What’s your blood pressure? Not in general, but right now, this very minute! Unless you get out your blood pressure monitor and actually measure it as you are reading this article, you won’t have a clue. That is because your blood pressure will vary minute-to-minute and hour-to-hour, not to mention day-to-day! This reader asks an important question about how blood pressure will vary.
Controlling Hypertension: Diet, Drugs & Exercise
Q. Everyone talks about blood pressure as if it were a fixed number. I take mine every morning after breakfast and keep a running daily, 30-day and 90-day average.
If I don’t take it at about the same time every day, the reading will be higher. My running average is 113/65. My heart rate is 55. But during the day, I might get up to 130/70 or maybe a little bit higher. So, the question is, what is my BP? Is it the one early in the day or the one that fluctuates throughout an average day? Arguments or exciting sports push it up even more.
When I was first diagnosed with hypertension a year ago, the reading was 220/110. The doctor put me on amlodipine and olmesartan. I have gradually gotten my pressure down to the current levels with medication, diet and exercise.
A. Thank you for pointing out how activity, emotional state and time of day can change blood pressure readings. Your blood pressure will vary naturally from morning to afternoon to evening. Blood pressure will vary even when you are sleeping. Imagine how your body reacts if you have a nightmare and you find yourself falling. We suspect that if you were to take your blood pressure at that precise moment, it would be elevated.
Exercise can raise blood pressure. So can an argument with a family member. If you see a blue light in your rear view mirror and are pulled over by a policeman, we bet your BP will be high. And if the phone rings at 2:00 in the morning from someone you love, chances are that you will have an immediate spike in blood pressure until you know that everything is OK.
Your blood pressure will vary when you are relaxed. If you are meditating or listening to calm music, you will probably have lower blood pressure than if you are watching an action movie. And watching people argue about politics on television can almost assuredly raise your blood pressure.
The only way to get a sense of your “true” blood pressure is to measure it under a variety of conditions. Over several weeks and months you will be able to get a reasonable sense of how your blood pressure responds to a range of conditions. We suspect that you will discover that your blood pressure will vary from day to day and week to week.
The technique used to take the BP measurement can also affect the reading.
Mistakes When Taking Blood Pressure:
We are constantly amazed to discover how many mistakes health professionals make when measuring blood pressure. Would you like to learn the most common errors? Here is a link:
Seven Mistakes to Avoid When Measuring Blood Pressure!
Do you avoid mistakes when measuring blood pressure? We are constantly amazed at how many technicians incorrectly take blood pressure readings. Here are tips to help you eliminate errors.
Reader Stories:
There were lots of mistakes when Jeanne had her blood pressure measured:
“I had a doctor’s appointment today. It was really frustrating. I monitor my blood pressure at home almost daily and when I follow the guidelines for taking BP, it is fine. Today when I got to the clinic, I got whisked down to a station where I stood for an oxygen test and answered a couple questions. Then I was whisked into a room where I was told to sit on the examining table. I am very short, so I had to use a stool to get on the table.
“There I am–legs dangling, arms down, light blouse on and she takes my blood pressure and says it’s high. No kidding? I have tried to say something in two doctors’ offices about blood pressure measurement and I get this look of you-are-the-patient-I-am-the-one-who-knows-what-I-am-doing look and they go on. I get a comment, ‘your blood pressure is on the high side.’
“Don’t nurses get any training any more? Don’t doctors check on this?I feel like it is rigged. If you have a high BP reading, then you will have to either go on medicine or increase what is already being taken. Then there are falsely high numbers in your medical record.
“When I tell them my BP is often below or around 120/80, I get a ‘yeah right’ look. I know my blood pressure machine is good and it has been checked for accuracy. I just don’t get why clinics are not following the American Heart Association standards for blood pressure readings. It has to be about time/money.”
Lor shared this experience having her BP measured:
“It seems every primary care physician and specialist I’ve seen has med techs who follow the same procedure: You take off shoes and coat for weight, then pick up shoes, coat, and purse from floor and tramp to exam room, sit down and have BP taken immediately while answering questions about history and meds. My husband sees a different set of docs but has the same experience.
“Because I regularly take my BP at home on a calibrated machine, I’m familiar with the 15 – 20 point systolic ‘leap’ under the circumstances described above. So, I refuse measurement until the American Heart Association recommendations are followed. My primary care doc has accommodated to this demand, but other doctors express displeasure.
“Perhaps if more of us started requiring observance of the AHA recommendations, fewer folks would be diagnosed with hypertension.”
Controlling Blood Pressure IS Important!
Our reader has set a good example for everyone on addressing blood pressure through attention to exercise, diet and blood pressure medications. Others who would like to learn more about controlling hypertension may wish to consult our eGuide to Blood Pressure Treatment.
This online resource discusses a range of medicines as well as nondrug approaches to controlling this risk factor. It also describes in detail how to measure BP properly. You will find it in the Health eGuides section of this website.
Please share your own experience with hypertension in the comment section below. How have you managed to get your blood pressure under control?
