BLOOD PRESSURE – KNOW THE FACTS

Blood pressure problems? Don’t let them sneak up on you. They can be mean and nasty.

One of the most common problems in healthcare is blood pressure – specifically high blood pressure. In fact, if you could only deal with one issue when it comes to improving your health, controlling your blood pressure would be at the top.

Maybe controlling your weight would be next, but that’s an issue I will deal with later. Before proceeding, however, I will simply say that one way of reducing your blood pressure is by controlling your weight.

Two “Key” measures:

Every time you visit a doctor, notice that the two measurements they always take are your weight and blood pressure. There are many reasons for this, but mostly it’s because the two factors – excessive weight and high blood pressure – are likely the mothers of most diseases.

OK, I know this is hyperbole, but there’s still a lot of truth to the statement. To keep things simple, however, I’m going to assume that you’re in the middle of the BMI’s Normal zone. This leaves us to focus entirely on blood pressure.

Disclaimer:

Almost every time you go to a doctor’s visit, you’re going to get your blood pressure checked and recorded. This is standard procedure. It is mostly inaccurate for several reasons. Still, it is important because it might reveal a concerning situation needing further attention.

Your primary care provider will have your blood pressure history and look for unusual changes up or down. This usually results in a second test a few minutes later to see if this is an anomaly. If there is still a concern, then your doctor will do a proper follow-up under more controlled circumstances.

If you have high blood pressure, you will likely be put on medication to bring it down (there are several choices here).

Please take this seriously and follow your doctor’s orders:

So, what is blood pressure?

Blood pressure is the pressure inside your arteries at any particular time. It has a high (systolic) and a low (diastolic) point. Both of these are important. The difference between these points is called your pulse pressure, which can also be important.

There is no universal agreement on the ideal blood pressure level. Usually, though, this would be between 115 and 120 systolic and 75 to 80 diastolic. Pulse pressure should be 40 (there’s not much disagreement here).

For the record, the cuff that goes on your arm should be on your upper arm at or around your heart’s level. Always use the left arm. First, it is closer to your left ventricle (the pump feeding your arteries), and second, the left and right arm will have an 8 to 10 point difference. Because of location – the right side will always be higher.

What do the numbers mean?

Typically, blood pressure is talked about simply using numbers. This is because of the clumsiness of the number’s meaning. One point of blood pressure is the amount of pressure it takes to raise a column of mercury one millimeter in a graduated cylinder.

This means a systolic pressure of 120 is enough to raise a 120-millimeter column of mercury in a graduated cylinder. This is an archaic measurement, but somehow it stuck. So, because of its awkwardness, the mercury part just gets left off, and people use only the numbers.

Blood pressure ratios:

High blood pressure is generally above 140 systolic but is often higher:

High blood pressure is the most common blood pressure issue, and its most common cause is atherosclerosis (sometimes referred to as hardening of the arteries). This usually comes with aging and is caused primarily by plaque buildup in the arteries.

When artery walls get stiff from the scarring brought on by damage over time, the blood doesn’t flow as well, so the pressure inside the arteries must rise. Plaque buildup can also narrow blood passageways through the arteries and cause pressure to rise. In both these cases, your heart rate will likely rise to push harder and pump faster.

Of course, there are other reasons for high blood pressure, but arterial disease restricting blood flow is the major one.

Low blood pressure is usually below 90 systolic and 50 diastolic.

Usually, low blood pressure is diagnosed using the numbers and accompanying symptoms. Nothing will be done about low blood pressure in the absence of symptoms.

This can be serious, however, and indicate heart failure or heart valve problems. Always discuss this with your doctor, and follow his advice. Here’s more on low blood pressure.

Blood pressure numbers are elusive.

Neither high nor low blood pressure is easy to diagnose. There are a few reasons for this, here are some obvious ones:

1. Your blood pressure naturally changes throughout the day and is a moving target.
2. Blood pressure can vary based on what you eat and when you eat it – it’s the same with what you drink.
3. Your emotional state can change your blood pressure like a roller coaster.
4. “White coat syndrome” causes distortions in your blood pressure numbers when taken in a doctor’s office.
5. Blood pressure readings taken along with blood pressure affecting medications (and there are many) hide your baseline blood pressure and return a false reading.

In addition to these, there are other reasons blood pressure might be difficult to diagnose.

Your baseline blood pressure is important and deserves consideration when your blood pressure becomes an issue. Accurate baseline blood pressure and resting heart rate assessments are usually done in a clinical setting. You can, however, closely approximate these with self-testing.

Either way, baseline blood pressure, and resting heart rate are key numbers you should know. Here’s the way for you to find them…

FINDING BASELINE (RESTING) BLOOD PRESSURE

First, you will need a reliable home blood pressure monitor. You might already have one, but if you don’t, I recommend the Omron Platinum Bp monitor; this is the same monitor I use – get it here: OMRON.

So, if you’ve got your BP monitor and know how to use it, let’s get started.

Set up:

You will test your blood pressure on three consecutive days, which will take 30 minutes each day. You should not eat anything after 6:00 PM on each previous day and drink only water. It doesn’t matter what days you choose. They just need to be consecutive.

Get out of bed 30 minutes earlier than you would normally arise. Urinate, and drink 8 ounces of plain water, if you weigh more than 150 pounds, drink 14 ounces of plain water.

Don’t take your morning meds until after your blood pressure tests (exception: if you take a BP med in the morning, you will want to do this as you normally would).

[Note: If you’re on blood pressure meds, and usually take these in the morning, but forget, your blood pressure will likely be higher than you expect. Simply stated, this is your untreated morning blood pressure.]

Do not eat anything, and do not watch the morning news. In fact, no TV at all, and no pets jumping in your lap. Find a comfortable place to sit where it will be quiet. Put the BP monitor’s cuff on your left arm and, with it on your arm, sit there and relax for 15 minutes.

Your left arm should be resting on the arm of a chair, and the monitor’s cuff should be at the same level as the middle of your chest (heart level).

Start testing:

Start the monitor after 15 minutes. Let the monitor go through its cycle without moving your left arm, and try to remain as still as possible. Record your results: top and lower numbers and pulse rate.

Relax for 5 minutes, and repeat the above.

Relax for another 5 minutes and repeat the above.

Done.

When completed, you have three sets of three different numbers. These numbers describe the upper and lower limits of your blood pressure and your pulse rate. Add up all three sets of numbers by kind and divide each sum by three.

Example: Systolic 135 +125+ 118 = 378. Divide this number by three, and you get 126. This is your average systolic blood pressure for that day.

Now do the same with your diastolic pressure and your heart rate. You will now have your average systolic and diastolic pressures and heart rate.

Record these in your logbook or on a calendar. Add date and time (try to do the three tests at the same time each day.)

Repeat this same procedure two more mornings. Sum up all the numbers and divide by three. You will now have three days of the average numbers for your systolic and diastolic pressures and heart rate.

Now for the final step, calculate the average of each of these three groups of numbers, and you will have a three-day average of your baseline blood pressure numbers and your heart rate.

Validity:

Your numbers will be very close to your clinically determined resting heart rate and blood pressure. Knowing these numbers is important; you should probably repeat this procedure every three months to maintain their validity.

As pointed out above, high or low blood pressure is hard to diagnose, and having your baseline tracking data records will help you guard against the misdiagnosis of blood pressure problems.

Discuss your methodology and numbers with your doctor and have these put in your medical records. You can update them once a year.

[Note that these are not your numbers while you’re sleeping – these are your baseline numbers when you’re relaxed and before you start your day. Your sleeping numbers can be determined, but this takes special equipment.]

Caveats:

Blood pressure in your left and right arm are not the same. The right arm’s pressure is usually higher, so you should always use the same arm to avoid a mixup. By convention, we usually use the left arm.

Morning dehydration is normal. Just breathing all night is one cause of dehydration, and there are others. But urine production plays a major role too.

It is normal to feel the need to urinate when we arise. The water in urine collected from your blood overnight winds up in your bladder and is not available in your bloodstream.

Since most bladders hold between 8 and 14 ounces of fluid, your circulating blood fluid is “low” by 8 to 14 ounces. This water has already left your bloodstream and will go out when you urinate.

Be sure to drink your water.

Drinking 8 to 14 ounces of water replaces the fluid in your blood that your kidneys moved to your bladder overnight. This is why it’s important to drink your water and sit for 15 minutes before testing your blood pressure.

Without drinking the water and waiting 15 minutes, unreliable pressure and heart rate readings will result. Dehydration causes your heart to beat faster and harder to compensate for lower fluid levels.

Final warning:

In almost all cases, blood pressure has no symptoms. Yes, there are exceptions, but this is a general observation. Also, just because your blood pressure is normal today doesn’t mean it will stay that way.

High blood pressure is known as the “silent killer” for a reason, It can kill you without warning, or eat away at your organs slowly, destroying their function little by little. It’s sneaky.

Don’t let it get you. Keep track of it, and follow your doctor’s advice if you have it (or discover you have it). The good news is that there are many ways to deal with blood pressure issues, and, like any other condition, the sooner you start treating it, the better your outcome will be.

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I heard something like this at my gym not long ago: “Yeah, my doc says my headaches are cause I got really high blood pressure, so she gave me some pills to take. They made me feel like shit, so I stopped taking ’em. Besides, I feel better now anyway.”

I was looking at a healthy-appearing, “gym body” guy who was gonna have a short life.

Please don’t be “that guy.”

OMY1

Note: You can also find your baseline weight here: My Honest Weight.

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