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Comment by girvo | Hacker News Reader

Okay, so I have some straight up anecdotal evidence done with a real blood pressure cuff by a trained medical professional for a related phenomenon.

I have to get a buprenorphine injection monthly.

As a part of this, they take my blood pressure.

I was talking to the nurse, animatedly about the silly policies our state government has around electric scooters, as she was taking my blood pressure.

She didn't read out both for me, but I initially had "135" as the result.

The nurse got me to take 5 minutes doing a guided (heavy) breathing and relaxation protocol, and sure enough, on running the blood pressure test again, I got "118"

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If you are going to study effects on blood pressure in your own physiology, I very much recommend getting a home device so you can take a lot of measurements. Blood pressure changes constantly for any reason or (as far as I can tell) no reason.

When I take my own measurements, I take five measurements back to back without moving and see bigger swings that you did. I've seen that using three different home devices. I've seen it in clinical settings being measured by many, many professionals. I remember once seeing a thirty point swing between two measurements taken immediately back to back by a nurse. The sheer amount of downright superstitious behavior I've seen in nurses surrounding blood pressure measurements is pretty incredible, too: lots of retaking measurements until the number is what they expect, repositioning, or trying something random like you did. I find it all very reminiscent of the 2 4 6 Puzzle -- a lot more confirmation and explanation than investigation.

I'm not trying to say this sort of thing is statistically invalid at a population level. On the contrary. I'm pretty convinced in my own case that breathing exercises are worth about ten points. But I strongly recommend developing a healthy respect for the sheer variability of the number before drawing strong conclusions from a low number of measurements.

It’s called the “white coat syndrome” — when you’ve just arrived to the hospital to make your appointment, and the nurse/doctor start taking your readings in a high-stress environment, the reading ends up being higher: https://www.mayoclinic.org/diseases-conditions/high-blood-pr...

I actually think this is why fitness devices like the Apple Watch (v8 is supposed to be able to check blood pressure) are great in that high sampling rates probably yield overall more accurate results as outlying deviations can be more easily and methodically sorted out.

Apple Watch 7 doesn’t measure BP. But yeah I get white coat syndrome every visit.

I agree, this is a great trick. I've been using it for almost 20 years and it's kinda funny to use around friends too, if you are playing around with home blood pressure equipment for any reason. Also take off any hats, wear loose-fitting clothing, wear sandals instead of shoes if possible, and uncross your feet if they are crossed.

Also if they are weighing you clothes-on, it's worth some care as well. A lot of doctors offices will happily register that you gained a significant amount of weight without taking into account that you are wearing work boots, jeans, a vest holding your phone, etc. vs. your last appointment in the summer when you were wearing shorts, a T-shirt, and sandals. Your doctor won't see any of this of course, so it's your word vs the EMR.

And finally, a friend tells me that you should always feel out the doctor first before showing them your full noot stack or other health experiments. ;-)

The weight thing never made sense to me. At some point I noticed doctors offices started weighing me on the way in instead of wearing the gown, as you note it's less standardized between readings. Fine whatever, but if that's going to be the case maybe don't needle me over < 5lb shifts in weight? One visit I'm wearing shorts, t-shirt, sandals, and not much else. The next visit its a heavy coat, jeans, and my pockets full of crap. I wonder what the difference was.

IIRC standard protocol is (don't know how closely adhered to) to give the patient a 5 minute resting period before doing a BP reading anyway.

My BP is always high while I'm talking

It might just be the sitting there for 5 minutes, and not so much the protocol. I get my BP checked regularly by my PCP's nurse. Usually they have me sit for a few mins and then come in to check. It's not uncommon that the first reading is higher than they'd like, and then they tell me to wait there for 5-10 mins and voila when they come back it's much lower.

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