individual BP readings may fluctuate in the same day and across days so don't panic. Yes, take 3 readings and average the second two.

    With the right Monitor (as you say correctly calibrated) prepare yourself as follows:

    Patients should empty bladder.

    Patients should rest quietly in a seated position for at least 5 minutes.

    Patients should not talk or text.

    Seated with back supported.

    Both feet flat on the floor; legs uncrossed.

    Measurement arm should be bare.

    Cuff should be placed directly above the antecubital fossa.

    The centre of the bladder of the cuff (commonly marked on the cuff) should be placed over the artery of the upper arm.

    The cuffed arm should be supported on a flat surface such as a table.

    Ideally take your Monitor and readings to your GP. Some monitors allow you to stream readings via Bluetooth to Smartphone.

    Here are the new 2017 guidelines. For those with resistant hypertension elevated stage would be acceptable (if not good).

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  • Posted

    I've been taking mine at home for over ten years now. I've never seen the need to take it more than once at a sitting, but if the reading seems odd, I might take another an hour or two later as a double-check.

    I usually take mine at least once a day, typically right before I take my daily meds, when otherwise I'd expect the effects to be at their lowest.

    When the BP runs especially high (or low), I will take it several times a day, looking for any kind of pattern - and to see if the meds are having any effect.

    Of course learn how to take it correctly, make sure you are rested and quiet when you take it, sit down, keep your arm relaxed and still.

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  • Posted

    My point is that I am trying to get to a result at which my doctor will say that's OK just carry on as you are? But as you know if you go to a surgery to have it checked they do it just the once and base a decision on that one reading. I was trying to reach a situation where I was able to produce evidence of a series of readings in order to produce an average overall figure but it seems nobody is able to provide/commit to a satisfactory statistical way of producing such a figure. I have therefore reached a situation whereby I say "what's the point"

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    • Posted

      Openspaces, I think you are complicating something that is very straightforward. I suggest you set up a spreadsheet, or if you're not computer literate a table on a sheet of paper. Record the Date, Time, BP Systolic and BP Diastolic readings and your heart rate. Take this sheet with you when you next visit the doctor and compare it with his readings. I suggest you take your BP two to three times and record the lowest pressures. I'd be very surprised if your BP at the doctor's is not higher than those you take at home. It called "white coat syndrome". Don't stress about it as this will raise your BP !!!!

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    • Posted

      I did design a wonderful spreadsheet and took it the doctors and said "could this be of any use for other patients". It had weekly averages , 4 week ra and cumulative, the bees knees. They did not want to know saying that any measurement is a matter between the doctor and his patient. So it strikes me there is no method available which suits everyone . If you have a measurement which can vary so widely during the day what is the right figure?. I have tried to get the question answered but with little success. I now do a whole week once every so often and tell my GP the average.

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    • Posted

      But as you know if you go to a surgery to have it checked they do it just

      the once and base a decision on that one reading.

      LOL, I was just going to say that, and that they seldom follow all the "rules" when they do it in the doctor's office.

      If they get a good first reading they tend to go with it, but if they get a bad (very high or very low) reading they'll take a second, and maybe then try the other arm for good luck, too.

      Also, fwiw, I tend to trust the robots more than the old bulb and stethoscope bit. I've seen a couple of doctors who had some really nice automatic (robot) BP meters, much faster than my home model.

      I've also heard that you're better off when a nurse takes it, because they do it much more often than a doctor does. Of course a nurse told me that. And I've seen this, 10-15 point difference in the readings between the nurse and the doctor, taken with the old bulb (sphygmomanometer). Robot is more consistent. But then nothing is all that consistent, because the BP itself can change from moment to moment, by at least a few points.

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  • Posted

    You'd be surprised at the number of variances even from medical professionals as to how to average out the bp readings.

    A kidney specialist once told me to take 3 readings...throw the 1st reading aside, then average the next two. Another healthcare professional said to take a single reading...toss it out because it's very likely to be inaccurate, then take 3 consecutive readings each 1 1/2 min. to 2 min. apart, then average those 3.

    If you have a cuff with a bulb...which my doctor has., you can bet it's accurate. Doctors keep close tabs on their bp cuffs.

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  • Posted

    This aligns with my experiences i.e. no two people will tell you what is the right way. Perhaps there isn't one !!

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  • Posted

    Openspaces - you seem to be well organised so I'm surprised your Doctor doesn't take note of your efforts - mine does and has adjusted my medication based on my figures. There is normally information in the book you get with your BP monitor that tells you what pressures you should be aiming for.

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