Measuring blood pressure

[Snoopy]

Hi, everybody.

      Given how important blood pressure tracking is for us--both during the donor approval process, and for post-donation follow-up--I'll share the following experience:

      My doctor has often found my pressure to be borderline high, or even, actually, a bit "over the line" for hypertension...but nobody else finds my BP high. Not in the hospital, not when I give blood, not when I get it measured by nurses at my HMO.  People immediately suggest "white-coat hypertension", in which patients are frightened of going to the doctor, and therefore show up with high BP readings.  I've always discounted that, because I'm friendly with my doc, and feel totally comfortable with him.

    I think I've finally gotten to the bottom of this mystery.  A nurse pointed out that a normal-size BP cuff may be too small for my arm, and the squeezing artificially raises my BP.  My doc has only a standard-size cuff, while a larger cuff seems not to produce high BP measures for me.

   Therefore, if you're ever told you have high BP, you might suggest trying a larger cuff.

        Be well, Snoopy

[Clark]

Bravo! Glad you're going to get good readings from your PCP from now on. My troubleshooting list after dealing with exactly the circumstance you describe: high readings only at PCP, not elsewhere:


1) Proper cuff size? (as you say)


2) Proper alignment of acoustic sensor to artery?


3) Left arm, not right?


4) Comfortably seated, with arm comfortably supported horizontally at heart level?


5) Calm circumstances, and time to recover from stresses of arrival?


6) Repeated measures to support or further identify anomalous readings?


7) Experience/attentiveness of measurer, or quality/calibration of automatic device?


Dehydrated? Hungry?


9) Medications?


10) "White coat" fear is only one possible stimulus and emotion that might increase pressure...

[sherri]

Some good suggestions on taking an accurate blood pressure.

Proper blood pressure should actually be taken in both arms. They should be within 20 mm Hg of each other in the systolic number (top number). deviation from that may indicate a blockage. this sometimes happens with people who have a history of vascular disease. (see subclavian steal)

Best way to monitor your blood pressure if your readings are high at the doctor's office is to monitor at home and bring in the numbers.

Sherri