Blood Pressure

[XFool]

My BP has been a bit high, nothing too serious, for years. I have had it measured now and then at clinics and have a rough and ready record (along with access to the online results).

Recently the GP asked me to obtain my BP reading and send it to them, as they had not had a reading for some time. I used the DIY machine in the GP medical centre. The results were surprisingly higher than I expected: 154/82. Subsequently they asked me to measure my BP morning and evening over a week and send the results to them. I obtained a BP machine and am proceeding.

OK, the results seem disappointingly high. But that isn't the thing that has mainly jolted me - it's the variation.

I take two tests on each occasion, as told by the GP. There is a small, natural variation each time from test to test. No great surprise there. But look at this:

Last night: 164/90
This morning: 124/75
(I chose respectively the higher and the lower of the pairs for effect. But the two were close in each case.)

I can't get to grips with this. Natural variation you expect, as with your weight. But to me that is like weighing myself in the evening at 14 st and weighing myself in the morning at 11 st. Surely this cannot be the typical natural variation in BP? To me the above demands some kind of explanation: "What caused that?"

Has anyone here who already is used to regularly monitoring their BP, or who knows about such things, have any experience or explanation. In the past, with clinical tests taken irregularly, many months apart, I have had the seemingly occasional outlier. But have never before had my BP measured day to day like this.

TIA

[Golam]

Blood pressure varies during the course of the day, that is normal. When recording one's BP, do so at the same time of day on a regular basis. Should figures arise that are of concern, your GP will equip you with a 24 hour BP monitor.

[Itsallaguess]

I take two tests on each occasion, as told by the GP.

There is a small, natural variation each time from test to test.

No great surprise there. But look at this:

Last night: 164/90

This morning: 124/75

In all seriousness, do you think spending all day on here arguing with people helps?

Cheers,

Itsallaguess

[Urbandreamer]

Has anyone here who already is used to regularly monitoring their BP, or who knows about such things, have any experience or explanation. In the past, with clinical tests taken irregularly, many months apart, I have had the seemingly occasional outlier. But have never before had my BP measured day to day like this.

TIA

I measure mine regularly and have made mistakes doing so.

First sit in front of a table for at least 3 minutes with your arms upon the table.
Then take your measurement.
Wait for at least 3 minutes.
Now take a 2'ed measurement.

This should produce valid measurements.

Being impatient is the main cause of large variations. As is waving your free arm about.

That said, you will see some variation.
I.E mine went from 128/87 to 151/96 between morning and evening two days ago.

Note, lot's of things can affect BP. Dehydration is one of the obvious ones.

[kempiejon]

I had a go at reducing my pressure following a prompt by a health professional so bought a home monitor to record changes bought on by my efforts with diet and exercise. I have a spreadsheet and there is a fairly noticeable variation though generally lower in the morning than afternoon. Picking a few numbers, one day I logged 128/79 and 143/81 and a few days later 106/64 and 131/77.
First thing in the morning while still in bed lying down is a good way to score a lower number.
I concur with the advice for sitting still at a table for a few minutes with your arm on table, well that was the instruction I was given.

[GrahamPlatt]

Google scholar search for papers on on BP variation… numerous.
These seemed to me to stand out:

https://www.nature.com/articles/hr2010241

https://www.bmj.com/content/354/bmj.i4098.short

“Variability in systolic blood pressure was a significant predictor of death when blood pressure was measured in the morning or evening, or both”

[the0ni0nking]

Nine or ten years ago, I failed a pre-operative assessment for a stapedectomy due to high blood pressure which resulted in the hospital discharging me from the care of the ENT specialists back to my GP to deal with it. (I presume it also got me off the waiting list).

It took more than two years of investigations and drugs to establish the appropriate cocktail of drugs that brought it down. During that process, I was referred back to the hospital but the cardiology department with numerous tests and ECGs as well as the 24 hour blood pressure monitoring.

I was also diagnosed with "white coat hypertension" - where your blood pressure is elevated when in a clinical/GP setting.

I've got into the habit of taking my BP at the same time each day (when I do decide to take it) but also on the same arm - as taking a reading on one arm and changing to the other always seemed to result in more of a change than taking it a 2nd time on the same arm.

Looking at my records now, my readings generally bounce around between 120-130 / 65-75.

About 3 or so years ago they dropped the Ramipril from my drugs cocktail and the BP has not been materially adversely impacted.

I do notice a steady uptrend if for example I have a number of weeks where I might have a drink nearly every day (in whatsoever quantity) so it's clear that that does have an impact on my blood pressure which isn't much of a surprise although the extent of the impact does surprise me.

NB - I was eventually re-referred to ENT and had the stapedectomy about 3 years after the time I was first scheduled to have it. I've since had to have another stapedectomy on the other side and sailed through all the pre-operative assessments which included my BP showing lower than it ever has done at home on the hospital monitor - so maybe my home one isn't that accurate (although it's one of the BHF approved ones).

[GrahamPlatt]

PS Measuring BP is an art in itself https://www.amazon.co.uk/Handbook-Blood ... 1468471724

[88V8]

...I measure mine regularly and have made mistakes doing so.

First sit in front of a table for at least 3 minutes with your arms upon the table.
Then take your measurement....

Being impatient, not sitting with the arm level..
Reason the walk-in machines in GP surgeries often give 'wrong' results.

V8

[XFool]

Thank you to all who made constructive and interesting comments.

XFool

[Mike4]

I heard on the radio today that the very best and most effective thing you can ever do to reduce your blood pressure is stop watching "Question Time" on the telly.

Speeling edit!

[Dicky99]

Has anyone here who already is used to regularly monitoring their BP, or who knows about such things, have any experience or explanation. In the past, with clinical tests taken irregularly, many months apart, I have had the seemingly occasional outlier. But have never before had my BP measured day to day like this.

TIA

I measure mine regularly and have made mistakes doing so.

First sit in front of a table for at least 3 minutes with your arms upon the table.
Then take your measurement.
Wait for at least 3 minutes.
Now take a 2'ed measurement.

This should produce valid measurements.

Being impatient is the main cause of large variations. As is waving your free arm about.

That said, you will see some variation.
I.E mine went from 128/87 to 151/96 between morning and evening two days ago.

Note, lot's of things can affect BP. Dehydration is one of the obvious ones.

I agree with this that for consistency you should sit down and relax for a few minutes before starting. I ignore the first reading always because for some reason it is always higher irrespective of how long I wait before starting. Also if you need to pee, do so before you start.
I've never had a normal BP reading in a clinical setting. It always indicates pre hyper tension but at home my BP is fairly consistent around the normal level.

I have occasionally had periods where my BP had risen noticeably for a couple of days before settling back to normal. Bear in mind that some supplements and medications can temporarily affect blood pressure

[Boots]

The full set of advice Mrs Boots and I read when we first got our home b.p. machine coincides with much of the above. It was:

A consistent time of the day, preferably early in the day.
Go to the loo
Don't eat or drink
Sit quietly for five minutes
Set up the machine and take three readings - don't talk (and that includes shouting at the radio!)
Discard a reading that is an outlier

Obviously one could drive a coach and horses through some of this, but overall it seemed to give a sensible set of results. Far better than walking in to the Doctor's surgery, being told to take your coat off and roll up your sleeve, one reading - bang!

[kempiejon]

Bear in mind that some supplements and medications can temporarily affect blood pressure

And food, pal of mine, into juicing, the first time he did fresh beetroot he came over peculiar. Consensus was the beets' nitrates dropped his bp low.

[bluedonkey]

I heard on the radio today that the very best and most effective thing you can ever do to reduce your blood pressure is stop watching "Question Time" on the telly.

Speeling edit!

Seriously, I agree with that. Also CAN on lemon fool.

[swill453]

The full set of advice Mrs Boots and I read when we first got our home b.p. machine coincides with much of the above. It was:

A consistent time of the day, preferably early in the day.
Go to the loo
Don't eat or drink
Sit quietly for five minutes
Set up the machine and take three readings - don't talk (and that includes shouting at the radio!)
Discard a reading that is an outlier

Obviously one could drive a coach and horses through some of this, but overall it seemed to give a sensible set of results. Far better than walking in to the Doctor's surgery, being told to take your coat off and roll up your sleeve, one reading - bang!

Your technique might give a low or average reading.

But there's an argument for treating blood pressure that is high in adverse circumstances. It may be "white coat syndrome", but it still stresses the physiology.

Scott.

[mtk62]

I have been monitoring mine for years.
I read that talking raises one's BP.
Wanting a pee will do so too.
I find that sitting still for 5 minutes will give you a good BP.

I find that exercising regularly will lower my BP.
So if I haven't done so for a while my average will be elevated but after a couple of weeks of cardio it will reduce.
I'm 62 and my average BP is 125/75 with a pulse of 55.
My exercise puts me in the athlete category for my age.

[Mike4]

I find if you take a series of say half a dozen readings, each consecutive reading tends be lower than the previous.

So another technique is to keep taking readings until you get one you are happy with, then stop and write that one down. I don't suppose my GP would think much of this idea!

[seagles]

I have been taking my BP regularly for over 20 years after being diagnosed with hypertension. It varies greatly depending on time of day, what exercise or activity I have taken prior to it. I also have been diagnosed with "labiled hypertension due to being in a clinical environment " which is the technical diagnosis of white coat syndrome (it is in my health records). I have also noted that the machines in surgery are or seem to record higher than I expected. My method is to take them at roughly the same time twice a day and take 3 readings, with a short 30 second gap between them. During the last week my records show the systolic between 108 and 136. Diastolic between 65 and 85. I have a spreadsheet where I record one the 2 best results a day and use the average weekly result as a guide to how i am doing. Have just changed tablets from Ampolodipine to Rampril after recent doctors appointment for an unrelated health problem as he noticed swollen ankles and lower legs. Within 2 days they returned to normal and other health condition was diagnosed. Apparently as you get older your body can react differently to medication and mine should have been changed.

[Arborbridge]

Like Kempiejon I also have set of BP readings going back several years. It's been fairly consistent. but oddly this week, my evening reading and the following morning and evening readings jumped quite alarmingly. No reasons for it - I made the measurements in my usual way and had not been drinking. Three days later, all was back to normal, so I can only conclude there was some sort of virus I was fighting.
Incidentally, the Systolic reading can raise very easily just by body movement - I hate to think what it goes up to when exercising.

Alarm bells first rang with a clear case of white coat syndrome - readings were 200/90 or100 - but there was a problem which seems to have been brought under control with a cocktail of things.
Usually, I'm around 130/75 to 80.

BTW, I've replied to a post which no longer exists but you may as well see the text as it was relevant here:

I think you dropped something when you got out of bed... your sense of humour...

Yeah, I can see why you would think that. But, unlike you, I have 'priors' to go on.

Well, "priors" aside, about which I know nothing....

IAAG's remark could easily have applied to me, because I too am concerned with what causes my BP to be high. In that context, I found his remark amusing and apt - had it been directed at me, I would have just LOL'd and taken in as a joke.

You and I are usually on the same side of any argument, but I don't think his remark was meant to be vicious.


Arb.