Blood Pressure always hurts

December 18, 2018 9:32 AM

Whenever I get my blood pressure taken, it hurts. This is not just a little discomfort or squeezing. This is a painful pinch that makes me grimace. Is there anything I can do about that?

I have chubby upper arms (like 16 inches or so) and this happens at two different clinics using a machine with a velcro cuff and all pharmacy machines with the slide-in cuffs. Often the machine has to try more than once (sometimes 3 times) and in the clinics, the velcro will sometimes partially separate. Should I ask for a redo if the velcro tears?

I tend to read high (130-140 systolic) but I don't really trust the measurements because I am anticipating the pain. I don't think this is White Coat syndrome exactly, since I am not scared of getting treated for hypertension if needed. I have no issues with blood draws or other uncomfortable medical procedures. I just want this measurement to be correct.

posted by soelo to Health & Fitness (11 answers total)

Best answer: There are larger-sized blood pressure cuffs made and any adequately-stocked doctor's office should have them available--request that they give you a larger cuff. The pharmacy cuffs can't be sized-up, so just don't use those. You need to be relaxed, not tense when having your BP taken--I've seen a big difference in my reading when the practitioner reminds me to relax my shoulders before being tested.
posted by agatha_magatha at 9:36 AM on December 18, 2018 [6 favorites]

Best answer: Also, if the cuff doesn't fit the reading can be off for that reason alone - if it's pulling loose they should give you a larger cuff. I have the same problem, because I'm...extremely evenly fat? People tend to underestimate my actual measurements.
posted by Frowner at 10:03 AM on December 18, 2018 [4 favorites]

Best answer: The larger cuff should work if it is coming apart.

I have the same problem even when they use the larger cuff. My problem is that my blood vessels are deep and they have a heard time hearing the thump. I don't think there's any solution for me. I do ask for them to do it by hand instead of the machine. That is a little better than the machine which apparently wants to kill me.
posted by jraz at 10:12 AM on December 18, 2018

Response by poster: Possibly relevant: I am a very hard stick when it comes to drawing blood. They often have to bring in the expert to find my veins and I generally just tell them to use the back of my left hand.
posted by soelo at 10:16 AM on December 18, 2018

That is my problem (and experience with stick locations) as well soelo. My mother was the same way.
posted by jraz at 10:28 AM on December 18, 2018

The machines hurt. I don't let staff use them on me anymore. (My PCP's office doesn't use the machines at all because they hurt and aren't as accurate.) I just say, "Would you please take my blood pressure manually?" Only one person has given me a hard time about it, and I persisted until she gave in.

Instead of using the pharmacy machine, I'd suggest getting a home machine if you can afford it. For some reason, those don't hurt as much. I have this one, which has an extra large cuff.

(I am also a hard stick and find the machines super painful.)
posted by FencingGal at 10:30 AM on December 18, 2018 [4 favorites]

It's less accurate, but they can also use the machine cuff on your forearm. Same goes for if they don't have an extra-large cuff (or refuse to go find the single xl cuff shared by an entire practice, which I have occasionally encountered).

Retaking your pressure right away will give you an elevated result. My kidney doctor is the one who does most of my blood pressure management and she always checks it herself manually about halfway through the appointment. It's generally quite a bit lower than when her assistant checks it the moment they bring me in from the waiting room, not to mention a lot less painful.
posted by camyram at 11:04 AM on December 18, 2018

If the cuff comes apart it's too small. They should use a cuff that wraps comfortably. Many cuffs have markings indicating the maximum arm circumference they will give an accurate measurement for.
Being a hard stick is likely unrelated - blood pressure is about your arteries not your veins.
posted by M. at 11:39 AM on December 18, 2018 [1 favorite]

yep, you need what i call "the fat lady cuff." standard cuffs only go up to about 14" upper arm. it is a known thing that using too-small cuffs leads to higher-than-actual blood pressure readings. so always ask for the larger cuff.

and also note that generally wrist readings are inaccurate, but a lot of places are moving that way because "it's easier."
posted by misanthropicsarah at 11:46 AM on December 18, 2018 [1 favorite]

Oh goodness, I thought about asking this question because just yesterday I had my blood pressure taken before a medical procedure at a specialist and the cuff on the upper arm was really painful!

And they said my blood pressure was 160 over something! It's never higher than 126-129 at my own doctor, where the cuff is not painful at all.

But the cuff yesterday had my eyes tearing up! I don't think I've ever measured my upper arm but I guess it could be more than 14".

And yesterday I said, "That was very uncomfortable," and they just said, "oh sorry" so I guess they weren't too concerned anyway but I'm a polite lady so by uncomfortable, I meant "that really fucking hurt."
posted by Squeak Attack at 12:08 PM on December 18, 2018 [1 favorite]

Measure your arm in centimeters. Keep this measurement on your phone. Look at the size range on the cuff (it should be printed on the cuff.) if you are outside the range or right on the top end, ask them to get a larger cuff. If they won't, decline to get the BP taken (you don't have to! they can't make you!).

I have disproportionately big arms and I run into this all the time. If they try to force it with a too-small cuff, my read will be abnormally high. My allergist doesn't have a cuff big enough so I don't let them take it there because I don't want false-high readings in my chart.
posted by oblique red at 10:15 AM on December 19, 2018