Blood pressure question

[deluz]

Originally Posted by reuben

So what's a reasonably accurate monitor that won't break the bank? Or does such a thing not exist? I used to see them in grocery stores, but haven't noticed any lately.

I just recently got an Omron BP5350 ($78). It replaced another Omron unit we had for many years but started to act erratic. I like that it has bluetooth to send the readings to an app on my Iphone. That way I can easily show it to my doctor.

[Ozz]

Originally Posted by ridethecliche

White coat hypertension

+1

My BP is always higher in the doctors office....

get a bp monitor for home, take reading throughout the day...Omron Silver ($50 on amazon) is a good one and connects to bluetooth app on phone. Tracks everything automatically....print out and bring to doctor appts.

[OtayBW]

[Nerd] I'd rather have long-term averages than multiple daily readings - one reading per day at most. I have a pretty good automatic unit, but I also have a manual sphygmomanometer with stethoscope, which I consider to be the gold standard. Anyway, when I take a reading, I sit intentionally still for a few moments, with feet flat on the floor, and then do it. I plot systolic, diastolic, and HR and calculate long term averages (and std. dev/CV). The data is fairly consistent with no crazy spikes that someone could freak out over. The doc seems to be pretty happy with that...[/Nerd]

[jlwdm]

I have an Omron BP5450 which I don’t use too often. But when I do I follow the protocols:

Avoid bathing, drinking alcohol or caffeine, smoking, exercising and eating for 30 minutes before taking a measurement.

Rest for at least 5 minutes before taking a measurement.

Sit quietly with your legs uncrossed and your feet flat on the floor.

Plus:
Cuff at same level as heart.
Back and arm supported.


Jeff

[jimbolina]

This.

[unterhausen]

I was going to mention white coat syndrome, which I definitely have. I thought it might not apply to the OP, because he wasn't worried when he had it measured. This probably will change now that a problem has been identified.

Otoh, doctors have horrible technique usually, ignoring best practice. I have been sick for the last 10 days and finally went in to see a doctor. My bp was high, and I realized it was measured totally incorrectly. We did it again and it dropped 15mmhg. That's a big drop. And I still didn't have my arm at the right height, so it was still a little high. Although my bp does tend to go up when I can't breathe.

I resisted going on meds for the longest time. For one thing, my bp gets much better if I lose weight, and we all know cyclists are going to lose weight. But I couldn't argue with the trend, it just kept going up. So even though I figured a lot of it was white coat syndrome, it definitely made sense to do meds. I think I would have gone on them long ago if I knew what it would be like.

One thing that has really helped my bp is getting my cpap dialed in. Knocked my pb down 10mmhg even though it was resisting the meds I have been taking.

[Ralph]

Just an observation....since I've been thru these phases....In your 60's and early 70's one can have BP that is borderline high sometimes in 140's, and cholesterol borderline high (total slightly over 200 and LDL around 100) and Docs will tell you it's not too bad for your age, etc., and to monitor it closely. Then maybe in a few more years, some will present to ER with unusual chest pain, they will diagnose as an artery clog and install a stent....and immediately put you on blood thinners to avoid a clot at stent site, put you on BP meds to lower your BP, put you on cholesterol lowering drugs to get your LDL under 70 and tell you 50 is even better(some data suggest plaque build up might reverse "some" if LDL is under 50), and suggest you improve your diet, avoid salt, lose any extra weight, and basically suggest a life style change. And perhaps at same time in hospital blood work will show your kidneys have been damaged and they will diagnose with chronic kidney disease (CKD), and also refer you to a nephrologist. One day merrily going thru life thinking all is well, and in hospital you get this big wake up call. One day LDL at 100 OK, next day gotta be aiming at 50. That seems to me to be how the medical system works for us. If you can survive the first cardiac event, they will fix you up...although your life is forever changed. Looking back....wish I had recognized these warning signs years ago. But no one seemed really that concerned about my numbers. I guess my point is make sure you can survive that first cardiac event, they will fix you up, and you can still ride, although maybe not with same intensity as before. My CKD damage is mild, but nephrologist doesn't want me to ride long enough in hot weather to get dehydrated....that's hard on kidneys. He has suggested 100 miles a week, spread over 3-4 days, is more than enough for good health. I suggest one starts working on their numbers now, why wait?

[buddybikes]

One thing about white coat syndrome, a long ago respected diabetes doc of mine said white coat is really not an excuse because if you are in other situations regularly (meeting, dealing with kids etc) bp is probably up. He treated, I have had diabetes for 58 years, with no kidney disease or heart issues.

Of course exercise through all my years is also been great

[Ralph]

Mosp people in your situation would have some sign of kidney function decline I think. You’re doing something right.

[unterhausen]

Get a validated device
https://www.ama-assn.org/delivering-...-devices-grows

[thwart]

Originally Posted by Ralph

Just an observation....since I've been thru these phases....In your 60's and early 70's one can have BP that is borderline high sometimes in 140's, and cholesterol borderline high (total slightly over 200 and LDL around 100) and Docs will tell you it's not too bad for your age, etc., and to monitor it closely. Then maybe in a few more years, some will present to ER with unusual chest pain, they will diagnose as an artery clog and install a stent....and immediately put you on blood thinners to avoid a clot at stent site, put you on BP meds to lower your BP, put you on cholesterol lowering drugs to get your LDL under 70 and tell you 50 is even better(some data suggest plaque build up might reverse "some" if LDL is under 50), and suggest you improve your diet, avoid salt, lose any extra weight, and basically suggest a life style change. And perhaps at same time in hospital blood work will show your kidneys have been damaged and they will diagnose with chronic kidney disease (CKD), and also refer you to a nephrologist. One day merrily going thru life thinking all is well, and in hospital you get this big wake up call. One day LDL at 100 OK, next day gotta be aiming at 50. That seems to me to be how the medical system works for us. If you can survive the first cardiac event, they will fix you up...although your life is forever changed. Looking back....wish I had recognized these warning signs years ago. But no one seemed really that concerned about my numbers. I guess my point is make sure you can survive that first cardiac event, they will fix you up, and you can still ride, although maybe not with same intensity as before. My CKD damage is mild, but nephrologist doesn't want me to ride long enough in hot weather to get dehydrated....that's hard on kidneys. He has suggested 100 miles a week, spread over 3-4 days, is more than enough for good health. I suggest one starts working on their numbers now, why wait?

A good observation.

For medical providers, figuring out exactly who to treat more aggressively for BP and lipid disorders (or pre-diabetes) is an elusive goal. You can look at family history and other risk factors to help make a decision, but…

Almost no one really wants to be on medication if there’s no sign of disease. And few docs want to be seen as a pill pusher. Numbers are just numbers, and as people have outlined above, BP readings can vary significantly. Cholesterol level results can vary as well.

A cardiac CT scan with a high calcium score can convince some to take cholesterol medication and have their blood pressure treated more aggressively… but as outlined in a thread a few months ago this test can, for some, be inaccurate.

Genetic testing may have some promise here.

[Ralph]

My cardiologist says everyone is different, and hi cholesterol for some not as dangerous as for others. And sometimes risk of falling and other side effects from BP meds maybe greater than the risk of slightly higher BP, etc, etc, etc. Lots of opinions.

However...I notice after you have a cardiac event (if you live) and how to avoid another ....advice to everyone seems to be the same. Medical community seems to be in agreement on that.

[bigbill]

I see a GP twice a year. For the two weeks before my visit, I do morning and evening BPs, write them down, and bring the 4x6" card to my appointment. I take BP meds, but only one type and small doses. Two years ago, I was on three different meds before I decided to stop being fat. I lost almost 60#, and the docs reduced my meds.

Bottom line, I trust my doctor; I'm a recovering engineer who loves data; I know what the data means, and if my BP is high on a random check, I'll follow up with a few days to ensure it was an anomaly.