Blood pressure should be measured lying down: study
newsroom.heart.org
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Regardless of whether you're lying down, standing up, or sitting in a chair, it would be beneficial to take more frequent blood pressure readings, throughout the day and during typical routines, than it would to only take them every time you visit the doctor. This seems like common sense, and you can even buy blood pressure sensors for $20 on Amazon, but how many people take their blood pressure on a regular basis? Once you're a diagnosed diabetic, then maybe you start measuring it every day - but wouldn't it be better to start such a habit before you become diabetic? After all, if you're continuously measuring a variable then you can notice patterns and anomalies, and take steps to mitigate them - possibly avoiding becoming diabetic before it's too late.
It seems the limiting factor is sensor technology, which is obviously lacking compared to wearable sensors for tracking heart rate. Any health-conscious person with an Apple Watch or similar wearable device can easily track their pulse throughout the day. But no similarly accurate and seamless sensor exists for measuring blood pressure (as far as I know?), so nobody measures it as frequently as they do their pulse. Once we have the technology to accurately and passively measure blood pressure throughout the day, preventive medicine will become much easier, and people will have a better feeling for how their blood pressure responds to small changes in their environment and lifestyle.
I've been getting much better readings at the doctors but then I realized I always ride my bike there, sit in the waiting room for a while and then get a low reading. Not representative!
The biggest correlation with my blood pressure is how regular my sleep is. Once I started militantly waking and sleeping on a set schedule, the numbers came down. They seem to spike for a few days if my sleep gets messed up badly somehow.
I also have been trying to standardize my measurement: same time of day, after sitting quietly alone for five minutes.
This is a known thing called White Coat Syndrome
People underestimate how valuable a medical tool the Apple watch already is and how game-changing it can get if they manage to extend the sensor suite - as you say, blood pressure, perhaps also body temperature and glucose level.
Another fun fact from the visit, they did monitor glucose level and one morning they did so directly after waking me up. Which caused the nurse to run to get me an early breakfast as it was very low. Not as if I hadn't known for decades, that I need a slow start and at least a small bite for breakfast to get into gears...
https://www.amazon.com/Amazfit-Fitness-Monitoring-Tracking-R...
Some of the reports it produces are superior to Apple Health (it measures stress, a proprietary overall health score, and I prefer its sleep monitoring analysis).
It’s $39. The 15-25 day battery life claim assumes you disabled most of the functionality.
Insert privacy disclaimer here.
https://my.clevelandclinic.org/health/diagnostics/16330-24-h...
I have worn a holter several times. I had better results than in a doctor's office. It seems to be a classical case of white coat syndrome.
What I learned is that, for me,
-salt intake had zero impact
-coffee had no impact
-stress level had almost no impact
-alcohol had no impact
-exercise / activity levels had no impact
The single and only controllable factor I could find, short of drugs, was that if I was cold my blood pressure spiked significantly. I had much higher BP in the winter than in the summer, and could improve it by wearing layers, gloves, etc.
My body decided to go full ham on blood pressure and it was destroying my kidneys. I would be constantly annoyed by the sound of my own heartbeat doing things like trying to sleep.
Telmisartan + Caduet (which is amolodipine + lipitor) and now my blood pressure averages 100/60. And courtesy of the lipitor my cholesterol and triglycerides dropped 60%, from high to normal. Many thanks to the very brilliant people who work in that field and developed those drugs.
Anyways, thanks for coming to my TED talk on the magic of modern medicine.
I also have been checking my levels a little obsessively, unsuccessfully trying to find ways to drop them. And like you, I noticed that I spike during cold weather. I’m probably particularly sensitive because I have very low body fat.
This has dramatically improved/disappeared under the medication listed above.
If you have symptoms like Raynauds and POTS (note that POTS can be hard to demonstrate, so may be less convincing to a doctor) then Amlodipine or similar may be helpful. If you take it and you feel lightheaded when standing up, or have trouble with exercise or fatigue, you probably don't need it and it isn't good for you.
You may have more consistently high blood pressure rather than transient spikes if you don't have POTS, or if you don't react immediately to cold temperatures. In that case an angiotensin blocker like Telmisartan may help. It can take weeks to become effective, vs Amlodipine should show effects in just a few days.
If you have high blood pressure then just telling your doctor you want Amlodipine or something will probably be enough- convincing insurance will be harder. Amlodipine can be used off-label for Raynauds. If you don't have particularly high blood pressure and haven't systematically tried to exclude causes it will be harder to convince your doctor. They might let you try it for a bit to see if it helps, and the generic isn't too expensive.
There are a lot of different blood pressure medications (like a ridiculous array of options) and I let my doctor decide. There are side effects but I have suffered zero of them, and now that the blood pressure is under control my bloodwork across the board has been improving significantly.
One extra pill to take at night does not make a huge change to my nightly routine of taking all my drugs. So taking one less pill wouldn't be a huge improvement, either.
But the lack of availability and much higher cost of the combined drug means that I don't ever want to do that again.
If the drug is taken with food (when drug absorption is highest), some folks will develop edema in their legs for several hours.
Been on Olmesartan since then and couldn't be happier
After doing a bit of research I got myself a monitor, and sure enough my readings one between 150-170/90ish. I'm also a type 1 diabetic to add to it.
It came and I was sure it was defective because it kept measuring 170+ / 120+, which seemed impossible. A few days later I stopped by a pharmacy with one of the big units, and it read the same thing. So I visited my doctor.
He put me on 5mg of amolodipine and it did very close to nothing. Then it was upped to 10mg and still little benefit. It was the addition of telmisartan that completely changed everything for me. The effect was overwhelming.
It's hard for me to really identify the symptoms because I lived with it, I suspect, for many years. It was my norm. I will say this: at my current blood pressure I constantly feel way more relaxed, physically. Like my body doesn't feel in a constant fight state.
For the record, my blood pressure is not nearly as high, but its typically 140/85 as infrequently measured. I’ve never measured during a migraine, but I will now.
One strange thing: In the past I'd get auras and then not long after an enormous headache. I still occasionally get auras...but then it just resolves and the day goes on normally. Very strange.
Wait what? explain more please.
PT is the one thing so far that I haven't been able to get fixed with the four different high blood pressure medications that I'm currently on.
Potassium relaxes the walls of the blood vessels. It's a counterbalance to sodium.
Doctors will say 3.5 is fine, but there are several studies demonstrating that as you approach 4.5, the risk of cardiac events drop.
Doctors get very tense about potassium supplementation in fear of hyperkalemia.
But the RDA for potassium use to be ~4200mg. I'm guessing most don't remotely approach the new or old RDA.
If you're taking potassium sparing medications, things are further complicated. K levels would have to be checked more often.
I supplement with potassium citrate. My blood pressure has normalized.
I didn't add it as one of my listed items, but I did try supplementing with potassium before starting with medication and for me it wasn't beneficial, though it certainly would be for people with deficiencies.
If someone has a consistently low potassium level, you should see an endocrinologist and get tested for Hyperaldosteronism.
Surplus aldosterone causes the body to retain more salt, which in turn increase blood pressure.
Consistently low potassium, early onset of hypertension, taking three or more BP medications (one of which is a diuretic), all red flags.
Hyperaldosteronism should be pursued.
I had my left adrenal gland taken out to address it.
> Doctors get very tense about potassium supplementation in fear of hyperkalemia.
Supplementing with potassium is not recommended because it's not very effective. 99 mg of potassium citrate gives you only 38 grams of potassium- *you need ~100 pills to get your daily value!* You will see much better results from changing your diet to include more potato (note: 1/4 of the potassium is in the skin), beans, and spinach (although a lot of spinach- 10oz has as much as a large potato). One large potato can give you 900 mg of potassium.
My guess is that it's effective for those that are chronically K deficient, through Hyperaldosteronism or some other condition.
That would still be four large potatoes a day, to hit the original RDA. Every day.
I buy it in powder form to get the high levels needed. https://www.bulksupplements.com/products/potassium-citrate-p...
Agree, the dosing on tablets are ridiculously low.
Eating several large potatoes, bananas, avocados every single day sounds miserable.
Same with nuts and other seeds. Fine, in moderation. Phytic acid literally is a chemical countermeasure to stop animals from eating the next generation of a plant.
Oxalic acid, abundant in spinach, is another fun one.
I've had multiple lithotripsy procedures, thanks to kidney stones.
I wouldn't wish kidney stones on my worst enemy.
>If you're taking potassium sparing medications, things are further complicated. K levels would have to be checked more often.
The middle-aged part for sure, but I don't drink, I'm an ideal weight and have a mid to high level of fitness -- high cholesterol and a super high BP before medication. Sometimes it just be the way it is.
Caduet comes with a list of warnings, primarily courtesy of the Lipitor (atorvastatin) component. Periodic bloodwork is necessary to make sure there isn't liver damage occurring, etc. I've endured zero side effects of any sort, and my bloodwork has been stellar. With a 10/20 caduet (which means 10mg amlodipine / 20mg atorvastatin) my triglycerides fell from 2.63 to 1.06, cholesterol from 6.33 to 3.64, LDL from 4.23 to 2.2.
Was super surprised at the scale of the improvements.
- Coffee increases systolic by 15 mmHg for 6 hours, so does smoking.
- Lisdexamphetamine (I am diagnosed ADHD) decreases BP by 10 mmHg
- Good sleep for 5+ consecutive days decreases BP. One day isn't enough.
- Rebound hypertension when forgetting my BP meds is a thing. +10 mmHg the next day.
- Low carb diet decreases BP steadily after the first week or so, especially if your metabolism is out of whack (understandable due to the deleterious effect of fructose on nitric oxide production)
- Amateur BP readings (wrong time of day, single measurement, not relaxed enough) can add 30 mmHg easily. Readings taken at the GP's office are worthless for this reason. My advice is measure every 3 minutes until your BP measurement stabilises. The correct reading is the lowest. Sometimes you need 15 minutes to reset to baseline.
- Also important is the delta between systolic and diastolic. Mine is around 40 mmHg, if it's higher than that, it's an indicator of a stress peak (bad sleep, bad day, overwhelmed) that usually resolves after a couple days.
Some people will be like me, many others won't, but the real lesson is that there are no hard and fast quick fixes.
I have tracked by BP over 50 kg of weight change, and BP correlates really nicely with fitness level, stress, etc. even though trends are visible over months, not hours.
There certainly are no quick fixes, apart from taking a BP pill (I take telmisartan+amlodipine, the latter replacing a diuretic that made me drier than the Sahara desert)
I started donating blood -- some report it as beneficial to BP -- and the effect was extremely short lived for me and very minimal regardless. I still donate blood regularly now as I'm an O- and they remind me constantly.
People are different. Someone who has mild hypertension probably can tweak some lifestyle dials and control it. I had severe hypertension with nothing to point the finger at (e.g. obesity, lifestyle, etc). For whatever reason my body was malfunctioning and in a recursive death loop of escalating hypertension.
Have a look at the effect of fructose on blood pressure. Low carb seems to work well for me, but I'm not consistent enough to see my BP trend down to the point I can throw my pills away. I'm working on it.
And yeah, the entire salt scare is pretty much nonsense that's slowly being debunked. I have a friend who eats more salt than a goat, and he's got hypotension. Go figure. Hyponatremia is not fun, I tend to use salt liberally these days.
You could of course argue that if he ate a ton of salt, his blood pressure would surge. But I wish he would've taken the surgery sooner rather than trying to out-diet and out-exercise his genetics as the diet/exercise had really small effect.
My favorite example of this is from figure 2g of [0]. It shows the time series of blood glucose levels from two participants after eating a cookie or a banana, and they have nearly the opposite responses to each other. It was the thing that convinced me that a ton of modern nutrition that isn’t personalized is basically useless.
Maybe I am misunderstanding, or there is something wrong with my own knowledge, but "30 mmHg" added to systolic seems extremely high.
I am currently an EMT-B student here in the United States, and taking vital signs like blood pressure is our bread and butter. We practice it several times a week, on different people with different body types and different blood pressure baselines. Anything more than ±4 mmHg in a manual reading is terrible accuracy, and anything like +30 mmHg probably comes from someone who doesn't know how to use the equipment.
But again, maybe there is something I am missing. If there is I'd love to be educated and hear about it!
When you're at the GP's office, you might have been rushing to get there, you do a minute of small talk and then they strap on a cuff and tell you "oh my, it's very high", this is the reason. And it happens so often it even has a name: https://en.wikipedia.org/wiki/White_coat_hypertension
I have seen dozen of times, because of effort, anxiety, whatever, my BP being 160/110, which drops to 130/85 after 15+ minutes of complete relaxation. Many amateurs (which apparently includes most GPs) simply do not let the BP settle. The medical value of tracking BP is to know its baseline at rest, otherwise it's a meaningless number.
Just before our wedding, my dad had an crisis, and had to go to the hospital with an infection. He went to Johns Hopkins. They put him in the research wing. The doctors couldn't figure out what the heck to do with him because he was reacting so weird to so many medications. They ended up having to pump him full of vancomycin in hopes that he would last long enough on the three hour flight to get back home where his regular doctor could see him.
People are individuals, and their bodies can react in weird and unexpected ways.
That said, whether I'm oversensitive or more attuned than most ADHD people, I take a light dose, which doesn't turn me into a productive robot machine going 1000 mph.
Stimulants follow a U-curve, and I wouldn't be surprised to know that most people take far too much and have to keep increasing their dosage. A single 30 mg dose makes my anxiety skyrocket, I usually take 20mg twice a day, I've recently experimented with lowering to 15mg twice a day and I think I like it even better.
Vyvanse saved my life.
Omrons are accurate and reliable, and most new models like the Silver have bluetooth and with the Omron connect app will share the data with Apple Health if that's your platform, or you can just keep it in the app and it gives you trends and insights.
Maybe if you did that, you wouldn't disagree so much?
Is this universally true or just you? Is there any source for this? My diastolic pressure is always in the normal numbers while my systolic pressure is borderline high, resulting in a pretty high delta (50-60 mmHg). Sometimes I also get numbers in the normal range for systolic pressure, but maybe 75% of the time it's a bit high.
The root cause was that I moved to a 2000’ higher elevation, and was dehydrated.
Since winter air is lower humidity, I suggest you drink two extra pints of water per day, spread across three-four sittings.
Will it work? Probably not. But, I’d give it an over 10% chance, and it will cost you nothing.
If my blood pressure is low before hand, the nurses get me to drink two jugs of water, blood pressure goes up to normal range with in minutes. Same before they let me drive home.
This has turned out to be a really useful tip for me life in general. If I'm feeling shit, I now suspect low blood pressure and force myself to drink two or three pints of water. It usually results in me feeling much better
Blood letting - wow!
> Haemochromatosis
Haemochromatosis is an inherited condition where iron levels in the body slowly build up
I just want to speak against a trend people have to dismiss bad medical news by finding excuses. "The blood pressure reading doesn't count because I was nervous in the doctors office"; it's true, but the guidelines have probably accounted for that. "That medical study doesn't apply to me because it was done on the general population, but the general population is overweight and I'm not"; "that study doesn't apply to me because I do yoga, they didn't study people who do yoga"; etc.
I know it's hard, I'm in the middle of excusing some bad medical news of my own right now, trying to decide what's best for me.
Medicines have risks, untreated conditions have risks, choose your risk, but don't live in denial that the risk exists.
I know very much about the issue because I had kidney failure due to an autoimmune disease and had to deal with years of dialysis and just recently got a kidney transplant. High blood pressure is a very common issue in kidney failure and even that with the right combination of medications it was mostly manageable.
Its much hard to get life insurance after kidney disease. The best shot is through an employer group life insurance plan. And with my last employer I was able to covert it to an individual plan after I left.
They have not. The guidelines are against controlled studies with strict protocols on how to take the measurement.
To know your blood pressure relative to the guidelines, you want to be as close to the guideline protocols and possible. That can be a 20/10 point difference or more.
The average physicians office doesn’t follow those protocols unless you deviate significantly. e.g you walk in with 140/90 and they aren’t going to bother. 160/95 and they will recheck you with more care given to the proper measurement technique.
This isn’t to say one should dismiss the numbers when taken properly; I’m just pointing out that calibration is necessary.
I think this might be an example of what I was talking about: you think blood pressure guidelines might not apply to you because of something your watch says.
[1] https://my.clevelandclinic.org/health/diseases/23989-white-c....
On average, men are taller than women. That doesn't mean every man is taller than every woman. If a woman is taller than a man and says she needs specific treatment because of it, she may be 100% right.
After this experience I did some reading and as far as I can tell, blood pressure is the least consistent, least rigorous test you can do in mainstream medicine. The “normal” range spans ~10mmHg and yet readings can vary by 10-20mmHg according to each of: stress level, standing up in the last 15 mins, recently having a drink of water (as you do in a doctor’s waiting room), whether your legs are crossed, etc. Without controlling for all of these (which is almost never done properly) they might as well be reading your tea leaves.
Personally I definitely have some degree of "white coat" syndrome, doctors offices just put me on edge for whatever reason. Several years ago as a healthy 30 year old at a routine office visit, the doctor found my blood pressure to be right on the upper bound of normal. She didn't immediately take any action on it, she just told me to stop by a local pharmacy and use their automatic machine a few times over the following weeks, and to enter the numbers in her organization's medical chart app. I did, it was normal, she sent me an email "thanks, looks good!". Case closed.
My Withings BPM Connect takes 3 measurements automatically at intervals and takes the average of those + saves them to Apple Health.
Before I was taking my BP when I was feeling "weird" and of course it was through the roof, by taking it in the mornings my BP is still a bit high, but not Hypertension Level 2 high.
I am not nervous when they measure my blood pressure, but I might have been late to my doctors appointment, so of my 25 min walk to the doctor, I was running half of it. I had non-optimal blood pressure values at the doctor, because I was running not to miss the appointment, and as I arrived, I had to immediately go get my BP checked.
After the incident, I religiously measured my BP at home various times a day for a week and my numbers looked okay.
After being diagnosed with elevated BP, I googled and read what I could and concluded: 1) Cheap "BP monitors" on Amazon just show random readings or the same readings so they are worse than useless: someone may actually use them and believe their readings. 2) There are only few smart watches that have BP measuring function.
I am currently using Samsung Watch Active2, and it seems to do the job. There is calibration that is good for 30 days only. After 30 days it expires and I calibrate it again. Calibration involves making 3 measurements in parallel, watch on one hand and manual BP monitor on the other. After each measurement on the manual BP monitor, I tell the watch App what was measured.
After each calibration I do another 3 measurements in parallel, again using both the watch and the manual monitor. I compare the watch (post calibration) readings with the manual BP readings. Usually the difference is small within few percent. If it is more than 8-10% I redo the calibration. This has happened 2 times in the 25 odd calibrations I have done. Usually the reason is noise instead of perfect silence (person coming in the room and talking, TV being turned on).
I have tried using the watch on Person2 after being calibrated on Person1 - and Person2 got crazy BP readings. So the calibration really does something, it is not nothing.
The watch measurements also approximately agreed with measurements taken over 24h period when I wore BP holter (automated BP cuff that inflates every 30 mins and measures and records the BP).
Over time I have become more lazy with the re/calibration: now several days pass before I re/do it. So I'm acutely aware that any non-100% automated data collection will eventually be abandoned on long enough time horizon. Redoing the same is boring and becomes more so with time.
This is a healthcare issue specific to your country. It is not a problem of "not enough measurements".
Regarding using tech like smartwatches for blood pressure measurement, it is currently not possible. They aren't measuring your blood pressure, they are simply correlating optical data like pulse transit time with your blood pressure, which is mostly inaccurate. If you have to calibrate every now and then using actual bp measurements, then you already have enough data and don't need your smartwatch.
It's surprisingly tricky. The way a BP cuff works (the auscultatory method[1]) is that the pressure is continuously decreased and you listen for the sound of a pulse. When the cuff pressure is higher than your systolic (peak) pulse, bloodflow is blocked and you don't hear a pulse. When the cuff pressure is lower than your diastolic, the cuff is no longer blocking bloodflow at all, and the pulse suddenly becomes much quieter because it's not restricted. It's only between the two pressures that you hear it extra clearly.
So the problem with a sensor is that you can't just measure pressure against the skin. At minimum, it really should actually impede a large artery. You can squeeze the arm as tight as you like but if the brachial artery is not affected then your measurement will be very poor.
You can do fancy computer vision etc to look at special veins/arteries, and coupled with some demographic assumptions you can infer somewhat accurate measurements- but they really miss out on outliers, which is really a lot of the point of taking measurements. This also generally will require an upper arm strap or something, and be fairly tight. Not great to wear always
At some point, I think we will probably see implantable blood pressure monitoring. We do something similar with implantable glucose monitors- which need regular replacement, unfortunately. BP probably wouldn't. Problem is that direct pressure measurement is usually done by tapping off an artery- something that will never be routine. You'd want to do some combination of acoustic and pressure measurement, and it'd need to be calibrated from a base station regularly.
[1]: https://en.wikipedia.org/wiki/Blood_pressure_measurement#/me...
The technology already exists and is approved by the EU.
1. Since they can't measure blood flow, only volume, they can't tell if your BP is low or if they just aren't centered on an artery. They can't measure diastolic, only the difference between systolic and diastolic.
2. Since they don't know the flow, they can't even guess the size of the artery, so they're basically just guessing how much it should be expanding. They also have to know how tall you are to even get close.
3. They measure the derivative of the increase in volume to try to correlate that with blood pressure. That's very variable with the specific artery and the condition of the artery- there's a lot of (primarily age) variance in artery elasticity.
Papers indicating accuracy should be subject to high scrutiny. The device basically starts out by guessing that you're healthy and normal for your age and height. If you take a bunch of people that are healthy for their age and height (most people), the device will perform very well. It will also be practically useless.
If you have ideopathic large swings in blood pressure, like POTS, or fainting, or migraines, a device like this can give you a bit of warning. It will not give you accurate readings or track long-term changes, and those issues are made much worse because of opaque calibrations etc.
It looks very promising and it is clinically approved.
Your theory craft seems to check out, but they could have proprietary technology that Huawei is yet to clone/rip-off, so it's not a well-known methodology. Funnily enough, they actually tested some of their algorithms in China based on their papers, so maybe it is just a matter of time.
That being said, if you have industry inside knowledge, that's a little different.
Exactly what regulation do you think applies to this device? Do you think it's an approved medical device?
I'm not trying to embarass you, I was just genuinely curious if you had any special knowledge.
(I'm not a medical professional nor do I know much about sensing, or even really the basics of how blood pressure is measured or what it indicates.)
It would be, if the most reliable way to get BP data wasn't to apparently violently compress the upper arm until it physically hurts and leave it like that for a minute. How people can do that on any kind of regular basis completely escapes me, and I'm not convinced it's not actively harmful. The wrist monitors are tolerable but seem to be very sensitive to wrist height.
No blood test over the next decade showed even a hint of elevated blood sugar.
It also does nice things like a detailed check of my sleep, how I'm acclimatizing to altitude when visiting the mountains, the number of steps I walked and pulse-ox.
I don't know how these correlate to what blood pressure tells you, but I blood pressure will be directly measured in the same way in a few years.
https://omronhealthcare.com/blood-pressure/
Even these, though, tend to overestimate your actual blood pressure, sometimes by as much as 10 points.
But having one in the home makes it easy to take several readings throughout the day, since each one hardly lasts a minute.
How? Do we have any idea what we would do with that data? AFAIK, all treatments we currently have aren’t suited for treating short-duration spikes in blood pressure (do they even need treatment? I wouldn’t know).
Also, why would we need preventive medicine for most people with hypertension? https://en.wikipedia.org/wiki/Hypertension#Prevention:
“The 2004 British Hypertension Society guidelines proposed lifestyle changes consistent with those outlined by the US National High BP Education Program in 2002 for the primary prevention of hypertension:
- maintain normal body weight for adults (e.g. body mass index 20–25 kg/m2)
- reduce dietary sodium intake to <100 mmol/ day (<6 g of sodium chloride or <2.4 g of sodium per day)
- engage in regular aerobic physical activity such as brisk walking (≥30 min per day, most days of the week)
- limit alcohol consumption to no more than 3 units/day in men and no more than 2 units/day in women
- consume a diet rich in fruit and vegetables (e.g. at least five portions per day);
- Stress reduction”
Gets rid of most of my white coat hyper tension
At least in the United States, you'll get your pulse, blood pressure, and iron levels all checked. Additionally, your blood will be tested for some infectious diseases like HIV.
Lots of free testing, and you also get to help someone out!
>right after you've driven to the appointment, made your way through the intake pipeline, and finally sat down in the chair, is not representative of its reading during a typical day in your life.
So? It is taught pretty early in med school that before measuring the vitals, you should let the patient rest while you take their story, and ask questions related to things that might change the measurements (did you walk here? did you walk up the stairs? did you drink coffee? did you smoke etc.). And if you still want more measurements throughout the day for various reasons, you can just use holter.
>all combine to make blood pressure a fairly variable statistic with limited diagnostic power when it's only measured infrequently.
[citation needed]
If you are hypertensive, non of the things you've mentioned will matter. Your blood pressure will be high regardless, and it will still be caught. In addition, you can't just diagnose with a single reading anyways.
It is funny to read comments regarding medicine on HN.
With 70% of the population being overweight or obese and on a dog shit diet I very much doubt that.
We already know what we do is bad, we know how to fix it, virtually no one does it. If people can't be arsed to even walk 30 min a day I don't think they'll care about continuously monitoring their blood pressure. You can track your pulse continuously with ultra cheap gadgets and it'll tell 50%+ of the population their heart is in bad shape, nobody cares
The best preventative medicine is your lifestyle, if you wait for symptoms you already failed your body and are 10+ years late to the party
[^1]: https://newsroom.heart.org/news/high-blood-pressure-while-ly...
Submitters: "Please submit the original source. If a post reports on something found on another site, submit the latter." - https://news.ycombinator.com/newsguidelines.html
I decided to work on it and see if I can "fix it naturally". I did 2 main things : first one was extremely easy (for me), I dropped more than 29kgs (approx 60lbs) which was 34% of my body weight over more than 15 years (techinally the first 20 kg was pretty quick, last 9 kg took a few years and experimenting with food and eating habits). Secondly, I started practising meditation. That's a hard one, takes me a lot of effort but I'm doing it quite consistently now.
Anyway, I barely check my blood pressure now and last I checked it was 118/75. I can't emphasize how important it is to eat well and live a stress free life to keep your heart healthy. Of course it worked for me because mine was just borderline high (on the best days it used to be 135/85), it won't work if you have severe hypertension but there's no harm in trying, it will definitely drop a few points on the meter and your heart will thank you.
Most people though, even being technically capable of similar feats, are not in a position to do so, because of the time and attention expenditures required. Rebuilding large chunks of your life to accommodate for a new lifestyle is the harder the more other people depend on you. Keeping your resolution for many years also.becomes harder.
I'm not sure of your circumstances. I'm pretty lucky being young, single, and having no kids, so maybe I could manage a similar feat in your position.
I don't think it's the norm, though, which maybe is why medication is the default.
Why not? Serious question not an attack.
Outside of catatonic states and so on what would make those things impossible?
Caloric deficit is the only way to lose weight. If you hear someone say, “No! You need to exercise and reduce calories!” That’s just burning the candle from both ends - increasing caloric requirements and decreasing caloric intake (e.g. caloric deficit). There are good reasons to do exercise, but it’s not strictly required for weight loss.
(Consult a medical professional before beginning any weight loss routine, etc., etc.)
You don't have a bad habit you need to "just" stop doing?
Everybody's got a monkey or two on their back.
It certainly takes willpower and it sucks for several weeks while the body adjusts, and when a treat sounds really good (come on, you earned it!). It takes breaking snacking habits and requires social trade offs. It’s completely unmotivating to weigh more when the previous day was hard to stick with the plan. Plain popcorn can’t compare to movie theater butter flavored topping.
For me, in the past, it has been that food is a comfort that I seek when I'm stressed/bored/anxious. Weight loss is just CICO, but the solution is not always as simple as the equation.
Question: what kind of meditation has helped you the most?
That said, what works for me is : I have been a gym rat for many years now, I never skip my gym and I am there 6 days a week. I recognized that the only way I can stick to meditation is by including it in my gym routine. So I always do my meditation after working out. Minimum 10 minutes and on good days 20 to 30 minutes. But I never leave the gym without doing it.
I try different meditation on different days. Some days I do simple focus on breathing type meditation, other days I imagine myself circling some random star/planet and focus on it, then sometimes I just imagine waves coming in going out (I try to think of waves as thoughts that pop in and out from my mind), I have also tried chanting meditation - that can be extremely useful in the beginning - I don't do it much though. Finally on days when I have my headphones with me I also try guided meditation (generally I prefer Sam Harris or someone like him who guides through as a non-religious practice).
I really think the key is to try a few styles and experiment with them. I won't trust all the "self-proclaimed experts" who say "this is the only way", just find one that you can relate to and understand the basics of it and come up with your own style - meditation is an art and not a science. I would also recommend that you include it in your routine that you never break (it could be as simple as saying I will meditate before I brush my teeth assuming you brush your teeth everyday :-)). Some days are better others not so much. On some days, the thoughts just keep popping in and out, and other days I feel in a zen mode.
It is incredibly powerful practice, the biggest improvement I noticed is that you become aware of your emotions before they take control of you. For instance, I am short tempered, (and although I am still working on it) these days I notice right before when I am going to loose it and then I think of my "zen state" and suddenly the anger can't take control of me. It is almost like magic.
All the best in your journey :).
Similar thing with my petite old grandma. Always measured high if an unknown person did it because they would overinflate. But when someone would just put it 20 over her previous known good reading, then her blood pressure was fine.
But nobody cares. In, out, get paid.
Try measuring my BP while pinching me, don't be surprised what you get.
When I went to the medical exams to get my drivingllicense one year ago I was told my blood pressure was a bit high - maybe due to the nervousness of being checked, but it was better to ask my doctor - both of my parents suffer from high blood pressure.
So I did. He told me my blood pressure was high and gave me that famous table to fill up with daily readings for two weeks.
My sister (physiotherapist) has a sphygmomanometer at home but she will scream at me to be perfectly still and seated for at least 5 minutes before doing the reading - and it _always_ was 120/80.
Went several days to a nearby pharmacy and they gave me a little chair to be sat for 10 minutes before standing up and going to a small cubicle where they did the measurement with an electronic sphygmomanometer. Measurements there always were fairly inconsistent and above 131/87 - going up to 150/87.
Also went to several other points to get my blood pressure measured and they always had a different method and (unsurprisingly) yielded different results. But for some reason when they measured with analogic/traditional sphygmomanometers, the measurements always were lower compared with electronic ones.
Fortunately could afford a decent electronic sphygmomanometer for myself and started doing my own measurements, which are fluctuating between 117/77 and 122/82.
BP level seems to highly correlate with the environment you're in, stressful driving can bring it up and keep it high for a while.
Instead, using a sphygmomanometer is much more likely to give accurate results.
Anecdotally, I always have a super weird initial blood pressure reading when I go to the doctor and they use the electric machine (one time it was 112/95), but when it is rechecked with a sphygmomanometer it tends to level out at somewhere around 130/85.
You will probably find that your blood pressure varies more over a 10 minute window than the difference in readings between the two meters.
[1] Oscillometric vs. Auscultatory, JFYI:
I redid the measurements after reading the manual, sitting straight up, feet on ground, measuring at heart level, etc. Suddenly I got 100/110 over 80/85, and while that wasn't ideal, it obviously calmed me down a good bit.
“Our findings suggest people with known risk factors for heart disease and stroke may benefit from having their blood pressure checked while lying flat on their backs ... Efforts to manage blood pressure during daily life may help lower blood pressure while sleeping. Future research should compare supine blood pressure measurements in the clinic with overnight measurements.[emphases mine]”
How to Lower Blood Pressure Naturally with Lifestyle Changes
https://www.youtube.com/watch?v=fZc5Is98yDc
Healthiest Foods for Your Heart | Dr. Neal Barnard
https://www.uclahealth.org/news/why-you-should-have-your-blo...
Salt has zero effect for me, I ate ~15g + salt and it had zero effect on blood sugar.
Carbs though...oh boy.. It may take a month or two for the change to become noticable.
Doctors never test me lying flat. Closest I've gotten is laying at an angle in a hospital bed.
I'm a middle-aged heavyset guy as well, so I know I'm at greater risk for these things.
This seems pretty normal in Norway - but I don't think it was in the US (Am from the US, father had heart problems). Perhaps your doctor would be able to do something similar, though.
I've also fainted during a blood draw. I wish I wasn't this guy... but alas. I am begrudgingly this guy.
Also I've fainted, or almost fainted, in an array of circumstances related to needles. My experiences range from moderately humorous to dangerous (I fainted after my first COVID shot at the wheel of my car...thankfully I knew it was coming and put it in park just in time).
Don't feel too bad about being "that guy" — while the experience is incredibly personally uncomfortable, it's actually fairly common. I've just resorted to always having someone with me who knows what may happen and informing all the people involved about my history. Not fun, but it keeps me safe.
What could help (or could have no effect) is taking the blood pressure with the electronic device. There nobody could be next to you (entrap you) and you would have a complete control over the strap - you could take it off any time you felt uncomfortable if you just wanted to.
I have an electronic meter at home and I use it time to time to check my pressure. I can be much more relaxed and I indeed usually lay down first.
I do wonder about recent changes that suggest anything beyond 120 / 80 is above 'normal'. You would think that something like blood pressure would be highly regulated in the body but it varies throughout the day, month and year.
They also say that salt is seriously bad for high blood pressure but I find little effect for myself personally. I do wonder how much sensitivity varies from person to person.
You’d be shocked at how much salt some people consume. A little bit with your vegetables or steak isn’t going to move the needle, but some processed foods have unbelievable amounts of sodium relative to how they taste.
Salt definitely impacts blood pressure. Salt supplements are used with good effect in certain conditions of low blood pressure/volume.
That healthy prepackaged salad option at the grocery store? Often has more salt than a burger!
We've discovered that humans respond really well to a particular mixture of sugar, fat and salt. Basically every prepared food has about the same mix of those three. That mix is lethal for me.
In the case of salads they do that by using the veggies as a salad dressing delivery mechanism. If I can't add the oil and vinegar myself, I can't eat the salad.
https://news.ycombinator.com/item?id=37355083
Sodium isn't the problem
Yeah, and that's what makes salt increase your bp. More salt in blood = more water retention = more volume = higher bp.
I'm at the extreme end of sensitivity. If I want my blood pressure medications to work, I need to eat something like half the recommended daily allowance of salt. Let's just say, eating out is a challenge.
I either prepare my snacks, or just have fresh fruits and vegetables.
yep. I've taken my BP laying down and it's generally lower than when I'm sitting up, but then again, I usually do that after going to bed, blood pressure is generally going to be lower at night so maybe I'm just noticing that difference vs during the day.
https://www.heart.org/en/health-topics/high-blood-pressure/u...
The highest you can be and be considered "normal" is 119/79.
Elevated is 120-129/<80
Stage 1 hypertension is 130-139/80-89
Stage 2 hypertension is 140+/90+
And why is it different? Are the studies that shaped the recommendations in the US no good?
In the US they continue to revise numbers down to prescribe more medication and every doctor just kind of gets in line with this. Rarely do US doctors even attempt to find the cause of elevated BP, they just recommend medication immediately. BP medication is typically a lifelong thing. It's so effective that once you start it becomes difficult to get off of it safely. You kind of "grow with" the medication and risk a heart attack if you stop.
In the US it's all about money. The goal was to revise numbers down low enough so that almost all of the population over 30 qualifies as needing medication. The earlier you can get someone on BP meds the longer the average lifetime revenue. The target is 35+ years. It's basically a monthly recurring subscription to live.
Counterpoint: a 6' (1.83 m) tall column of blood has a pressure of 142 mmHg at the bottom- higher than your normal blood pressure. When you change posture from prone to sitting to standing, your blood pressure is basically swinging 100%. Hell, the diastolic blood pressure at your feet is almost double what your arms are at.
Plus, the oxygen consumption of various body parts is hugely variable. More oxygen requires more blood and more blood requires more pressure. With that kind of variance all over your body it's not a shock that it's also generally pretty variable.
Human body is a combination of multiple very complex systems. These are so complex that you can't even begin to grasp the complexity without diving pretty deep. Majority of non-MDs (especially non-MD health workers like nurses ironically - Dunning Kruger maybe?) heavily underestimate the knowledge required to graduate medical school.
This complexity of human body brings with it lots of tiny nuances. So much and so tiny that even specialists with decades of experience can miss them. Add to this the mechanisms we still don't completely understand, you get the perfect recipe for "dangerous bad advice from non-medical professionals".
Some of the misinformation is a direct health hazard, like claiming "your body can get rid of what it doesn't need so your salt intake is not an issue". Some of them aren't directly harmful to your health but damages the healthcare, either by breaking the trust like "blood pressure measurement during visits is incorrect and leads to misdiagnosis", or by putting extra pressure to spend healthcare resources unnecessarily like "measuring your bp during the day is useful".
If you want to do any further reading on any of these problems I mentioned, especially the last one which is hard to grasp and counterintuitive, I can link you some resources.
Edit: by MD I mean also DO for Americans.