Measuring Blood Pressure

[Mick F]

I had an arm one, right at the beginning of the thread. It eventually packed up.
I bought the wrist one on recommendation, as a home device it's simple and you don't have to get half undressed.
Mine seems as reliable as the arm one did.

The issue with accuracy and precision and repeatability are the main subjects here.
Repeatability, even on medical grade stuff is beyond abysmal. All people use is a snapshot, and then take that as fact. Not true in the slightest.

If I see the doc and he measures my BP, he WILL get a false reading, but still uses it to diagnose high BP.

147 over 67 this morning as measured by me.

[axel_knutt]

Hi,
Wrist devices are not particularly very clever.
Upper arm ones or advised.

Which magazine warn against wrist mounted monitors, as they found they're not usually reliable. I think kinetik was one of the manufacturers that got poor reviews too, but I'm not sure, as the older obsolete models have been taken down from their website now.

Any wrist mounted kit I've used has proven to be less than useless. Smart watches that say they are BP compatible should be banned

Which:
"Wrist blood pressure monitors ... are more prone to giving inaccurate readings as your wrist isn't naturally at heart height.
Arm blood pressure monitors are less prone to inaccurate readings as they’re easier to position at heart height. "
They say they've only found one wrist monitor that's accurate enough to recommend.

I chose my Omron because it had top marks for accuracy, was the same make as the surgery use, and at £20, it was the cheapest. It's obsolete now, bit it looks to me as if the same one is now being sold as Boots own brand (still a Which best buy, and still £20).

By reliable above, I meant can't be relied upon to give accurate readings, some will, most don't.

[simonineaston]

it had top marks for accuracy, was the same make as the surgery use, and at £20, it was the cheapest...

Blimey - such a combination is usually mutually exclusive ! Fancy the medical centre buying the cheapest, mind... I reminded of that Andie woshername on them telly adverts.

[Bonefishblues]

it had top marks for accuracy, was the same make as the surgery use, and at £20, it was the cheapest...

Blimey - such a combination is usually mutually exclusive ! Fancy the medical centre buying the cheapest, mind... I reminded of that Andie woshername on them telly adverts.

I think I was well below that for mine - but it's on the approved list, and I trust its consistency.

[Mick F]

Just tested it on Mrs Mick F, 110 over 67. Typical! Little miss perfect!

Any road up, I've made a medical review request, and I'll get an appointment through in the next few days.
Meanwhile, they want me to got to the health centre "pod" and measure height, weight and BP and hand the printouts into the office. Doing that later today. I have no issue about height and weight, but their BP readings (may be accurate) but they are pointless because they are false.

However, I'm on Fostair inhalers for my asthma, and inject myself with Repatha once a fortnight for my familial high cholesterol.
Before I was put on Fostair preventers, I used Beclazone. Was on Beclazone for decades, and Fostair for maybe the past six years.

Well ........................ I read the leaflets just now.
Fostair can give you elevated BP, as did Beclozone.
Repatha does as well. Been on that for nearly seven years.

Statins and BP medication of various sorts, made me ill.

I want to see the doc about all this, as I'm considering stopping the Repatha and the Fostair.

[Mick F]

PS:
When I go to the HC later, I'll take my wrist BP device, and experiment.

When I did similarly with my arm one, the HC unit was much at odds with mine. Basically, the whole thing is pointless for me.
My BP will be very much elevated.

[Bonefishblues]

Have you ever done a 24-hour ambulatory BP test?

[Mick F]

Yep!
Mentioned up thread.

In a nutshell:
I went to the hospital and they fitted it and gave me the instructions. One was not to get it wet, and the other to carry on as normal.

Every 30mins for 24hrs, it took my BP.
I went for a bike ride and the thing repeatedly squeezed so hard, it nearly had me off. I gave up and came home.
I couldn't sleep that night.

When I went back to the hospital, my arm was severely bruised, and many of the readings were so out of spec, they weren't recorded.
Just wearing the awful thing made me tense and wound up and angry .............. and I told them so.

As far as I'm aware, they don't use them any more. Good thing too.

[Mick F]

Here's a photo of my results from the health centre, followed by my device taken basically at the same time.

The unit is on a standard dining chair and the thing to put you arm into was for the RIGHT arm.
It wasn't adjustable for short people or tall people. I'm Mr Average I think, but many people aren't at all.

I took the first reading, then took two more.

Note how HIGH these readings are.
I handed them into the receptionist who had a sort of gasp whe saw them!
I explained that I wanted an appointment with someone to talk about all this and mentioned that I had a history of it, and how my readings are wrong and not typical of me despite the accuracy of their device. I also mentioned that my medication has much to do with it and she said that the doc will telephone me tomorrow.

Got back the 100yds to the car in the carpark, relaxing all the time, and then used mine. It wasn't convenient or simple to use both at once.
Pay no attention to the time on mine as I haven't bothered to set it up.

[pete75]

Here's a photo of my results from the health centre, followed by my device taken basically at the same time.

The unit is on a standard dining chair and the thing to put you arm into was for the RIGHT arm.
It wasn't adjustable for short people or tall people. I'm Mr Average I think, but many people aren't at all.

I took the first reading, then took two more.

Note how HIGH these readings are.
I handed them into the receptionist who had a sort of gasp whe saw them!
I explained that I wanted an appointment with someone to talk about all this and mentioned that I had a history of it, and how my readings are wrong and not typical of me despite the accuracy of their device. I also mentioned that my medication has much to do with it and she said that the doc will telephone me tomorrow.


IMG_1611.jpg

Got back the 100yds to the car in the carpark, relaxing all the time, and then used mine. It wasn't convenient or simple to use both at once.
Pay no attention to the time on mine as I haven't bothered to set it up.
IMG_1609 copy.jpg

I measured mine with one of those wrist things and it came out at 220 over 130, then did it with a bicep cuff device and it was 117/77. Checked an hour later with the same thing and it was 108/67. Different devices give different readings and I've no idea which of these is correct.
My late mother was nurse for many years, and she always said the most reliable method was with a mercury sphygmomanometer and stethoscope. That's how she used to do my dad's anyway. My GP always does it that way too.

[Mick F]

i have a nasty cold, though getting over it, but having breathing difficulties.
Saw the doc today, and been put on a course of steroids for the lung inflammation. I suspected I had pneumonia (again), but not.

However, the lady doc didn't check my BP but listened to my heart and lungs, and pronounced me fit with strong heart and lungs .......... other than the inflammation.

Which gets me onto this subject - yet again!
I wondered if a strong heart pulses more strongly in the measured arm?

The way I see it, the strap goes around the arm and restricts the blood so the pulse fades. That pressure is then noted.
The pressure is then released so the pulse returns. The two pressures go together to do the high figure vs the low figure.
Systolic vs Diastolic.

Just say you have strong heart.
Those two figures would be higher compared to someone who had a weak heart.

Yes, or no?

[Vetus Ossa]

I went to the Doc’s this morning for a checkup.
The conversation turned to blood pressure.
She took it twice with the thing that wraps around your arm, and both times it registered around 190/100.
Being a sensible lady she said, I know that can’t be right so took it the old fashioned way with a stethoscope and the other gizmo that goes with it. It was 145/80 which is not bad for me as I do tend a suffer a little from white coat syndrome, though I have no idea why as I am perfectly comfortable there.
When I check my BP home I get wildly different reading as others seem to, so seldom bother to do it.

[531colin]

...............
Just say you have strong heart.
Those two figures would be higher compared to someone who had a weak heart.

Yes, or no?

No, Mick, there are a variety of controls for blood pressure. (Apart from the fact that the phrase "a strong heart" is pretty meaningless.)

Your blood pressure (and the discrepancy between your readings taken at home and the readings taken at the surgery) looks pretty normal to me. My GP practice accept my home readings, I think your practice should also.

Untreated familial hypercholesterolaemia is a death sentence, I would urge you to continue to treat both that and asthma.
BTW, "Fostair" contains beclomethasone https://www.netdoctor.co.uk/medicines/a ... ormoterol/

[axel_knutt]

I went for a bike ride and the thing repeatedly squeezed so hard, it nearly had me off. I gave up and came home.
I couldn't sleep that night.

When I went back to the hospital, my arm was severely bruised, and many of the readings were so out of spec, they weren't recorded.

It would seem reasonable to suppose the cuff would inflate until the pressure exceeds systolic by a sufficient margin, but the pressure to which my BP monitor inflates varies widely.
If you look below, the data is grouped into two distinct clusters pretty much independent of systolic bp.

Is it inflating for a preset time? No.
Is it inflating until it exceeds sys bp for a predetermined time? No.
Is it inflating until it exceeds sys bp for a predetermined number of pulses? No.
Is inflation pressure dependent on how tightly the cuff is wrapped? No.

So what are the criteria?

I have AF. I don't think it's different when the arrhythmia's present, but I'll pay more attention for a bit.

There are those who will tell you that BP monitors are useless with AF, but my monitor doesn't seem fazed by it, nor do the NHS. Some monitors have a function that reports arrhythima, which suggests they're likely to be capable of measuring BP reliably through it, and a nurse with a sphygmomanometer was capable of measuring my BP whilst commenting "ooh, I can hear your AF". I have a plot somewhere of of some BP data when I was in Resus, and it's interesting that my BP was rock steady, but high, whist I was in AF, but then started fluctuating wildly as soon as I reverted to NSR.

(Monitor: Omron M2 Basic, HEM-7120-E))

[Psamathe]

My GP gives most patients with BP problems an accurate monitor to take home which records over a 24hr period, I don't know if this is a novel device or is been around for a while. Solve a lot of 'white coat' problems though .

They've been around for ages. My consultant asked my GP to run one on me for 24 hrs (but GP just ignored the request so it never happened).

Ian