BP machines

[johnef]

I have used an upper arm BP monitor at home and a wrist one at my surgery for ages. Recently, after a spike in my BP after being taken off a medication, I saw my GP who told me that those monitors are no good for measuring BP for people with AF. He used one with his stethoscope and said it was necessary to take the measurements while listening. Any thoughts or experiences?

[CDreamer]

I took my machine to GP and did direct comparison with GP using stethoscope and then I used the machine. Obviously they weren’t exact readings but within a few units. My GP was then happy to use my readings.

HOWEVER - when in AF it’s often really difficult to get a good reading as your BP will not be stable so the older machines always used to return an ERROR message but I always had the opposite problem of BP dipping so low it was unrecordable by the machine. The newer machines tend to ask you to take 3 readings, have an indicator that shows AF and then takes the average of the 3 readings to record. It won’t be as accurate as using a mercury unit with stethoscope but would it be good enough for what you want?

[mav7 in reply to CDreamer]

johnef Take CDreamer's advice.

[BenHall1]

At one time NICE gave information on BP monitors (digital) that were recommended for use with AF. I had one ... a Microlife , can't remember the details now. Omron also have a similar product.

[Rambler398]

Do you have permanent AFib or episodes of AFib?

[johnef in reply to Rambler398]

Hi Rambler, I have permanent AF

[PansyCat in reply to johnef]

Has anyone offered you Amiodarone? My husband was put on it about 18 months ago, and hasn't had any AF since. But it's Horton start with, alters taste, changes sleep patterns, lots of nasty side effects, but it really works for the AFib, and the side effects wane.

[Rambler398]

Hi johnef,

I also have permanent AFib and hypertension.

My understanding is that digital BP machines are not validated or accurate in permanent AFib. The accuracy of the old mercury column sphygmomanometers depends on the skill of the doctor.

I think the advice is to take 3 readings at one minute intervals and take the average. The better validated machines have a setting to do that.

When my BP was too low my GP, asked me to do 4 readings a day for 7 days before reducing my dose of Lisinopril.

I think you will find advice about this problem on the British and Irish Hypertension Society (BIHS) website and possibly too on the NICE website.

[johnef in reply to Rambler398]

Hi Rambler Thanks v much for your help and advice. When I took my readings I usually took quite a few as they varied so much, including on each arm. The general trend was a low BP so I was taken off Indapamide after which the BP shot up . I got a follow up appt. with the nurse but her monitor was the digital one as well .

[Palpman]

The accuracy of the old mercury column sphygmomanometers depends on the sensitivity of one's ears and the quality of the stethoscope.

[NooNoo14]

My GP did a comparison by doing 3 manual and 3 electronic tests. It was clear that the electronic one did not work. I was told my notes would now be clearly marked that I should only be tested manually in future.

[50568789]

I have an upper arm BP monitor which produces a shaky heart symbol if in AF to indicate irregular heart beat, so I know the BP readings may not be reliable. When it doesn't show I can assume I'm in NSR. It feels like it has been very reliable in these respects the last couple of years. However, also have a finger oximeter which also shows an active wavy line, supposedly indicative of the pattern of the heartbeat / pulse rate, along with the actual rate. I can sit for ages staring at that. It's great when in NSR as the nice even normal pattern is very reassuring. The irregularity in AF is a bit scary to look at, it shows the heart is in a very uncertain state, there are hints of it reaching out for those nice even waves but something keeps throwing it out of sync or barely beating at all in short bursts. A GP once dismissed this as unreliable and not worth his time. I did the same to him.

[Dollcollector in reply to 50568789]

I agree. My oximeter clearly shows when l am in a.f. The wavy line is all over the place and my pulse is very high. It shows when l am in n.s.r. my pulse is down and the wavy line is regular. I don't know why some doctors say oximeters aren't accurate. When l have compared it to my blood pressure machine , the pulse rate is the same. I only use my oximeter to confirm what l am already feeling and l find it very reliable.

[Sleepyzz]

I have an arm cuff one from Boots not a wrist one, it does fine for bp if I’m in afib it shows I’m in afib but then the heart rate reading obviously doesn’t show the variation so I use the ecg on iPhone for that. The bp readings have been pretty accurate when in afib, I used it while waiting for an ambulance and when they came they got much the same readings.

[Ppiman]

He's right; and even that isn't perfect according to studies on the internet that I have read. You need to take your BP when your heart is in NSR if you're using a home automated device, apparently, and do it while fully relaxed, first thing in the morning before tablets and food, sitting at a table, arm on a cushion and repeat to three times.

Steve

[Cat04]

My GP and a nurse told me that if your BP machine is more than 3 years old it is unreliable and shouldn't be used 🤷‍♀️

[JOY2THEWORLD49]

Hi

I agree with your Dr that AF patients are better to have their heart rate read physically for the whole minute.

I changed my monitor because it would say eRRRR meaning error. Always have your monitor checked by your clinic.

But my Microlife BP monitor has never done that and I have persistent AF. The AF rapid has been controlled by Diltizem 120mg AM.

PM Bisoprolol 2.5mg.

Is your Heart Rate not controlled at rest less than 100bpm.

cheri jOY. 75. (NZ)

[Karendeena]

I was told exactly the same by the paramedic who came to me when I was in a fast AF episode. My monitor read 83/60 and when they took it it was 152/80. He then told me to take it while he was there immediately after his reading and it was way out.

[bean_counter27]

According to Dr AFib...."Are blood pressure monitors accurate for individuals with AFib?

Yes, but it’s crucial to choose a monitor that has been validated for accuracy, especially for people with AFib."

Investigate Omron HEM7361T. It's clinically validated, has AF detection and mode and recommended by Dr AFib.

A good doctor might do a better job but if you don't have a good doctor at home then something like the Omron above might meet your needs.

It works for me but YMMV.

[Omniscient1]

My BP monitor is ok with AF. I have permanent AF