Automated Office BP
In recent years, Automated Blood Pressure Monitors have replaced the traditional mercury sphygmomanometer, and are just as reliable, without posing a risk to the environment in terms of mercury pollution.
An additional concept is that these machines can be programmed to deliver Automated Office Blood Pressure (AOBP).
The protocol for Automated Office Blood Pressure (AOBP) is as follows.
Programmed on an Omron ( or similar ) device
- 3- minute rest with doctor or nurse absent (conversation can elevate systolic BP by 20mm)
- 3 readings 1 min apart – averaged
- Repeat if systolic readings vary by more than 20 mm
The results demonstrate that AOBP is more reproducible and reliable than random single arm BP recordings.
AOBP overcomes issues of how problematic it can be to attain an optimal blood pressure reading whilst engaged in conversation , particularly where the conversation may entail potentially stressful emotional or medical issues.
Home Blood Pressure Monitors
Now that home and office use the same equipment in automated BP devices, then home BP monitor reading can be accepted by the treating doctor, if clinic readings are erratic as in “white coat” hypertension.
The Home BP Protocol is to:
- set up the BP monitor and place the pressure cuff on the arm;
- have a three minute rest, watching TV, or reading; then taking:
- 3 readings one minute apart, averaged; and
- repeating if systolic readings vary by more than 20 mm: these readings are recorded on a paper chart or (better still ) a computer file.
One week of home monitored readings is usually sufficient to establish a level, before or after a medication change.
Then, weekly home BP readings can be used to supplement the doctor’s three-monthly readings.
Too often, the outcome of home BP monitoring can become an exercise in measuring stress levels. Most medical conditions such as headache, stress, fever, and pain of any cause produce normal elevations of blood pressure which is acceptable. In terms of “urgent” assessment of acute illness or stress, simply having a BP monitor does not give your home an accreditation as an emergency department.
When in doubt go to the emergency department first, and think blood pressure second .