Which BP reading?

Dave B said:

It is not uncommon to have an initial reading of 155/90 when I first use the monitor. However, if
immediately after this I repeat the measurement I often find that my BP has fallen quite
considerably (not uncommon to fall to 140/85). If I then take a third measurement it tends to be
close to the lower measurement (usually 1 or 2mmHg lower).

Sit and relax for five minutes with the machine before taking the reading. Always take it at the
same time of day under the same conditions; in the morning not long after rising and after emptying
the bladder is a good time. With this done, the first reading is the one you should log--logging
only the lowest of several readings is cheating.

With time you'll find that you'll be less nervous as you take your BP, and the first reading won't
be disconcertingly high. Whatever it is, though, log it. Over weeks and months the average will
reflect your true, normal BP correctly.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Dave B said:

It is not uncommon to have an initial reading of 155/90 when I first use the monitor. However, if
immediately after this I repeat the measurement I often find that my BP has fallen quite
considerably (not uncommon to fall to 140/85).

If you need to take a second reading, you should wait about 5 minutes after the first to allow the
blood vessels to restore, or else use your other arm. (This I recall from the booklet that came with
my tester. But when I was in the hospital, whenever they had an "error" they just kept reinflating
the cuff until they got a reading - even though they agreed when I told them the above...)

Dave B said:

My doctor has asked me to keep a note of my BP during the day. At work I have a an automatic BP
monitor that I use (I work in an MRI dept). However, I am finding it hard to decide what my real
BP reading is!

It is not uncommon to have an initial reading of 155/90 when I first use the monitor. However, if
immediately after this I repeat the measurement I often find that my BP has fallen quite
considerably (not uncommon to fall to 140/85). If I then take a third measurement it tends to be
close to the lower measurement (usually 1 or 2mmHg lower).

In this situation what is my BP?!? I tend to take the first measurement shortly after I have gone
to collect the monitor and sat down.

(I am a fit 30 year old, with a high BP. I am currently taking Benrdoflurazide)

Cheers

Dave

On Yahoo is a group called bloodpressureline. They have a resident expert on blood pressure named
Dr. Clarence Grimm from Milwaukee. He put together a written, standard procedure for measuring
blood pressure.

From memory:
1) Sit straight up in a kitchen type chair with both feet on the floor for at least 5 minutes.

2) Take 3 readings about a minute apart.

3) Discard the first and average the next two.

Do find that group and verify these important steps.

A.L.

<Chuck@MI.> wrote in message
"]news:[email hidden]...

Quoted message said:

Dave B said:

It is not uncommon to have an initial reading of 155/90 when I first use the monitor. However, if
immediately after this I repeat the measurement I often find that my BP has fallen quite
considerably (not uncommon to fall to 140/85).

If you need to take a second reading, you should wait about 5 minutes after the first to allow the
blood vessels to restore, or else use your other arm. (This I recall from the booklet that came
with my tester. But when I was in the hospital, whenever they had an "error" they just kept
reinflating the cuff until they got a reading - even though they agreed when I told them the
above...)

Why do error readings occur? I find that if my heart misses a beat when taking the reading and the
pause is longer than normal that I get the error sign on the monitor. When I had a 24 hour monitor
last year it seemed to happen a couple of times then. I am having another 24 hour monitor in ten
days time sand intend to ask the technician about it. Derek.

Dave B said:

My doctor has asked me to keep a note of my BP during the day. At work I have a an automatic BP
monitor that I use (I work in an MRI dept). However, I am finding it hard to decide what my real
BP reading is!

It is not uncommon to have an initial reading of 155/90 when I first use the monitor. However, if
immediately after this I repeat the measurement I often find that my BP has fallen quite
considerably (not uncommon to fall to 140/85). If I then take a third measurement it tends to be
close to the lower measurement (usually 1 or 2mmHg lower).

In this situation what is my BP?!? I tend to take the first measurement shortly after I have gone
to collect the monitor and sat down.

(I am a fit 30 year old, with a high BP. I am currently taking Benrdoflurazide)

Cheers

Dave

Most folks waiting 5 minutes after sitting down to take their pressure find their readings
repeatably consistent.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

I have read somewhere that the third reading is the most reliable.

--

Herb
Boulder, CO

"Derek F" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

<Chuck@MI.> wrote in message
"]news:[email hidden]...

Quoted message said:

Dave B said:

It is not uncommon to have an initial reading of 155/90 when I

first use

Quoted message said:

Quoted message said:

Quoted message said:

the monitor. However, if immediately after this I repeat the

measurement

Quoted message said:

Quoted message said:

Quoted message said:

I often find that my BP has fallen quite considerably (not uncommon

to

Quoted message said:

Quoted message said:

Quoted message said:

fall to 140/85).

If you need to take a second reading, you should wait about 5

minutes

Quoted message said:

Quoted message said:

after the first to allow the blood vessels to restore, or else use
your other arm. (This I recall from the booklet that came with my
tester. But when I was in the hospital, whenever they had an

"error"

Quoted message said:

Quoted message said:

they just kept reinflating the cuff until they got a reading - even
though they agreed when I told them the above...)

Why do error readings occur? I find that if my heart misses a beat

when

Quoted message said:

taking the reading and the pause is longer than normal that I get the

error

Quoted message said:

sign on the monitor. When I had a 24 hour monitor last year it seemed

to

Quoted message said:

happen a couple of times then. I am having another 24 hour monitor in

ten

Quoted message said:

days time sand intend to ask the technician about it.
Derek.

Derek F said:

<Chuck@MI.> wrote in message "]news:[email hidden]...

Quoted message said:

Dave B said:

It is not uncommon to have an initial reading of 155/90 when I first use the monitor. However,
if immediately after this I repeat the measurement I often find that my BP has fallen quite
considerably (not uncommon to fall to 140/85).

If you need to take a second reading, you should wait about 5 minutes after the first to allow
the blood vessels to restore, or else use your other arm. (This I recall from the booklet that
came with my tester. But when I was in the hospital, whenever they had an "error" they just kept
reinflating the cuff until they got a reading - even though they agreed when I told them the
above...)

Why do error readings occur? I find that if my heart misses a beat when taking the reading and the
pause is longer than normal that I get the error sign on the monitor. When I had a 24 hour monitor
last year it seemed to happen a couple of times then. I am having another 24 hour monitor in ten
days time sand intend to ask the technician about it. Derek.

When I was in the hospital a few months ago with Afib, and PACs and PVCs and you name it I had it,
my heart rate was so erratic that the machines would not work at all. They would just display ERR.
They had to dust off a blood pressure cuff and rummage around for a stethoscope to take mine.

Bob

Thanks folks for the replies.

I understand that by waiting a while before taking a BP reading will result in lower and more
consistent readings. However, how real is this and how relevant is it to the levels quoted as
suggested levels upper levels. For example during the day you will very rarely be relaxed enough to
have real blood pressure at the 'relax for 5 minute' levels. Therefore, is my first high level
reading not more representitive of my typical BP? Or have the suggested levels been set by assuming
the patient has taken time to relax before hand.

Thanks for your help

Dave

Dr. Andrew B. Chung said:

Dave B said:

My doctor has asked me to keep a note of my BP during the day. At work I have a an automatic BP
monitor that I use (I work in an MRI dept). However, I am finding it hard to decide what my real
BP reading is!

It is not uncommon to have an initial reading of 155/90 when I first use the monitor. However, if
immediately after this I repeat the measurement I often find that my BP has fallen quite
considerably (not uncommon to fall to 140/85). If I then take a third measurement it tends to be
close to the lower measurement (usually 1 or 2mmHg lower).

In this situation what is my BP?!? I tend to take the first measurement shortly after I have gone
to collect the monitor and sat down.

(I am a fit 30 year old, with a high BP. I am currently taking Benrdoflurazide)

Cheers

Dave

Most folks waiting 5 minutes after sitting down to take their pressure find their readings
repeatably consistent.

--
Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

Dave B said:

I understand that by waiting a while before taking a BP reading will result in lower and more
consistent readings. However, how real is this and how relevant is it to the levels quoted as
suggested levels upper levels.

It can be the difference between 160/110 and 120/80.

Quoted message said:

For example during the day you will very rarely be relaxed enough to have real blood pressure at
the 'relax for 5 minute' levels.

You just need to be physically inactive. Stress can raise BP, but in most cases not by that much
unless you are really preoccupied with something.

Quoted message said:

Therefore, is my first high level reading not more representitive of my typical BP?

BP goes all over the place during the day. The only reliable reference is at rest, since there's no
telling what it might be under other conditions.

Quoted message said:

Or have the suggested levels been set by assuming the patient has taken time to relax before hand.

Yes. That's the easiest way to get consistent readings.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Dave B said:

Thanks folks for the replies.

I understand that by waiting a while before taking a BP reading will result in lower and more
consistent readings. However, how real is this

Consistent readings are more real than inconsistent ones.

Quoted message said:

and how relevant is it to the levels quoted as suggested levels upper levels. For example during
the day you will very rarely be relaxed enough to have real blood pressure at the 'relax for 5
minute' levels.

Depends on what you are doing. You could be asleep and be more relaxed.

Quoted message said:

Therefore, is my first high level reading not more representitive of my typical BP?

No.

Quoted message said:

Or have the suggested levels been set by assuming the patient has taken time to relax before hand.

Thanks for your help

You are welcome.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

Dave B said:

Thanks folks for the replies.

I understand that by waiting a while before taking a BP reading will result in lower and more
consistent readings. However, how real is this and how relevant is it to the levels quoted as
suggested levels upper levels. For example during the day you will very rarely be relaxed enough
to have real blood pressure at the 'relax for 5 minute' levels. Therefore, is my first high level
reading not more representitive of my typical BP? Or have the suggested levels been set by
assuming the patient has taken time to relax before hand.

Thanks for your help

Dave

Consider the following:

1) For mild to moderate hypertension, resting pressures slightly or somewhat above 140/90 mmHg, the
benefit of treatment is really quite small. A British study of some 75,000 participants,
published in the early 80's, found that treating such pressures resulted in only one less stroke
per year in a group of 850 people being treated. Most of us would be in the 849 population that
derives no measurable benefit. People with kidney problems derived a greater benefit.

2) The treatment of hypertension is "not without risk to the patient." From the Framingham study
book published in 1980.

3) I have pumped 240/?? on a treadmill test and the professionals said nothing. Weightlifters can
achieve pressures of 400 mmHg without apparent damage.

Resting blood pressure is the standard.

A.L.

Al. Lohse said:

Dave B said:

Thanks folks for the replies.

I understand that by waiting a while before taking a BP reading will result in lower and more
consistent readings. However, how real is this and how relevant is it to the levels quoted as
suggested levels upper levels. For example during the day you will very rarely be relaxed enough
to have real blood pressure at the 'relax for 5 minute' levels. Therefore, is my first high
level reading not more representitive of my typical BP? Or have the suggested levels been set by
assuming the patient has taken time to relax before hand.

Thanks for your help

Dave

Consider the following:

1) For mild to moderate hypertension, resting pressures slightly or somewhat above 140/90 mmHg,
the benefit of treatment is really quite small. A British study of some 75,000 participants,
published in the early 80's, found that treating such pressures resulted in only one less
stroke per year in a group of 850 people being treated. Most of us would be in the 849
population that derives no measurable benefit.

Small consolation to the one. Especially if you happen to be the one.

There are folks buying lottery tickets for that one in a million chance of winning big.

Quoted message said:

People with kidney problems derived a greater benefit.

2) The treatment of hypertension is "not without risk to the patient." From the Framingham study
book published in 1980.

Do you routinely rely on opinions written more than 20 years ago?

Quoted message said:

3) I have pumped 240/?? on a treadmill test and the professionals said nothing.

Speaking as a professional cardiologist, I would have said something to you about a 240/?? blood
pressure on the treadmill.

Quoted message said:

Weightlifters can achieve pressures of 400 mmHg without apparent damage.

It's called Russian Roulette.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

Dr. Andrew B. Chung said:

Al. Lohse said:

Quoted message said:

>>>>>>>>>>>>>> snipped >>>>>>>>>>>>>>>>>>

2) The treatment of hypertension is "not without risk to the patient." From the Framingham study
book published in 1980.

Do you routinely rely on opinions written more than 20 years ago?

What might negate that 20 year old opinion? What?

Simple, prove that it is wrong. Everything old is not wrong.

I've seen you rely on writings over 4000 years old :-)

Quoted message said:

Quoted message said:

3) I have pumped 240/?? on a treadmill test and the professionals said nothing.

Speaking as a professional cardiologist, I would have said something to you about a 240/?? blood
pressure on the treadmill.

What? The pressure was nowhere near as high as those obtained by weight lifters.

Quoted message said:

Quoted message said:

Weightlifters can achieve pressures of 400 mmHg without apparent damage.

It's called Russian Roulette.

One in six succumb to the pressure???????? One in six?

Do weight lifters have more cardiovascular problems than others?

Documents please?

A.L.

Dr. Andrew B. Chung said:

Small consolation to the one. Especially if you happen to be the one.

If medication were entirely without side effects or inconvenience, your point would be well taken.
Unfortunately, that is not the case with medical treatment of hypertension, and so a trade-off is
necessary, with the decision point depending on the patient.

As an extreme and purely hypothetical example, a medication that produces double vision or makes
both hands numb isn't going to be worth taking unless going without it produces even worse symptoms.
A higher risk of catastrophic events leading to death or permanent and severe disability must be
balanced against years or decades of seemingly minor inconvenience or unpleasant side effects.

Quoted message said:

There are folks buying lottery tickets for that one in a million chance of winning big.

There are folks smoking cigarettes even though they have a 50% chance of being killed by them.

Quoted message said:

It's called Russian Roulette.

The odds are probably better for the weightlifter. Still, a BP of 400 mm/Hg is a bit frightening,
but apparently weightlifters are willing to take the risk in order to engage in their preferred
sport. Race drivers do the same thing all the time, as do many other people.

I've heard that the hormones taken by bodybuilders produce sustained and severe hypertension
as well (?).

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Al. Lohse said:

Dr. Andrew B. Chung said:

Al. Lohse said:

>>>>>>>>>>>>>>> snipped >>>>>>>>>>>>>>>>>>

2) The treatment of hypertension is "not without risk to the patient." From the Framingham
study book published in 1980.

Do you routinely rely on opinions written more than 20 years ago?

What might negate that 20 year old opinion? What?

Opinions get stale after a few years.

Quoted message said:

Simple, prove that it is wrong. Everything old is not wrong.

Clinically, it never had utility.

The treatment of *anything* is not without risk to the patient.

Indeed, crossing the street is not without risk.

Quoted message said:

I've seen you rely on writings over 4000 years old :-)

Not for opinions :-)

Quoted message said:

Quoted message said:

Quoted message said:

3) I have pumped 240/?? on a treadmill test and the professionals said nothing.

Speaking as a professional cardiologist, I would have said something to you about a 240/?? blood
pressure on the treadmill.

What?

Too high.

Quoted message said:

The pressure was nowhere near as high as those obtained by weight lifters.

Still too high.

Quoted message said:

Quoted message said:

Quoted message said:

Weightlifters can achieve pressures of 400 mmHg without apparent damage.

It's called Russian Roulette.

One in six succumb to the pressure????????

Weight lifters are not known for long life.

Quoted message said:

One in six?

Possibly if all six achieve pressures of 400 mmHg.

Quoted message said:

Do weight lifters have more cardiovascular problems than others?

A word to the wise:

tinyurl.comp3vpOpen ↗

Another word:

tinyurl.comp3vzOpen ↗

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

Mxsmanic said:

Dr. Andrew B. Chung said:

Small consolation to the one. Especially if you happen to be the one.

If medication were entirely without side effects or inconvenience, your point would be well taken.
Unfortunately, that is not the case with medical treatment of hypertension, and so a trade-off is
necessary, with the decision point depending on the patient.

As an extreme and purely hypothetical example, a medication that produces double vision or makes
both hands numb isn't going to be worth taking unless going without it produces even worse
symptoms. A higher risk of catastrophic events leading to death or permanent and severe disability
must be balanced against years or decades of seemingly minor inconvenience or unpleasant side
effects.

Quoted message said:

There are folks buying lottery tickets for that one in a million chance of winning big.

There are folks smoking cigarettes even though they have a 50% chance of being killed by them.

Quoted message said:

It's called Russian Roulette.

The odds are probably better for the weightlifter. Still, a BP of 400 mm/Hg is a bit frightening,
but apparently weightlifters are willing to take the risk in order to engage in their preferred
sport. Race drivers do the same thing all the time, as do many other people.

I've heard that the hormones taken by bodybuilders produce sustained and severe hypertension as
well (?).

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

See my reply to Al Lohse.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

Al. Lohse said:

Dr. Andrew B. Chung said:

Al. Lohse said:

>>>>>>>>>>>>>>> snipped >>>>>>>>>>>>>>>>>>

2) The treatment of hypertension is "not without risk to the patient." From the Framingham
study book published in 1980.

Do you routinely rely on opinions written more than 20 years ago?

What might negate that 20 year old opinion? What?

Things can change in the medical and scientific field overnight. 20 Years is ancient history in the
world of medicine.

Bob

Quoted message said:

Simple, prove that it is wrong. Everything old is not wrong.

I've seen you rely on writings over 4000 years old :-)

Dr. Andrew B. Chung said:

A word to the wise:

tinyurl.comp3vpOpen ↗

I just knew there had to be a reason to avoid sit-ups. I wish I had had this reference in
high school.

But the reference doesn't mention what neurologic signs to watch for.

Still, my comments on reasons for non-compliance remain valid. Doctors are trained to treat disease;
they are not trained to consider the practical implications of compliance with their prescribed
treatments. It is interesting to note that doctors themselves are notorious for their poor
compliance.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.