Which BP reading?

Discussion in 'Health and medical' started by Dave B, Dec 17, 2003.

  1. Dave B

    Dave B Guest

    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
     
    Tags:


  2. Mxsmanic

    Mxsmanic Guest

    Dave B writes:

    > 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.
     
  3. Chuck

    Chuck Guest

    On Fri, 26 Sep 2003, Dave B <[email protected]> wrote:

    >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...)
     
  4. Al. Lohse

    Al. Lohse Guest

    Dave B wrote:
    >
    > 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.
     
  5. Derek F

    Derek F Guest

    <[email protected]> wrote in message
    news:[email protected]...
    > On Fri, 26 Sep 2003, Dave B <[email protected]> wrote:
    >
    > >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.
     
  6. Dave B wrote:

    > 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
    http://www.heartmdphd.com/
     
  7. Herb

    Herb Guest

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

    --

    Herb
    Boulder, CO

    "Derek F" <[email protected]> wrote in message
    news:[email protected]...
    >
    > <[email protected]> wrote in message
    > news:[email protected]...
    > > On Fri, 26 Sep 2003, Dave B <[email protected]> wrote:
    > >
    > > >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.
     
  8. Bob Cardone

    Bob Cardone Guest

    "Derek F" <[email protected]> wrote:

    >
    ><[email protected]> wrote in message news:[email protected]...
    >> On Fri, 26 Sep 2003, Dave B <[email protected]> wrote:
    >>
    >> >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
     
  9. Dave B

    Dave B Guest

    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, MD/PhD wrote:
    > Dave B wrote:
    >
    >
    >>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 http://www.heartmdphd.com/
     
  10. Mxsmanic

    Mxsmanic Guest

    Dave B writes:

    > 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.

    > 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.

    > 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.

    > 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.
     
  11. Dave B wrote:

    > 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.

    >
    > 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.

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

    No.

    > 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
    http://www.heartmdphd.com
     
  12. Al. Lohse

    Al. Lohse Guest

    Dave B wrote:
    >
    > 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.
     
  13. "Al. Lohse" wrote:

    > Dave B wrote:
    > >
    > > 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.

    > 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?

    >
    > 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.

    >
    > Weightlifters can achieve pressures of 400 mmHg without apparent damage.
    >

    It's called Russian Roulette.

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  14. Al. Lohse

    Al. Lohse Guest

    "Dr. Andrew B. Chung, MD/PhD" wrote:
    >
    > "Al. Lohse" wrote:
    >>>>>>>>>>>>>>>>> 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 :)

    >
    > >
    > > 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.

    >
    > >
    > > 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.
     
  15. Mxsmanic

    Mxsmanic Guest

    Dr. Andrew B. Chung, MD/PhD writes:

    > 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.

    > 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.

    > 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.
     
  16. "Al. Lohse" wrote:

    > "Dr. Andrew B. Chung, MD/PhD" wrote:
    > >
    > > "Al. Lohse" wrote:
    > >>>>>>>>>>>>>>>>> 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.

    >
    > 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.

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

    Not for opinions :)

    >
    > >
    > > >
    > > > 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.

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

    Still too high.

    >
    > >
    > > >
    > > > 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.

    > One in six?
    >

    Possibly if all six achieve pressures of 400 mmHg.

    >
    > Do weight lifters have more cardiovascular problems than others?

    A word to the wise:

    http://tinyurl.com/p3vp

    Another word:

    http://tinyurl.com/p3vz

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  17. Mxsmanic wrote:

    > Dr. Andrew B. Chung, MD/PhD writes:
    >
    > > 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.
    >
    > > 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.
    >
    > > 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
    http://www.heartmdphd.com/
     
  18. Bob Cardone

    Bob Cardone Guest

    "Al. Lohse" <[email protected]> wrote:

    >"Dr. Andrew B. Chung, MD/PhD" wrote:
    >>
    >> "Al. Lohse" wrote:
    >>>>>>>>>>>>>>>>>> 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
    >Simple, prove that it is wrong. Everything old is not wrong.
    >
    >I've seen you rely on writings over 4000 years old :)
     
  19. Mxsmanic

    Mxsmanic Guest

    Dr. Andrew B. Chung, MD/PhD writes:

    > A word to the wise:
    >
    > http://tinyurl.com/p3vp

    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.
     
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