Hospital Blood pressure results Vs Home BP results

[MrScratch]

Over the years here in Thailand I have been to both private and government hospitals along with a few clinics . Nearly every time while being checked by a member of staff before seeing a Doctor I had my blood pressure taken . After checking my blood pressure I was on many occasions told that my blood pressure was high . So when I returned home from the hospital / clinic visit I again re check my blood pressure using my Omron HEM- 7130 monitor , and always my home blood pressure reading was in its normal ideal BP range and showing a lower reading than the BP results I received from a hospital.

 

Every one in my family ( 5 ) also checks their BP readings using the same Omron HEM- 7130 monitor and the result numbers do vary , so the monitor seems to be working ok.

 

I have put the high BP numbers when visiting a hospital / clinic down to the White Coat Syndrome ----

 

White coat hypertension, more commonly known as white coat syndrome, is a phenomenon in which people exhibit a blood pressure level above the normal range, in a clinical setting, though they do not exhibit it in other settings. It is believed that the phenomenon is due to anxiety experienced during a clinic visit.

 

So today I went to a local clinic to obtain a Doctors certificate that may be required when I go to renew my 5 year driving license. The receptionist checked my BP and low and behold I was told my BP was high ( 149 / 79 ) HR – 66 .

 

So 30 minuets later I’m back at home and I check my BP on the Omron HEM- 7130 monitor and its shows ( 112 / 65 ) HR 62 , which is within the range I normally see.

 

With so many continuing BP result away from home saying that my BP is high , as apposed to my home BP monitor’s lower BP numbers I’m starting to wonder if there may be some thing that I’m missing .  I am now wondering about going to a Boot’s the Chemists branch or some where else I could get a BP test thats not in a hospital / clinic , that would negate any possibility of the White Coat Syndrome phenomenon .

 

Any thoughts or suggestions or am I just worrying to much ????

 

 

 

 

 

 

 

 

 

 

[luk AJ]

I can only confirm your observation but I also have no explanation..


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[Puchaiyank]

Doctors, nurses, clinics, and hospitals have been known to send one's BP out of the normal range...

 

If you relax...take BP three times in a row...your BP will likely return to normal...try it!

 

[Vacuum]

8 minutes ago, Puchaiyank said:

Doctors, nurses, clinics, and hospitals have been known to send one's BP out of the normal range...

Not to mention driving to these places (unless your clinic/hospital is in a remote place).

[donim]

37 minutes ago, MrScratch said:

 The receptionist checked my BP and low and behold I was told my BP was high ( 149 / 79 ) HR – 66 .

 

22 minutes ago, luk AJ said:

I can only confirm your observation but I also have no explanation..

 

It is the combination of these two, in bold, that is making my BP going up.

 

 

 

 

[scubascuba3]

i know that my heart rate constantly changes depending what I'm doing, maybe its the same for blood pressure, I don't know, I'll be checking mine when my new monitor turns up

[donim]

40 minutes ago, MrScratch said:

So today I went to a local clinic to obtain a Doctors certificate that may be required when I go to renew my 5 year driving license. The receptionist checked my BP and low and behold I was told my BP was high ( 149 / 79 ) HR – 66 . 

  

So 30 minuets later I’m back at home and I check my BP on the Omron HEM- 7130 monitor and its shows ( 112 / 65 ) HR 62 , which is within the range I normally see.

 

Normal.

At the doctor you just did walking. Jumped from the chair moving to the BP device.

And people around you and the fact you are at the doctor a place many people sweat about like as they are going to the dentist known of his medival tools.

Pressure is high.

 

Once at home, you are in peace in YOUR enviroinment. Your pressure drops.

 

 

[thaicurious]

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20047889

"Make sure your arm is positioned properly. Always use the same arm when taking your blood pressure. Rest your arm, raised to the level of your heart, on a table, desk or chair arm. You might need to place a pillow or cushion under your arm to elevate it high enough."

 

You've got a better chance of the airline offering you a pillow.

Edited May 6, 2019 by thaicurious

[Saltire]

I bought a similar OMRON recently to check this and in 3 months i have never been outside the normal range, in fact always on the low side of normal. I have been on meds for high blood pressure for years, because when tested in doctors surgery or hospital it is always 'slightly high'.

 

Next time I go for a med certificate I plan to take a health chart, downloadable from the OMRON APP. Not sure if it will help but who knows. My 'slightly high' readings have never stopped me getting the medical certificate.

 

I am seriously considering dropping the BP med in the same way I have already dumped statins and metformin (diabetes meds).

 

Finally when I was researching what meter to buy, the wrist type in your photo were not recommended at all. 

[mommysboy]

I think there are many in the same position. I don't think anyone can say for sure but it sounds like white coat syndrome.  There is also the possibility that the machines are poorly calibrated or the measurement is being taken with an inappropriate arm position.

 

Mood, and stress levels can dramatically change bp readings, and waiting a few minutes won't help either.  I can't say if your monitor is accurate- it could be measuring low.

 

I don't think you will get an answer that satisfies in all honesty, because people will argue arm position even with home monitors, but even allowing for a 10/5 point error your bp is fine by any standards.

 

Blood pressure does rise with age, mostly due to stiffening of the arteries, and you are right imo to be worried about the readings at hospital, because this can be an early indication of bp problems according to some.

 

I am in a similar position.  I regard myself as pre-hypertensive.  

 

 

[Mike Teavee]

Not sure how long you've had your home test machine, but they can lose accuracy after a while & need to be serviced (Seem to recall every 3 years when I bought my 1st one but that was 8 years ago).

[Stocky]

There is a term for this "whitecoat hypertension"

[Thailand]

Excessive waiting time to see a doctor usually makes my blood boil, is that a similar effect?

 

But yes, my home monitor always shows less than those in hospitals or doctor's surgeries.

[scubascuba3]

 
Normal.
At the doctor you just did walking. Jumped from the chair moving to the BP device.
And people around you and the fact you are at the doctor a place many people sweat about like as they are going to the dentist known of his medival tools.
Pressure is high.
 
Once at home, you are in peace in YOUR enviroinment. Your pressure drops.
 
 

I guess that sitting at home in a chair with no stress isn't normal though, most people go out do things and life has stress in it

[Moonlover]

I'll go straight to your last paragraph. Yes, I do believe you are worrying about this too much.

 

Fortunately I do not have any medical issues so I do not have to seek medical help often, but on those rare occasions when I do, my B/P is always higher than my own home readings.

 

The classic situation was when I was attending hospital for check ups following an accident. I was riding my motorcycle through heavy downtown traffic to the hospital and once there they would immediately take my B/P and declare it too high! Yes, well it would be wouldn't it!

 

I use the same monitor as you do O/P with the correct size cuff (important) and my home environment readings are the only ones I trust. 

[Moonlover]

42 minutes ago, Mike Teavee said:

Not sure how long you've had your home test machine, but they can lose accuracy after a while & need to be serviced (Seem to recall every 3 years when I bought my 1st one but that was 8 years ago).

Omron recommend every 2 years.

[scubascuba3]

 
The classic situation was when I was attending hospital for check ups following an accident. I was riding my motorcycle through heavy downtown traffic to the hospital and once there they would immediately take my B/P and declare it too high! Yes, well it would be wouldn't it!
 

So under normal life conditions such as heavy traffic etc etc blood pressure was high. Not many people sit at home all day meditating

[MrScratch]

This scary thought has just gone through my mind ???? , there you are in the hospital for a minor problem , before you see a doctor your BP is checked and you are told that your BP is high . You then see the doctor who treats your minor issue but then they say I see your BP numbers are high , let's take your BP again????

 

The second BP test still shows your BP numbers are raised and the doctor recommends that you go on a course of drugs to lower your high BP . When in fact all your suffering from is the dreaded WCS

 

Makes me wonder ????‍⚕️

 

[MrScratch]

I wonder what would happen if I took my own battery operated portable Omron HEM- 7130 BP monitor with me the next time I have to go to a hospital , then after my BP is checked there by the staff  ( and told its high ) , I then use my own Omron HEM- 7130 monitor to take my BP just after , and see what the difference may be ????

[hugocnx]

( 149 / 79 ) HR – 66 is not high if you are older than 50. 

The systolic pressure comes from your present activity (traffic/white coat) and your diastolic is perfect.

I even tend to say that the home measured diastolic of 62 is a bit at the low end. 

[mommysboy]

1 hour ago, scubascuba3 said:

2 hours ago, donim said:

 
Normal.
At the doctor you just did walking. Jumped from the chair moving to the BP device.
And people around you and the fact you are at the doctor a place many people sweat about like as they are going to the dentist known of his medival tools.
Pressure is high.
 
Once at home, you are in peace in YOUR enviroinment. Your pressure drops.
 
 

I guess that sitting at home in a chair with no stress isn't normal though, most people go out do things and life has stress in it

 

I think this is an important point, particularly for people who lead stressful, busy lives.  It may not be essential hypertension, but it could go that way.  It's difficult to know what to do for the best. 

[kkerry]

26 minutes ago, MrScratch said:

I wonder what would happen if I took my own battery operated portable Omron HEM- 7130 BP monitor with me the next time I have to go to a hospital , then after my BP is checked there by the staff  ( and told its high ) , I then use my own Omron HEM- 7130 monitor to take my BP just after , and see what the difference may be ????

Take it, but you will likely find both readings to be similar for the reasons others have said... you've been active getting to the hospital versus sitting around at home. Highest I ever had was after being late for an appointment due to my taxi driver getting lost and ignoring my instructions. Nurse took one look at my reading and asked if I needed to lay down or take medication... which in a way turned out to be a good thing as I realised then it was time to get healthy again, loose some weight and exercise which I did, so now usually good.   

[kevvy]

In my home country when I seen my doctor most of the time my blood pressure was up. He would then talk to me for 5 minutes and then take it again. The second time was always lower than the first . He said there were various reasons why, white coat syndrome , walking too  fast to get the the appointment , stress driving there etc etc .

[RJRS1301]

Besides making sure your arm is properly positioned, allow at least two minutes, seated and relaxed breathing, then check your BP

I can almost guarantee that the receptionists/ nurse do not wait two minutes before taking your BP after you have walked in, or moved to the chair?? 

Edited May 6, 2019 by RJRS1301

[RJRS1301]

The WCS is very real also.

Weight control and regular exercise as we age is essential as well as a balanced diet

 

[Lacessit]

The only ACCURATE measure of blood pressure is a mercury-based sphygmanometer in the hands of an experienced doctor or nurse. Whether the electronic ones are accurate is a lottery, depending on when they were last calibrated, and battery condition.

Edited May 6, 2019 by Lacessit

[Moonlover]

41 minutes ago, MrScratch said:

This scary thought has just gone through my mind ???? , there you are in the hospital for a minor problem , before you see a doctor your BP is checked and you are told that your BP is high . You then see the doctor who treats your minor issue but then they say I see your BP numbers are high , let's take your BP again????

 

The second BP test still shows your BP numbers are raised and the doctor recommends that you go on a course of drugs to lower your high BP . When in fact all your suffering from is the dreaded WCS

 

Makes me wonder ????‍⚕️

 

This situation was alluded to very recently. A doctor recommended meds based on just one high B/P reading. And despite his own doubts, the patient accepted the treatment offered. See:

 

 

[billd766]

2 hours ago, Puchaiyank said:

Doctors, nurses, clinics, and hospitals have been known to send one's BP out of the normal range...

 

If you relax...take BP three times in a row...your BP will likely return to normal...try it!

 

I normally take my BP 5 times in a row with my Microlife BP meter and select the middle reading. Sometimes I get high readings and the next one comes in normally.

 

If I have been outside working for a while, I take my BP and then again about an hour later and there is a difference.

 

When I go to the hospital for a FBS, PT+INR and HbA1c tests I take my BP at home and then an hour later at the hospital on their monster arm grabbing BP tester. If your arm is cot ithe exact place the reading comes out wrong. If it does I try again or use the hospitals Omron. The hospital is 65 km away and about an hours drive.

 

I don't blindly accept the first reading if I think it is wrong as most Thais do. 

[billd766]

56 minutes ago, MrScratch said:

I wonder what would happen if I took my own battery operated portable Omron HEM- 7130 BP monitor with me the next time I have to go to a hospital , then after my BP is checked there by the staff  ( and told its high ) , I then use my own Omron HEM- 7130 monitor to take my BP just after , and see what the difference may be ????

Good idea. They might whine but what can they do about it?

[jvs]

Thank you op for starting this,i just bought a bp monitor last week after getting a bit high rating at the clinic.

Very good idea from some posters to take your own bpm to the hospital and see what the reading is there.You can do it while you are waiting and right after they check your bp.

In the hospital i was 136 and at home 117.

Big difference.