Blood pressure checks in thai hospitals = waste of time

[Gary A]

I go to the local small hospital every three months for a blood test and check up. When I check in they take my blood pressure and weigh me. Previous visits are in their records. If my blood pressure is higher than it normally is, they check it again further down the line. This is a public hospital and not a rip off private hospital. My last visit cost me 550 baht and that included the blood test and my three month supply of drugs. Ridiculously inexpensive.

[xylophone]

3 hours ago, Dagnabbit said:

 

Of course BP varies.

 

But at 180 after driving to the hospital or a walk up some stairs? 

 

Mines not that high after a 5km run.

 

Different BPs for different folks and as Sheryl has pointed out many factors can influence blood pressure and it's not the "once off" reading that matters it's readings taken over a period of time.

 

Anyway it's easy to see why the blood pressure readings taken when you visit the doctor can be all over the place, not only because of the "white coat syndrome", possible physical exertion in getting there and the fact that the blood pressure reading protocols are not followed, but also because many of the machines are not calibrated and the readings are not worth much (see my example in another post).

 

One instance which I didn't mention was the fact that my blood pressure reading was at some astronomical level when taken by the "nurse" and I queried it and she said nothing. I knew it wasn't correct and it was so out of kilter as to be laughable.

 

I'm lucky enough to have relatively good BP for my age (69) however others are not so lucky and many may not been a position to be able to do a 5 km run or similar.

[Changwatchap]

Glad I'm not the only one who thinks this way.

 

I guess the nurses realise the circumstances (rushing you into the test), and poor machinery mean the test is pointless, and that's why they don't pay attention to the results.

 

 

I still have to bite my tongue not to say anything when they see high results and immediately redo the test on the same arm. I'm sure that's not in the manual book...

 

[theguyfromanotherforum]

 
Of course BP varies.
 
But at 180 after driving to the hospital or a walk up some stairs? 
 
Mines not that high after a 5km run.

You measure your blood pressure right after the sweaty run? I find that hard to believe.

[mercman24]

went to suk hospital 7 days ago, blood pressure normal, 3 days later i go again and it is very high ??, i say to the nurse? you should not be talking to me asking me all these questions,while doing the test, i got the normal blank expression in return.

Edited October 16, 2016 by mercman24

[Dagnabbit]

You measure your blood pressure right after the sweaty run? I find that hard to believe.

Yes.

Why not?


Sent from my iPhone using Tapatalk

[Dagnabbit]

went to suk hospital 7 days ago, blood pressure normal, 3 days later i go again and it is very high ??, i say to the nurse? you should not be talking to me asking me all these questions,while doing the test, i got the normal blank expression in return.

You are right but once again - if the simple act of speaking spikes your BP to very high levels, then that's probably where your levels are most of the time. Unless you spend most of your time horizontal!


Sent from my iPhone using Tapatalk

[xylophone]

20 minutes ago, Dagnabbit said:

 

Yes.

Why not?


Sent from my iPhone using Tapatalk

 

 

More to the point, why, because normally blood pressure increases during exercise anyway........ that is unless you have a blood pressure problem of course.

[MikeyIdea]

1 hour ago, xylophone said:

 

More to the point, why, because normally blood pressure increases during exercise anyway........ that is unless you have a blood pressure problem of course.

 

Your systolic pressure increases, your diastolic generally drops a bit, with a blood pressure problem more than a bit

 

So you are right 

 

1 hour ago, Dagnabbit said:

if the simple act of speaking spikes your BP to very high levels, then that's probably where your levels are most of the time

 

Speaking always affect BP and you will not get a BP at rest even if you have laid down resting for 10 minutes if you talk while you take it

 

[theguyfromanotherforum]

I think some posters here don't know what blood pressure is.

[Dagnabbit]

On 10/16/2016 at 6:24 AM, xylophone said:

 

More to the point, why, because normally blood pressure increases during exercise anyway........ that is unless you have a blood pressure problem of course.

 

Because recovery rates in both heart rate and blood pressure are a pretty good measure of fitness.

 

I never said I took BP during exercise but I do afterwards at intervals to assess recovery rate.

 

Plus - you do want to know that you aren't pushing yourself too hard. I'm 47 and whilst I enjoy exercise, I have no urge to kill myself with it...

 

http://www.hopkinsmedicine.org/Press_releases/2004/04_06a_04.html

Quote

 Normally during exercise, blood pressure increases to push the flow of oxygen-rich blood throughout the body.  However, in some individuals, the response to exercise is exaggerated.  Instead of reaching a systolic (upper number) blood pressure of around 200 mmHg at maximal exercise, they spike at 250 mmHg or higher.

 

This paper quotes an upper end systolic reading of 200 a MAXIMAL exercise  - as in running your tail off! 

 

Another study here (https://www.ncbi.nlm.nih.gov/pubmed/2313223) showed BPs maxing out on average 190 at maximum exertion.

 

You have guys here hitting 180 'driving a car', 'talking' or 'walking' and thinking that this is perfectly OK. 

 

 

 

 

[lopburi3]

On 10/7/2016 at 9:10 AM, Dagnabbit said:

 

Of course BP varies.

 

But at 180 after driving to the hospital or a walk up some stairs? 

 

Mines not that high after a 5km run.

But physical exercise is not the only factor to cause blood pressure rise - just reading this forum can do it - worry or drugs can do it - fear often does it.  So yes a drive to a hospital and the fear that might entail could make a huge difference in your blood pressure.  As a matter of fact hospitals can, and do, test your heart condition with drugs the same as using exercise treadmill.

[xylophone]

11 hours ago, Dagnabbit said:

You have guys here hitting 180 'driving a car', 'talking' or 'walking' and thinking that this is perfectly OK

 

Following the heading of this thread that BP checks in Thai hospitals are a waste of time, then I don't suppose one should pay much attention to anyone who has a faulty blood pressure reading at the hospital, irrespective of what it is?

 

It's already been stated by the majority of people on here that they take them incorrectly anyway, so what good are they.

 

And as if to add weight to the above, please consider the following: –

 

Blood Pressure UK, “If you are very anxious your systolic blood pressure can rise by as much as 30mmHg”

 

10 Factors That Can Affect Blood Pressure Readings (SunTech medical).

 

1). Blood Pressure Cuff is too Small. It is extremely important to make sure the proper size blood pressure cuff is used on your upper arm when taking a measurement. In fact, most blood pressure measurement errors occur by not taking the time to determine if the patient's arm circumference falls within the Range indicators on the cuff. Studies have shown that using too small of a blood pressure cuff can cause a patient's systolic blood pressure measurement to increase 10 to 40 mmHg.

 

2). Blood Pressure Cuff Used Over Clothing. When having your blood pressure measured, the cuff should always be placed directly on your arm. Studies have shown that clothing can impact a systolic blood pressure from 10 to 50 mmHg.

 

3). Not Resting 3-5 minutes. To obtain an accurate blood pressure measurement, it is important that you relax and rest quietly in a comfortable chair for 3 to 5 minutes before a reading is taken. Any activities such as exercise or eating can affect your systolic blood pressure measurement 10 to 20 mmHg.

 

4). Arm/Back/Feet Unsupported. When having your blood pressure measured, you should always be seated in a comfortable chair, legs uncrossed, with your back and arm supported. If your back is not supported, your diastolic blood pressure measurement may be increased by 6 mmHg. Crossing your legs has shown to raise your systolic blood pressure by 2 to 8 mmHg. The positioning of your upper arm below your heart level will also result in higher measurements, whereas positioning your upper arm above your heart level will give you lower measurements. These differences can increase/decrease your systolic blood pressure 2mmHg for every inch above/below your heart level.

 

5). Emotional State. Stress or anxiety can cause large increases in blood pressure. If you are having your blood pressure taken while thinking about something that causes you to tense up or become stressed, your blood pressure levels could significantly increase.

 

6). Talking. If you are talking to the nurse/doctor while having your blood pressure taken, studies have shown that your systolic blood pressure measurement may increase 10 to 15mmHg.

 

7). Smoking. Tobacco products (cigarettes, cigars, smokeless tobacco) all contain nicotine which will temporarily increase your blood pressure, so refrain from smoking at least 30 minutes before having a blood pressure measurement taken.

 

8). Alcohol/Caffeine. Alcohol and caffeine (sodas, coffee, tea, etc) consumption causes blood pressure levels to spike so stay away from alcohol/caffeine at least 30 minutes before having a blood pressure measurement taken.

 

9). Temperature. Blood pressure tends to increase when you are cold. Therefore, if you are at the doctor's office and the room temperature is "chilly" to you, be aware that your blood pressure readings may be higher than expected.

10). Full bladder. Your blood pressure is lower when your bladder is empty. As your bladder gradually fills, your blood pressure increases. Studies have shown that your systolic blood pressure measurements could increase 10 to 15mmHg when you have a full bladder.

 

Certainly points 1 through 6 would be suspect in the Thai hospitals I have been in and quite possibly 10 would come into play as well and in the majority of cases, the cuff has been placed over part of my shirt when my BP is being taken.

 

So having said that, those folks (me included) who have had wide ranging BP results taken in Thai hospitals should understand that the protocols/procedures with regards to the taking of blood pressure are not being followed and if they are worried, then 2000 baht spent on a BP machine would be well worth the outlay. 

 

 

 

[Dagnabbit]

On 10/18/2016 at 1:21 AM, xylophone said:

 

Following the heading of this thread that BP checks in Thai hospitals are a waste of time, then I don't suppose one should pay much attention to anyone who has a faulty blood pressure reading at the hospital, irrespective of what it is?

 

It's already been stated by the majority of people on here that they take them incorrectly anyway, so what good are they.

 

And as if to add weight to the above, please consider the following: –

 

Blood Pressure UK, “If you are very anxious your systolic blood pressure can rise by as much as 30mmHg”

 

10 Factors That Can Affect Blood Pressure Readings (SunTech medical).

 

1). Blood Pressure Cuff is too Small. It is extremely important to make sure the proper size blood pressure cuff is used on your upper arm when taking a measurement. In fact, most blood pressure measurement errors occur by not taking the time to determine if the patient's arm circumference falls within the Range indicators on the cuff. Studies have shown that using too small of a blood pressure cuff can cause a patient's systolic blood pressure measurement to increase 10 to 40 mmHg.

 

2). Blood Pressure Cuff Used Over Clothing. When having your blood pressure measured, the cuff should always be placed directly on your arm. Studies have shown that clothing can impact a systolic blood pressure from 10 to 50 mmHg.

 

3). Not Resting 3-5 minutes. To obtain an accurate blood pressure measurement, it is important that you relax and rest quietly in a comfortable chair for 3 to 5 minutes before a reading is taken. Any activities such as exercise or eating can affect your systolic blood pressure measurement 10 to 20 mmHg.

 

4). Arm/Back/Feet Unsupported. When having your blood pressure measured, you should always be seated in a comfortable chair, legs uncrossed, with your back and arm supported. If your back is not supported, your diastolic blood pressure measurement may be increased by 6 mmHg. Crossing your legs has shown to raise your systolic blood pressure by 2 to 8 mmHg. The positioning of your upper arm below your heart level will also result in higher measurements, whereas positioning your upper arm above your heart level will give you lower measurements. These differences can increase/decrease your systolic blood pressure 2mmHg for every inch above/below your heart level.

 

5). Emotional State. Stress or anxiety can cause large increases in blood pressure. If you are having your blood pressure taken while thinking about something that causes you to tense up or become stressed, your blood pressure levels could significantly increase.

 

6). Talking. If you are talking to the nurse/doctor while having your blood pressure taken, studies have shown that your systolic blood pressure measurement may increase 10 to 15mmHg.

 

7). Smoking. Tobacco products (cigarettes, cigars, smokeless tobacco) all contain nicotine which will temporarily increase your blood pressure, so refrain from smoking at least 30 minutes before having a blood pressure measurement taken.

 

8). Alcohol/Caffeine. Alcohol and caffeine (sodas, coffee, tea, etc) consumption causes blood pressure levels to spike so stay away from alcohol/caffeine at least 30 minutes before having a blood pressure measurement taken.

 

9). Temperature. Blood pressure tends to increase when you are cold. Therefore, if you are at the doctor's office and the room temperature is "chilly" to you, be aware that your blood pressure readings may be higher than expected.

10). Full bladder. Your blood pressure is lower when your bladder is empty. As your bladder gradually fills, your blood pressure increases. Studies have shown that your systolic blood pressure measurements could increase 10 to 15mmHg when you have a full bladder.

 

Certainly points 1 through 6 would be suspect in the Thai hospitals I have been in and quite possibly 10 would come into play as well and in the majority of cases, the cuff has been placed over part of my shirt when my BP is being taken.

 

So having said that, those folks (me included) who have had wide ranging BP results taken in Thai hospitals should understand that the protocols/procedures with regards to the taking of blood pressure are not being followed and if they are worried, then 2000 baht spent on a BP machine would be well worth the outlay. 

 

 

 

 

Yes - don't worry if your BP is 400/200 when you go to the hopsital - it's probably just the walk from the car.

 

Just get yourself a BP monitor at home - those silly nurses don't know what they are doing - you'll all do a MUCH BETTER job on your own.

[xylophone]

3 hours ago, Dagnabbit said:

 

Yes - don't worry if your BP is 400/200 when you go to the hopsital - it's probably just the walk from the car.

 

Just get yourself a BP monitor at home - those silly nurses don't know what they are doing - you'll all do a MUCH BETTER job on your own.

 

Even through your sarcasm you may have eventually got the message and that is...............

 

Blood pressure checks in Thai hospitals = waste of time

 

as the heading suggests and also because of my points above..........I'll do it myself and do it right.

[Dagnabbit]

7 hours ago, xylophone said:

 

Even through your sarcasm you may have eventually got the message and that is...............

 

Blood pressure checks in Thai hospitals = waste of time

 

as the heading suggests and also because of my points above..........I'll do it myself and do it right.

 

Thanks - but I'll take a medical professional over some guy on a forum that has a low end BP monitor at home.

[lopburi3]

And that might be a foolish choice - the low end monitor is very likely just as accurate as the high end monitor and when being used without the medical stress factor and with repeated readings over a period of time will more often than not provide the more reflective reading of your actual BP condition IMHO.  And my experience at one of largest government hospitals 4 months ago was you DIY sticking your arm through a supermarket type machine and take your own weight with no supervision.

[Don Mega]

lol @ so many people getting worked up about a BP test.

 

First world problems I guess.

[lopburi3]

Actually blood pressure is a serious issue and something that we can take actions about; so not something that only the first world nothing else to do members should be aware of.  

[xylophone]

5 minutes ago, lopburi3 said:

Actually blood pressure is a serious issue and something that we can take actions about; so not something that only the first world nothing else to do members should be aware of.  

 

Very much agree with that statement and I certainly wouldn't mind paying for that service at the hospitals I visit if it was done properly, but my experience to date has been that the service they provide is woefully inadequate and the readings are all over the place.

 

I noted about 10 points as to what could cause an inaccurate BP test and the most common ones are getting your BP taken immediately you arrive (without any or very little resting period), having the cuff put over, or part over, clothing and being spoken to whilst the test is underway.

 

When I eventually did get fed up with this facade, I asked the girl who had taken my BP and recorded one which just seemed too high, if she would kindly take it in 10 minutes time, which she did, and all the questions had been asked so I sat silently whilst the test was underway AND I recorded a much lower reading and back to my normal range.

 

Always refuse to have that done now, and if these people are "medical professionals" as another poster has suggested, then why don't they follow the recommended procedures?

[theguyfromanotherforum]

 
Thanks - but I'll take a medical professional over some guy on a forum that has a low end BP monitor at home.

Hopefully not a Thai medical professional.

[losworld]

On 5/3/2016 at 3:16 PM, Hedghog said:

On 5/3/2016 at 0:21 PM, losworld said:

Don't be too confident about any of the medical here due to incompetence and corruption. Not all but its a business here and a big business in the private hospitals.

You must of had some bad experiences,or just following a trend?

No trend just the reality of the situation observing and being immersed in Thai culture for ten years. I have personal friends who are doctors and nurses and competent but many are incompetent.  Are you by chance flogging overseas medical services lol.

[Sheryl]

Hate to tell you, but there are plenty of incompetent ones back in the West too. More than patients realize. I've worked with them.