Big variations in blood pressure

[stripycats]

I started using a home blood pressure monitor yesterday as at my last routine appointment about a month ago the nurse said my bp was 'slightly high'.

Yesterday morning I got readings of 167/85 followed by 180/91 so rang 111 as per NHS guidelines. I had no other symptoms so they arranged for my GP to ring me, which she did in the afternoon and gave me a prescription for ramipril, which I started yesterday, and booked me an appointment for this morning. In the evening my readings were 175/101 and 171/98.

Before the appointment this morning my bp was 135/86 and then 130/83. When I showed this to the doctor she was shocked and said one pill wouldn't have got it that low, even though I have continued taking 40mg of propranalol 3 times a day, which I have for anxiety.

At the appointment she used the home monitor and it was 145/88. She then used her surgery monitor and it was 117/86 and then 123/52. Both machines are owned by the surgery though and were checked/serviced whatever you call it in February.

GP seemed very surprised by all this and has booked to see me a week today. I have to keep monitoring it and keep taking the ramipril. She said maybe buy or borrow another machine but don't be too obsessed with it!

Does anyone have any experience of these big fluctuations or any idea what could be going on? I've been having minor chest pains on and off over the last couple of years and have had a few ecgs which have always been normal, not had one recently though and no pains atm but I know high bp tends to be asymptomatic.

Exactly what the GP says.

You might have a dodgy machine so could purchase a different one, home machines aren't terribly good. If you get consistently high readings then a check is needed (our pharmacy does one) and if needed a referral to the practice nurse to wear a 24 hr monitor to double check.

It can also take around 6 weeks for the ramipril to work and readings are affected by food, caffeine etc.

Yes, I was diagnosed with high BP in January, readings of 170/99, my usual BP was previously really low, around 84/57. I have been taking Ramipril and gone from 2.5mg to 10mg and my BP is back under control at 117/74.

In the surgery my BP is 164/99 and at home it is usually around 117/74, on the same machine. GP puts this down to 'white coat syndrome', although I don't feel stressed in any way.

I do not feel any difference on medication although I do have a slight cough which I think is sometimes a side effect of Ramipril.

Is your machine one that a cuff goes on the top of your left arm, or a wrist one?.

The wrist ones don't work well.

Do you take three readings then write down the best of the them, morning and night.

GP's need at the minimum a weeks worth of readings so they can work out an average.

This is what my GP told me when I went for a smear and had three readings in the critical band.

Only had the BP test done as I hadn't been to the doctors in years, the nurse did the BP then the smear, then got me into see the GP straight away.