Hi. I started cardiac rehab today (again) and the electronic blood pressure monitors still present me with a problem. The readings always show much higher than they really are. Last time I was at rehab, they were sending me to my Doctors twice a week to be checked, which made her angry in the end. Using a stethascope she would get 120/70 to 130/75. In rehab the automatic devices always show 140-145/100-104. A huge difference.
I have read some sites that seem to say the bottom of the cuff should be about an inch from the elbow crease, which is never the case. The bottom of the cuff is always in my elbow crease. It also states that my arm should be heart level, on a desk or table, whereas the tables used at rehab are below heart height. They are just above knee height. I don't suffer with white coat syndrome and I know it's going to be high because the cuff blows up very hard, on the verge of painful. My pulse is always 51-61 during the tests so I'm pretty relaxed.
Any ideas? Pleeeeease.
A cuff that is not the correct size can be an issue: too large or too small can provide an inaccurate blood pressure readings. My doctor's office has several sizes of cuffs to ensure an accurate blood pressure reading.
Reading my BP unit it states the blood pressure cuff should cover about 80 percent of the circumference of your upper arm. The cuff should cover two-thirds of the distance from your elbow to your shoulder. I am not aware of a cuff being too close to the elbow or to close to the deltoid muscle.....if there is a 20% gap there shouldn't be a problem. If I remember correctly the arm should be at heart level.
Have you always used the same arm. I understand the pressure should be about the same with either arm, but it seems the right arm would have lower pressure being the distance from the heart...but it shouldn't.
They try both arms every time because they can't believe it's so high. Another guy in the same rehab group joined today and his blood pressure was reading 200/110. Now is that accurate I wonder? When they try my other arm only the diastolic alters, and this goes up by about 4.
If you imagine my arm bent at 90 degrees, the cuff could be touching my forearm. So it must go higher? There's a small yellow arrow which they seem to put right into the middle of the elbow crease and I believe this is where the sensor is. I'm sure they think it's supposed to sense an artery in the elbow crease somewhere. When my Doctor uses a cuff with a stethascope, there's room for the stethascope between my elbow crease and the cuff, so it's definitely higher. When she inflates the cuff, I can hardly feel it compared to the arm crushers they use at rehab. I'm wondering why other patients seem to get more normal readings than I, with the cuff so low down? Do they have an artery being sensed, that I don't? Either that or they perhaps have low pressure and don't know about it?
"Reading my BP unit it states the blood pressure cuff should cover about 80 percent of the circumference of your upper arm"
So the cuff shouldn't go all the way around the upper arm? This one does but it may be a bit different in design. It's not unrolled, it's like a loop all the time and you slide it up your arm. You then pull the end of the cuff which is through a clasp and it tightens it. I know in hospital there is a spare piece of material either end of the cuff, which has velcro. So when it's attached to the arm, it probably covers about 80% with the inflatable section.
Cosumer Report did a test a while back on commercially available "cuff type" blood pressure monitors and there findings were that most of them were within 1% of the actual pressure, if I remember correctly. Since I found out in the doctors office that my pressure readings taking manually vary by as much as 10mmHg from left to right, I had to investigate this and I bought a second unit. When I use only one of them, take a reading on the left arm and then on the right I could confirm the doctors readings, but when I atached them both, one left one right, and triggered them simultaneously, the readings where within 2-3mmHg of one another, which you can explain by the internal plumbing differences. Reading your post, I took two readings this morning, one at 6:15am and one 15 minutes later. The first Syst.: 141, Diast.:71, Pulse: 63 the second Syst.:126, Diast.:71, Pulse: 57
I just looked here http://bloodpressuremonitor101.com/blood-pressure-monitor-reviews/omron-hem-432c-manual-inflation-monitor/
They use omron at the rehab centre and this site doesn't seem to sing their praises much.
I simply use an Omron HEM637 wrist monitor. It is extremely accurate and is always in sync with my doctor's office as I take it in to verify when I go in. This model has a built in position sensor so it will ONLY take a reading when in the correct alignment with the heart. Also, it is the only wrist unit currently (although more are beginning to recommend them) by the British Hypertension Society.
I hate dealing with cuff size. I work out quite a bit and it's hard to find one that always fits. As Ken said, too small or wrapped too tight will give an artificially high number.
Just a thought. Were your readings at rehab before you exercised? If they were taken during or after they should be higher and of course will be lower just sitting at drs unless of course you have white coat syndrome. I believe there are some electronic bp machines that aren't calibrated and are faulty but for the most part I believe them to be accurate.
They are even used in ICU now so I think they wouldn't use them if not.
My BP is taken on arrival at the centre. I have to sit and relax for 20-30 mins first.
Another odd thing this time at rehab is my heart rate. I can't get it above 107 no matter how hard I push. My last rehab which was around october 2007 was totally different, my heart rate would quickly go to 186-190. I'm not on beta blockers and very quickly after exercise, I'd say about a minute, it's back to 61-68.
That is odd for your heart rate to be low. Your recovery is not too far off. I just got back from a 13 mile ride and I always measure my heart rate at peak after the most difficult section of the ride. Today it was 155 BPM and my recovery number was 42 beats after one minute from peak so I don't know if your recovery rate is off, it just may be very good. Can't say about the low heart rate at peak though.
Last week my Doctor said my BP was borderline and she put me on 2.5mg Ramapril, which the cardiologist had suggested. Over a few days I started to develop chest pains and throat discomfort which was quite bad two days ago after my rehab session. I called my Doctor and she said to stop taking the Ramapril. Amazingly, all the discomforts disappeared after just 24 hours and today at rehab I managed to get my heart rate to 111 with a lot of pushing. Big difference with the Ramapril being stopped, there is no shortness of breath at all.
On arrival I rested and then took my BP on one machine which said 150/116 on the left arm and 148/114 on the right. I waited a few mins then tried another machine. This time 140/85 on left arm and 138/84 on the right. How odd. I was in the same chair and didn't even get up in between. Pulse was 68 on both machines.
Why do you think the difference in readings is odd? You rested a bit between them so you BP should be lower the second time and differences between the machines could account for some of the difference. At least both arms were very similar. The true test is to retest BP using same machine.
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