Blood Pressure Readings: Key Questions Answered by Dr. Lin

Q: Blood Pressure Readings: Key Questions Answered by Dr. Lin

Hello： <br>1. <br>Because the cuff of a tunnel-type blood pressure monitor has a fixed aperture, unlike the adjustable cuffs of arm-type monitors that can accommodate different arm widths, if your arm is thicker than average or if you are wearing clothing, blood pressure detectio

Follow-up Inquiry #181218 Blood Pressure Consultation

Dear Dr.
Lin,
Thank you very much for your response to my personal inquiry in the article “#181218 Blood Pressure Inquiry Consultation.” I have greatly benefited from your insights.
I have a few more questions I would like to ask:
Q1.
Although I was wearing a thin jacket while measuring my blood pressure with the oscillometric blood pressure monitor in the hospital, I did feel a slight constriction from the cuff during inflation and deflation.
Based on this, are the two blood pressure readings I obtained from the oscillometric monitor (first: 134/89 mmHg and second: 161/98 mmHg) still considered inaccurate?
Q2.
Following up on the previous question, is it generally true that wearing a jacket (or clothing) during measurements with an oscillometric blood pressure monitor tends to result in "higher" blood pressure readings?
Q3.
You mentioned: “If the blood pressure measured at home frequently shows a systolic pressure above 140 or a diastolic pressure above 90, then it is advisable to seek medical evaluation and treatment…” Therefore, is my understanding correct that your recommendation is for me to regularly monitor my blood pressure at home, and only seek medical evaluation and treatment if my home measurements "frequently" exceed 140/90 mmHg?
Thank you again, Dr.
Lin.

Axiang, 40~49 year old female. Ask Date: 2022/04/29

Dr. Lin Zhebin reply Family Medicine

Hello:
1.
Because the cuff of a tunnel-type blood pressure monitor has a fixed aperture, unlike the adjustable cuffs of arm-type monitors that can accommodate different arm widths, if your arm is thicker than average or if you are wearing clothing, blood pressure detection can be significantly affected.
During the inflation of the cuff, greater pressure is needed to compress the artery, and then the pressure is released to measure blood pressure, which often results in a higher blood pressure reading.
2.
A single blood pressure measurement taken at the hospital can certainly be referenced, but blood pressure is inherently variable and can increase due to discomfort, stress, or physical activity.
A one-time elevated reading does not diagnose hypertension; it is generally more accurate to measure blood pressure when you are physically and mentally comfortable and to observe long-term average blood pressure changes.
3.
It is recommended that you choose one or two times when you are calm (such as before breakfast in the morning or before bedtime at night) to measure your blood pressure, and then record the readings for a month.
If the average is above 140/90, it would be advisable to seek medical evaluation and treatment.
Additionally, your age qualifies you for government-funded adult health screenings, which can be done every three years.
These screenings can help identify potential issues with blood pressure, blood sugar, blood lipids, liver, or kidney function.

Reply Date: 2022/04/29

More Info

Understanding blood pressure readings is crucial for managing cardiovascular health, and your questions reflect a thoughtful approach to this important topic. Let’s address each of your inquiries in detail.

Q1: Accuracy of Blood Pressure Measurements in a Tunneled Monitor
When measuring blood pressure using a tunneled monitor while wearing a thin jacket, the accuracy of the readings can be affected. Although a thin jacket may not significantly impede the measurement, any clothing can potentially lead to inaccurate readings if it interferes with the cuff's ability to compress the artery properly. The sensation of the cuff feeling "stuck" during inflation and deflation could indicate that the cuff is not fitting properly or that the monitor is not functioning optimally. Ideally, blood pressure should be measured on bare skin or with minimal clothing to ensure accuracy. Therefore, the readings of 134/89 mmHg and 161/98 mmHg may not be entirely reliable, especially the second reading, which is significantly higher and could indicate a transient spike in blood pressure.

Q2: Impact of Clothing on Blood Pressure Readings
In general, wearing clothing during blood pressure measurements can lead to falsely elevated readings. This is particularly true if the clothing is thick or if the cuff is not positioned correctly. While a thin jacket may not cause a significant increase, it is still advisable to measure blood pressure on bare skin when possible. If clothing is necessary, ensure that the cuff is applied directly to the skin or that the clothing is not constricting the arm. If you consistently find that your readings are higher when wearing clothing, it may be worth measuring your blood pressure without it to compare results.

Q3: When to Seek Medical Attention for Blood Pressure
Your interpretation of Dr. Lin's advice is correct. Regular monitoring of your blood pressure at home is a good practice, especially if you have concerns about hypertension. If your readings frequently exceed 140/90 mmHg, it is advisable to consult a healthcare provider for further evaluation and potential treatment. This approach allows for a better understanding of your blood pressure patterns and can help identify any underlying issues that may require medical intervention. It is also important to consider factors such as stress, activity level, and time of day when measuring blood pressure, as these can all influence readings.

Additional Considerations
1. Home Monitoring: When measuring blood pressure at home, use a validated device and follow the manufacturer's instructions. Take multiple readings at different times of the day to get a comprehensive view of your blood pressure.

2. Lifestyle Factors: Maintaining a healthy lifestyle can significantly impact blood pressure. This includes regular physical activity, a balanced diet low in sodium and high in fruits and vegetables, maintaining a healthy weight, and avoiding tobacco and excessive alcohol consumption.

3. Follow-Up: If you notice consistent elevations in your blood pressure readings, it is essential to follow up with your healthcare provider. They may recommend lifestyle modifications, further testing, or medication to manage your blood pressure effectively.

4. Understanding Readings: Blood pressure readings consist of two numbers: systolic (the top number) and diastolic (the bottom number). Systolic pressure measures the force of blood against artery walls when the heart beats, while diastolic pressure measures the same force when the heart is at rest between beats. Both numbers are important for assessing cardiovascular health.

In summary, your approach to understanding and monitoring your blood pressure is commendable. By ensuring accurate measurements and being aware of the factors that influence blood pressure, you can take proactive steps toward maintaining your cardiovascular health. If you have further questions or concerns, don't hesitate to reach out to your healthcare provider for personalized advice.

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