High Blood Pressure After FIRE?

[RetiredGypsy]

Every time I go into the hospital and they hook me up to their blood pressure monitor, it always reads some high combination. This time it was 156/105, then the nurse switched to a manual blood pressure pump thing and it was 130/80. I've had this happen once in the past where the nurse switched from the machine to manual too. Same result. I was surprised at the difference between the two methods.

All you who FIRE'd up, have you noticed that your blood pressure has dropped during your check ups now? Do they hook you up to the machine or do they use the little manual pump?

 

[dumpster56]

Every time I go into the hospital and they hook me up to their blood pressure monitor, it always reads some high combination. This time it was 156/105, then the nurse switched to a manual blood pressure pump thing and it was 130/80. I've had this happen once in the past where the nurse switched from the machine to manual too. Same result. I was surprised at the difference between the two methods.

All you who FIRE'd up, have you noticed that your blood pressure has dropped during your check ups now? Do they hook you up to the machine or do they use the little manual pump?

I would say no work less stress, so in theory you might have lower pressure. BUT, I would get a home BP unit and start taking pressures morning and night and get a look at what is really going on.IF you see high readings its time for weight reduction, exercise or meds. And quite frankly BP meds WORK!! See the doctor sooner than later!

 

[loosehead]

Yes, mine dropped to 117/72 from not too far from your high reading. That's all meds same-same "just" no longer in the workforce. Mine are typically taken manually. I concur with the above, that serial blood pressure readings are important to really zero in on accurate results. You had a significant discrepancy for which I would definitely speak to your physician.

 

[Rich_by_the_Bay]

You're really discussing two separate issues. One is manual v. automated BP readings. Both are accurate and should be comparable if all is done correctly. But BP can vary from minute to minute, so it is hard to know which one is "off."

Things to watch for to see if the human being is doing it by the book: there should be no talking either by you or to you during the procedure. Your mid-upper arm where the stethoscope is should be roughly at heart level (lower breast bone). You should be sitting and not grasping anything. The taker should do so slowly (a big whhooosshhh from top to bottom is bad, but a final whooosshhh at the end when the diastolic reading is complete is OK), and not push down on the stethoscope too hard, just firmly.

Most people who try too hard to relax during a BP test usually accomplish just the opposite. Just sit, observe with casual interest and let the chips fall where they may.

As to BP and stress, it's real and can progress from episodic stress-related elevations from adrenaline and the like, to permanent. Finally, about 10-12% of high blood pressure is related to excess alcohol intake relative to your body's set-point. I always advise a recheck after abstinence for 2 weeks if the reading is borderline.

Sure hear lots of stories about how retirement from a stressful job into a relaxed retirement lowers blood pressure.

 

[RetiredGypsy]

Rich, thank you. that's excellent advice! I need to get back there to discuss this in some detail, now. Nothing like trying to get your point across and not having the vocabulary to do so.

I've heard a lot of stories about BP dropping like a brick after retirement, which really spurred this post. I've heard just as many stories about at-rest heartbeats doing the same. Must be all that exercise you get from not sitting in the office all day. I can't wait.

 

[whitestick]

Obviously Rich is the expert, but I have observed from the patient end, that the mechanical devices often use a standard size cup or sleeve, and that, or other reasons might be a source for the difference. I have had similar experiences as you with lower readings from a human taking time, with a proper cup and technique, then the machines. When I was in the hospital last year recovering from hip replacement, I had similar experiences, and often the nurse after taking a reading from the little roll around robot, would take it herself, because it was so inconsistent with previous readings, and her reading would be significantly lower. Glad they did that as well, because a few times when they did the mechanical thing, they immediately wanted to put me on some BP medicine, and once when I wasn't able to convince them otherwise, they gave me the medicine, and a few hours later, my BP was so low, that they wouldn't let me take the exercise, because they were afraid I would faint. After that, they decided that me and the robot just didn't get along, and they did it my hand. No problems with that. YMMV

 

[oma]

I think our clinic depends too much on the electronic BP monitors/machines. They are fast and convenient, but cause clinical staff to lose their skills on measuring BPs and other vital signs. It makes you wonder when you read that the monitor and manual readings are so far off as gypsy mentioned above.

The correct cuff size is very important. Larger folks need a bigger cuff - obviously. Depending on the quality of the clinic staff, some assistants may no take the time to change the cuff size. The other thing I have the staff do is allow the patient to sit for a few minutes if possible. Since some patients come in for their appt stressed, in a hurry, running late, and in a hurry, their readings will likely be high. It think its a good idea to let them sit/relax for a few mins (up to 10 min if they're visiting just to have a BP reading).

Personally, I think that I suffer from "white coat syndrome" --where just the thought of being in a clinic, awaiting a discussion and examination with a physician (or dentist) causes me to be anxious ----leading to high BP readings. I work in a clinic, and still think that I get this - odd, isn't it?


I've purchased my own home monitor. I paid $50 for it. I believe that higher quality monitors are best - not worth buying a cheap one. You get what you pay for with accuracy, imo. Would also recommend buying one that checks the brachial (upper arm) BP rather than one that checks the radial (wrist) BP.

 

[kaneohe]

I would like to believe that the nurses' readings are the correct ones.....but somehow I had arrived at a different conclusion. My experience over a number of years suggests that BP taken by nurses whether at work or at my medical clinic were always lower than those taken by my doctor or by a variety of machines.....both at work, drugstores, or my personal one at home. Readings taken by nurses were almost always "normal" and readings by my doctor or the machines were mostly elevated to some extent. I am aware of the white coat syndrome but I am very comfortable with my doctor and when I told him about the apparent discrepancy, he would retake the BP after some minutes and usually is able to repeat his readings. I am aware that BP can vary during the day but have taken multiple readings during the day and am convinced (if my home monitor is accurate....it has a cuff that goes around the upper arm) that my BP is elevated to some extent.

Just for fun, I once had the nurse at work try to train me to determine BP using the old way w/ stethoscope. My readings were always low....perhaps because I didn't know what I was listening for and waited too long. Since my readings and the nurses were on the same side (lower) than the doctors and machines and since I was probably the least competent, I made a tentative conclusion that my doctor and machines were probably more correct......perhaps because they led a less harried lifestyle at work than the nurses and could afford to spend more time to measure more accurately.

your experience and conclusions may differ.....and I would love to have the nurses' readings (normal BP) be the correct ones.

 

[Charlotte]

Once when my blood pressure seemed high, the nurse actually went to go switch cuffs and got a smaller cuff. (I'm thin/small-frame and she had a large adult sized cuff.) She said something about larger cuffs giving inaccurate readings on small arms, and that also included the kind you find at the pharmacy where you slip your arm in at the machine and it runs automatically. I had no idea if that could be true?

Charlotte

 

[Rambler]

For me, it doesn't matter if it is the doc or the nurse, the manual method usually turns out a little lower that the machine at the clinic or the drugstore. But, my wrist BP monitor is always about the same as the manual reading.
R

 

[megacorp-firee]

Finally, about 10-12% of high blood pressure is related to excess alcohol intake relative to your body's set-point. I always advise a recheck after abstinence for 2 weeks if the reading is borderline.

uh Rich ..., abstinence for 2 weeks?

 

[megacorp-firee]

My GP found that I have (had) white coat syndrome. When I am in the dr.s office, my blood pressure would read a bit higher than normal. We discovered this when he told me to buy a cuff and calibrate it at his office. I did and then recorded my daily bp. It was much lower than the readings in his office. When I went back with my readings and the cuff so we could make sure it was still calibrated to his, the readings were in the same range.
After I retired, a funny thing happened, ... the readings in the office dropped to normal levels. go figure...

My non scientific study shows that this retirement stuff is good medicine.

 

[Alan]

Rich, thank you. that's excellent advice! I need to get back there to discuss this in some detail, now. Nothing like trying to get your point across and not having the vocabulary to do so.

I've heard a lot of stories about BP dropping like a brick after retirement, which really spurred this post. I've heard just as many stories about at-rest heartbeats doing the same. Must be all that exercise you get from not sitting in the office all day. I can't wait.

Retirement and giving up a sedentary existence often occur simultaneously so I certainly believe the stories about people with high BP suddenly seeing a big improvement. I would also be interested in seeing a study that relates weight loss to retirement.

 

[FreeBird]

Nice thread that everyone should ponder upon... then act. I read somewhere that everyone should keep up with their daily blood pressure after age 50 since a rising pressure is just part of the aging process. I'm 51 and my doctor tells me that I'm so healthy I need only get an "annual" check-up every 18 months, but I still continue to check my BP twice daily because it's just a good way of keeping in touch with my body. I always get higher results in the afternoon and all of the readings can vary so my main concern is to look at the overall more long-term result averages to see if there's an unusual pattern developing.So far, so good and heck... I'm still working a full-time job counseling problemed kids but I have always been a runner/bicycler, eat the right diet, and pray probably too much.

 

[Meadbh]

It's not surprising that the measurements differ.....

Manual measurement of blood pressure involves detecting the onset (systolic) and disappearance (diastole) of pulsatile sounds using the height of a mercury column, and is inherently accurate provided the person doing it is using the appropriate technique. This includes having the mercury column vertical and using a cuff that is 2/3 the length of the upper arm. If the cuff is too small, the blood pressure reading will probably be high. Doing it in a hurry is prone to error and it has been known for a very long time that healthcare professionals tend to round numbers; e.g. they will say 120/80 rather than 121/79.

Oscillometry uses an electronic pressure sensor rather than a stethoscope. It's easier to learn so it's suitable for home monitoring. Here's how it works: When the pressure in the cuff deflates to between systolic and diastolic pressure, there is some blood flow blood flow through the main artery in the arm, and the cuff pressure, which is monitored by the pressure sensor, will increase and decrease (oscillate) with the cyclic expansion and contraction of the artery. The values of systolic and diastolic pressure are not actually measured, but are computed from the data using an algorithm. The algorithm makes certain assumptions that may not always be true. For example, if the person's heartbeat is irregular, or he/she has arterial disease, oscillometric monitors may produce inaccurate readings. Also, the machine must be calibrated regularly. So if the readings are not making sense, double check using the oldfashioned method, and consider sending the machine for service.

 

[Zoocat]

Rich, I need to thank you for mentioning the connection between drinking alcohol and high blood pressure. I'm pretty sure I read it here first. Since then I've been monitoring my BP after cutting out the wine and bingo! Back to normal. Thanks so much for all you do here!

 

[Rich_by_the_Bay]

Rich, I need to thank you for mentioning the connection between drinking alcohol and high blood pressure. I'm pretty sure I read it here first. Since then I've been monitoring my BP after cutting out the wine and bingo! Back to normal. Thanks so much for all you do here!

Always a pleasure. But wait - there's more: you can probably reintroduce wine back into your life a little at a time. You may find that one glass a week does just fine, then maybe two, then three. Sooner or later you'll find your threshold.

Happy experimenting.

 

[JanF]

A lot of the time the clinic "nurse" isn't an actual nurse, I've had a blood pressure taken by an unidentified assistant over a sweater and shirt using a really cheap stethoscope and I don't know how she could have heard anything! In the ICU we use automated BP cuffs on really sick people and they correlate pretty well with invasive arterial blood pressure, which is the gold standard. Also, an easy way to get your blood pressure checked is to donate blood every 8 weeks!

 

[dumpster56]

A real easy way is to get two different automatic pressure cuffs and use them on a daily basis at home. Just read the instructions. I actually have a good stehescope and a real cuff and learned how to listen and take real good readings with the old school way!