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Am I measuring blood pressure right, or are the hospitals ?


skippybangkok

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When going for what ever check up, sys blood pressure was always 145 to 135 . Bought a Withings blood pressure sleeve to keep an eye on it..... And I am constantly 120 range.

My process,... Relax and read news during breakfast , then measure with 2 feet on the ground and sleeve at heart level. Hospitals seem to measure you after you have walked far to get there and only a few mins rest.

Question is.... Am I doing it right ?

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Yes you are doing it right - should be a five minute sitting rest before measurement. Not only is that not observed at many doctor offices the white coat factor can add a lost of extra stress to the readings (or perhaps the eye candy) - always best to take at home for reliable long term indications. For me even doing, as often done in US, at a supermarket will increase readings 10-20 points. Hospital setting used to be even more but getting used to it after many years so a bit better now.

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Best to take your unit with you next time you go to the hospital and compare readings

Better still, have the doctor use the conventional method to make the comparison as you can not rely 100% on the hospital machines nor the method they use it IMO.

I have the same thing, quite high at the hospital most of the time but good at home . Sometimes at the hospital my left arm BP is too high other times my right arm is. They always measure through my shirt sleeve so don't know how much effect that has. They also don't seem to align the arm cup consistently and seem to arbitrarily place it. At least on my home unit there is a line/mark to place the arm band in line with the artery.

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I found that many nurses take a new reading of the blood pressure if it is high after 10 or 15 minutes or after the doctirs visit as an extra check for the "white coat factor"

I would ask them to check you again after the doctors visit.

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My blood pressure is consistently high but kept in check at a reasonable level with pills. During a recent stay in hospital two nurses regularly took my BP using the usual pressure bulb and slider at different times. As the problem I was there for healed, one consistently said my BP was now about the same as I measure it at home. The other reported falling readings until I had the BP of a very fit young man. They can't both be right. I'm nearly 70, and I know which I believed, unfortunately.

Edited by writeshack
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Yes you are doing it right - should be a five minute sitting rest before measurement. Not only is that not observed at many doctor offices the white coat factor can add a lost of extra stress to the readings (or perhaps the eye candy) - always best to take at home for reliable long term indications. For me even doing, as often done in US, at a supermarket will increase readings 10-20 points. Hospital setting used to be even more but getting used to it after many years so a bit better now.

"Not only is that not observed at many doctor offices the white coat factor ..."

Whenever I go to see my cardiologist, immediately following checking in at the nurses desk they want to take my BP, etc. Then after waiting awhile before seeing the doctor, he checks the BP in his office and it's always lower than the reading obtained when I first arrived at the hospital. His reading is usually about the same as what I get when checking at home.

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Are we charged for the BP test in hospitals?

Sometimes hospitals have stands set up in malls from time to time offering free blood pressure testing ... most likely as an advertising exercise on their part. I think Boots pharmacies sometimes do the same.

But if you go into a hospital you would normally be expected to make an appointment to see a doctor. Usually on the itemized bills I get there's an item for "other medical charges" along with the physician's fee, etc, which probably covers the nurse checking you in. So at least indirectly you'll be charged. I doubt you could just walk into a hospital and ask for a blood pressure check without expecting some charge.

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I am one who gets very erratic readings from the electronic cuff machines, and own an aneroid sphygmomanometer ( http://en.wikipedia.org/wiki/Sphygmomanometer ) for taking BP readings. I often get readings 30-50 points higher on the electronic cuff machines at hospitals, so I always take this with me when I go to prove to them that their machines do not work on me. I once had the nurse take 3 readings in a row, and their machine showed a 32 point deviation from low to high, and the lowest was still 12 points higher than taken with the sphygmomanometer where both she and I took the BP and were within a couple of ticks. Placement (should be at heart level with you sitting straight up,feet on the floor), cuff pressure and maintenance all come into play with the electronic cuff machines, as well as the software that runs the computer chip. Some people, me included, will have a 'bump' 30 or 40 points higher than the the 'thump-thump' you use to get the systolic pressure. Often, the electronic machines will read that bump as the start, even though there are no detectable beats for another 30 or 40 points.

It is good to monitor your BP, but please do not put much faith in the readings from the electronic cuff machines unless you compare them to sphygmomanometer readings from time to time. smile.png

KB

Edited by KBTexas
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Are we charged for the BP test in hospitals?

Sometimes hospitals have stands set up in malls from time to time offering free blood pressure testing ... most likely as an advertising exercise on their part. I think Boots pharmacies sometimes do the same.

But if you go into a hospital you would normally be expected to make an appointment to see a doctor. Usually on the itemized bills I get there's an item for "other medical charges" along with the physician's fee, etc, which probably covers the nurse checking you in. So at least indirectly you'll be charged. I doubt you could just walk into a hospital and ask for a blood pressure check without expecting some charge.

It is a common misconception tat the :other" (or sometimes "nursing" or "hospital") fee tacked onto bills for OPD visits at hospitals is a fee for having had your vita signs taken. It is not. It is a hospital surcharge, to offset their costs in providing the physical facility and support staff (and also to give them a share of profits, if a private hospital) since the consultation fee goes straight to the doctor.

It will be there regardless of whether your vital signs were taken.

In most hospitals, vital signs will be taken routinely on all patients and recorded in the chart, though this is skipped in some depts. I would not count on anyone reviewing them unless directly related to the immediate problem you are in for, though. It is useful should you suddenly faint or otherwise collapse/become worse while there to know what your signs were on arrival, though.

If you go to a private hospital solely to have your BP checked you may be charged for it, otherwise no, it is a routine part of the service. But there are easier options, like your local pharmacy.

As others have said, it is common to have an artificially elevated BP while visiting the doctor. One clue is that it will be mostly the systolic (first number) that is elevated rather than the diastolic (second number). In addition, waiting a few minutes and cosnciously trying to relax will often releive it, wheras it will not with true hypertension.

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The first reading, the higher number, is your heart when it contracts. This can be influences by white lab coat, walking, fear, dehydration, lots of things. The second number is the amount of pressure produced by your heart on the arterial walls in between contractions, at rest. This number is very important to be kept in a certain range; it should not jump about depending on environment. Many at home BP machines give strange readings sometimes. I would test on someone you know who is younger and healthy and look for that sweet 122/80 indicator suggesting it is most likely correct then when you do it.

You might try this on different arms. The difference should ideally be less than 5mmg. Frequently the left is a bit higher; ok.

It is smart to take after resting, sitting down, as you announced. But if you have a need for home monitoring might as well draw a total picture and do orthostatic BP tests.

After your first one rested, stand up and take bp a few minutes later standing. You see, the pressure should adjust to gravity within a few minutes and compensate to give a nearly exact reading, nearly. Large changes of greater than 10mmg should be reported to your doctor (of if large differences per side). There is one other lying down but this is not as important.

So, confirm your BP is kinda accurate (calibrate on a likely healthy BP person), and placed correctly on the biceps (forearm readers will always give a dodgy reading).

Make sure the arrow points to the depression in your arm where the artery vein is- you can see it, then test.

Test both sides. This can be informative.

Test after standing a few minutes.

You now have a fairly complete picture of your whole body and how it responds to gravity (this might be important for older folks who may be prone to fainting when standing quickly).

Good luck.

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Hospital visit can definately raise BP, last check up the Dr. came over and said "your pressure is up a little" . I told him if he took it instead of his cute nurse who had leaned over me to take it (and she with 36 D chest) it might be lower. He took it and it was 25 points lower , he laughed.

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Thanks..... answers a lot for me. Relieved that i am kinda normal with regards to BP, where as i always thought i was on the limit of hyper tension. Cuff i have is from Withings, so i assume since its brand new, its still accurate. Keeps graphs too

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Edited by skippybangkok
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Had my BP taken at AEK Udon a week before a procedure. Electric machine,,,Not sphygmo and stethoscope...150/96...I queried the result, but the nurse was adamant she was right...Went home and had my mate take the BP with stethoscope and sphygmo. We're both ex paramedics so know what we're doing. I was 120/80. Went back following week for procedure. Same machine, same result 147/95. I talked to the surgeon and asked if I could have it taken manually. He asked the same nurse to do It..She initially refused, but he actually raised his voice to her and she did it reluctantly.117/75. The doc ordered the machine be not used and re calibrated.

Makes me wonder how many people have been diagnosed with high BP at the AEK due to not calibrating equipment. The doc was good...The nurse was a bitch.

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Best to take your unit with you next time you go to the hospital and compare readings

Hospital readings are 99% times higher than normal just because you are probably not as relaxed as at home,,,mine is like that,,Just from driving to the hospital it goes up to 165,,, at home around 125/60 not to worry :))

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Had my BP taken at AEK Udon a week before a procedure. Electric machine,,,Not sphygmo and stethoscope...150/96...I queried the result, but the nurse was adamant she was right...Went home and had my mate take the BP with stethoscope and sphygmo. We're both ex paramedics so know what we're doing. I was 120/80. Went back following week for procedure. Same machine, same result 147/95. I talked to the surgeon and asked if I could have it taken manually. He asked the same nurse to do It..She initially refused, but he actually raised his voice to her and she did it reluctantly.117/75. The doc ordered the machine be not used and re calibrated.

Makes me wonder how many people have been diagnosed with high BP at the AEK due to not calibrating equipment. The doc was good...The nurse was a bitch.

Yep... great point. Wondered why my BP swung so much....

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Correct what most of you experiene. Please be aware that your breathing has a very strong influence on your bp.

If you want to lower your bp, for a couple of minutes breath deeply but breath out in a realxed manner. Doing the breathing ewxercise

can lower both numbers by between 10 and 2o points.

Indeed I figure higher than 'normal' bp is often due to shallow breathing. Check it out !.

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Just yesterday, after my wife drove me to the hospital, then a long walk from the car park, my blood pressure was 189!! They plonked me in a wheel chair and wouldn't let me walk, to have other tests. It was taken again half an hour later and it was 149. I suspect the wife's' the driving could have had some bearing on the 189 reading, because the previous day the same thing happened. My wife drove me to the local doctor, blood pressure 189 and faces aghast. I then drove myself to another doctor and it was 149.? A bit over the top he said?w00t.gif

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My Omron BP machine says normal BP is 135/85, which google tells me is right for SE Asia countries, wondering if those of us who been here a long time gradually adjust??although i stick with the 120/80 scale,

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Did have a problem, do I need to take pills for High or Low BP ?

The Dr found the problem these new fangled machines.. he does it the old way and is always about the same, maybe a little low.... try telling the Nurse that the old pump up one give the correct reading, never listens so Dr has to do it again...

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Are we charged for the BP test in hospitals?

Yes most hospitals insist, hua hin hospital firmly that you do this every visit and they bill you 150 baht, seems it's one way of getting some income, once I went to ask the dentist at BKK hospital in Hua Hin a simple question, same deal but I refused to pay and walked out.
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The nurses seem to have little idea of how to do it properly. And they only take it once, which isn't terribly accurate. My own cardiologist isn't too enamoured with the way they do it in her hospital.

BTW, the lower figure - the diastolic number - is the more important one.

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White coat anxiety!

Same happened to me, every time I went to the hospital it would show up as high..

Bought my own kit, and it was normal..

Tried to explain this to a nurse once, and it was all lost in translation! She thought I was a sex pest when I tried to explain that her uniform makes my BP high :-)

Make sure that the device is at the same level as your heart though for accuracy..

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Yes you are doing it right - should be a five minute sitting rest before measurement. Not only is that not observed at many doctor offices the white coat factor can add a lost of extra stress to the readings (or perhaps the eye candy) - always best to take at home for reliable long term indications. For me even doing, as often done in US, at a supermarket will increase readings 10-20 points. Hospital setting used to be even more but getting used to it after many years so a bit better now.

If you ask, the kind nurses at most hospitals will wait for an additional five to ten minutes after you walk in. I do this every time and my BP is always ten to fifteen points lower than when I first waddle my fat rear end to the nurses station.

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Best to take your unit with you next time you go to the hospital and compare readings

Better still, have the doctor use the conventional method to make the comparison as you can not rely 100% on the hospital machines nor the method they use it IMO.

I have the same thing, quite high at the hospital most of the time but good at home . Sometimes at the hospital my left arm BP is too high other times my right arm is. They always measure through my shirt sleeve so don't know how much effect that has. They also don't seem to align the arm cup consistently and seem to arbitrarily place it. At least on my home unit there is a line/mark to place the arm band in line with the artery.

When I go for my 3-monthly check up, the nurse takes my BP with an automatic machine soon after reaching the hospital - after driving through Phuket's rush hour traffic, and it is always higher than the reading at home. An hour or so later the doctor checks it with the manual system, and it is within a point or two of the home reading. Moral - only believe the reading after a proper rest period.

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Your numbers in the hospital are ok, especially as you have no time to relax.

Anyway, the number to worry about is the second number - in your case 74, and it's excellent, you have absolutely nothing at all to worry about!

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