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
http://www.heartmdphd.com/

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
http://www.heartmdphd.com/

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
http://www.heartmdphd.com

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
http://www.heartmdphd.com/

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:

http://tinyurl.com/p3vp

Another word:

http://tinyurl.com/p3vz

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

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
http://www.heartmdphd.com/

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:

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.

Al. Lohse said:

Weightlifters can achieve pressures of 400
mmHg without apparent damage.

MOF, it is unknown whether or not that type of repetitive BP has long
term consequences or not.

Ime, taking BP"s before, during and after lifts, we rarely see
anything close to this number.