Blood pressure discrepancies

I just would like to understand my blood pressure. I had a stress test and in the hospital they use the cuff rigged up to the computer they got 160/104. At rest middle of the day even After being on lisinopril for at least 6 weeks. My doctor on an old pump up machine a few weeks earlier got 120/80. On my home machine just now I got 142/89 in the morning. The question is basically do I trust electronic machine or the old fashioned pump up machines? I do think the tablets are working but it is just the discrepancies. Between the two types of machines. I may have been a bit apprehensive in the hospital. I suppose as long as it seems to be coming down over time.

[Palpman]

My top number varies from 110 to 140 depending on time of day. I now only take it immediately after breakfast.

The first reading is always higher so I disregard it and take the average of the next 2 or 3. Round off the figures to the nearest 5. My GP rounds off to the nearest 10.

Walking to the GP and white coat syndrome can push up your BP substantially so take your own morning readings to the GP.

[Hidden in reply to Palpman]

My numbers can vary from 128 to 160 top figure on my home machine. But at least I do seem to be starting to be more in the middle about the 140 mark. So something regarding tablets is working. But I do prefer to have my blood pressure taken with an old style pump up machine my doctor uses. But my pressure can be high in the mornings. But it is interesting reading what you have sent and I appreciate the reply.

[Mart25]

Blood pressure varies a lot depending on what you are doing. I guess you have your own BP machine and I'm sure the instructions tell you to sit down and completely relax for quite some time before you take the measurement. Mine says "Avoid eating, drinking alcohol, smoking, exercising, and bathing for 30 minutes prior to taking a measurement. Rest for at least 15 minutes prior to taking the measurement". Only then will you get a proper resting measurement. So a bit a mental or physical stress at anytime will increase your numbers. (as you have found in the stress test!)

I suspect that all the measurements you quote were correct at the time, and all the machines are reliable. The only way I have found to really judge BP reliably is to measure BP a few times in one day....and do that again maybe every week for a few months and plot the numbers on a graph. It's all a bit geeky but it's very helpful (and hopefully reassuring). Also useful when anyone asks whether you know your blood pressure.

[Hidden in reply to Mart25]

Yes I have admit my dad does graphs. The thing iam still a bit confused is and you are right to follow the instruction to the letter. But you then you go to surgery and the you sit down cuff goes and reading is taken. No time to rest prepare or anything.

[Mart25 in reply to Hidden]

Yes - I agree with you that it feels meaningless for GPs and hospitals to take BP in stressful situations and expect to get a sensible result. For example, I had chest pains two years ago and was sent by my GP for urgent assessment at the hospital cardiac unit. They took my BP in the first few miniutes of arrival. It was rather high. "Not too surprising (I said) considering that it's possible I've got a heart problem!" But they still diagnosed high BP, which I know to be untrue.

[Silvertail]

When I used to take my BP (I don't bother any more) it used to jump up and down all over the place. I have had more than one Omron device, Supposed to be one of the best and I had different results 5 mins apart. Also at GPs and hospitals. I think the old pump up ones are more accurate. Just my opinion.

[Tindy2 in reply to Silvertail]

The trouble with the old type of BP machine is that you are relying on the person who is taking it to have good hearing . You have to able to hear the first and last beat . I’ve lost some my hearing so I would only rely on the electronic ones now.

[CyclingTime]

Make sure you have sat down and relaxed for 5m before taking. I had to do mine morning and evening for a month after coming off bisoprolol and doing that way gave me relatively stable readings. You will always get the odd outliers though

[Mountwood]

Good morning Felly 12. I have white coat syndrome so my BP is always up at the surgery though not at home, but I have been on Bisoprolol 5mg daily for so long I have forgotten why. Some weeks ago I noticed I was feeling very strange, light headed and off balance first thing in the morning, and my BP in the early morning was high, the systolic between 150 and 170 with a normal diastolic. Through the day and evening it was normal. I kept a graph for 2 weeks and then went to see my GP who suggested taking my Bisoprolol at night rather than in the morning. After 2 weeks of this it was still the same so I went back to the surgery, saw a different GP who ordered an ECG, blood test, and 12 hour BP monitor. The daft part is that the monitor was set to record my BP between 10am and 10pm. I pointed out that that was not the time of day about which I was concerned, but no alteration was made and the result was, of course, "spot on" 122/80. However, I have to admit that the systolic is now down to the 130s or 140s, and the weird feeling in the early morning has gone, so maybe the change of time for the Bisoprolol has worked.My GP suggested that perhaps my monitor, which was years old, was at fault so I bought a new one but the results were the same. Good luck with sorting out your BP.

[Ewloe]

In response to the question about the difference between the machines. I’m trying to think how to explain it. The pump one where a stethoscope is used to listen for the sounds. The top reading ( the systolic) you hear when the blood flow returns to the arm. And when it muffle’s it’s the lower ( diastolic) reading. Ideally the same person should do your BP as I might hear it at slightly different levels to you doing it.

The machines measure the levels slightly differently. They I think measure by sensing the pulse return in your arm and how it changes.

We were always!!!!! taught that the machine can give you an inaccurate reading that often is lower than it should be. So if we wanted to repeatedly ( say every 5/10 minutes) use a machine for say taking a BP in poorly women then we should use a manual one at the beginning and compare it with the machine reading to make sure we’re getting a reading at the correct/ same level.

Then as others have said there’s how where you are when it’s taken that will affect the results.

It’s the trend that’s important not a one off reading. I’ve got both an electronic one and manual one at home ( I was trained on manual ones which is important). Electronic ones will struggle to give you an accurate reading if your in AFib at the time.

The above might just be a load of waffle 😂😂

[JennyRx]

At My last check with practice nurse she said they are now told to expect a higher reading in the surgery so 140/90 and max at home is -5. Ie 135/85. That’s the cut off they use for triggering intervention. So it takes account of white coat syndrome. She also told me to wait quietly before she measured it. So mine was 123/73 in the surgery. Can be lower at home. Literally affected by just going to bathroom or similar. And it will fluctuate. Would be weird if it didnt

[ExPharmacy]

Could be white coat syndrome. Try to take your BP same time every day NOT straight after food, give it an hour. Make sure sitting up straight, feet flat on floor and relax for a few mins before taking. BP tends to go down more early afternoon. I always take first reading before morning pills and then lunchtime before eating and early evening. As someone has already said ignore first reading and take two more. Good luck and try to chill x

[bridgeit]

I have the opposite problem Felly, low BP; regularly 90/60 ish. What I've learned is that you can always ask the hospital nurse/assistant if they could please take another reading 15 minutes later using a different machine. Certainly, my low readings over the years have generated several unprompted attempts with different machines before the realization sets in that I really do have consistently low BP.My Omron machine at home shows a fairly regular low reading, so readings are more or less in line. However, I think a few hospital machines are in need of re-calibrating (or binning) and thereby generate inaccurate results, usually on the high side. I've seen my readings when quite relaxed show as 120/80 ish more than once and thought "that can't be right", but medics are content with this reading so I don't question it.

Nonetheless, I expect hospital staff would be happy to oblige with a second (or even third) attempt if the reading looks to be way off centre in a way that might generate unwarranted/additional high BP medication.

Meanwhile, I think as long as your meds are stable and you're feeling OK, there's very likely no need to worry about the odd dodgy digital reading.

[Villagelife]

By old fashioned pump machine do you mean the syphigmonitor when the Dr uses the stethoscope? They are only as good as the person listening to the blood pressure.

[mrhappydays]

I learnt a vital lesson with regard to blood pressure.

I went to hospital for a consultant appointment; they took blood pressure - it was something like 150/90; the consultant's assistant said " wow, that's way too high!". I then showed her the results I had taken 3 times a day for the last 3 days with my omicon. The top number was well below 130 for most.

I did say that the train broke down getting to hospital, we had to find a taxi and arrived 10 minutes late (which always stresses me as I think being late for appontments is unacceptable).

If I hadn't have checked bp beforehand, I was going to end up with more tablets!

[Larivee]

Yeah. I use the cuff type and the readings vary a lot. I guess where you place the cuff on your upper arm and exact location on arm can change the readings. Causes a lot of angst unnecessarily.

[Qualipop]

Doctors call that rise in BP when in hospital or the surgery"White coat syndrome" Some people without even knowing, get anxious as soon as they are in a medical situation and their BP Goes up. The best way to check yours is to take it 3 times a day at home on the same machine. Do it for a full week and work out your average. Sit down for 5 minutes and rest before you take it. Don't eat or drink. Make sure your arm with he cuff is at heart level. 3 readings a day at roughly the same time. YOu can give the whole week of readings to your GP and he will work out the average. When I do it I also wrote down my heart rate.

[Dastardly]

It's not until you take your blood pressure every day that you realise how much it can vary - particularly the systolic. Mine can go as low as 105 and as high as 162. I don't think individual readings are as important as we think they are. The thing to look out for is a trend or consistency. I have been told to seek help if my BP is regularly over 150/90. The highs and lows average out and my figure for the whole of June was 128/75.

[Palpman]

When I was a medic many moons ago we had syphigmonitors and I did not always bother to listen to the beats. I looked at the Mercury level and when it starts to pulse then that's the systolic and when it stops then that is the diastolic.

It is more accurate than listening especially in noisy areas as in heavy industries.

A £20 stethoscope is not nearly as good as a £220 one for listening for beats.

[Aliceeliza]

Mine is always low in hot wea ther, currently running at systolic between 90 and 125 but diastolic 55 to 60. Spoke to GP once as I take lisinopril 10 mgs daily but she was disinterested. Would love to drop my drug but have white coat syndrome and a very labile BP so I can't get them to agree to it. Feel rotten when it drops low.

[Goldfish7 in reply to Aliceeliza]

Mine also goes very low in hot weather so I tend to drop some or all of my bp meds dependent on the reading to prevent myself feeling faint or my heart labouring. Ive mentioned it to nurses before and they havent appeared too concerned about it. I work on the principal that the meds are to lower high bp so if its low they are not needed. Obviously daily bp readings are needed as constantly fluctuating weather means that sometimes tablets are just taken later in the day.

[Aoki]

My blood pressure varies wildly depending on time of day, where its being taken and nothing in particular. I seem to have the reverse of white coat symptom -- much better readings at the GP and hospital than at home with my BP machine -- which I've had calibrated with the GPs machine. I spoke to my kidney specialist about this and he said it was the lower readings that he paid attention to -- so many things can send BP shooting up. What mattered was that the reading could be reasonable a lot of the time.

[Blueskystar]

Now taking 50 mgs of Losartin. BP usually 135/ 84. Consultant thinks I should up dose to 75 but it makes me feel lightheaded and nauseous. Am I right to stay on 50mg?Any other ideas to lower diastolic BP?

[Hidden]

Interesting. This is my story. I was started on losartan but soon change to lisinopril 20mg. I take these at 9pm so I sleep through Any side effects. The next tablet I was then put on was spironolactone 25mg been on these a week. But I have to take these in the morning these are a water tablet and the main reason for these is to assist gas transfer in lungs to bloods as my ailment of epstein anomoly. Which Is birth defect has cause my right side of heart to not be efficient and therefore Al my life my body has coped with low oxygen levels. This was proven on stress test on a bike machine and I did manage 7 minutes and only stopped because of my leg muscles getting painful because of the build of lactic acid. So the reason for this tablet is to get maximum effect from my lungs which according to test are in good condition. So if my heart can pump a bit more efficiently and I get the most out of my lungs for gas transfer. I hope I don't need an op. Any way .we will get away from the op word. My blood test came back within limits and the nurse done my blood pressure on an old style pump up machine and I had 128/80. So currently the blood pressure is definitely coming down. This will all help the heart. To bring the blood pressure down any more I walk for 4 minutes and run or jog for 1 minute then walk for 4 run for 1. I don't go mad as i do have physical job. But I will admit all this news from February has effected my mental health and this does not help. But I can get light head or dizzy if I stand up too quick so I have to a bit careful with this . But it seems blood pressure tablets can cause light head due to gravity and how quick the body reacts to the change of position. I have to admit I don't know if over time your body gets use to the lower pressure? But I can only do what they tell me. MRI Monday so another test to get through.