Blood Pressure Measurement Accuracy and Medication Concerns

Issues with Blood Pressure Monitor Accuracy and Medication Concerns

Dear Dr.
Chen,
I would like to ask you the following questions:
1.
I compared my home electronic blood pressure monitor with the clinic's mercury sphygmomanometer, and found a difference of 11.5 mmHg in systolic pressure and 14.5 mmHg in diastolic pressure.
Is this difference reasonable?
2.
The doctor at the clinic prescribed me only a 3-day supply of antihypertensive medication.
I currently feel fine, and my home blood pressure monitor shows 122/77.
Should I continue to visit the clinic for treatment?
3.
A few days ago, I visited another clinic where their electronic blood pressure monitor showed a reading of 134/90.
The doctor there believed that I do not have hypertension.
Whom should I trust?
4.
Additionally, my blood test results showed my red blood cell count at 3.94 x 10^6/µL, mean corpuscular volume (MCV) at 106.1 fL, and mean corpuscular hemoglobin (MCH) at 37.1 pg.
The lab technician mentioned that this could be the reason for my elevated blood pressure.
Is this true?
5.
Which should be considered more accurate, the electronic blood pressure monitor or the mercury sphygmomanometer?
6.
My family has prepared Jin Yong Shen Ming Wan (a traditional medicine) with 6 pills, and it has a health department registration number.
Does this indicate that the medication is safe, or should I consult a doctor about it?
I apologize for the complexity of these questions and appreciate your understanding.
Wishing you peace and well-being,
Chen Xiao Yan

Chen Xiao Yan, 20~29 year old female. Ask Date: 2015/01/16

Dr. Chen Zonglin reply Family Medicine

1.
Blood pressure can vary due to different physical and mental states at different times and places.
If the blood pressure monitor is regularly calibrated, the readings obtained are reliable.

2.
It is recommended that you bring your blood pressure records from the past three days to your physician for evaluation on whether to continue medication, as a single blood pressure reading is insufficient for decision-making.

3.
Monitoring blood pressure over several days can facilitate a better assessment of blood pressure issues.

4.
I am unsure what you mean by "spiking high"; could you clarify how high and for how long it lasts?
5.
The government has published standards for non-invasive automatic blood pressure measurement technology; any approved devices on the market are accurate.
Regular calibration is still necessary to maintain accuracy during use.

6.
Medications with a health department approval number generally have a lower risk, but individual responses may vary, and side effects can differ among individuals, so caution is advised during the course of treatment.

Reply Date: 2015/01/16

More Info

Dear Chen,
Thank you for your thoughtful questions regarding blood pressure measurement accuracy and medication concerns. I will address each of your inquiries in detail to provide clarity and guidance.

1. Difference Between Electronic and Mercury Sphygmomanometers: The discrepancy you observed between your home electronic blood pressure monitor and the clinic's mercury sphygmomanometer is not uncommon. Electronic monitors can sometimes yield readings that differ from mercury devices due to factors such as calibration, user technique, and the specific algorithm used by the device. A difference of 11.5 mmHg for systolic and 14.5 mmHg for diastolic is significant and may indicate that one of the devices is not calibrated correctly. It is advisable to have your home monitor checked against a validated device to ensure its accuracy.

2. Medication and Follow-Up: If your home blood pressure readings are consistently around 122/77 mmHg, which is within the normal range, you may feel reassured. However, it is essential to consider the context of your overall health and any symptoms you may experience. Since your doctor prescribed medication for hypertension, it is crucial to follow their advice regarding follow-up appointments, especially if you have a history of elevated blood pressure. Discussing your current readings and any concerns with your physician can help determine the best course of action.

3. Conflicting Blood Pressure Readings: The variation in blood pressure readings from different clinics can be confusing. The reading of 134/90 mmHg does indicate elevated blood pressure, particularly the diastolic value, which is classified as stage 1 hypertension. However, a single reading does not confirm a diagnosis of hypertension. It is essential to consider multiple readings over time and consult with your healthcare provider to interpret these results accurately. Your physician's assessment should take precedence, especially if they are familiar with your medical history.

4. Blood Test Results and Blood Pressure: The laboratory values you provided, including a red blood cell count of 3.94 million/µL, an MCV of 106.1 fL, and an MCH of 37.1 pg, suggest macrocytic anemia, which can be caused by various factors, including vitamin B12 or folate deficiency. While anemia can influence overall cardiovascular health, it is not a direct cause of hypertension. It is essential to discuss these results with your healthcare provider to understand their implications fully and to determine if further evaluation or treatment is necessary.

5. Choosing Between Electronic and Mercury Devices: Mercury sphygmomanometers are considered the gold standard for blood pressure measurement due to their accuracy and reliability. However, electronic devices are more convenient for home use. If you have access to both, it is wise to use the mercury device for confirmation, especially if you suspect your electronic monitor may be inaccurate. Regular calibration of your electronic device is also recommended.

6. Safety of Over-the-Counter Medications: The presence of a health department registration number on the "Jin Yong Kidney Brightening Pills" indicates that the product has been approved for sale and is generally considered safe. However, it is always prudent to consult with your physician before starting any new supplement or medication, especially if you have underlying health conditions or are taking other medications. Your doctor can provide personalized advice based on your health status and any potential interactions.

In summary, it is essential to maintain open communication with your healthcare provider regarding your blood pressure management and any medications you are taking. Regular monitoring and follow-up appointments are crucial for effective management of your health. If you have further questions or concerns, do not hesitate to reach out to your physician.

Wishing you good health and peace of mind.

Best regards,
Doctor Q&A Teams

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