What are the latest NHS guidelines for home blood pressure monitoring?

I was told by my doctor to take it twice a day [I think she said random times, not sure on that] and take it twice/three times with a minute or two in between. Then choose the lowest number and to do this for a week, working out an average reading. NOW she says goalposts have changed and to take 2 readings a day for a week, using all numbers to work out an average. BUT every time I take a reading the first one is always about 20 points higher than the second or third. Why is this and should I be using what I consider is an artificially high number? I am on 50 mg Losartan btw. When I have it taken in the surgery it goes quite off the page [200/100 the last time] so it's a good job I have the home monitor or I I would be over medicated - that's my feeling anyway.

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7 Replies

  • I have the same problem which the medics refer to as white coat hypertension if in clinic or gp surgery my BP goes off the scale. I monitor my BP at home and keep a diary from which the consultant at renal clinic takes an average, this is done for the same reason to ensure they do not overmedicate, I do not have any sort of regulatory whilst keeping my diary I do not take my bp daily just randomly a couple of times a week. As my appointments are 3 monthly I think they are happy to work an average on this basis.

  • I have been taking my BP at home for years as I definitely have a severe case of white coat syndrome. I record my readings taken randomly perhaps a couple of times a week on a smart phone app. When at the surgery, I show my GP the recorded data and they accept this. My BP machine is compared with readings taken in the surgery with their device to verify the error margin of mine is acceptable. I have not been advised to change my method of recording readings which is the best of three, taken in a seated position usually in the morning. As with yourself, the first reading is almost always the highest, I know not why.

  • ? Have you ever had a 24hr blood pressure test, bp band and small box recording for a period on and off over 24hrs

    ? do you take your bp on different arms it can make a difference, are you under a cardiologist and what do they say about it.

  • No, not under a cardiologist or anything else. Had all tests done last March and all fine. I did have a 24 hr monitor last March when they confirmed the hypertension and the doctor was happy for me to do my own readings and take them to her when I had monthly check-ups. Hopefully monthly will become 3monthly, will have to wait and see. Initially it was to be taken twice daily and 2/3 readings, recording just the lowest and using these to give an average over several days. Now she is saying I have to use ALL the numbers and because of the initial high number at each reading makes the average much higher. I'm worried I will have the medication increased as a result of this. I absolutely hate taking pills !!

  • I have that reaction too. BP through the roof when at surgery. I bought my own monitor from Boots and go to the hypertension clinic about every three months. The monitor retains the last 14 readings and I have to say my blood pressure varies quite dramatically during the day but doc says that is normal. I haven't heard of taking three readings and working out an average, sounds feasible tho.

    My doc stressed that I wasn't to "obsess" about taking readings, although when you are told your blood pressure is too high it tends to prey on your mind.

  • Thanks everyone for your response, it's interesting to note what others do and say. When I bought my monitor a friend told me it was quite the wrong thing to do as it made you 'obsess' - as cleocat says. There is some truth in that. She herself has had hypertension for over 20 years [she's 75 now] and has been on the diuretic Benzifluro....for most of that time; until recently she was found to have gout. Obviously she'd never read the side effects of that med, as gout is a known side effect. Even more recently she was in hospital for a hip replacement when they found her BP was very low and have now taken her off all BP medication. Am I a cynic I wonder? I just felt that had she had her own monitor she would have possibly realised she was being over medicated. I was under the impression that once you were diagnosed with hypertension that was it -it didn't go away. It killed you silently unless you took your medication and adopted all the lifestyle changes too.

  • All,

    The comments are very interesting. My wife is waiting for blood test results and a 24-hour NHS, BP home monitor.

    My wife has high BP, work stress? or home life stress? now retired therefore may be home stress? simple BP check has always given high reading!, GP has not given any medication. In the gym heart rate has shown high rearing and new coming now (2-months). When my heart rate is 100 on tread mill, my wife's is 120.

    MY wife who is a NHS believer and NHS is managing as she says, will leave it alone!

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