Hi there,

I have some blood pressure questions and am looking for some help interpreting my readings. I'm a 34 year old, slightly overweight, exercising regularly and on several supplements (approved by my doctor) for overall and heart health.

I previously was diagnosed with borderline hypertension and have taken some steps to bring that down (trying to eat healthier, exercise more, the right supplements, fewer stimulants, moderating alcohol, etc.). I believe I have brought it down and all my readings fall into either normal or prehypertension now generally speaking, but I'd still like to get it to 120/80 or under as much as possible.

I use an Omron BP652 blood pressure monitor as I find it very convenient. I know wrist blood pressure models have been controversial in the past, but this one seems pretty well-reviewed for accuracy. Also, I tried to buy a cuff model (a higher end Omron) and had many problems getting it to read and not error out (improper cuff fit/air leakage error), so I returned it. (I may try again at some point, but the experience was frustrating).

I'm trying to get an accurate picture of my blood pressure, and it's especially difficult as I have anxiety/panic when it's being taken, especially at a doctor's office, so my readings there always seem high. This I believe leads to inflated readings, but I also don't feel 100% sure of that.

Onto my questions:

1.) I generally take three readings and average them together. First I do left wrist, then right wrist, then left wrist again. I do these in fairly quick succession as unfortunately, waiting between readings for me tends to boost my anxiety (the waiting and anticipation). For whatever reason, my first reading is almost always quite a bit higher than the other two, with the right wrist reading almost always being the lowest.

For example, a few minutes ago, I tookreadings. First reading on the left wrist was 127/81 with a pulse of 74. Then I did the right wrist and got 118/73 with a pulse of 69. Finally on the left wrist again I got 118/76 with a pulse of 67.

Another example of a previous reading with even more variation is the first, left wrist reading at 130/75 with a 78 pulse, right wrist 111/69 with a 67 pulse, then right wrist again 120/76 with a 69 pulse.

Is the first reading being so much higher attributable to anxiety? Or is it because I'm doing the second left wrist reading too soon after (~1 minute or less) and my arteries are still compressed?

2.) I've read >10mm of difference between left and right readings can be concerning, and this worries me a bit. Readings are often near 10mm off and sometimes above, though not always, and usually that second and third reading are much closer together than, say, the first and second. How concerned should I be?

3.) My blood pressure is almost always <120/80 for both systolic and diastolic soon after waking (sometimes quite a bit lower)...the higher readings tend to happen later on in the day. Is this significant? If I take 3 readings a day, 3 measurements (Left-Right-Left) each reading, and average them, I tend to come out at 120/80 or less lately (something that didn't used to happen, so I know I'm getting there), but is this a fair way to do it?

4.) How often should blood pressure machines be replaced? The one I have is from 2011, but has only gotten heavy usage the last year or so.

Thanks for your help! High blood pressure scares me and I just don't want to put myself at future increased risk of heart attack and stroke.