I didn't reverse-engineer the protocol for my blood pressure monitor in 24 hours

White coast hypertension isn't just about a clinical setting, it's more generally about the worry about the results of having your BP measured. [EDIT] OK, well maybe there's another type of hypertension which is related to anxiety about a high result regardless of the measurement setting.

I have to take daily BP measurements during titration for ADHD medication. (Using an _A&D UA-611 Plus_ machine at home.)

I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. They'll vary quite wildly (anything from, say, 115/75 to 135/90) despite not moving between measurements or having any reason to be more or less agitated. I generally just ignore the low/high outliers and average the others. There's no pattern either, sometimes the outliers are first, sometimes last.

Also it's not just the monitor I have at home, the same is true of a probably more trustworthy machine in a clinical setting. I mentioned this to my doctor when I last visited and we saw the same thing with multiple measurements using a more sophisticated machine at the clinic.

I check my BP a lot for reasons, too, and this matches my experience as well. A few tips to reduce the variance (but it'll never go away):

* the position of both of your arms, and the angle your elbows are bent at matters. make sure the edge of your desk isn't pushing into your forearm.

* same goes for both of your legs. make sure you're sitting with legs uncrossed, relaxed angles, make sure the edge of your chair isn't pushing into the back of your thighs excessively.

* control your posture. slouching seems to have an effect too, but I'm unclear on the mechanism.

Anecdotally, the nurses at the doctor's offices I go to rarely (~never) bother to control for any of this other than telling me not to cross my legs. So while I fully believe white coat hypertension is a thing, I also think there's a lot of poor control of variables here. If you look up the AMA/AHA guidelines for blood pressure, the ranges they offer are predicated on some very prescriptive protocols for measurement.. which I virtually never see adhered to.

> I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. ...

Doesn't it take more than a few minutes for one's circulation to return to normal after a BP measurement?

Get on ACE inhibitors. Even a low dose cuts out the variance.

Eh, not really. We measure blood pressure every five minutes (or less) for patients under anesthesia. They're pretty reliable. Of course, they're unconscious, so they can't really anticipate the discomfort of the cuff going up on their arm and react to that, and frankly given that they are being carved open the pain of a cuff is pretty minimal by comparison.

Is this a digital reader? My readings were always high both at the doctors and at home. Bought an old school analog cuff and stethoscope, now it’s like 120/70 almost every time.

It was apparently the lack of control and the whizzing motor. Having direct fine control over the pump is downright relaxing in comparison.

No I have a machine, you can take multiple readings even 15-30s apart and they will be very similar