Legitimate Variation in BP or Error?
I'm curious about how to be sure I am obtaining the most accurate measure of my blood pressure possible so I don't end up on medication I don't need. To give some back story, my blood pressure has been running a very consistent 145-150/90 when taken at my primary physicians office. As such, he has been pushing either 100 mg of Losartan, or 10-12.5 benazepril/hctz combo. I contested these readings for 2 reasons: the nurse always takes the reading just seconds after having me chase her through the office at a sprint to get to the exam room and secondly, my BP readings at home, the cardiologist, neurologist, hematologist and orthopedist (apparently everyone needs a BP reading these days) is never anywhere near that high.
At home, it runs in the 130-135/78-90 range, at the cardiologist it has been 116/74 every time, 106/70 at the neurologist, and 120-128/75-85 at both the hematologist and orthopedist. I brought up my concern about this variation to my primary and took my blood pressure himself and found that it had dropped from 145/90 to 135/80 in just the time I had been sitting talking to him. Additionally he found that it is very difficult to hear the top # in my BP on my left arm, which explained why I get so many error messages when electronic machines are used.
Often times the nurses will use a cuff that is much too small for my upper arm, or use it on my lower arm instead. They also use wrist monitors that never clip properly on me (very obese). I'm wondering if these things are affecting the accuracy of my readings. I don't like to imply that these nurses who take hundreds of BPs every day are making huge errors, but I'd hate to think that I'm taking too much/not taking enough medication because I'm not getting accurate measures.
How do you ensure you're getting an accurate BP reading? I can't even seem to verify that my home machine is getting a correct reading when there's so much variation.