blood pressure

[jjaammeess]

hi I have mild high blood pressure.I was in hospital for cataract.They took my blood pressure and said it was a bit high (150/95) but it was OK.The problem is I have 2 blood monitors and each one is always less at home than the hospital and doctors.I told the doctor and he told me to monitor my blood pressure 3 times a day for a fortnight and report back to him.He looked at the results and said they were quite good and that I should continue monitoring and let him know if it goes above 140/90 consistently.
This is all very well because I am getting big variations at home.In the last week my lowest reading was 106/73 and my highest was 141/98.I follow all the instructions such as 5 mins relax and 2 mins between each reading (I take 3 readings each time and take average.) How can doctors rely on blood pressure readings to prescribe you drugs since last week there is a report that there are thousands of people prescribed drugs with bad side effects.
The doctor said I suffer from white coat hypertension.Should I be hesitant in taking any drugs that he prescribes and does any body have big variations at home and have they done anything obout it. Answers appreciated
Regards ----James

[Sqad]

James...I agree with all that your doctor has said.

[scotman]

When you are at home you should take readings at the same time each day if possible. I find that if I do readings shortly after a bath/shower they are lower than normal.
Did the doctors take readings with the mercury manometer or use an electronic meter?

[woofgang]

Yes my Dh has huge variations, low when he is tired and fasting, high when he is stressed and yes he has a white coat reaction too.

[jjaammeess]

hi scotman thanks for your answer.He used the mercury one.Is this more accurate.

[boxtops]

The ones in the clinics will be recalibrated on a regular basis so should be accurate - are you able to do this with your home monitors?

[scotman]

As a general statement the mercury system will measure the pressures more accurately. Any problem comes from the stethoscope and the doctor's hearing. The electronic machine I have quotes an accuracy of ± 3% and while this figure will not change it is very difficult to find out its precise value.

[Sqad]

JJ

<<<<<<.He used the mercury one.Is this more accurate.>>>>> more accurate?
depends on how often they are calibrated.....just guess.

probably once every ten years, unless i am out of date.

[Sqad]

boxy

<<<<the ones in the clinics will be recalibrated on a regular basis>>>

Really?......things must have changed.Who calibrates them?

[boxtops]

Sqad, the recommendation is every 6-12 months, often undertaken by the manufacturer as part of the contract.

[Sqad]

boxy...mmmmm! recommendations eh?

I have known may sphygmos in GP practices and hospitals that were NEVER calibrated.... particularly in GP surgeries.

[anneasquith]

times have changed sqad.

[Sqad]

anne....mmmmmm! I wonder....for the better or for worse?

[Scylax]

I used mercury-type sphygmomanometers in hospital practice for many years. These were never recalibrated. Latterly, I began to doubt the accuracy of my readings, since these depended, in part, on the acuity of my hearing, and blessed the day when electronics came to the rescue.

The best home monitors are those which use an upper-arm cuff, rather than a wrist-cuff. Of the 2 readings the diastolic (lower) is the more significant, as this is the residual pressure in the arteries between heart beats. Even minor exercise will tend to make the systolic pressure vary, as will one's emotional status, hence the 'white-coat phenomenon'.

I trust my home monitoring, taken weekly during a period of absolute rest, and doubt the accuracy of readings. taken at GPs surgeries.

[Sqad]

Scylax....exactly.....my experience also.