Hello you lovely people.
I have been asked by my GP to take my blood pressure twice a day as I haven’t had a review for sometime. I use the Omron machine and because I am in permanent AF I take three readings each time. The problem is each reading is very different from the previous one . Some are high then some are a bit lower, Just wondered if anyone else has had to do this and had this problem, or is it just something that happens with AF.
Many home blood pressure devices are not accurate when in afib. Ask your doctor if you can come into the office and check your Omron against the office machine. This is fairly common protocol at least in the US. You may end up needing a different Omron model, or perhaps the average of your three readings are good enough.
Jim
Thank you for your reply. My machine has been checked against the one the nurse used at the surgery. Funnily it was the exact same machine.
How much do the three readings vary? Are you waiting at least 2-3 minutes before readings? That's important.
Jim
Thank you for your reply. Here are some examples of my BP taken 10mins apart. 165/137 151/100 141/109. PM 194/102 177/105 180/115. Pulse rates all within normal limits. Crazy !
Even though they vary, all three readings seem to fall within the same category therefore for medication and monitoring purposes probably ok. What might be interesting is to take three readings at your doctor's office, 10 minutes apart. Blood pressure can normally vary from minute to minute and it just may be that this variance is normal for you.
Jim
Thank you for reply. I am seeing nurse at surgery on Thursday with the readings. I also am of the opinion that one size does not fit all.
Hi Florence-Nightingale,
Perhaps this is yet another type of example which is known as 'the white coat syndrome'. Another expression would be mind over matter.
In other words there is a stress influence on a test result which is creating some weirdities in the results themselves. In other words you might not be aware in a physical sense that you are a bit stressed about having to do these readings ( and possibly stressed about unknown outcomes too ) that this invisible stress factor is distorting the results.
Not sure that I know of a way around this BUT .............. why not set your mind to taking a 3 reading test at 09.00 am and another at 03.00 pm ( or something convenient ). Imagine you are taking medication at these set times and just do the BP checks at these times...... then see how the results stack up.
Would you be willing to provide an example of the readings that concern you ?? My readings are very stable .......... BUT ............ I am on so many BP meds I could set up my own pharmacy.
TBH, when I test at home ( which I now have to do regardless, as my Cardiac Consultant wants to see results over a time period ) I know intuitively that my results are gonna be 'Whacko Jacko ' but at least I know they are gonna follow a trend. Remember, like all number tests - a result is only as good as the moment in time it is done .......... the important bit is seeing the TREND over a longer period of time. BP is soooooooooooo fickle!
John
That's the problem with afib. Readings can vary wildly. Mine do. Apparently the 'old fashioned' way of taking a reading, where the medic pumps and a stethoscope is used additionally to listen to the pulse, is far more accurate. I take 3 with my omron and then roughly average. MOH is more pedantic and has the calculator out!
I have read that automated home machines are very inaccurate when an irregular beat is happening. I sometimes take four, even five, readings and just record the lowest (I do get white coat syndrome even at home!). Your surgery should have a manual type machine that needs a stethoscope to detect the pulse, also, and these have been shown to be the most accurate when AF is happening.
Steve
and hopefully there will be an old fashioned person who knows how to take it correctly. I still have my sphygmomanometer and stethoscope - I can take my own reading with a bit of help to get the cuff set up.
In my younger days, as a medical rep for Riker Laboratories (who made the original Medihaler, if you recall it, with isoprenaline), we offered a free service to all doctors, repairing and restoring mercury sphygmomanometers. They were often in lovely wooden boxes.
Steve
I totally agree Ppiman. It is recommended that a manual BP should be used on AF patients. When I asked the nurse to use that method she hadn’t got a syphigmomanometer in the surgery!!!! I wonder if they are taught the manual way anymore.?
I thought all doctors had them for just the reason we are discussing, but even hospitals use electronic ones, now.
Steve
Hi Florence
I changed to MicroLife.
Explaining to your Dr that you have AF. She/he should be taking your Heart Rate physically and via her stethoscope.
You can take your H/Rate yourself if you know how or at the Chemist will take it physically.
BP was better on the microLife without Err.
Also wait relaxed 15 minutes lying down. Machine above your heart. Yes, take 3 readings 5 mins apart. Take average.
cheri JOY. 75. (NZ)
My diabetic nurse asked me to record my BP at home for a week and advised me to take 3 readings each time and use the lowest. I still do this when I need to but tend to favour the average rather than lowest. Inaccurate readings due to irregular heartbeat is just another complication so really I don't think you can expect to be too precise at home.
When I've had bout sof arrhythmia, I've found it impossible to get proper BP readings. The only reliable way is for a GP or nurse to do it the old fashioned way. Frequently I just got error messages on my Omron and no readings at all.
Because AF has a varying pulse rate it is not possible to get accurate reading with standard oscillometric machines as they can not sense the 'Koroktof' sounds like the docs used to with a hand pump mercury column and stethascope. Best machine is VEROVAL DUO which has a microphone set in it do a bit of research mine was 70 uk pds. V accurate for AF and uses the Aculstatory method like the old but accurate gp method.
On top of anything and everything others have mentioned, it is very easy to get inconsistent readings for lots of reasons.
Different arm height;
Someone speaking to you - or you to them;
Poor cuff positioning;
Significantly different hydration.
I live in South Africa, and my Gp would never rely on my readings (quite rightly) - she uses her faithful pump type machine on my six monthly visits(I have white coat syndrome). I have the additional disadvantage of having thin arms, and wrapping the cuff (even the smallest I can get here), on my upper arm is a nightmare, so I use wrist ones which are notoriously inaccurate. I have 4 from different manufacturers, and mostly they show widely different readings - the only thing they agree on is my HR! So, I can say that I have a rough idea of my BP, and really only worry if I feel dizzy or faint (seldom happens) or if one of the devices gives a reading in the crisis range !!!!!!
The old faithful pump type machines which rely on mercury are effectively banned in the UK and many other countries.
The most significant issue was the danger to the technicians who were maintaining and calibrating them. The mercury levels in their working environments were sky high.
(There are also the issues of the whole supply chain for mercury, spillage, etc., but it was maintenance that became the killer issue.)
If I saw a healthcare work (nurse, doctor or anyone else) using a mercury sphygmomanometer, I'd be as near as possible certain it had not been re-calibrated in years.
I really don't know what the maintenance situation is here, but I do know that if my GP gets a reading that she's unhappy with, she send me to the nurses' room where they do ECGs, dressings, injections, BP and that sort of thing and . There they have this very sophisticated large wall mounted machine which is supposed to be super accurate, and there is never very little difference between the reading from the two machines. She tells them not to use the standard electronic one (like the home models you can get )with an upper arm cuff on me. What is the ruling for dentists who must be replacing old amalgam fillings every day, and are people who still have them given priority visits to have them removed?
Here are some examples of my BP taken 10mins apart. 165/137 151/100 141/109. PM 194/102 177/105 180/115
Florence-Nightingale Suggest you visit your GP's nurse for a blood pressure reading. Your rate is very high (ideally below 120/80, 130 can be acceptable).
Are you taking medication for high blood pressure ? Best to inform doctor of these readings.
Also, if you google lot of info on how afib patients should take blood pressure readings.
Hi mav7. Thanks for reply and yes am on lots of meds for Bp am trying to avoid anymore. Am seeing nurse on Thursday with readings.
have you tried using the other arm? It was a tip I read way back that everyone seems to use just the left arm but they should also use the right as a counter balance. Also the position of your arm in important it should be straight and at a right angle so use a pillow to achieve this.
Bisoprolol, best time of day?
If you have Vagal AF should you be identified when they join the forum?
Persistent AF/Exhaustion
Advice from your experience please. 
IAfib and mental health 
