Are automatic blood pressure machines accurate? A COMPARISON 

I found that when you have your blood pressure checked at your doctor, the nurse rush you in, straps your arm with the bp cuff ( sometimes not even completely deflated from previous reading or too small for the arm circumference ) and while measuring starts asking you all sorts of medical questions . So if patient is nervous to start with( white coat syndrome), answering questions, feet most of the time dangling from the examination table and if his/ her bladder is full then that will result in false measurements.

The trouble with BP is that it actually fluctuates quite rapidly, minute to minute. It's not just the home units that show differing measurements, but even clinical ones if you measure two or three times.

There's always a significant difference when you take blood pressure several times even with manual method. I think it depends on how relaxed you are during the process. Please keep your videos on blood pressure coming, I love to watch them. Thanks

I am extremely happy that I found this video, and more overjoyed at the fact of how informative it is. A few days ago, I took my BP using my gf’s digital bp reader (arm cuff one). It gave me a reading of 134/88 after eating a large meal. Now this reading alone is out of the norm for me as I have NEVER had high bp like this. Now just like the gentleman who commented below, I was in a state of panic and went to get my BP checked at the doctor with another digital reader and one arm was 141/90 while the other was 137/88. Needless to say I was scared straight; however after some calming down, he then brought in his manual reader with stethoscope and checked both arms for me. They were each completely normal! 120/80 and the other was 118/78. About 30 minutes later, he retook both arms again manually and they were still in the safe zone of about 118/80 and 110/76. This video demonstrates just how erratic and crazy these digital readers can get. From now on, I am only sticking to manual having to be read by a licensed physician. The digital readers are too haywire in my honest opinion. Great video Doc!

Your position you are sitting in, and how you hold your arm and whether you are relaxed is important.

I use an Omron upper arm machine that stores up to 100 readings for two separate people. I have the machine set up to take three consecutive measurements with a two minute pause between each reading. My pulse is always 59-60, systolic 110-137 and diastolic of 68-74. I take the unit to the doctors with me,so we can compare it with his mercury and wall mounted dial units. We get the same readings on my machine as on his wall units and he gets to scan through my last 1 to 100 readings if he wishes. The model number of this unit is BP785N and it is extremely accurate/repeatable and is quite pricey to purchase. I bought it because of the fibrillation indicator function which is also stored in memory for my Cardiologist.

What I found out is that the medical community lies about digital devices because that leaves them unnecessary and jobless, yet they use it everywhere and every time. Inaccuracies due to human error occurs more often than they are willing to admit. Anyway, I suggest using digital BPM for a week in a row and write down the readings. They may or may not be accurate but anyway they show tendencies and you can clearly see if your blood pressure is constant or irregular. The more data you have the better you can rely on your device. If you visit 5 doctors, you will have 5 different blood pressure readings. DO NOT GET RID OF YOUR DIGITAL BLOOD PRESSURE MONITOR.

Glad to see some one show the difference. Thank you doctor. Appreciate your guidance in various medical issues.

Thanks dear Dr. that was a helpful test.

Very interesting Doctor! I've had an Omron unit for a couple of years and it consistently reads 10 points higher than my Doctor's when I have an office visit. I think the only thing my home unit did was cause me to worry for no real reason!

Finally, somebody seeing the same thing with BP devices. I was using the local pharmacy for monitoring my BP on their BP machines. I decided to buy a wrist cuff type (expensive little buggers) I took one model back because it was all over the place with readings. I spent a little bit more money and got the expensive wrist model. If you look at the instructions..It shows the arm extended resting on some arm support. Those readings were high compared to holding close to my chest over my heart (like your vid did Adam) This was a Rite.A.Model like yours. My card Doc wanted me to take readings and record them and submit them to his office. I rec'd a call and was asked to take more readings and submit them again. Once again, I didn't trust the meter and kept comparing the readings. The readings were bouncing all over the place within 5 min back to back tests. I'm not going to submit those readings. He's not comparing apples to apples with percent error factors with store bought BP cuffs. I'm still deciding what I'm going to do to get repeatable readings. Thanks for the Vid Adam ! Oh, normal 3 month appt Doc readings 130/80

I returned a $25 BP monitor to Target, telling the manager that there was no way it was accurate. It was way, way over. The manager laughed and said his mother had the same problem with the same monitor and called him to take her to the hospital because it was so high. The manager suggested that the $69 monitor was much more accurate. So, I asked him why they even sold the less expensive one. He didn't have a response.

Just started shopping for a BPM for my daughter. It's an electronic jungle out there! Thanks for your help, Dr. Story. (May you and yours stay safe and healthy as COVID-19 continues its rampage.)

Thank you , as always you give excellent help and information to people !!! By the way , listening to you always feel my blood pressure is in good reading numbers !!!...lol

Here is my take on this: Yes, blood pressure machines can be inaccurate and they are. I will also say that having a human read your blood pressure manually can be inaccurate and is most of the time . When I go to my cardiologist and my family Doctor, when I go into room, the first thing the assistant does is take my blood pressure time I sit down. That is WRONG, you are suppose to sit 5 minutes BEFORE they take a reading. I learned that in rehab. And, I learned in rehab that if you have more than one aid read your BP right behind another, that they are all over the place. I forgot where I read it, but a Dr. that teaches nursing said that he would buy dinner for anyone who could read BP correctly in his class. He said that he never had to do that as nobody read it correctly. I believe him. The worst offense is NOT WAITING 5 minutes. Next to that is the one manually taking the BP not doing it correctly. I know, I tried it and I cant read it correctly for whatever reason, this was after buying professional high dollar manually reading equipment, same as Doctors and nurses use. Now, yesterday, my wife goes to Doc and take our BP machine in and they tell her it is not reading correctly, so now, today, she won't use it. So is a string of readings on the same machine to see the averages better with a not perfectly correct BP machine than not checking BP at all? They sure trust all kinds of automatic equipment while you are in hospital. It would be great if there were a way of checking calibration of you personal BP checker, but no feasible yet, perhaps someone will come out with one that does this accurately. I have two checkers and they run fairly close, so I dont worry that they are not accurate as they should be, the ones who check it in the Doctors office are probably no more accurate than a reasonably accurate BP machine and as someone said on here that BP fluctuates quite rapidly, so you never get the same reading on them within seconds of reading the two.

Thanks - good video! I have found the electronic machines accurate (+ or - 5 points SYS) IF you average a minimum of at least three readings (have only used the arm cuff). With the manual method, I've gotten in the habit of asking a nurse to take a 2nd reading if on the high side, even though they are often rushed and don't want to. With me the 2nd reading is almost always lower, but in any case they are ALWAYS different, sometimes significantly (15-20 points SYS), even with the same individual taking the reading. It seems to me many doctor's offices just want to get you in and out quickly and often prescribe medication based on a single reading. Don't let them. If they have legitimate concerns about your BP, they should not only take more than one reading but average it over multiple visits, and ask you questions about things that might affect the reading (having a bad/stressful day, driving incident on the way over, large meal right before, poor night's sleep, aggravated because you had to wait an hour, etc.). And unfortunately many doctors offices are NOT good at putting people at ease. So I think you'll probably get a more accurate reading with an electronic monitor when you're relaxed at home, if you average multiple readings. Btw, the standard cuff will work with most adults. You'll need a different size for a child or adult with either a very thin or very large arm.

I'm on a one meal a day diet, 4th week, to lose weight and lower A1C. I have been testing blood glucose several times a day for my own information (my A1C is 6.6, pre diabetic). I use a Lifesource automatic blood pressure cuff several times a day. I log my results down in a composition book. Something failed in the cuff and it will no longer pump 2 days ago. I used a spare Walgreen's A-730 unit with cuff too small, got systolic numbers 10-12 points higher than my base line. Diastolic numbers are similar to my base line. I got the ''new and improved'' soft start Walgreen's cuff machine yesterday. It consistently shows systolic numbers 30 points higher than my baseline. The new unit is an A-950. I do not like the fact that it pumps quickly to remove slack from the cuff, then pumps terribly slowly on low speed for too long. The machine pump stops right at the ''systolic'' reading. Every other unit including manual cuffs overshoot the systolic number then bleeds pressure off, then readings are taken. It makes no sense to stop pumping then record that number as systolic. I am returning the unit today. I have a new Lifesource coming from eBay, same unit that has been my old friend.

Thank You this was very helpful.

Amazing comparison. Like stepping on a scale 3 times in a row and having 3 different readings. Blood pressure readings are a serious matter and it just lets us know that machines aren't perfect. Appreciate this information and the volunteer for demonstrating the different methods. Thank you.

I use an Omron machine. The first time I use it I get pretty high systolic and diastolic readings. Like 145/82/72. I immediately took another reading from the same meter. The reading was 126/73/67. These readings are very upsetting and I don't know what to believe. I am 71 years old. Also, I have been diagnosed with blood pressure problem about a month ago.

Nice reminder, this is why every Doc, need to remember to educate their patients. I've left 3 Docs due to this. Coincidentally my current one asked me to bring in my cuff to compare. Nice vid , thanks.

My bp measured 148/102 at home the day of my doctor visit. I was sitting with my feet flat on the floor for ten minutes. At the office it was 124/82.

Appreciate this helpful info.

Thank you for taking the time doing this video

Thank you for sharing!!

Nice video. Thanks, Dr.

Mine is an upper arm automatic unit from the VA. Yeah... it's always all over the place. Causes a lot of stress. But now I know. Makes you wonder about the ones they use at clinics that are automatic.

When I visit my local GP he informes me that my bp is naturally slightly higher when I visit the surgery, he explains that it's referred to as 'white coat syndrome' and it's nothing to worry about.

Thank you sir bp monitor is the reason why i get anxiety thinking about my bp is too high ♥ i consult to doctor and it as around 120/70 something but when it comes to home it hits 130 to 140..

The first thing to do to use the machine is to read the directions of use. There you find what you need. First most machines give you an average of the last 3 blood pressures you have taken previously therefore your B/P # are NOT going to be accuarate. You need to disable your machine's memory to get the real # every time. The problem comes in the machine not having that feature. Unless is in again in the manual and you memorize how to do it daily before a reading. AMROM made a machine about 15 yrs ago that had that feature and I loved it. Newer machines don't have that big button that say memory off. I think OmROm should bring that feature back. Hope this helps.

One thing I learned recently is blood pressure machines often give wrong readings the older they are and how much they are used. My new wrist machine has been running a even level reading each use while my older ones vary a great deal often running very high, even though the numbers with the new machine is in normal range.

Great video thank you.

I have a automatic BP reader and I usually get a reading and then wait 10 minutes and do it again. If the two readings are pretty close to each other than I have a feeling that it’s somewhat accurate and if the two Readings are Way off from each other I will usually give it some time and then start over. It’s kind of a law of averages type of thing. At least that’s how I do it

Upon observing your test. I noticed that you didn’t have the automatic bp tube/cuff fitted against the artery as you did with the cuff for the Manuel bp.

I'm going for a check up tommorow. Will take my BP machine with me and ask my doctor to check. Will note the difference. Seems like the arm unit is higher than normal.

It always makes me wonder how many people take medications for hypertension when they may not have to. Resting BP is Resting. Not anxious at the doctors office after a grande latte and a busy nurse not using proper technique.

A paramedic took my blood pressure. The cuff was so tight, I thought my arm was going to explode. The reading was 188. I said "the cuff is too tight!" She said it's because your BP may be too high. I got it done at the hospital it was high, but then it went down. I hope they come up with something that is more precise. There is no way you can be calm when taking your BP. I always get anxious when taking it, whether at home or away.🤦‍♀️🤦🏽‍♀️

this is good to know... it freaked me out using walmart bp machine today... i was feeling great but the readings stressed me out...last time they were way lower... and i am in better shape now..

I’m only going to get my doctor now to measure blood pressure manually

This happened to me. Inaccurate readings from Auto to manual we're way off. I watched as my doctor picked up the phone and ordered the auto bp machines be taken out of his section.

We have an Omron HEM-711 and we have found it to be inaccurate to the point that the readings were alarming. So, we went to the doctor's office for comparison and the Omron read at least 15 points higher. Recently we think it is getting worse at reading blood pressure, giving readings some 20-30 points higher. For example this morning readings were inconsistent, 157/76, 160/76, then 133/73, 136/74. This is one after the other and my spouse had already been sitting 5 minutes. We are not encouraged that the machine is really all that useful.

My high school students and I do an anecdotal experiment every year as part of the Project Lead the Way Biomedical Science curriculum. We practice with all sorts of cuffs (manual gauge, wrist, Vernier automatic), and they always notice differences. Sometimes they are so different it is laughable (20+ points). We always note that our work is not diagnostic and the skill is an art:)

Hi doctor Adams, thanks so much ,you've been a wonderful man ,your videos are helpful to me ,please I need your advice o how I can get off medication, thank you

I thought so too... the reading from the automatic machine is usually higher than the real machine?! 😧

ha ha this is crazy..so i got home from walking etc..and bought a brand new wrist monitor and yes it was cheap..19.00..! it read like 188/122.,and knew that wasnt correct,and took another reading and it was like 220/138..now i knew it was off!!so i got semi nervous and ran to town,and talked to pharmist Dr at walgreens and he took it with arm cuff and it was alot lower like 160/100..but he said thats because i was uptight because of the readings from that stupid wrist cuff monitor...so he told me to send back those,and told me to get the OMRIN series #3 arm cuff..he said it will read alot more accurate..so 1 hr later when at home tryin to relax,ha ha i took 3 readings and it come down alot more.avg .it was like 140/90..yes a little high BUT my dr says he is ok with me as he knows my history with my Diastolic # to be around 90 as usual...and the systolic at 140 was just a little higher ,but the point im makin is dont purchase a damn wrist monitor especially tryin to go cheap on it like i did for 19.00!! because its possible you will get a scare like i did!!!

A very good eye opener to know the differences between BP machines. Now, mercury BP m/cs are no more in use I heard. Reason is not known.

After sitting down and relaxing , I take about 3 readings with my digital, arm cuff BP machine. If 3 readings are pretty close, +/- 5% or so, than i say it's a good reading! Had the manual one, just too difficult to use by my self.

At office you may have white coat hypertension. Also, nurses rush you through the process, sometimes not even making sure you are in proper position with cuff on flesh and not sleeve. When they do the oxometer on me they just look at the initial number which might be on the low side as opposed to giving it about 30 seconds or so to stabilize. There are plenty of reasons why in office BP and blood oxygen, pulse might be off. I think good at home devices , done according to instructions, in a quiet , relaxed manner, say at least 3 readings throughout the day , then averaged, gives you a much better snapshot of what your true BP is at any given moment is, imho.

My bp is lower with automatic wrist monitor and higher each time in doctors office . It’s 20 to 30 degrees different. Measuring at home my systolic is 111/55 47 pulse while in doctor office is 140 or 150 (systolic).

I totally agree about these more up to date risk,automatic,every since those started my pressure always up every time I go to dr.sometimes it's taken more than once every time different at home is the same.way when using stethoscope it's always normal being on bp medicine it really confusing

Use non- dominant arm, relax patient, and elevate extremity above heart. Patients on certain conditions bp can go 150/90 P100.

Most BP equipment advises against doing multiple measurements soon after eachother like you did. Perhaps it is worth trying your tests using a different sequence of units and seeing if that has an effect.

We had a Omron it read way higher my wife was put on BP meds based on it she passed out ER said her BP was too low. What we found was the machine reading 190/100 for her the true BP was 123/77. She has terrible anxiety going to doctors offices her BP runs very high there too only after nurse came to the house 3 times a week took it we found it was normal.

I have used the Omron wrist monitors for years and have found them to be reasonably accurate. Meaning they are similar to my Omron arm monitors, clinical readings, dental readings, and pharmacy readings. What is unreliable is getting sloppy readings in doctor's offices. I have had wrong readings with traditional mercury units , and have asked them to bring in a hospital digital meter. Then the reading was similar to my Omron. One should have more than one meter at home, to verify close agreement. The great advantage of a wrist meter is their convenience. One can check BP while away from home. On the road or at work. Modern electronic meters are great for people who numerate and experienced with electronic devices. Other people are better off depending on professionals. The problem with standard medical practice is that they treat everyone the same, ignoring levels of education and motivation.

In my own experience following suggested methods, it's best to average out numbers over maybe a week and always make sure you are relaxed.

I've pretty much resigned myself to thinking that when using the same machine, if that machine is showing a trend downwards then your BP is getting better and if most readings are the same then it isn't changing much and if they keep getting higher then you need to seek help. I'm salt and mood sensitive. Just playing a video game can have an extreme affect on my BP as well as just eating a normal American meal loaded with sodium. I own 5 automatic machines (2 wrist 3 arm all FDA approved) and they can give drastically different results at times. My $15 wrist machine seems pretty accurate while $100+ arm machines can be erratic. Price is not an indicator of accuracy. For reference I must keep my meals around 300mg or less of salt to keep BP in check.

Recently, I noticed that my BP increased from normal. But true enough, I had issues that the automatic (wrist) device tends to be higher compared to the manual reading, sometimes about +15-20 over +10-20. Which actually scares us because it requires medication.

i picked up one recently but my only concern is that my arm is the exact size of the upper limit of their medium cuff 13inches, would that skew the reading?

Wow, so many negatives about them being wrong. I bought the Omron BP760N almost 2 years ago after being diagnosed with heart failure. When I took my month of pressure results into the cardiologist, he asked me to take my Omron into the office to compare pressures with the sphygmomanometer. Only a few systolic and diastolic number differences. I think he was surprised. I don't take my numbers from the Omron as spot on, but it hasn't been very far off.

Today i went to the doctor, automatic monitor shows 95/150 while the manuel one shows 80/140 , what a difference!

I feel I'm hypertensive, but somehow all nurses tell me I'm 120/80

I got put on blood pressure meds because my pressure is always high in the office but is mostly normal at home. even at home I sometimes get weird readings on my machine so I end up taking several readings. I stopped taking those meds and my BP is still reading normal at home. it was still reading high in the office even on the meds, so I see no point in needing to take them.

Wow. I use the wrist one. And yes the numbers go up and down. One minute its normal then if I take it again the numbers are higher.

Yes the numbers were very eradic! I have a wrist, cuff and stethescope one.

I (senior citizen) don't trust digital BP metre because I have all sorts of readings like Systoric 135 to 160 and worse when I see a doctor the reading is 180 to 195! However the reading drops to 135 to 140 when I see a doctor using the manual/mercury type. One thing that I fail to understand is that whenever I use the digital BP metre the number will go up to about 170 then stops for a second or two and shoots up again to about 210 to 220 before coming down.

But when i go to the doctor , the nurse always use the digital ones. One time it showed a little high, then when i saw the doctor I asked him of my pressure showing a little high, so he told me the one they use is a generic one and something might not be accurate so he used another one, one smaller that he brought and my pressure showed more or less what i had expected

Take 3 readings, 5 minutes apart and take the average. Home machine may not be perfect but will give an idea if it's high or low. The patient can then decide if he needs to go to hospital

I have a question. I've always been under the impression that your arm should be laid flat on a table when taking the reading, but I noticed that your patient had her arm across her chest. What is correct. Thanks

mine was accurate when it comes to systolic but fails to in the diastolic reading it a margin of error by 20-30mmHg. btw which is more important the systolic or diastolic reading

This is truly sickening I'm an emergency physician and they use automatic machines to check the blood pressure on admission or triage and throughout the hospital stay. These blood pressure monitorings are entirely ballpark and the nurses refuse to take on a regular basis manual blood pressure in fact I don't trust that either Nursing education has gone online and has truly deteriorated compared to old nurses

If you want to test your cuff for the pulse rate, you can easily do that part yourself if you have a clock/watch/device that has a second hand. I know that we are talking about BP; just a thought regarding the accuracy of these tools.

With the wrist one, the display is supposed to be facing the palms up position.

I use a wrist monitor. As long as my readings are consistently below 130/80 I consider it good.

July12 2021, my BP read 217/130 and immediately I tested again and it read 159/103 on second reading. Went to the hospital and got a reading on 150/100. Currently on BP meds and I feel horrible, prior to this I felt fine.

I was told by an EMT that wrist monitors make no sense. Then he gave me the technical explanation, which I've forgotten but has to do with the way the blood flows in the arm. He was well educated so I took his advice and got rid of the wrist monitor that I had been using for the last year which NEVER gave me consistent results. I'm using a good quality, fairly expensive upper arm cuff model now and unfortunately, I'm having the same problems - inconsistent and always higher than at the doctor's office. So frustrating. The medical community needs to find a better way to do this.

Does the Rossmax X1 blood pressure read accurately? I just brought a week ago. Tq.

Pls do a video on how to take on a manual mercury one. And explain how the stethoscope is used /function of it. How to read pulse in minutes /seconds.

Thanks.please can u prescribe which one to use at home.we are not doctors and we cannot go to the clinic on a daily basis to check our blood pressure.whichever u recommend we will get.thanks

Hello, I have a question. I bought an electronic home BP device (VISOCOR OM60) to keep track of my BP because I had a scare that I might be having high BP. I read that its best to take the average of 3 readings while in the same position but even then sometimes there is a big difference between the 3 and sometimes they are close to each others, is that possible? another question, right now I take the readings 3 times aday 3 readings at each time, sometimes the Ireegular heartbeat sign comes up and I do a reading right after this one and it does not show. does this mean that I have a problem or something is wrong with the device? If a person has an irregular heart rate, should not the device show the sign at any BP reading? thanks.

Might be worth noting that there is an organization that VALIDATES monitors for accuracy. Make sure the one you choose is validated and of course read and follow the directions.

Interesting.

My primaries have said never let an automatic cuff to take blood pressure. And medical personnel never follow the instructions.

I use an Omron at home and take average readings 10 minutes apart in the morning. On one occasion I compared the reading from a doctors visit and found the Omron was just 4 points higher. What the Omron does do it tells me if my blood pressure is high or low which is good enough backed by monthly doctors visit. Having quick access to an Omron I have learnt my symptoms when blood pressure is high or low. Also, I have caught my doctor giving me inaccurate readings on purpose.

When you inflat a cuff you get divets on the inside and tension on the outside. This creates irregular pressure points that may or may not line up with a major vein. Making it more likely to get a higher reading.

Mine is always normal with the manual at the doctor, always high on automatic, any ideas? I get nervous feeling like I have untreated high bp.

The level of the cuff, be it arm or wrist based, at, above, or below the heart level, even by a mere 1 cm, can yield significant difference in readings. Therefore is important to maintain the same level be it with automatic or manual blood pressure data taking. Automatic blood pressure monitors should be checked not only for accuracy, but even more importantly, its consistency in its readings. An automatic blood pressure monitor cannot and should not replace a manual sphygmomanometer. Therefore, it is better to have both.

Correct me if I'm wrong but the one attached to the upper arm should the position be that the tube coming out of the cuff is in line with the artery in the middle of the arm joint. Unless you're monitor reads from a different position to my suresign blood pressure monitor.

At the age of 65, I tried the CVS wrist and upper arm BP monitors I got her and the wrist monitor averaged about 160/100. The left wrist gave me lower numbers than the right. The upper arm monitor averaged around 140/85. I'm reading that for my age, 135/85 would be normal. I haven't had a professional BP test for a long time so I don't know which monitor is more accurate. Maybe I should see a doctor. Do you think?

I am constantly arguing with my doctor about accurate blood pressure reads from the digital machines. I don't trust them. I want them to do it manually and with the cuff. But I don't know which one to pick. please advise because she wants me to start checking.

This video is stunningly bang on. Omron 7121 was giving me ridiculous readings. Range 170-148 / 110-90. Went to Doc who did it manually 130 / 88. 65 yrs, 176cm and 74kg. NZ

I use the machine at the pharmacy which I’m told automatically recalibrates itself, I have an automatic one at home and they give me numbers averaging 118/78. I go to my doctor and I’m 130+/88…. My anxiety goes off the charts with him….I can’t help it. I had a colonoscopy and in recovery my numbers averaged about 120/82….the machine performed 6 tests while in recovery……. I’ve used many pharmacy machines and friends units and they all are fairly consistent……

The thing to bear in mind is that there's a ton of home BP monitors, all very professional looking, but it's important that the home machine bought has actually been 'clinically validated'. In the UK, there is an organisation called BIHS (British and Irish Hypertension Society). I went to their website yesterday and they list a whole bunch of unvalidated/not recommended machines and have a list of recommended/validated machines each tested by 5 or 6 medical professionals. Of the validated machines, there are several different brands. I bought one today on Amazon from their validated list which I should receive on Tuesday, an Omron 3 Intelliseries. Since I haven't used it yet, I obviously don't know if it'll read +/-, but it should be perfectly accurate and is recommended by doctors. It's possible that the machines used in the video might not have been clinically validated by a professional medical organisation?

on our degital auto machine BP.. i got high blood pressure and high pulse rate which is 95... but when i check on the clinic and take an ECG.. i got only 71 pulse rate.. sometimes it nervous me..

ALL of the digital wrist and arm home use bp machines are VERY high compared to the ones you buy in a medical supply store (stethoscope and bp cuff).

thank you May Allah guide you to the straight path

I have the wrist machine and always present the same 130-90

I previously used a wrist one, i took it once and my BP was 145/114 , then I took it again and it was 115/74. Lol?? These things are bullshit

You are using an aneroid sphygmomanometer for the manual measurement, which needs to be calibrated to consider it as a reliable form of measurement. In addition to the human error, the values obtained with the aneroid sphygmomanometer could even be more skewed than the ones obtained with the automatic methods if the device hasn't been calibrated in a while. The true gold standard is the use of a mercury sphygmomanometer with proper training.

my blood pressure 115/70 on manual and 145/90 on digital

Well at lest the auto BP monitors error on the high side making you push to lower your blood pressure with diet and exercise.