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Blood pressure changes?*
Old 12-08-2009, 11:19 AM   #1
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Blood pressure changes?*

*Went to the Dr. for a regular check-up some 3 weeks ago I think it was. Blood pressure is normally 117/78.
Then at a general physical exam a few weeks ago it came out 130/80. Then the next week I went for the prep information for a colonoscopy and it was 130/80 again.
Today at my colonoscopy it was 120/78 when I was having a pleasant and fun chat with the nurse for awhile as the Gastrointerologist was almost an hour late (first bad snow of the year).

My question is this: does your blood pressure change that much depending on the situation? And THAT much?

Yes, I have not had a check-up or complete blood check for over 6 years. Yes, I am definitely a chicken about going to have anything medically done. Yes, I have no guts.
I have had whooping cough & my tonsils out at 6 and a C-section for my 10 lb. whopper kid at 33, so having a lack of medical needs makes we think, "Someday that other shoe is going to fall" and "they" will find something. Nothing like a little negative thinking there, eh? I go in like a scared 5 year old each time--yes, me, who's so gutsy in business and most of my life (hey! we all have our vulnerabilities).

Would this influence your blood pressure reading? I'm guessing it does as mine has bopped around so much, but thought I'd ask here.

(*Excuse this post, but I am medical knowledge challenged.)
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Old 12-08-2009, 12:49 PM   #2
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Sure, people experience changes in the blood pressure. But also, many of us start to get high BP in our 50's and 60's. Since high BP is sometimes called "The Silent Killer" (at least on TV), it is a good idea to have regular checkups.

Also, I don't trust those machines and prefer mine to be done manually. My BP is usually lower when done manually, than when done by a machine.
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Old 12-08-2009, 12:55 PM   #3
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In my experience blood pressure can change significantly based on external issues. I know mine was always about 10 points/5 points lower at the end of a doctor's appointment than at the beginning. Also, ever since I've developed some pain in my (right) arm, my BP has soared up from normal to ~150/90. They put me on meds to keep it down while we determine what is causing the pain. I know low grade infections and/or fever can cause changes too, as can stress (ie. colonoscopy). I think the most important thing is to be aware of it on average, and not to worry too much about relatively minor spikes as long as they seem to be temporary.
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Old 12-08-2009, 12:57 PM   #4
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Well, I'm definitely not a doctor, but as a retired engineer with the usual Engineer's Obsessive Compulsive Order (it's not a disorder in engineers!), I've been measuring and tracking my blood pressure daily along with weight and exercise for a couple of years. I've got spreadsheets...

You know how the instructions for the BP monitors tell you to empty your bladder, sit upright in a chair with good back support, and rest your arm at about heart height, and wait 5 minutes before taking a reading? You know, the stuff the physicians assistant doesn't do when they run you back, pop you on a stool, slap on the cuff and get a quick reading...

Between the rush-rush, nervousness at being in the doctor place, and related factors, your reading could be high some times, and normal others. Even at home after doing this for years, I get wildly 'off' readings if I don't sit still for a few minutes.

I'd suggest going out and picking up one of the automatic monitors like a basic Omron or Microlife. These are maybe $35 at Costco. Follow the instructions and , a few days a week, check your BP in the morning on rising, and in the evening between dinner and bed. Write down the numbers, and anything interesting you can think of about the day ("Had 8 cups of coffee", "Dog emergency - went to vet", "Headaches, skipped exercise"). Think of it as a medical diary for yourself. You might spot things that move your BP around.

Oh, and just to give you an idea of how things can fluctuate, here are my morning readings for the month so far as Systolic/Diastolic and Pulse:

116/74 48
117/76 51
119/75 53
127/84 50 Upset stomach this morning
108/67 63
124/71 58 Busy; have to prep for holiday party
121/75 55
106/76 63
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Old 12-08-2009, 01:17 PM   #5
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I read, recently, that blood pressure goes up in cold weather. I don't remember the reason.
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Old 12-08-2009, 01:50 PM   #6
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I read, recently, that blood pressure goes up in cold weather. I don't remember the reason.
Do you have a link to that article? It's been a pet theory of mine for years to match my observations that my readings are generally higher in winter than summer; also if I sit in the nice warm greenhouse car on a cold sunny day, my pressures are lower than in the cold house. My theory was that the blood vessels constrict and increase pressure. Must be heretical thoughts tho....none of my doctors has bought in to the idea.
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Old 12-08-2009, 02:43 PM   #7
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My question is this: does your blood pressure change that much depending on the situation? And THAT much?
Yes!

When it happens in the Dr's office, it's called "white coat syndrome".

My husband and I both have problems with it occasionally.

And yes, they are often bad about rushing you in the Dr's office and sitting w/o back support to take the reading.

We have a Omron blood pressure monitor at home - digital read out, easy to use. So we are able to monitor our own and the readings are always below the 120/80 limits. A few years ago DH took it to the Dr's office to compare readings and they were the same.

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Old 12-08-2009, 03:50 PM   #8
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Article said that pressure rises about 5 mil for each 25 deg. drop in temp. That does not seem like a lot to me. It also said rise was higher for folks over 80. It quoted a French study of 8,801 people published in the Archives of Internal Medicine.

Not much info there, but it was a short blurb in a sidebar.
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Old 12-08-2009, 04:01 PM   #9
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Interesting. I don't keep track of my BP routinely but one of the nurses in my office took mine today and it was unusually high for me...130/80(L). I have a sore right upper arm; don't know the cause but it has been griping for a while... and was stressed dealing with an issue in my caseload, so maybe that is it. Anyway, I scheduled a physical with my PCP in a week. I haven't had fasting blood work in about 10 years. Heart disease runs on the paternal side and my sister in CA(age 61) told me Sunday she is having a cardiac catheterization on the 29th due to failing a stress test. Geez. We are getting old!
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Old 12-08-2009, 04:51 PM   #10
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Thank you for that information, folks! I didn't realize it went up and down so much so fast depending on SO MANY factors. I had no idea.
Usually I have low normal blood pressure so this 130/80 reading freaked me out the TWO times I had it. Never ever had anything like that before, so I wondered what was going on.
Now I realize it's just cause I'm so chicken and get nervous, had drank some strong Starbucks coffee before and no! I did not have a good sitting position when they took it (they didn't care).
I'd really get neurotic about this if high blood pressure or cardiac problems ran in my family, but it doesn't. I'm just chicken sh*t, and I admit it...cluck, cluck, cluck.
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Old 12-08-2009, 04:55 PM   #11
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Many people have "labile" blood pressure. Any of the various stressors above can contribute to it. Problem is, even labile hypertension is a risk factor in proportion to how high it goes. Not as risky as sustained high blood pressure, but riskier than always-normal blood pressure.

I use home monitoring under a variety of conditions, presence of other risk factors, and lifestyle issues to decide when labile hypertension should be treated. And importantly, the evidence of benefit from treating labile cases is not strong. Probably best looked at as a precursor to sustained high BP down the road.

Lifestyle helps, as usually is the case.
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Old 12-08-2009, 05:15 PM   #12
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Never had this moving all around with the bp ever. BUT am dieting and cutting out so much fat as I can AND have upped my exercise, so it should level out like usual I'm hoping. Losing weight will help surely...or I'll definitely look and probably feel better. Watch out Sophia Loren! (har!)
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Old 12-08-2009, 08:10 PM   #13
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White coat syndrome and Saint's games - it doesn't seem to matter if they are ahead.

High blood pressure runs in the ole family tree - so I take meds and check at home often with my cheap made in China unit.

heh heh heh -
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Old 12-08-2009, 08:48 PM   #14
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High blood pressure runs in the lineage of both sides of my family, so I've followed suit with everyone else. My bp has been pretty normal all my life until about a year and a half ago it went goofy....174/114.....176/108....YIKES!!! It freaked me out, 'cause it had always been normal. So I immediately visited the Doc and was put on meds.

He monitored my bp twice a week for about a month, and then it went to once a month, now we're down to once every two months. It's been consistently hanging between 110/68 to 120/70 since about a week after starting the meds....one pill a day before bed.

If I have coffee, or I'm rushing around, or anything like that, my bp is always very slightly higher than it is otherwise. So I always get to the Doc office at 8:30, 1/2 hour before he 'officially' open at 9:00, and sit and visit with the him and the staff for about 15 or 20 minutes before he takes my bp and boots my @ss out the door before the real patients show up.

Yesterday's visit showed 120/70...probably 'cause I had to clear some snow off the cars and driveway before I left home.
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Old 12-08-2009, 08:50 PM   #15
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I think I may have labile hypertension from my own observations, it definitely swings about a fair bit, and stress is a big factor I think. A few weeks back I got a whiff of some chemicals on one of the plants at work so reported to Medical on site where I had my eyes and nostrils flushed, and when my bp was taken it was 148/85 and that really did worry me. That evening when I took it myself it was 130/70. Next morning it was 115/ 70. At my annual physical I was concerned about it and first the nurse took it at the start (106/60, heart rate 46) then later when I told the Doc about my concerns he took it again and it was 110/60, heart rate 39, plus he checked on the treadmill stress test report from the previous year and told me not to worry.

But I still have this nagging concern about it. I'm hoping the drop in stress levels after retiring will help as most other factors are about as good as I can get them. I even gave up my glass of wine a day for 6 weeks and that didn't make any difference. If I was getting regular consistent high readings I'd go back to the doc.
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Old 12-09-2009, 06:33 AM   #16
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The clinic DID ask me if I was under any kind of stress, and seeing that I am here with my mother who appears to be going into the dying phase...yes I am. Maybe that's doing the labile bp to me? It IS very stressful, and I insist on going to the pool while she sleeps to work out every other day otherwise I'm a bundle of nerves I found.
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Old 12-09-2009, 10:16 AM   #17
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Originally Posted by M Paquette View Post
...

Between the rush-rush, nervousness at being in the doctor place, and related factors, your reading could be high some times, and normal others.
And I've also seen mine be really low at the Doctor's office. The nurse said, well, you've been sitting here for a while, relaxed, no food or water - that will lower your BP.

So how do Doc's determine the level of meds? I really need to start tracking myself and use a log book I guess. I have the manual cuff, but I seem to not be very good at measuring myself. Maybe I should get an auto unit. I used the auto unit almost daily at w*rk, it told me I was OK or borderline (taking 20mg Quinapril) - that has likely changed.

-ERD50
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Old 12-09-2009, 10:26 AM   #18
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Yes, it does. I suspect mine is up 20 points from a couple weeks ago because of some issues related to household financial security.
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Old 12-09-2009, 11:22 AM   #19
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And I've also seen mine be really low at the Doctor's office. The nurse said, well, you've been sitting here for a while, relaxed, no food or water - that will lower your BP.

So how do Doc's determine the level of meds?
Good question. You ideally approach it the same way you would any numeric phenomenon that is volatile. If it's way up or way down, no problem -- even with lots of scatter you know what to do. If it's in the middle range, straddling the upper limit for example, I always get numerous samples.

That might involve quick office BP readings (we don't charge for that), or home readings, or even a 24 hour BP monitor deal. Take averages, max, min. Sometimes it is highly situational so the patient keeps a log (mine goes up a bit before dental visits, which I hate for no apparent reason).

Finally you consider how bad a patient's other risks are, so you lean toward or away from meds if it's a close call. All in all it's a bit soft but most cases are clear cut.

The reassuring thing is that
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Old 12-09-2009, 11:36 AM   #20
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This is interesting... to see others results...

I have had some mid level and some low... and some very low...

I used to be in the 95/55 to 100/60 range when I was young and fit...

Now it is about 120/80 because I am old and overweight...

I have had it measured as low as 60/35 just after a medical procedure... whenever blood is taken from me, or I start to imagine the worst that can happen while a doctor is doing something, I can feel my blood pressure drop.. and then I drop Once when they were taking blood, the blood actually stopped coming out... I can not give blood for this reason...

I tell the people before they do anything, so they know to be ready... but since I have higher pressure now, I do not think it drops that low anymore and I do not pass out....
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