Medical Forum / Diseases and Disorders / Prostate Cancer / May 2008
Blood Pressure Monitor
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From Bob - 17 May 2008 11:33 GMT Does anyone check there blood pressure on a daily basis, how accurate are these monitors, which one do you use ? TIA
Larry Sabo - 17 May 2008 13:20 GMT >Does anyone check there blood pressure on a daily basis, how accurate >are these monitors, which one do you use ? TIA There are good reviews at...
http://www.consumersearch.com/www/health_and_fitness/blood-pressure-monitors/.
I use an old Omron HEM-431C unit, which my PCP thinks well of. It's a very besic unit, with manual cuff inflation and no history function. I keep my and my wife's pressure history in my pocket organizer, so I can share it with him on my visits.
Larry
Leonard Evens - 17 May 2008 14:04 GMT > Does anyone check there blood pressure on a daily basis, how accurate > are these monitors, which one do you use ? TIA I've been using them for years, and I've found them to be generally reliable, if you use them properly. You should take any monitor to your next office visit, have them take your blood pressure at least twice during the visit and also take it with the monitor and see how they compare. That way you can calibrate the the monitor. If you know how much it is off, you can continue to use it.
There are some caveats about taking blood pressure, and sometimes even doctors or nurses don't go about it right. First, you have to wait a few minutes. Just getting up and sitting down could raise the systolic by 5 points or more. Second, the cuff should be at heart level. If it is below heart level, that could raise your systolic by up to 10 pts. In my case, I've found it is something like 2 pts on average per inch, so if the point on the artery where the measurement is made is 4 inches below the heart, the systolic could be almost 10 pts high. The usual kind of arrangement with the cuff on your upper arm puts it at most an inch or two below hear level, so it may register slightly high but still be very close. Wrist monitors which incorporate the cuff in the device can be way below heart level unless you hold your arm up.
The least expensive monitors require you to listen with a stethoscope on the artery for your pulse. The automatic ones do everything for you and I think they are fully worth the price differential. Extra features like memory of previous values can be helpful, but it is not essential. You can just keep a log book and write down the values, which you should do anyway.
There are also monitors which can compensate for irregular heart beat, which, it turns out, can lead standard monitors to read too low. I encountered this problem when I developed premature atrial contractions. The condition is more or less innocuous, and eventually it just went away, but I kept buying additional monitors figuring that something had gone wrong with the previous monitor, when it was me all the time. I ended up with four monitors by the time I was done. In the process I discovered that different monitors can vary by as much as 10 points on systolic, which is a reason for calibrating the monitor in your doctor's office. Keep in mind though, that the doctors and nurses don't usually get the procedure just right. In addition, blood pressure can vary significantly even over a course of five or ten minutes. Of course there is also "white coast hypertension", where your blood pressure goes up in a medical setting, even if you are not consciously aware of being anxious.
In taking it at home, do it twice a day and always at the same time and in the same way. Sit down and get set up but wait five minutes before tightening the cuff and taking the pressure. You might also spend a day or two following your blood pressure over the course of a day by taking it every few hours. Blood pressure normally varies quite a bit during the day, the systolic by up to 20 pts. According to one things I read, even someone with "normal" 120/80 pressure may at times have a systolic almost as high as 140. It can also be affected by eating and other normal activities.
Discuss this all with your doctor, but don't be surprised if he/she is ignorant of the various factors I just mentioned. A blood pressure monitor will come with a manual which should explain some of the things I mentioned.
I.P. Freely - 17 May 2008 15:07 GMT > There are some caveats about taking blood pressure, and sometimes even > doctors or nurses don't go about it right. I've also read that we should be sitting in a chair with a backrest so we're not using muscles to sit upright, as we do on the end of the doctor's gurney. And to emphasize Leonard's meal caution, my BP may hit an alarming 145/90 after a full meal, up from its normal 95/65 or so (thanks to aerobic exercise). And, of course, no talking during BP check. When the nurse asks me questions during a BP check, I just don't answer.
I.P.
len - 19 May 2008 22:03 GMT > > There are some caveats about taking blood pressure, and sometimes even > > doctors or nurses don't go about it right. [quoted text clipped - 8 lines] > > I.P. I.P. It is admirable that you are able to maintain a sufficient level of aerobic exercise to keep your blood pressure low. I was also able to do that for quite a long time, but when I reached 70, my blood pressure started edging up. I've tried doing everything possible to keep it down. My diastolic is fine, 60 or less, but the systolic keeps rising. I eat a low salt, low fat diet. I still manage to exercise 40 minutes a day getting my pulse rate above the target level for my age (111 bpm). I can't exercise much more intensively than that without my spinal stenosis acting up. In the end I had to start using a mild diuretic drug. I think one factor may be years of taking Naproxen to control my the stenosis. The other just may be age.
So if you have any other advice about keeping blood pressure down, let me know.
I.P. Freely - 20 May 2008 00:50 GMT > I still manage to > exercise 40 minutes a day getting my pulse rate above the target level > for my age (111 bpm). I can't exercise much more intensively than > that without my spinal stenosis acting up. Ah, yes ... I had forgotten about the stenosis. OTOH, any individual's target heart rates are FAR better estimated by tests; those charts and equations are VERY crude WAGs. I exercised at 145-165 bpm for months because it was fun (with lively music) and I thought it was improving my aerobic capacity.
Nope. It was increasing my sprint (anaerobic) capacity, but LOWERING my aerobic (endurance) and fat-burning capacities. I was directed to drop my target rate to about 90, which was like napping. I'm sometimes literally barely moving the elliptical machine, moving it just barrrrrrely enough to keep it from going into PAUSE mode.
I also noticed that every machine feels quite different. I've tried at least a dozen varieties of cardio machines in our gym, and personal ergonomics make a big difference. If you walk, I'd guess that shoes matter significantly, too. MBT brand shoes are totally unlike any other shoe I have eve seen or tried, but are very expensive and best fitted by experts. They even advise a whole different gait. Zappo's sells them online, and gives you 365 days to determine whether you like them. If you don't, and they still look new, you get a full refund.
I.P.
len - 20 May 2008 18:09 GMT > > I still manage to > > exercise 40 minutes a day getting my pulse rate above the target level [quoted text clipped - 23 lines] > > I.P. I was using an old rule based on 220 less age as the maximum heart rate. That gives for me about 145 bpm. ( I gather that more recent research casts doubt on this rule, and in any case any given individual has to be tested to find the real maximum.) With that value and a 60 percent intensity factor, I get a traning rate of 111 bpm. With an 80 percent intesity factor I get 128. My maximum rate may actually be a bit higher, but that is roughly what they took me to in a recent stress echocardiogram, so I think it is pretty close. I can just barely manage 110-115 but if I go higher, which I can do without too much effort, my stenosis starts acting up. I'm afraid that I have to get up to 120 or above to have much effect on by blood pressure, but I can't sustain that over the long term.
BH - 17 May 2008 17:51 GMT >Does anyone check there blood pressure on a daily basis, how accurate >are these monitors, which one do you use ? TIA I have used an Omron wrist monitor for several years. It is very easy to use. If used properly it is very reliable. Keep the wrist at the level of the heart!
Burney RP in 1995 (age 52) RT in 2000 ADT (Casodex) 10/06 - 8/07 Latest PSA - 0.23
len - 19 May 2008 21:49 GMT > >Does anyone check there blood pressure on a daily basis, how accurate > >are these monitors, which one do you use ? TIA [quoted text clipped - 8 lines] > ADT (Casodex) 10/06 - 8/07 > Latest PSA - 0.23 Let me add that the monitor I currently use most often is the Omron wrist monitor. But when I developed the premature atrial contractions, it read much too low. I would have liked to believe the readings, but they were too good to be true. That was when I got a (Life Fitness) arm meter which detects an uneven heart beat and supposedly compensates for it. As I noted previously, the premature atrial contractions disappeared, and the last time I saw my doctor, I took the Omron writer meter. It checked pretty well with his readings and those of his nurse.
The Life Fitness meter tends to read 5 to 10 points higher than the Omron, but it also seems to be highly dependent on just how it sits on my arm.
If you are trying to tell the difference between 160/90 and 110/60, any meter will suffice, but if you are edging up to where you need to consider medication, as I was, then you really need to calibrate your meter against the measurements in you doctor's office.
I.P. Freely - 20 May 2008 00:30 GMT >calibrate your meter against the measurements in you doctor's office. Within a couple of minutes, in the same chair and posture, on the same spot on the same arm, in the same frame of mind, lest you still be off noticeably, maybe significantly.
I.P.
BH - 20 May 2008 00:38 GMT >>calibrate your meter against the measurements in you doctor's office. > [quoted text clipped - 3 lines] > >I.P. I.P., according to everything I've seen, your suggested method can very likely result in different readings. At least 15 minutes between readings is recommended to allow time for pressure to "normalize" in the blood vessels after being restricted by the cuff. RP in 1995 (age 52) RT in 2000 ADT (Casodex) 10/06 - 8/07 Latest PSA - 0.23
I.P. Freely - 20 May 2008 01:43 GMT >>> calibrate your meter against the measurements in you doctor's office. >> Within a couple of minutes, in the same chair and posture, on the same [quoted text clipped - 7 lines] > readings is recommended to allow time for pressure to "normalize" in > the blood vessels after being restricted by the cuff. Makes sense. But which affects BP more ... repeating the test too soon, or changing the conditions, including rest time? I don't know.
I.P.
BH - 20 May 2008 02:17 GMT >>>> calibrate your meter against the measurements in you doctor's office. >>> Within a couple of minutes, in the same chair and posture, on the same [quoted text clipped - 12 lines] > >I.P. Good question. I don't know, either. Maybe it's just another one of those medical mysteries that we lay people are not allowed to know the answer to? :-)
Burney RP in 1995 (age 52) RT in 2000 ADT (Casodex) 10/06 - 8/07 Latest PSA - 0.23
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