Different pulse ratings

[Thom7]

When I have my blood pressure and pulse rates taken at the Gps & also with my own blood monitor the pulse results are much higher than if I take my pulse at my wrist manually.These rates were all taken within 30 minutes of each other. Has anyone else had this situation and what have you done about it? Thanks

[BobD Volunteer]

Nothing. Your heart will accelerate or slow according to lots of parameters such as mood, exercise . stress etc. Don't get hung up on it. Just getting out your machine can change it.

[Thom7 in reply to BobD]

Thank you Bob for your reply. If blood pressure readings can vary so much how do we know when we have an accurate reading.? The reason I am so consistent about this is that my EP has asked for blood pressure to be monitored following stopping my Verapamil . I now only take 1.25 Ramipril daily along with Warfarin and Atorvastatin and wonder if I am now under medicated for my blood pressure. I have asymptomatic AF which is constant and I know I am lucky not to have the horrendous symptons some people have to endure but I worry about what is happening to my heart that I do not know about. Sorry for the moaning but I do get hung up about this.

[CDreamer in reply to Thom7]

Hi Thom -

Firstly if you are in constant AF then getting a consistent heart Rate from a BP machine will be almost impossible. For instance - a recent admission in A&E showed the monitor I was strapped to was 90 whilst in the same moment - ECG showed 145.

Secondly wrist band BP monitors tend not be as accurate as arm one.

Thirdly - the newer models of BP monitors do recognise Arrythmias whilst the older models don’t so make sure your model is a modern one.

Fourthly - your doctor wants you to monitor your BP - not your heart rate, although it is always interesting to note.

Lastly - advice I was given was to take 3 readings, one after the other and the. Record the average.

Hope that helps.

[Thom7 in reply to CDreamer]

Thank you CDreamer and Koll for your experience with pulse readings when in AF. I should have known that I cannot get a consistent reading when in AF but somehow that fact had escaped me. Feel much better now.

As to my blood pressure readings I will follow advice and taken3 readings and take the average.

So great to talk to people who have such good information and help.

[Hidden in reply to Thom7]

Like CD, I can't get readings when in AF. I tried all sorts of home monitors in the early days. I have even been on a large hospital monitor in A&E which also gave incorrect readings. I know because it took readings in two different ways and came up with two completely different figures. My rate was going up to 165'ish, and yet the other reading was 72!

Some people can get correct readings because they've said so on here; so I guess it depends on your precise arrhythmia.

I spoke to an EP about this at the AF Conference Day in Birmingham, and he explained why monitors can't usually monitor you reliably when in AF. He said something to the effect that they can't tell what is a proper heart beat and what isn't, or sometimes they can, sometimes they can't. He said it's best to simply go with how you feel. But, he added, if you really want to know more then listen to your heart, i.e. literally listen, with a stethoscope. I've never bothered though.

[irene75359]

Putting the upper arm cuff on and switching the machine on raises my blood pressure. I find the cuff inflating quite unpleasant and the first reading is always high. I distract myself by playing Sudoku and my blood pressure drops considerably - this is within a minute of the first reading.

[Thom7]

Thank you for your reply. I also find taking my blood pressure unpleasant and will try your method of distraction. How many times a day do you take readings and do they vary very much?

[irene75359 in reply to Thom7]

I take my blood pressure once a week, at the same time that I check my INR. I keep a note in my diary so I can chart any changes. My blood pressure can vary between 105/65 to 125/70 but see my reply to momist below!

[Mercurius]

Dear Thom7,

I'm also silent afibber. I have tiny personal Holter ECG monitor, so I could take more than 1500 hours ECG recordings on myself. For validation I have tested various pulse rate and heart rate rocorders. My experience:

- The most precise heart rate estimation comes from the ECG.

- The heart rate is varying beat to beats, which is called Heart Rate variance. The BP monitors displays an avarage of pulse rate for ~30 sec.

- Wrist bands are inaccurate for pulse rate measurement even during normal sinus rhythm. This phenomenon is related to the motional artifacts. For instance during cycling frequently I got with Scosche Rhythm+ 180 BPM, although from ECG it was clear cut that I had only ~90BPM.

- Of course during afib the wristband displays strong tachycardia, but this high rate also persent when I have clusters of ectopics. So basically the point, the pulse rate alone cant distinguish the afib from other arhythmias.

Mercurius

[BobD Volunteer]

Every six months I have to do a seven day chart . Morning and evening. Take two readings five minutes apart and average them out. Make sure that you have been sitting quietly for at least five minutes before starting. Yes I know for a busy person it is a pain but worth getting it right. Our medical centre provides a proforma to complete which is an aide memoir.

[momist in reply to BobD]

Also, although I don't now remember where the advice came from, to get more accurate blood pressure you should be comfortably seated for that five minutes and at the time of measurement have both feet flat on the floor (no crossing of legs or arms etc.), do not move, do not speak. Thinking about something like sudoku might work, but don't be filling in the answers! Another thing; no tea or coffee or other hot drink, and no recent meal. It's remarkable what can raise your BP!

[irene75359 in reply to momist]

Oh dear! Well I am comfortably seated with feet on the floor and no recent meal but I am having an active ie writing game of Sudoku and drinking a huge mug of tea to boot! I shall have to mend my ways, thank you.

[CaroleF in reply to BobD]

Yes. That's what I was told to do by the GP when I did a 7 day chart and I was also asked to note what I had been doing before taking the readings - and the advice (below) from momist is good too. The GP was then interested in the average over the 7 day period

[Thom7]

Thank you all for your good advice. It certainly makes sense to do a 7 day chart of readings and then take an average over the 7 days. This is much better than having a weekly test at GP surgery. I will do this for a week and see how the results average out and advise EP.

[Hidden]

Small variations of pulse and blood pressure occur normally throughout the day. Sometimes, can be more apparent, like when we are physically active, anxious, frightened, apprehensive, tense, angry, upset, etc. My suggestion is that should stop checking your pulse and the blood pressure constantly to avoid becoming a hypochondriac.