Variations in Blood Pressure Readings

[wgdanson]

I take my BP every morning and evening, using a recently bought Omron unit, and put the readings into an app on my phone called BP Watch.

 

Anyone can tell me why for example readings taken three minutes apart can vary so much, by quite a few mm's for both Diastolic & Systolic. And which one should I use, the first or the best?

 

I am going for a medical exam tomorrow for insurance purposes. I know the first thing they will do is take my BP after a 45 minute drive so It will obviously be much higher than normal.I shall try to persuade them to use my average over the past couple of months

[lopburi3]

Make sure they let you relax for at least 5 minutes after you get into office before taking BP - that should be normal but sometimes isn't.  If you have 'white coat' issues it will still be high however, and for some of us this can be a 40 or more point difference from at home.  

 

As for which figure to use would record all and then average out as it is never exactly the same between readings - but normally within 10 points in my experience, if remain in chair.

[Denim]

I used to do 9 readings a day in 3 clusters of three.

Morning ,afternoon, late evening.

 

Each cluster of three would be taken at 5 minute intervals. I then used the average as probably nearest reality.

 

Don't bother much now and only take it once a day. Still high but under control.

[Moonlover]

There are so many factors involved in BP variation, irregular heart beat, anxiety, movement, dehydration, caffeine etc, that's really not possible to pin down any one cause.

 

Neither have I been able to find any definitive guide that clearly spells out the best protocol.

 

So what I do is take 3 readings within 10 minutes and record the average. (My Omron is programmed to do this so no number crunching involved) 

 

As long as there are no alarmingly high readings I don't worry too much about it. Worry causes anxiety which increases blood pressure!

Edited June 27, 2019 by Moonlover

[BobBKK]

I take three a day in the morning. I have an Omron and I am 126/88 to 130/90 for last 3 years. If I go to hospital I go to 140/100 but take no notice as it's stress related (obviously).

[scubascuba3]

Readings mostly vary every minute of the day, yesterday i had two readings in the space of one minute and they were 5/5 different, it's not unusual when I've tested it. It could be inaccuracy of the device, could be you, could be how you are sitting, if mine are all in the Green normal range I'm happy with that. I use app "Blood Pressure Log - My Diary"

 

 

 

 

[rak sa_ngop]

I have both a wrist (Omeron) and cuff (Boots) model. With the cuff model it is easy to take both left and right arm readings.

 

Yes there always is a variation between the results even when made directly after each other.......and I do not believe that the cuff results are any more repeatable than the wrist measurements.

 

Only thing that you can rely on is that the hospital measurements will always be higher.

[jonwilly]

I agree, I use Ormon, wrist and upper arm types, different readings are normal.

Any doubts take proper Medical advice, Dr or Hospital.

 

john

[CGW]

1 hour ago, wgdanson said:

I take my BP every morning and evening, using a recently bought Omron unit, and put the readings into an app on my phone called BP Watch.

Why so often? every time you take BP you add stress - wondering?? I used to take mine daily then quit, now I prefer to look at "resting bpm" gives me a better overall picture.

[marcusarelus]

15 minutes ago, CGW said:

Why so often? every time you take BP you add stress - wondering?? I used to take mine daily then quit, now I prefer to look at "resting bpm" gives me a better overall picture.

Dr. Laffin says there is enough clinical evidence to suggest that when blood pressure is even a little over your typical average over time, the risk for heart disease and stroke go up. The physical effects of high blood pressure take their toll on your blood vessels.

“Essentially, for each increment of 20 mmHg over 115 mmHg systolic, your risk of heart attack, stroke, heart failure or chronic kidney disease doubles,” Dr. Laffin says.

Elevated heart rate can be a sign of danger, too, but the cause-effect relationship is not so clear. “Studies show that people who have faster baseline heart rates are more likely to have cardiac problems and premature cardiac death,” Dr. Laffin says. “But we’re not sure whether that is the cause of the problem or just a sign of what’s going on. The most common cause of a high resting heart rate is being deconditioned (in other words, out of shape).”

 

https://health.clevelandclinic.org/busting-6-myths-about-blood-pressure-and-heart-rate/

[ignis]

Test morning and evening....... Some times can be as low as 70/43, other times 140/82... Upgraded to a Arm  Omron unit last year [3,800 baht]

 

I record it all since 2014 on PC and the take the monthly daily average....  eg: May 31 days the Average was 120.1/69.2 with Heartbeat of 72 Averaged  ....  So far this month 27 days = Average 124.4/72.6 with Heartbeat of 70.

 

Mr Diabetic Dr does not even look at the Hospital readings that morning, but studies my Monthly day sheets every 100 days..  Hospital bloods test are now every 200 days.

[scubascuba3]

Dr. Laffin says there is enough clinical evidence to suggest that when blood pressure is even a little over your typical average over time, the risk for heart disease and stroke go up. The physical effects of high blood pressure take their toll on your blood vessels.
“Essentially, for each increment of 20 mmHg over 115 mmHg systolic, your risk of heart attack, stroke, heart failure or chronic kidney disease doubles,” Dr. Laffin says.
Elevated heart rate can be a sign of danger, too, but the cause-effect relationship is not so clear. “Studies show that people who have faster baseline heart rates are more likely to have cardiac problems and premature cardiac death,” Dr. Laffin says. “But we’re not sure whether that is the cause of the problem or just a sign of what’s going on. The most common cause of a high resting heart rate is being deconditioned (in other words, out of shape).”
 
https://health.clevelandclinic.org/busting-6-myths-about-blood-pressure-and-heart-rate/

I've been monitoring my BP closely the last week, aim is to spot trends so i have a better understanding. The Systolic seems to go up after exercise, usually at its lowest when you first wake up. Diastolic pretty consistent and in a narrow range. Not always consistent with times of day and how much it moves and exercise. Main thing for me, it's green normal

[billd766]

49 minutes ago, Moonlover said:

There are so many factors involved in BP variation, irregular heart beat, anxiety, movement, dehydration, caffeine etc, that's really not possible to pin down any one cause.

 

Neither have I been able to find any definitive guide that clearly spells out the best protocol.

 

So what I do is take 3 readings within 10 minutes and record the average. (My Omron is programmed to do this so no number crunching involved) 

 

As long as there are no alarmingly high readings I don't worry too much about it. Worry causes anxiety which increases blood pressure!

I normally take my BP readings with my Omron in the morning, sometimes twice a day if I have been out cutting the grass/scrub. I take 5 readings one after another sometimes more if the reading is unusually high or low) and use the middle reading as my target figure.

 

I then go and shower the sweat off me, eat my breakfast and repeat the readings. They are usually lower the second time around as I have rested between the 2 sets.

 

I go to a hospital once a month for FBS, PT and INR tests and I use their bigt BP machine but the results with that are higher than the Omron and I ask to use their smaller BP machine which givrs me a similar result to my Omron. 

[Sheryl]

1 hour ago, lopburi3 said:

Make sure they let you relax for at least 5 minutes after you get into office before taking BP - that should be normal but sometimes isn't. 

 

 

I would also add, make sure they use an old fashioned BP machine and stethoscope and not one of these machines which in Thai hospitals are often poorly calibrated if at all.

[wgdanson]

1 hour ago, CGW said:

Why so often? every time you take BP you add stress - wondering?? I used to take mine daily then quit, now I prefer to look at "resting bpm" gives me a better overall picture.

I am resting in the morning and the evening when I take my readings. 

[wgdanson]

Just now, Sheryl said:

 

I would also add, make sure they use an old fashioned BP machine and stethoscope and not one of these machines which in Thai hospitals are often poorly calibrated if at all.

Thanks Sheryl, I doubt whether they have a sphygmomanometer or know what one is. And just to add that at a hospital in Phitsanulok I was three different weights on three different scales. 

[lopburi3]

38 minutes ago, Sheryl said:

 

I would also add, make sure they use an old fashioned BP machine and stethoscope and not one of these machines which in Thai hospitals are often poorly calibrated if at all.

Normally have had doctors (and sometimes nurse inpatient) use but seems they are under tight control some places (due mercury?) from some reports here - and perhaps non nursing staff not allowed to use?  But agree some meters are very suspect - at major Bangkok government hospital you did yourself with supermarket type units that provided a printout several years ago and just gave them the printout - which could be anyone.  

[Sheryl]

The regional government hospital in my province has those useless machines and then the nurses who triage the patients afterwards have old fashioned machine at their desk. In cases where the machine reading looks off or in cases where they feel getting an exact BP really matters they repeat the measurement themselves.

[RJRS1301]

The auto machines, which so many Drs/Hospitals and individuals use are notoriously inaccurate, rarely calibrated,

The old fashioned cuff and stethoscope is more accurate. Rest at least 5 minutes before having BP taken

[CGW]

4 hours ago, marcusarelus said:

“Studies show that people who have faster baseline heart rates are more likely to have cardiac problems and premature cardiac death,”

So, if you know what your "baseline" is, mine is 68, if it increases to ~ 75, it's a sign to look a little further into the problem, rather than taking BP every day?

[wgdanson]

2 minutes ago, CGW said:

So, if you know what your "baseline" is, mine is 68, if it increases to ~ 75, it's a sign to look a little further into the problem, rather than taking BP every day?

But you need a BP monitor to accurately take your pulse rate?

[CGW]

Just now, wgdanson said:

But you need a BP monitor to accurately take your pulse rate?

I have a wrist band thing that measures constantly and averages for resting.

[watcharacters]

4 hours ago, wgdanson said:

5 hours ago, CGW said:

Why so often? every time you take BP you add stress - wondering?? I used to take mine daily then quit, now I prefer to look at "resting bpm" gives me a better overall picture.

I am resting in the morning and the evening when I take my readings. 

 

A cardiologist I was seeing told me instead of taking a BP reading, simply go for a walk to exercise.

 

 

 

[scubascuba3]

 
A cardiologist I was seeing told me instead of taking a BP reading, simply go for a walk to exercise.
 
 
 

Exercise has really helped a couple of friends who previously had high blood pressure

[CGW]

20 minutes ago, watcharacters said:

A cardiologist I was seeing told me instead of taking a BP reading, simply go for a walk to exercise.

Probably sound advice - though there will be many who disagree, for me it is limiting alcohol - if I drink more than a few beers in a day my BP goes up and continues to rise to a "point" each day, soon as I stop drinking it comes down again, which again from "my" observations are related to "my" resting pulse rate. Others will be different no doubt, I stay active, not overweight & eat well.

[Lacessit]

Don't worry about it. Accept you will have some white coat syndrome, and ignore. Unless your morning and evening readings are already high, in which case you should seek medical advice.

My readings ( with medication ) on a sphygmanometer in Australia are usually 110/60. When I go to my dental clinic at Rajavej, they are 140/90 on a battery-powered piece of crap. The bigger hospital machines usually run at 130/80. I just shrug my shoulders.

The variation in systole and diastole is part of the glorious world of statistics. Take ten readings and average them. That gives a better idea of the standard deviation. It does nothing to tell you if your machine is accurate. That can only be done by calibration against a sphygmanometer and stethoscope, used by a trained person.

I take my BP about once a fortnight. The meds I am on control it well. Before them, I was in stroke territory - 180/100.

[simon43]

Quote

 

So, if you know what your "baseline" is, mine is 68...
 

 

 

My baseline heart rate is about 48, down from 70 2 years ago. Why/how?  All down to daily cardio exercise (cycling fast, jogging etc), which has increased the strength of my heart.  At night, my HR is about 38 bpm.  I'm 60 years old.

Edited June 27, 2019 by simon43

[wgdanson]

3 hours ago, watcharacters said:

 

A cardiologist I was seeing told me instead of taking a BP reading, simply go for a walk to exercise.

 

 

 

But then how would you know whther the walk was doing any good if you did not take a BP reading? 

[scubascuba3]

 

So, if you know what your "baseline" is, mine is 68...
 
 

 
My baseline heart rate is about 48, down from 70 2 years ago. Why/how?  All down to daily cardio exercise (cycling fast, jogging etc), which has increased the strength of my heart.  At night, my HR is about 38 bpm.  I'm 60 years old.
what's your blood pressure like?

[scubascuba3]

But then how would you know whther the walk was doing any good if you did not take a BP reading? 

it's just well known that exercise is good