Blood pressure measurement - automated vs manual method

Thanks for bringing up the topic of accuracy of blood pressure data. I too do not know which readings are correct. A 24 hour monitor said my blood pressure was perfect. I had no problem. I noticed, however, that when I had symptoms, the monitor turned itself off and no data was collected. The device clearly detected something in order to shut itself down.

My home BP machine data shows my blood pressure all over the place, sometimes crisis level too high as defined by the cardiologist, and sometimes far too low, Many doctors over the years agreed that my bp is « volatile » or « labile », that is highly variable and they ask me about my bp, whether it is high or low during symptoms. I am old but never fat, but my arm may possibly be too small for the cuffs they use. Maybe they don’t have smaller cuffs? Who or what should we trust about blood pressure data?

I have the same problem in Dr office. My cardiologist takes mine manually as he holds my arm at heart level. BP is always 120/77. Any other Dr. office walks me down a hall and and I step on and off a scale then go to another room and automatically take BP with arm hanging down. And my BP is always 180/95. I tell them about the difference and get a hateful look.

Yes and I have small arms. It will sometimes do exactly what you describe and reinflate, squeeze too tightly and I know that reading will be high.

@tatiana987
I have BCBS FEP insurance in addition to Medicare. Every couple of years they offer an automatic BP machine free.

What they require is your doctor measure your arm and fill out the form. Based on that measurement they will send you the correct size for you.

I do know that I have seen Mayo Jacksonville change the cuffs before giving me my BP test.

There are published reports of scientific comparisons between automated and manual blood pressure measurements that show:
* lower readings from automated (https://pmc.ncbi.nlm.nih.gov/articles/PMC5515188/, https://pmc.ncbi.nlm.nih.gov/articles/PMC8031494/)
* no differences between them (https://www.academicmed.org/Uploads/Volume5Issue4/281.%20%5B1288.%20JAMP_Arpita%5D%201409-1411.pdf)
* higher readings from automated (https://pmc.ncbi.nlm.nih.gov/articles/PMC4843288/#sec9).

Manual measurements require equipment calibration and proper training of the operators. They are not fault-free.

I have been obtaining normal blood pressure readings weekly since 2021 using an automated instrument, which I share with my cardiologist.

You might try a smart watch if you are able to. My own Galaxy 4 and 6 versions of the Samsung Galaxy smart watch can record sleep stages, blood pressure, oxygen saturation, pulse, and even detect atrial fibrillation.
Or, if you prefer to use a cuff: https://www.theemtspot.org/best-blood-pressure-monitor-for-small-arms/
I measure my BP first thing in the morning, before turning over a single time and getting out of bed (which is where the Galaxy watch is always handy because I wear it to track sleep). Just like your morning pulse rate is a good indication of heart health and your corporeal health overall (a pulse rate five or more beats above a running average might indicate a virus or over-exertion the previous day, maybe you have arthritis acting up or some other intrusive pain, or even a poor night's sleep), your just-awakened blood pressure is a veridical measure of your overall health. During the day, though, hormones and diet and obligations, worries, physical exertion, and any stimulants such as teas or coffee might put you in the 'caution' or 'watch' range. Then, you go see your family doctor and he'll raise an eyebrow and say you should be checking your BP daily and report back in a week because it looks high. I hope I'm being clear: taking a BP and pulse almost anywhere else but as you awaken is likely to be 'confounded,'* and probably misleading.
*In research, a 'confound' is any factor influencing the measurements you're interested in taking, but which you fail to take into consideration. https://www.scribbr.com/methodology/confounding-variables/

Interesting. Thanks. Maybe I should try a Samsung Galaxy smart watch. Generally, I react to energy like radio waves in devices and I have been told to mention only skin irritation and heat from devices, not RF, but obviously the heat and skin irritation come from somewhere. At times the RF causes changes to heart rate imo. Possible?

People with huge faith in cell phones don’t like to talk about physical reaction like heating, skin irritation, disturbed sleep, increased heart rate caused by their device on skin.

In complete disclosure, my Galaxy watch has a glass back to it, but I wear my watch 24/7. I have learned, the hard way, that I must wash the back of my watch (it's waterproof) at least twice each week, and I use an anti-bacterial soap when I do this. If if don't, and don't rinse well, then I begin to get contact dermatitis. So, please be aware of that. Also, all smart watches us a powerful 'LASER-like' diode to put light through your skin so that the sensor can read what is happening under the skin. Weirdly, the lastest Galaxy watch will also read the skin, itself, and do a photo-assay of the free radicals in your skin (this is to see if you're getting enough anti-oxidants in your diet to maintain health....!!!). But I feel it incumbent upon me to let you know this if you have sensitive skin.
What I have done, and it doesn't seem to affect the function of the watch's sensor, is to apply a light 'skiff' of 'barriere cream' on my skin or on the back of the watch, but not normally...only when I begin to get a skin redness under the watch. My dermatitis fixes itself inside of 24 hours doing this.
RF should not affect heart rhythm. The frequency is too low to impart any useful voltage to nearby tissues. Also, RF catheter ablation is still widely used (on me twice in the past three years) to ablate tissue causing atrial fibrillation. If it were true that RF can cause arrhythmia, it wouldn't be useful. It DOES damage tissue, but only when the RF wand is held against tissue and energy applied....which is what ablation is.
Remember, Bluetooth and other forms of emissions are around us all the time, and this includes radio wave broadcasts. Their frequency and energy content are far, far, too low to affect human tissue.