Blood pressure monitors and how to use them; taking a blood pressure measurement; continuous monitoring

Thank you. I was afraid that was the real answer.

My current GP is the only one I can recall who has used an auto machine. All the others did it manually.

Currently on low dose candesartan for slightly high BP. Wondering if it is worth it. There seems to be considerable argument over the long term value of treating it.
 
If an automatic machine like an Omron is giving normal or near normal readings regularly it is probably reliable. The difficulty comes the you get rogue high readings due to malfunction.

I think there is a good argument for keeping blood pressure levels down to about 140/80 but maybe the most important thing is to check a suspect BP every week or so to ensure it is not gradually rising out of control.
 
I agree that the GP readings may be more accurate but I think there may be value in home machines for some people and I use one at home. At the surgery my blood pressure always reads higher because I'm being scrutinised.

My GP and I have taken readings using both his manual method and my machine in the surgery and we have been satisfied that the readings are similar. We've done this a few times (in the past, over years)

I also have my machine tested and serviced as recommended by the manufacturer (Omron).

It's useful because I can arrange to be checked at the surgery only if there seems to be an indication to, rather than fitting into some schedule of check ups that would mean more appointments with all the knock on effects.
 
Anecdote : My husband went to see a GP a year or two ago. I can't remember why. The doctor was unusually stressed - it was unusual in the fact that it was so obvious. She managed to put the blood pressure cuff on my husband upside down and at an angle, and the cuff wasn't snug when it reached full pressure. (It was an automatic machine.) The result was that his BP has been entered in his medical records as being something like 180/110. We have two blood pressure monitors at home, of two different makes, and neither has ever given a result higher than about 130/70 for my husband and on average his result is more likely to be around 115 -120 over 60 - 70. I wonder if that 180/110 result is going to come back and bite him on the bum at some point in the future.

Jonathan Edwards said:
The Moron automatic machine
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Jonathan Edwards said:
Sorry that should have been Omron automatic - spellchecker came up with a good one.
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I assumed that was deliberate and rather funny. :laugh:
 
Thanks for comments.

I am less concerned with accuracy than consistency. Doesn't matter so much if it is out a few points, as long as it is always out by that much.

Could those who mentioned having one at home add the brand and model they are using. Thanks.

Jonathan Edwards said:
Sorry that should have been Omron automatic - spellchecker came up with a good one.
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I also thought 'Moron' was a deliberate joke about mindless machines. :D

More seriously, is measuring at the upper arm better than at the wrist?
 
Sean said:
More seriously, is measuring at the upper arm better than at the wrist?
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I think the reason for using the upper arm is largely historic. The traditional method requires listening for Korotkoff sounds as the artery collapses under cuff pressure. That is easy enough at the elbow with the brachial artery but it is pretty tricky to get a stethoscope bell on to the radial at the wrist. Beyond that I think that the upper arm may be better because there is only one central bone and a circular cuff will reliably generate a uniform pressure around that compressing the artery. In the forearm there are two bones and the artery sits deep between them and might be protected from pressure in a thin person. Readings might come out falsely high. The other thing is that historically all data relate to the upper arm so I would be more comfortable believing results using an upper arm cuff.

The Moron mostly gives reliable repeatable results but it has a problem that can lead to getting completely inappropriate results under special circumstances. By and large the problem with automatic machines is that because you are not hearing the sounds directly yourself you do not know if the machine is doing something really stupid at times. For my wife a traditional cuff gives 140/80. The Moron gave either 140/80 or 200/120 - not useful.
 
I've looked into this recently for a family member, and also interested myself. I think Omron are the best known and most trusted brand for automatic machines, the brand that doctors seem to use. So that's what I'd probably get. You need to measure your upper arm, as the cuff that comes with the cheapest model (M2 Basic) is 22 to 32 cm and this may be a bit tight if you have big arms.

The branding across the Omron 'M' range of machines is a bit confusing, I think they all have 'IntelliSense' built in to inflate to the correct pressure. The more expensive models have 'IntelliWrap' cuffs, this means that the senser is larger and not so fussy about correct placement on the upper surface of the arm, and the cuff is larger, at 22 to 42 cm. This is available from the M3 Comfort BP monitor upwards (but not the cheaper M3 IntelliSense model).

Omron's most recent range is, I think, the 'X' series. This appears to be essentially the same in function as the 'M' range but with different colour scheme.

There is also the MIT5s unit, in a black colour scheme with smart functions.

The most expensive models have smart connectivity to sync with your smartphone via bluetooth and upload data to health apps. The flagship model is the mighty X7 with built in atrial fibrilation detection.

A word of caution here about cheaper devices is that I tried the Omron M2 Basic (1,000s of 5 star reviews on Amazon) and found that it inflated really hard and constricted my arm, and I think it slightly injured my arms. I tried it for a week, taking a few readings the first day then just once each following day, I tried either arm to see if there was any difference in the readings. My arms were sore for several months when reaching up, I think it's where muscle joins connective tissue in the top outside of the arm. I don't know if I got a faulty unit, or I'm just extra sensitive. I got a refund and gave the unit to a friend... who I think still has use of their arms.
 
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hinterland said:
found that it inflated really hard and contricted my arm
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I haven't had my BP measured very often, but I have noticed that the automatic ones bloody hurt. And pinch too sometimes. But my experience is only about 4 or 5 times - hardly ever visit doctor, last time was over 2 years ago when trying to get evidence for my PIP Tribunal. Oh, and walk in clinic in Wales last autumn when I fell over in the caravan shower stall, :rolleyes: nurse rather than doctor there.
 
Jonathan Edwards said:
The Moron mostly gives reliable repeatable results but it has a problem that can lead to getting completely inappropriate results under special circumstances. By and large the problem with automatic machines is that because you are not hearing the sounds directly yourself you do not know if the machine is doing something really stupid at times. For my wife a traditional cuff gives 140/80. The Moron gave either 140/80 or 200/120 - not useful.
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Is this just the problem of it slowly and ominously inflating causing different pressure or do you think that the machine is malfunctioning on some level?

It seems like it may be difficult for a patient who is severely I'll and has brain fog to learn to listen to the artery sounds to see if blood pressure readings seem accurate.

In that context, wouldn't a high end automatic blood pressure machine be a better choice? I imagine people with ME get white coat hypertension a lot, because of having almost universally stressful experiences w doctors. So taking blood pressure at home somewhat accurately seems important.


When people do 24 hr ambulatory readings , is the machine used much different from the best consumer grade machines?
 
hinterland said:
A word of caution here about cheaper devices is that I tried the Omron M2 Basic (1,000s of 5 star reviews on Amazon) and found that it inflated really hard and constricted my arm, and I think it slightly injured my arms ...
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Yes, good point. Some machines will inflate to a really high pressure (210? 220?) that hurts. You can get machines that will allow you to set that initial pressure to a lower number. I think the newer ones are smarter and will adjust dynamically depending on what they are measuring but I could be wrong.

Whenever a doctor/nurse measures my BP manually and pumps the cuff really high (if I forgot to remind them that my BP runs low) then it always causes bruising on my arm (starts out as long vertical red marks which turn into bruises). My machine doesn't cause that problem, thankfully. (no pain or bruises from my home blood pressure machine)

I agree that manual measurement of blood pressure is better. But a machine at home is meant to be a screening device, not a substitute for a doctor's measurement. The alternative would be either no regular measurements or going to a doctor's office regularly - not practical.

When my blood pressure machine fails, it fails completely. It just shows an error (forgot what it says). I think that usually happens for me when my pulse pressure is very low, e.g., when systolic pressure is close to diastolic pressure (top and bottom numbers very close). (I hope I got that right). As I said, my normal BP is always on the low side.

Interestingly, I have used this machine during an SVT episode, before I got the Kardia device, to see if it could record my heart rate (this thread talks about my SVT - not related to ME/cfs). It worked just fine during those SVT episodes which I find fascinating.

Edit: Just re-read my old post and I see that my Omron blood pressure monitor did sometimes show an error during SVT episodes. But it did work several times.
 
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