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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 56204
Experience:  Cardiology Expert
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I high mild hypertension and get wildly different readings

Customer Question

I high mild hypertension and get wildly different readings with different type blood pressure monitors. I have three fully automatic electronic monitors which consistently give systolic readings of 15 to 40 mm hg higher than I get with a conventional cuff with an aneroid gauge and a semi-automatic model which is inflated manually with a bub but then releases air and calculates the reading automatically. Most doctors and nurse-practitioners using a manual cuff (mercury or aneroid) get about the same reading I do with my manual cuff.
Only one doctor got the higher reading and only on one occasion (the only time she checked it). The public blood pressure machines at nearby drugstores like CVS and Walmart consistently give readings similar to my lower manual readings. They are also almost Identical to what their nurse practitioners in their walk-in clinics get.
What is going on? Why are my three fully automatic models (three different brands, all new, all highly rated by Consumer Report's Magazine) giving such higher readings than the doctors and I get manually? The diastolic readings are also higher on the electronic machines, but usually in the range of 10 to 15 mm hg. Whether taken manually or automatically, my diastolic is almost always in the normal range, but the systolic taken electronically is often 150 to 170 while it is only 120 to 140 manually. Which readings should I beleive?
That seems like a huge and unacceptable difference. My electronic monitors seem to work fine on my wife, giving almost exactly the same reading I get when I take it manually. The problem is only with my own blood pressure. Note: my manual cuff is probably 25-30 years old, but I'm pretty confident it is giving accurate readings since most doctors and nurses get the same readings. I have also swapped gauges with another old cuff that sprang a leak and both gauges give the same readings.
One other thing that might be noteworthy: When taking my blood pressure manually, I sometimes hear on VERY RARE occasions a very faint "swishing" sound very briefly (a couple of heartbeats) at around 20 mm hg before I start to hear the actual "thump" of my pulse. Could that be "confusing" the automatic monitors? What is going on? Which readings should I believe? The manual readings or the readings with the automatic units?
Submitted: 2 years ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 2 years ago.

what brand monitors do you have?

Expert:  Dr. Phil, MD replied 2 years ago.

By that I mean are you using omrons when you check with electronic cuffs?

Customer: replied 2 years ago.

All are upper arm types as follows:

1. a Rite Aid deluxe automatic model BP3AR1 which is the top rated model in Consumer Reports. I just bought this one a few days ago.

2. A ReliOn model BP 200 upper arm model from Walmart, which is also one of the top rated machines in the Consumer Report's guide.

3. A CVS Premium upper arm blood pressure monitor, model BP#MV1-3WCVS. This was Consumer Reports top rated model when I bought it nine months ago, but it has dropped in the ratings since then.

All three of those give relatively consistent readings, usually but not always within 10 mm hg systolic of each other. Diastolic is more uniform, but still 10 to 20 higher than I get manually. On occasion the systolic difference is bigger, sometimes almost identical.

An older model Eckerds semi-automatic electronic model E7623. You pump it up manually with a bulb, then it releases air automatically and gives the reading electronically. This unit just recently quit working due to an air leak, but until that happened, gave the same results I get with a manual aneroid cuff and pretty close to what my doctor gets.

An older (20-30 years old) blood pressure cuff with an aneroid gauge and a stethoscope. It always gives me a much lower reading on both systolic and diastolic than I get with my automatic electronic cuffs. I have tried swapping out the gauge for another one I have from an old cuff and get the same results. The stethoscope does not attach to the cuff.

I have about five stethoscopes, all are the inexpensive type that come with manual blood pressure cuffs or that came from a hospital when my mother in law was hospitalized a few weeks from a fractured femur and developed MRSA. A couple of my stethoscopes came from the "infections disease control" supplied to her in the hospital.

I learned to take blood pressure the old fashioned way 40 years ago as an ambulance attendant and EMT. Usually I tuck the stethoscope under the bottom edge of the cuff, but sometimes hold it or have my wife take it to make sure I'm getting an accurate reading with it tucked in under the cuff. It doesn't seem to make any difference which stethoscope I use.

Expert:  Dr. Phil, MD replied 2 years ago.

The experts in the field recommend OMron and omron only.

No other cuffs compare

Customer: replied 2 years ago.

I do not have an Omron but am willing to try one. Consumer Reports rated the Rite Aid slightly better than the Omron 10 series and significantly better than the Omron 5 series. Is there any difference in the blood pressure technology between those two that would cause more to be more accurate? I don't care about the bells and whistles as much as I do accuracy.

Do you have an opinion as to which model is the most accurate?

Expert:  Dr. Phil, MD replied 2 years ago.

Omron 700 series. that is what the experts recommend

Expert:  Dr. Phil, MD replied 2 years ago.

please don't forget a positive rating.

if you have more questions, just reply