Blood pressure question

[NHAero]

I read the thread from last year, very helpful.

A month ago I had a check-up and the Dr. says high BP, want to start you on meds. Numbers were 134/88. This was the first time (I'm 70) I ever heard anything about hbp from a Dr. and usually when a reading was taken it would be 120/80 or lower.

We have a bp gizmo at home so I started using that. Way lower numbers, systolic very uncommon >120. Average over the last 3 days (I leave the cuff on when at the desk, take numbers every 5-10 minutes 2-5 times) has been 113/76.

I brought the bp machine in to compare with manual number with a nurse, but she insisted on waiting 5 minutes between the machine and her manual measurement, so I don't feel it was a good calibration. Bp was high again. I took a machine reading before and after her manual measurement, and both machine readings were higher than hers (hers 124/88, machine 137/85 before, 132/92 after). So I don't think my machine is reading unusually low.

Finally - the last two days I have taken bp as soon as possible after riding. Yesterday after pushing hard for the last 5 miles (>140 bpm) after 10 minutes it was 108/69. Today 5 minutes after an easier ride it was 116/73, then 107/72 5 minutes later. I am wondering, does exercise open the pipes for more blood flow, so right afterwards there's less pressure drop before they return to normal? I kinda expected bp to be higher after exercise!

Besides not wanting to be taking drugs, esp. unnecessary ones, I'm also thinking about bp getting too low! My sister when she was younger occasionally fainted from low bp.

I ordered a second bp machine from Amazon, a model recommended by Wirecutter and on the approved AHA list. When it shows up I'll see if it reads differently from the machine we have.

Thanks for any insights!

[Louis]

Originally Posted by NHAero

she insisted on waiting 5 minutes between the machine and her manual measurement

Waiting between measurements is SOP, presumably to allow your body time to recover from the effect of the cuff.

For example: https://www.mayoclinic.org/diseases-...e/art-20047889

"Take a repeat reading. Wait 1 to 3 minutes after the first reading, and then take another. If your monitor doesn't keep track of blood pressure readings or heart rates, write them down."

[ridethecliche]

White coat hypertension

[rounder]

Normally, when I have my blood pressure taken at a Dr. office, I am told that it is good. But one visit, the technician told me that it was high, and a few minutes later the Dr. took it and said that it was good. Could anxiety from being in the Dr. office cause the blood pressure reading to be higher than normal?

[DfCas]

My bp goes down after a ride.

[C40_guy]

Originally Posted by ridethecliche

White coat hypertension

Read the OP's description again.

Potential white *skirt* hypertension, which is way more impactful.

[EliteVelo]

Originally Posted by NHAero

I read the thread from last year, very helpful.

A month ago I had a check-up and the Dr. says high BP, want to start you on meds. Numbers were 134/88. This was the first time (I'm 70) I ever heard anything about hbp from a Dr. and usually when a reading was taken it would be 120/80 or lower.

We have a bp gizmo at home so I started using that. Way lower numbers, systolic very uncommon >120. Average over the last 3 days (I leave the cuff on when at the desk, take numbers every 5-10 minutes 2-5 times) has been 113/76.

I brought the bp machine in to compare with manual number with a nurse, but she insisted on waiting 5 minutes between the machine and her manual measurement, so I don't feel it was a good calibration. Bp was high again. I took a machine reading before and after her manual measurement, and both machine readings were higher than hers (hers 124/88, machine 137/85 before, 132/92 after). So I don't think my machine is reading unusually low.

Finally - the last two days I have taken bp as soon as possible after riding. Yesterday after pushing hard for the last 5 miles (>140 bpm) after 10 minutes it was 108/69. Today 5 minutes after an easier ride it was 116/73, then 107/72 5 minutes later. I am wondering, does exercise open the pipes for more blood flow, so right afterwards there's less pressure drop before they return to normal? I kinda expected bp to be higher after exercise!

Besides not wanting to be taking drugs, esp. unnecessary ones, I'm also thinking about bp getting too low! My sister when she was younger occasionally fainted from low bp.

I ordered a second bp machine from Amazon, a model recommended by Wirecutter and on the approved AHA list. When it shows up I'll see if it reads differently from the machine we have.

Thanks for any insights!

Not a Doctor, but a Pharmacist by trade.

That is not a high based on your age.

If hers were hers 124/88, again, perfect. Based on your machine, when was the last time you replaced the batteries? Check the second machine vs the old and see what you come up with.

Get a second opinion if necessary and don't take meds unless absolutely necessary! For a doc to tell you that you need to start meds based on what you've wrote is ludicrous imo.

[alancw3]

Originally Posted by ridethecliche

White coat hypertension

Exactly! Happens to me all the time when I go to doc office. Very common . White coat syndrome. I am 76 for reference. Not unusual for my take at home to be 125/65. At docs office 145/85. Like you I bought another BP machine thinking mine off but almost identical reading.

[NHAero]

Originally Posted by EliteVelo

Not a Doctor, but a Pharmacist by trade.

That is not a high based on your age.

If hers were hers 124/88, again, perfect. Based on your machine, when was the last time you replaced the batteries? Check the second machine vs the old and see what you come up with.

Get a second opinion if necessary and don't take meds unless absolutely necessary! For a doc to tell you that you need to start meds based on what you've wrote is ludicrous imo.

Thanks very much. I take your opinion with great respect, not because you are a pharmacist, but rather because your AR Cycles custom is one of the most lovely bikes on the planet. So you are clearly a man of impeccable taste and therefore to be listened to with great care

A number of helpful posts here, much appreciated to all.

Is there truly a blood pressure number that is agreed upon to be the threshold for medication treatment?

I don't have typical risk factors besides age.

[deluz]

Mine is usually around 160 when I am at the doctors office, although the other day it was 140.
At home it is 110 - 120.
One time it was 180 at a new doctor (high anxiety) and he said do you feel ok to drive home?
Go to urgent care if you don't.

[unterhausen]

What matters is the trend. If it's really trending up, then take the meds. It's easier to track trends at home. Otherwise at that level I wouldn't take them. I have not noticed any ill effects from what I'm taking, so I'm not as anti-med as I used to be.

[Ralph]

It's normal for BP to be lower during and after exercise....then rise back to normal after a few hours. Your BP seems normal to me. For your age. I take BP meds, and they do slow you down some. And sometimes a little too low during exercise. My BP goal is to be under 130 most of the time. After 5-10m minute rest period. And I'm 82.

You want to be careful with this. If BP stays too high for a while, it can decrease your kidney function. EGFR etc, (along with cardiac issues) A very small dose of an Ace inhibitor or ARB at bed time won't affect your riding much if that's what the Doc recommends. But....I'm not a Doc. Just a guy who had a blockage in heart artery at age 79, ignored hi BP reading for several years, have some decreased kidney function now, and have taken about every class of BP meds there is to figure out what I can take with minimal effect.

[NHAero]

Originally Posted by Ralph

It's normal for BP to be lower during and after exercise....then rise back to normal after a few hours. Your BP seems normal to me. For your age. I take BP meds, and they do slow you down some. And sometimes a little too low during exercise. My BP goal is to be under 130 most of the time. After 5-10m minute rest period. And I'm 82.

You want to be careful with this. If BP stays too high for a while, it can decrease your kidney function. EGFR etc, (along with cardiac issues) A very small dose of an Ace inhibitor or ARB at bed time won't affect your riding much if that's what the Doc recommends. But....I'm not a Doc. Just a guy who had a blockage in heart artery at age 79, ignored hi BP reading for several years, have some decreased kidney function now, and have taken about every class of BP meds there is to figure out what I can take with minimal effect.

Thank you. You are always so generous in sharing your own experience in service of the rest of us.

[ridethecliche]

Originally Posted by C40_guy

Read the OP's description again.

Potential white *skirt* hypertension, which is way more impactful.

You realize that women can be doctors and still wear a white coat right? Most of my female colleagues don't wear a freaking skirt to work...particularly because of attitudes like this one.

[EliteVelo]

Originally Posted by NHAero

Thanks very much. I take your opinion with great respect, not because you are a pharmacist, but rather because your AR Cycles custom is one of the most lovely bikes on the planet. So you are clearly a man of impeccable taste and therefore to be listened to with great care

A number of helpful posts here, much appreciated to all.

Is there truly a blood pressure number that is agreed upon to be the threshold for medication treatment?

I don't have typical risk factors besides age.

I appreciate that, but take that advice because I am one. Considering the recent thread, I value my AR over the Ti. Another story for another day.

130/85 based on your age is acceptable imo. Again, keep a keen eye on it. Use the at home machines. Again, don't take meds at this point.