Blood Pressure Readings: Home vs. Hospital Measurements

Q: Blood Pressure Readings: Home vs. Hospital Measurements

Hello： <br>1. <br>The situation you experienced in the hospital while measuring blood pressure with a cuff-style sphygmomanometer may have been affected by wearing a coat, which can interfere with the inflation and deflation of the cuff as well as the detection of blood pressure.

Blood pressure inquiry consultation?

Dear Dr.
Lin,
Today, I accompanied my mother to a local hospital for a consultation.
While waiting, I noticed that the hospital had a "tunnel-type" blood pressure monitor.
I measured my blood pressure while wearing a coat, and the reading was 134/89.
Since I felt this was slightly high (it was not that high at home), I then used another "tunnel-type" blood pressure monitor in the hospital, again while wearing a coat (the hospital volunteer told me it was not necessary to remove the coat, just to keep my arm straight), and the reading was 161/98.
After returning home, I removed my coat and measured my blood pressure several times with an "arm-cuff" electronic blood pressure monitor, and the readings were around 120/80.
I have the following questions for Dr.
Lin:
Q1.
I measured my blood pressure twice using the "tunnel-type" monitor in the hospital, and there was a significant difference in the readings: the first was 134/89 and the second was 161/98.
Since I was wearing a coat, I felt that the measurement process with the hospital's "tunnel-type" monitor was somewhat constricted.
Could this have caused my blood pressure readings to be inaccurate?
Q2.
At home, my readings with the "arm-cuff" electronic blood pressure monitor are consistently around 120/80.
However, the readings from the "tunnel-type" monitor at the hospital almost meet the criteria for hypertension treatment.
Currently, I have normal readings at home, but the readings at the hospital indicate hypertension, which leaves me confused about which readings accurately reflect my true blood pressure.
What should I do next? Should I continue to monitor my blood pressure regularly at home, or should I seek medical attention immediately?
Thank you, Dr.
Lin.

Axiang, 40~49 year old female. Ask Date: 2022/04/28

Dr. Lin Zhebin reply Family Medicine

Hello:
1.
The situation you experienced in the hospital while measuring blood pressure with a cuff-style sphygmomanometer may have been affected by wearing a coat, which can interfere with the inflation and deflation of the cuff as well as the detection of blood pressure.
Therefore, the results may not be accurate.
Ideally, blood pressure should be measured with the arm exposed, and at most, wearing a thin long-sleeve shirt is acceptable.
2.
The standard condition for measuring blood pressure is to be in a comfortable and calm state, such as in the morning after waking up.
In a hospital setting, external distractions or internal stress can affect blood pressure readings, which is why the term "white coat hypertension" exists.
Therefore, measurements taken at home are generally more reflective of your true blood pressure.
3.
If your blood pressure readings at home frequently show a systolic pressure above 140 or a diastolic pressure above 90, it is advisable to seek medical evaluation and treatment.
Additionally, if you are concerned about hypertension, you may begin to adjust your lifestyle.
Most cases of hypertension can be improved through dietary changes and increased physical activity.

Reply Date: 2022/04/28

More Info

Understanding blood pressure readings can be quite challenging, especially when there are discrepancies between measurements taken at home and those taken in a clinical setting. Your situation is not uncommon, and there are several factors to consider when interpreting these readings.

Q1: Discrepancies in Blood Pressure Measurements
The significant difference in your blood pressure readings from the hospital's "tunnel-style" blood pressure monitors (134/89 vs. 161/98) can indeed be influenced by several factors. One of the primary considerations is the clothing you were wearing during the measurement. Wearing a tight or bulky outer garment can restrict blood flow and potentially lead to inaccurate readings. Blood pressure cuffs should ideally be placed directly on the skin or over a thin layer of clothing to ensure accurate measurements.
Additionally, the environment in which blood pressure is measured can also affect the readings. Hospitals can be stressful environments, and anxiety or nervousness can lead to what is known as "white coat syndrome," where a patient's blood pressure is elevated due to the stress of being in a medical setting. This could explain why your readings were higher in the hospital compared to your home measurements.

Q2: Home vs. Hospital Blood Pressure Readings
Your home measurements averaging around 120/80 mmHg are within the normal range, while the hospital readings suggest hypertension. This discrepancy raises an important question about which readings accurately reflect your true blood pressure. Generally, home blood pressure readings are considered more reliable for diagnosing hypertension, especially if you are measuring in a relaxed environment and following proper measurement techniques.

To ensure that your home measurements are accurate, consider the following tips:
- Measure your blood pressure at the same time each day, ideally in the morning and evening.

- Sit quietly for at least five minutes before taking a measurement.

- Ensure that your arm is at heart level and that the cuff fits properly.

- Avoid caffeine, exercise, and smoking for at least 30 minutes before measuring.

Given that your home readings are consistently normal, it may be reasonable to continue monitoring your blood pressure at home. However, if you experience symptoms such as headaches, dizziness, or chest pain, or if your home readings begin to trend higher, it would be wise to consult a healthcare professional.

Next Steps: Monitoring and Consultation
In light of your situation, I recommend the following steps:
1. Continue Home Monitoring: Keep a log of your blood pressure readings at home. This will help you and your healthcare provider assess your blood pressure trends over time.

2. Consult Your Doctor: If you have concerns about the higher readings at the hospital or if your home readings start to rise, schedule an appointment with your healthcare provider. They may recommend further evaluation or adjustments to your monitoring routine.

3. Lifestyle Modifications: Regardless of your blood pressure readings, maintaining a healthy lifestyle is crucial. This includes a balanced diet low in sodium, regular physical activity, and stress management techniques.

In conclusion, while the hospital readings may seem alarming, your consistent home measurements suggest that you are likely within a healthy range. Continue to monitor your blood pressure at home, and do not hesitate to reach out to your healthcare provider if you have any concerns or if your readings change significantly.

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