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Blood pressure measurement - automated vs manual method
I am not finding any information on my specific problem, but thought that someone here might understand.
I admit that I'm overweight. My upper arms are quite fleshy and flabby. I have also been a regular blood donor for my entire adult life. I've donated blood about 150 times.
The problem started about 10 years ago. I went to donate blood, as usual. But, for the first time, the donation center was using automated blood pressure machines, rather than the hand-pump and stethoscope method. During the measurement, the machine paused, released some pressure, then increased the pressure enormously - to the point I was almost in tears from the pain. For the first time in my life, I was about to be deferred for high blood pressure. But my blood pressure had always been on the low side, never even approaching a high number The nurse took my BP manually, and it was easily in the normal range. And the difference was not small. The manual method said my BP was something like 107/75, the automated machine said it was something like 185/105.
I continue to have the same problem with automated BP machines. If I go to the doctor's office or to a blood donation site where the machine is automated, the reading is extremely high (after crushing my arm). If my BP is taken manually, it is in a normal range. Again, not a small difference - readings of 180-200 for the upper number with an automatic machine, readings of 115-130 with a manual cuff.
Nobody believes me that this happens, unless I'm in a place where both methods are available. It always surprises practitioners that the automated machine is so inaccurate. Please remember that the practitioner can actually hear my heartbeat with the manual measurement, so it's clearly the automated machine that is wrong. It seems that the automated machines have a hard time detecting my pulse, which is why the machine increases the pressure to the point of extreme pain.
To answer the obvious questions - yes, they use a bigger-sized cuff. Yes, I sit with my feet flat on the floor. Yes, my arm is resting at heart level. No, I'm not talking while the measurement takes place. Yes, I do get frustrated when the person taking my BP doesn't believe me that the machine is wildly incorrect. No, this is not white-coat syndrome, or why would it not appear when I'm about to donate blood?
Fortunately, I can donate blood through the Red Cross, who still uses manual cuffs. If I go to another local blood donation organization, I'm turned away for high BP.
Has anyone else ever experienced this problem with automated BP machines?
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Perhaps the tightness? Experiment with more and less tight and see what happens?
Same thing for placement?
The doctors I see seem to realize that a manual blood pressure reading may give a more accurate result than an automated reading, and in cases where the reading on the automated monitor is questionable ( either high or too low), the staff will repeat the reading manually and go with that reading.
Both my PCP and cardiologist's offices use manual blood pressure readings.
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1 ReactionI have a few physical and mental health issues. I have a condition called Complex Regional Pain Syndrome (CRPS), Complex-PTSD, anxiety and am on BP meds.
Both the CRPS and C-PTSD are deeply intertwined with the sympathetic nervous system. For whatever reason, having my BP checked with those automatic machines used by hospitals and private physicians triggers my panic response, which naturally raises my blood pressure. I don't know if it's the fact that those machines inflate so much more than necessary, causing not only pain but anxiety in a lot of people, but it definitely triggers my panic response dramatically. It took me a long time before realizing that having it checked manually might not elicit the same panic response and instead render a more accurate reading of my blood pressure. My doctor's appointments are a lot less stressful now that I don't allow my BP to be checked with those digital automatic machines. It's inconvenient for the physician's staff (or they act like it is, and many of them don't even know how to do it manually) but it certainly improves my experience.
I remain, however, very curious as to why my nervous system negatively responds to these automated machines? I do know that I don't get triggered until the cuff severely overinflates. There must be a physiological reason and I wonder if all patients with CRPS have this experience or if anyone else has experienced this.
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1 Reaction@met
I am 77. My high BP numbers over the last year have been a concern (I have had well controlled BP with meds). I discovered......finally!....that the automated system does not read my BP accurately because I have a low heart rate. Only manual now and normal readings for my age.
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2 ReactionsThere is nothiing more frustrating than taking your BP on your automated home monitor before going to the Doctor's and it's 117/74. Then the tech uses the Doctor's office automated monitor and one hour later it's 150/80--white coat hypertension, or is it? I mean I use an Omron, silver edition, home BP monitor. Omron is touted as one of the more accurate home monitors.
So, one time the tech used a manual monitor, and it matched the Omron pretty close. There you go.
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1 ReactionI have ALWAYS found the automatic BP machine to be wrong….they are always too high.
I tell this to every nurse, the better practices ONLY take BP manually.
I’ve gotten to the place where I will refuse to have my BP taken with such an inaccurate device.
I wonder how many patients are being treated based on this erroneous equipment?
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1 ReactionYes. I have exactly the same issue. I always let them know that I want them to use the manual cuff for accuracy. My pcp told me that I have a low heart rate and the auto cuff misreads and tries to compensate and thus the crush and pain that causes my BP to rise even higher. I'm glad to have an answer. I was very worried. I don't pay any attention to those who don't understand.
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3 Reactions@proctors112 , it also depends on how they take it, are they giving you at least some time to calm down before slapping that cuff on ? Even at my cardiologist they v slap that cuff on as soon as I sit down. And continue to b talk with me while measuring.
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2 Reactions@gravity3
Very interesting about your heart rate comment!
I’ll be 70 this year and I’m extremely fit, running three-four 5K’s each week.
My VO2 Max is 48 (top 5% for my age group).
My resting heart rate is 52 bpm. Based on your comment, that may be the reason my BP, with the automated cuff, runs 30 units higher than when done manually.
Thanks for the insight!!!
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1 Reaction@gravity3
Clarification: when I mentioned manual BP cuffs I am not talking about home cuffs. I am referring to the manual office cuffs
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