Electronic Blood pressure vs Manual Blood Pressure show Different Results - Should I be Worried?

Patient

Q: Hi i have recently attended my gp in order to go back on the contraceptive pill and my blood pressure was taken using the electronic monitor, my result came back slightly high and as a result my blood pressure was taken a few times. Each time the result came back high however they the doctor also got the nurse to take my blood pressure manually and it came back normal on both occasions. As a precaution the gp sent me home with the 24hr electronic blood pressure monitor and again the results were high ranging between 140over80 and 160over80 and the results have been faxed to the cardiology section at my local hospital. I dont believe i have high blood pressure and think it is the electronic machine that sends my blood pressure high as i get nervous by the noise and the pressure of it! My arm was physically bruised from the 24hour monitor! Do you think i should be concerned seems i had normal readings on the manual blood pressure monitor i am eager to get this sorted quick as i am going on holidays in 5 weeks and really want to be back on the pill in order to skip a period while on holidays. i am 25 years of age slim build with a healthy diet however i do smoke.

Doctor

A:   I understand your concern. If its accuracy that you're looking for, the manual mercury manometer is the best. There have been some concerns raised as to the accuracy of using monitors other than the (manual) mercury manometer. It is suggested that users of electric and non-mercury monitors have them calibrated at least one to two times a year. One factor likely to account for the BP difference is that most automated BP devices detect oscillations, or movements, of the arterial wall rather than sounds created by blood flow in the artery (manual auscultation of BP) or pressure within the arterial system. In addition, each manufacturer has different algorithms to identify systolic and diastolic pressures in the automated devices. Many of those algorithms do not work properly in the presence of clinical conditions that lead to changes in the arterial wall (athlerosclerosis), hypotension, hypertension or irregular heart beats. Even though BP measured manually is far accurate, it is always best to have the high BP readings measured electronically evaluated by a cardiologist. I wish you well and thanks for your question.

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