blood pressure cuffs

[Alan Lightstone]

SO if i read your answer correctly
(1) no way to tell if BP readings taken in the doctor's office are accurate (so comparing your machine the PCP's machine is useless)
(2) One can only check out the "home machine" by comparing it to a professional machine in a hospital...meaning one is SOL unless you can convince a hospital staff to let you come in off the street with your machine to check it out.

Ergo...no way for a lot of folks to determine/monitor what their BP is.

If I've misunderstood your reply, or come to an erroneous conclusion, please correct me.
I'd like to be able to accurately monitor my BP. Thanks

Basically, what you said is true. But it is what it is. The machines or that human being measured BP may be perfectly accurate. Or not. But that's what we all get. There's no profit motive for doctor's offices to buy expensive BP machines, so most don't.

I would look at a trend of your BPs, taken at different times, in different locations perhaps and use that to judge what your blood pressure is. It doesn't have to be totally accurate, because it won't be. It's not like they're going to put an arterial line in your radial artery every time you go to the doctor's office to get an accurate reading (and there is artifact with the gold standard, too).

As I said, I'm content with my home Omron machine. I take my BPs lying in bed, watching TV. Don't watch the Red Sox or Rays losing. That would raise my BP. I look at trends. That's, at least to me, a reasonable approach.

[Patty Hann]

Basically, what you said is true. But it is what it is. The machines or that human being measured BP may be perfectly accurate. Or not. But that's what we all get. There's no profit motive for doctor's offices to buy expensive BP machines, so most don't.

I would look at a trend of your BPs, taken at different times, in different locations perhaps and use that to judge what your blood pressure is. It doesn't have to be totally accurate, because it won't be. It's not like they're going to put an arterial line in your radial artery every time you go to the doctor's office to get an accurate reading (and there is artifact with the gold standard, too).

As I said, I'm content with my home Omron machine. I take my BPs lying in bed, watching TV. Don't watch the Red Sox or Rays losing. That would raise my BP. I look at trends. That's, at least to me, a reasonable approach.

OK..."trends" works for me....fortunately my trends are fairly consistent, and (even better) low.
Thanks

[Alan Lightstone]

OK..."trends" works for me....fortunately my trends are fairly consistent, and (even better) low.
Thanks

What I used to say to people is if your BP is low, and you're not passing out.... Awesome!!

[Jim Becker]

"Trend" is what I keep trying to emphasize with our daughter...she's a bit, um...impatient.

[Lee DeRaud]

Also, I was reading a lot on BP measurements...not once in any MD's office has my BP been taken the way it's supposed to be.
Not once, ever, in any office. You are supposed to sit quietly for 10 minutes prior to them taking it.
I've never been in an office where the Aide or PA or NP waits 10 minutes.
And if you are answering questions while they take it that can raise the reading 5-10 points.

Yup. Their normal procedure is weighing me, commenting that I'm up/down a kilo or so from last time, and taking the BP measurement 30 seconds later while asking how much I typically eat/drink/exercise. Then when it's too high, they immediately take it again with me standing up. Seriously? Why do they even bother?

Mine was "white-coat" high at my last visit. They asked if I had a widget at home, and gave me pre-printed instructions on how to take it and report back. It was a sequence of (1) put on the cuff, (2) remain still for five minutes, (3) take three readings one minute apart, and (4) report the average. I'm not really sure what they do with the "self-report" numbers, but I suspect they'll never find their way into the official record.

[Patty Hann]

...They asked if I had a widget at home, and gave me pre-printed instructions on how to take it and report back. It was a sequence of (1) put on the cuff, (2) remain still for five minutes, (3) take three readings one minute apart, and (4) report the average. I'm not really sure what they do with the "self-report" numbers, but I suspect they'll never find their way into the official record.

My PCP (really a PA) had my spreadsheet scanned and put in my file. She's pretty thorough. I like having her as my "doc".
I see my real MD (sports med) when musculo-skeletal problems come up.

[Patty Hann]

ROTF.
As we used to say about orthopedists - "Strong as an ox. Similar IQ"

Oh, come now... that is hardly fair.
I know people who have had orthopedic guys work on their spines and necks.
That is some pretty scary work, to have someone messing around your spinal cord who (you say?) isn't very bright.
Now, for the record I have had work done on my spine and neck, (lumbar and cervical fusions) and I opted to go with a neurosurgeon precisely because that is what neurosurgeons do, they work near/on "nerve stuff".
They don't do shoulders or hips or knees or hands or feets.
But when I need one of those joints worked on (and I will need thumb surgery soon) it will be one those "oxen" that works on it.

[Dave Fritz]

When I originally posted my lack of faith in the ortho clinics BP readings I was referring to the people that checked me in. I'm not sure what level of training they have, I know they're not RN's. All they do is check your meds., put the cuff on your arm and push a button, then record the readings. Almost secretaries. Again, she said she'd be back to recheck BP but never showed up. I think a couple of things are at play. Over worked hospital systems, short staffed and in my case not the best pay. The physician's assistances and surgeons are top notch.

[glenn bradley]

My doc asked me to bring my meter in so they could test it in their office under the same conditions. Turned out to be pretty close.

Ding, ding, ding. You can get different readings in sequence by altering arm position, support, talking, breathing faster or slower . . . 9 out of 10 times the person taking my BP at the doctor's office does a poor job method-wise. At home we are testing for generalities, not the precision of continuous monitoring like when you are wired up in a controlled environment.

[Patty Hann]

When I originally posted my lack of faith in the ortho clinics BP readings I was referring to the people that checked me in. I'm not sure what level of training they have, I know they're not RN's. All they do is check your meds., put the cuff on your arm and push a button, then record the readings. Almost secretaries. Again, she said she'd be back to recheck BP but never showed up. I think a couple of things are at play. Over worked hospital systems, short staffed and in my case not the best pay. The physician's assistances and surgeons are top notch.

I know you and Alan were just joshin'...

[Jeff Clode]

This has been a meandering thread and a tiny bit worrisome to me - good control of hypertension is probably one of the most important and easily accomplished things that can be done in modern medicine- the payback is HUGE. If your BP is questionable , get a validated cuff ( look the choices up online under that name ) and use it per easily available online instructions. The readings in a doctors office are fraught with multiple sources of errors in terms of absolute numbers but if you take your cuff in for a check and it’s within about 10 points of the office reading (done by a reasonably competent practitioner) your cuff is probably good to go. Wrist cuffs are fine (if validated and used according to strict guidelines/instructions)- they are easier to screw up than arm cuffs because of arm position issues. The point is know your BP and make sure it’s treated appropriately if it’s elevated…monitor it yourself with a validated cuff
Jeff

[Scott Winners]

27 year RN checking in. I agree with Alan this is a slippery slope. Yes you should uncross your ankles. Yes you should "relax" for 5-10 minutes. I use the hospital calibrated automated cuffs for almost all of my BP measurements- so my colleagues can use the same gear and have comparable numbers to whatever I get when I use the same machines on you.

I use a $320 Littman CORE to assess your lung, heart and intestine sounds around my hearing aids and I can sure as the Lord made little green apples measure your blood pressure too, but the main thing is trends. Using the same equipment as my colleagues we can look at your trends over days and have useful data.

If I were to hook two hospital calibrated auto cuffs to your arms, one each right and left, and push the 'start' buttons simultaneously, I would record two different BPs. You are not a Small block Chevrolet with factory oil galleries, a blueprinted oil pump and Hohenzollern lifters. You are an organism. Your "blood pressure" varies not just all over your body but moment to moment as well.

Wrist cuffs suck. If that is all you can afford that is fine, but you MUST lay flat on your back with your arms crossed over your chest and hold the heck still while the cuff is up to get useful data. The auto cuffs that measure on your upper arms are much more repeatable and you absolutely should take your auto cuff with you to the doctors office, every time, to check your home cuff against the pro cuff. In my experience home cuffs are fairly consistent, but they might read +/- 10mmHg compared to calibrated cuffs. Consistently wrong, but consistent.

Finally, if your BP is so consistently borderline that you want to critique my OTJ performance with an auto cuff so you can stay off meds, there are a couple things you should know. 1. You are probably overweight. 2. You probably have too much fat and sugar in your diet. 3. You are probably getting sub optimal physical activity.

Eat your greens. Drink your water. Do your steps. Stay off my floor.
Scott RN

[Roger Feeley]

So here’s a question. Can I calibrate my cuff this way:
1 take my manual cuff to my doctors office,
2 partially inflate it and wrap my doctors cuff around it.
3 Inflate my doctors cuff to some value
4 compare the two readings

[Lee Schierer]

So here’s a question. Can I calibrate my cuff this way:
1 take my manual cuff to my doctors office,
2 partially inflate it and wrap my doctors cuff around it.
3 Inflate my doctors cuff to some value
4 compare the two readings

Not likely. The cuff then inflates until it fits tightly around your arm, cutting off your blood flow, and then the valve opens to deflate it. As the cuff reaches your systolic pressure, blood begins to flow around your artery. This creates a vibration that's detected by the meter, which records your systolic pressure.

The cuff on top probably would detect the pulse through the inner cuff.

[Alan Lightstone]

And, of course, there’s this:
https://www.cnn.com/2023/08/07/healt...ess/index.html