The problem with DIY Blood pressure

[ChrisGreaves]

Here's what's weird about these take-your-own-BP devices.
I took my reading this morning:
162 81 60
Not so good, huh? 162/81, much higher than it should be.
I pressed the button again.
The second reading:
149 78 62
Hmmm. 149/78 that's a little better.

162 81 60
149 78 62
131 80 59
134 75 61
144 79 57
130 77 58
140 78 61
136 71 61
133 76 60
133 74 62
131 81 60

Eleven readings in a row - about 4 minutes separating the first from the last - and the last one looks a lot better than the first.
Now yer average Joe takes the first reading, records it, and moves on.
But the Dr. sees an alarmingly high rate, panics, prescribes medication, tests etc. and orders a late-model Jaguar and goes home to a steak supper.

The dark blue line is the moving average; you can see that my blood pressure readings drop as I settle into the push-button, wait, record mode of four minutes of my life.

4.jpg

P.S. When I protested to my Dr. that I'd never been told I had high BP over 50+ years (immigration, platelets/plasma donations etc.) he finally broke down and admitted that "they" have lowered the bar on the definition of "high BP" over the past ten or so years.
That is, I've probably been at these levels all along, but the rules-of-the-game have changed.

[viking33]

You see, as you take more readings, you calm down a bit more and the BP goes lower.
Take about two dozen or so consecutive readings and you'll seem like a young stud again!
Easy!

[BobArch2]

Did you wait at least 10 minutes in a relaxed position before taking a reading?

The manual for mine suggests waiting 10 minutes and stay relaxed. If I take a reading immediately after plopping down in the chair, I'll get a "high" reading. Waiting the ten minutes before testing provides a better read. Also best not to take a reading if "stressed". For example if you pay a visit to your doctor and he/she takes a reading immediately, you can bet it will be high.

Just a thought or two...

[ChrisGreaves]

You see, as you take more readings, you calm down a bit more and the BP goes lower.

Quite so, Bob.
This is well-documented as "white-coat symptom" and was first mentioned to me a month ago on my first visit to the Dr.
He asked if I felt stressed out, and I replied no.
I had helped him with his computers 20+ years ago, his twin brother was my GP for 10 years. I chose this guy because I felt a comfort level with him.
I couldn't think of a reason why I might be stressed, although I'd arrived by public transit with 30 minutes to spare, and at 5pm had taken a coffee nearby - an unatural dose of caffeine for me.

On that visit (and on a subsequent visit) he sat me in a quiet room and programmed his machine to take an average of about 10 readings.
I'm not sure that the isolation and special treatment lowered my BP any.

Then he told me to spend $100 on a machine. But by then, mercifully, we weren't taking readings.

I'm puzzled over my morning readings because I am in my own home/office, it's 4 a.m.
All is peaceful.
The promise of a new day stretches before me (although I never get done what I hope to get done) ...

And yet the machine does demonstrate that I am calming down, in terms of BP, over the space of about 4 minutes.
Every morning!

[ChrisGreaves]

Did you wait at least 10 minutes in a relaxed position before taking a reading?

Thanks, Bob, and please see also my reply to - er - Bob!
I guess I've been sat down for 5+ minutes before I start.
I generally start the coffee-pot going, then sit down, reboot the computer, type in the TrueCrypt password, and fill in the "Goals/Objectives" sheet for the day.
A little ritual I've been going through for months.

This usually takes place about 10 minutes after I've risen, performed any necessary bodily functions, checked the cat's food bowls etc, so I've had perhaps 10 minutes quiet walking around the apartment then 5 minutes sitting. All very routine.

Of course everyone is different, right? So I might need a longer sit-down before things level out.
I can test this tomorrow morning by taking readings for, say, 15 minutes, and then the next morning, sitting still for ten minutes and then taking readings for the next 5.
I might expect that the 5-minutes of readings following a ten-minute sit would correspond to the last 5 minutes reading of the 15-minute marathon.

My posting was prompted by the thought that if one didn't know about this drop-off in readings, one might form the opinion that one was near-death on rising each morning.

[BobArch2]

My posting was prompted by the thought that if one didn't know about this drop-off in readings, one might form the opinion that one was near-death on rising each morning.

"...near death"... had to chuckle.

My readings vary from 120/76 to 138/76 except when I had my colonoscopy a few weeks back when the attendant said "Hmmm, do you have high blood pressure?" When I asked her what the reading was she stated 158/85. Of course the pending procedure might have had something to do with the high reading!!!

[Jezza]

Chris

I monitor my heart rate on a regular basis due to my sport activities as it is a good measure of my fitness. A few weeks ago I picked up Mrs Jezza from her work and she happened to have a blood pressure kit with her that was being transferred to another clinic.

That afternoon curiosity got the better of me and I had a go on the machine and was absolutely aghast when I found that my blood pressure was through the roof, so I rested and did it again, through the roof again (but less)

I mentioned it to Mrs J who did it later that evening and I realised that I had put the cuff on too tightly and the pressure tube was in the wrong position.....she did the test again and found that I was totally OK....DDDDDOOOOOHH

[ChrisGreaves]

... one was near-death on rising each morning. "...near death"... had to chuckle.

Well, yes.
Often enough when people ask me "How are you?", I reply with "I woke up this morning.", and leave it at that.
If they beg for an explanation I say "Thousands didn't".
I'm not near death, and have been quite healthy all my life, but (you and) I have seen enough people die to find myself grateful to have yet-another-day on this fair earth.

Mind you, that might change once those blizzards start sweeping up the Ohio valley again (grin!)

My readings vary from 120/76 to 138/76 except when I had my colonoscopy a few weeks back when the attendant said "Hmmm, do you have high blood pressure?" When I asked her what the reading was she stated 158/85. Of course the pending procedure might have had something to do with the high reading!!!

Today my differences Dia-Sys hovered towards 60, so perhaps that difference in pressure is what's important (although I'm sure the elevated readings are important too.)

(Makes note to self: "Must pick Drs Brains")

You differences (from the limited sample) are closer to 50.

Darn!

[ChrisGreaves]

... put the cuff on too tightly and the pressure tube was in the wrong position ...

Ah! The Loneliness of the Long-Distance Scunner! (weak joke)

Out of interest, when Mrs. J takes you readings with her machine, do they correspond to the readings with your machine?
I'm thinking of how the Drs scales are always different from mine, are always different from those in my friend's bathroom.
Which is why I focus on a gradual reduction in weight rather than an absolute value as a target.

[Jezza]

Chris

Many moons ago in another forum I posted how about how our digital scales gave different measurements in different parts of the Log Cabin and it never could be explained although Leif did come up with some very good ideas about electronic interference.

The BP kit was in fact the same one and it was down to the fact that she used the "two finger" rule, if she could fit two fingers under the cuff then it was tight enough. My issue is I have a very low heart rate due to exercise-induced bradycardia and therefore keep an eye on my BP.

I think the important message is to take 3 readings five minutes apart and take an average with the same equipment

[Hey Jude]

"I think the important message is to take 3 readings five minutes apart and take an average with the same equipment" Jezza, I totally concur :-)

My experience the past few years has been you are taken into the doc office and immediately the nurse begins wrapping the cuff around your arm. Meanwhile, I'm thinking to myself (outloud) that I am supposed to be able to relax with my feet firmly planted on the floor for about 5 minutes. You aren't even supposed to talk as that can raise your pressure. So, as the cuff is inflated, she begins her cross examination and I sit there refusing to answer and then she gets perturbed and my b/p rises. I just don't understand why they don't follow their own advice. Mine is invariably high systolically (in their office), but is right where it needs to be diastolically at or about 75/76; however when I was given a diagnostic shot using a fluoroscope it jumped to 158/112 but nobody was concerned one iota. Feeling the needles being threaded through your sacroiliac joints was not fun, but once I returned home and took the reading again, it was back to "normal" of 126/76. "White coat syndrome" is very real indeed. My boss would go to have his b/p checked and when it came back too high (even after being medicated for hypertension) the doc would make him sit in a room for an hour until it returned to normal. Now how ridiculous is that? Isn't it more prudent to average several readings for a more concise result? Being a former EMT, I am aware of the dangers of b/p exceeding certain thresholds. It is also a truism that the standards have been lowered, along with sugar levels and cholesterol LDL readings. I tend to shy away from supplying the next Jaguar for my doc if it's within my power :-)

Chris, you may have all our blizzards from the OH valley too!!~

[jonwallace]

Mind you, that might change once those blizzards start sweeping up the Ohio valley again (grin!)

Was that blizzards or buzzards

[ChrisGreaves]

... she begins her cross examination and I sit there refusing to answer and then she gets perturbed ...

That's why it's called a cross-examination.

"White coat syndrome" is very real indeed.

Agreed, and I know that now, but I fret (there goes my BP again!) at the number of people who must buy these $100 kits and take the initial reading as gospel.
At least my Dr. warned me about WCS- White Coat Syndrome; for which I'm grateful.
And yes, I really do trust this doctor.

the doc would make him sit in a room for an hour until it returned to normal. Now how ridiculous is that?

I know. It seems to me to be close to Solitary Confinement or Punishment or Prelude To Interrogation.

Isn't it more prudent to average several readings for a more concise result?

Agreed. I have mislaid (but not "lost") my manual. I think that with the low cost of electronics today every model should default to taking at least five, preferably ten, readings automatically and "averaging" them out. "Averaging" because I'm OK with a medical type adjusting figures that fall outside ranges; there may be "illegal" readings that we wouldn't comprehend.
I suppose that in the Blood Bank the nurses knew about WCS and while standing there holding my arm in their delicate little hands (OK, my real reason for donating platelets!) they had an elevated reading that was allowable to discount the effects of WCS. Those effects were very high for me. After many, many years i noticed that my chatter and joking dropped to zero AFTER the needle was in. The needle never hurt; the nurses (on every continent!) were professional etc. Just that my anxiety about having a sharp object puncture my skin sent my mind into waves of "escape this situation", manifest in chatter.

Chris, you may have all our blizzards from the OH valley too!!~

You really know how to screw up a friendship, don't you?

[ChrisGreaves]

... our digital scales gave different measurements in different parts of the Log Cabin ...

I remember that!

I think the important message is to take 3 readings five minutes apart and take an average with the same equipment

This morning I took 29 readings over 30 minutes. I won't bore you with the details.
I looked up the minimum SYS and grabbed its matching readings: 128/75 62.
The average over 29 readings is 142/81/61.

I should try doing it without turning the pages of a book. I find it hard to sit still and do nothing for ten minutes, let alone thirty.

[Doc Watson]

Coffee before you get your BP checked ??? Whatever were you thinking ???

Electronic interference shouldn't be a factor. What is electronic in a BP cuff ??

[Jezza]

Coffee before you get your BP checked ??? Whatever were you thinking ???

Electronic interference shouldn't be a factor. What is electronic in a BP cuff ??

These days clinics are using digital BP kits

[ChrisGreaves]

Coffee before you get your BP checked ??? Whatever were you thinking ???

Well, at the time, I thought I was visiting him about my left shoulder and my eyes.
No big deal.
It was HIS idea to slap the cuffs on me. (I've heard that before somewhere ...)

I mean, if he'd told me in advance he was going to take my BP I might have:-
(1) Skipped the coffee,
(2) Skipped the Boston Cream donut
(3) Not spent so much time ogling his receptionist etc. etc. etc.

[BobH]

Interesting thread about the different experiences each has had.

About 5 years ago, I had a very mild heart attack - no damage to the heart muscle measured, thankfully. I had 2 stents placed and have had one placed since then. Although my bp had never been recorded as above the threshold values, I was put on meds to prevent high bp. The first one, Metoprolol (a type of Lopressor) was accidentally prescribed at twice the intended dosage by a doctor; and only after 3 years of being absolutely torpid for several hours every day, did we discover the mistake. The pharmacy records - written from the prescription - were twice the medical records dosage. Even correcting the dosage left me with very low blood pressure and insufficient energy to move about safely during much of the day. Finally, the doc changed my drug; and I now take 1/4th the dosage I was on for 3+ years. After several months of this I'm beginning to get some energy back and don't suffer near-narcolepsy after medicating. The whole point of this story being: 1) I have some experience of what low bp can do to you; and 2) low bp can be a severe problem; and 3) the specific medication one takes can make a huge difference.

As for DIY bp readings, I bought a $15 digital cuff that goes on my wrist. I put it on, sit typing or watching tv or working the crossword for 5 or 10 minutes then press the activation button. The instructions with mine tell me to place my arm across my chest with the wrist at the same level as the heart. If I follow this routine, I get reliable, reproducible results. I've even calibrated my device against the readings the medicos get with a manual sphygnomanometer and with the automated cuff they use at the hospital. The readings vary by less than 10 points - which is within the margin of error they let nurses have. My resting bp is usually about 100/60 on meds. They have found it to be 80/40 before reducing the dosage. I think that was what finally triggered the match of actual dispensed meds against the records.

YMMV.

[Hey Jude]

Interesting thread about the different experiences each has had.

YMMV.

We are so very lucky to have you with us BobH
I enjoyed reading your saga, but am glad to hear you are on the mend and regaining your strength
and energy.

I will add a note to how they took my b/p while I was on the scoping table getting my shots. With my
long arms dangling towards the floor, the b/p cuff was put on my left forearm and it slipped down to around my wrist but it was very loose. I don't know how it took an accurate reading, but presumably the 150/112 came from that position. I thought to myself, "what good is that"? I'll be sure to ask when
I am down there for my 2nd round in another week or so. Oh boy, I can't wait!!! My pulse is already racing and I feel the pounding starting...