Blood Pressure

[Newbie Chris]

Firstly can I say that if I have posted this in the wrong forum then I would appreciate it if you could move it.

Now then, Blood Pressure!!! If you have read my introduction post then you will have noticed that I have a bit of an unhealthy obsession with my blood pressure. I ended up taking myself to A and E after a remarkably high spike a couple of weeks ago and despite being reassured all was well I have this awful addiction to taking it and of course the more anxious you are the higher it will be!!

Here is the thing though. The thing that I can't find the answer to online and the thing that has me baffled and will talk it over with my GP the next time I see him.

I have performed an experiment or two and I can categorically say that blood pressure (or mine at least) can be massively swayed purely by arm position.

I was taking mine with my left arm stuck out in front of me unsupported, but in my view that was at heart level. It was ok nothing to be worried about, generally in the 120's/80's. I then discussed it with my pharmacist who told me that I was doing it wrong and the arm should be relaxed and supported and I would get lower readings. So I tried at home sitting at the table, back supported , arm on a cushion. Suddenly it was 140/100. Tried it again and it was fluctuating 120's 130's/90's. I was slightly concerned. So I took it in the usual arm straight out position. 120/83 or something similar.

I then took it again with two cushions. Pretty normal. Returned to one cushion and it was higher again. Arm bent it was higher, arm straight it was lower. Now I know that it is meant to be at "heart level" but it may sound a stupid thing to say but what is heart level? The table in my pharmacists was a great deal higher than most peoples dining room table at home and as I have so far proved (with me at least) there can obviously be at least a 10 point difference on whether your arm is slightly higher or slightly lower than heart level.

Then of course at hospital they take BP readings with the patient lying down. In the Doctors surgery your arm maybe resting on an uncomfortable wooden arm of the chair. A whole host of inconsistencies that obviously can affect blood pressure,. I am now wondering which one is right, a 140/95 odd with one cushion or a 120/82 with two cushions?!?!?!!?

If I wasn't anxious before I am now!!!!

[Fishmanpa]

The real question is: Since all the reading are pretty much normal to borderline slightly high, what does it matter? Self testing just feeds your anxiety anyway.

But for the record, since I have to check mine due to doctor's orders, sitting relaxed for at least ten minutes prior to checking, arm resting comfortably, then taken three times to verify is what's recommended to get an accurate reading (per my cardiologist).

Positive thoughts

[debs71]

I know this is easier said than done, but I would strongly advise to please put away your BP machine and try to relax about this.

There are so many variables when it comes to a BP reading, and for starters, you will be getting unrealistic readings just by the action of checking alone, which will be doubtless creating anxiety through expectation, so your readings will be higher than they should be. You cannot possibly therfore know if your readings are true, whatever position your arm may be in.

Hospitals also don't always take BP's lying down. Doctors will sometimes ask for them lying down as well as sitting and standing, to see what changes occur, depending on what the issue is with the patient. Regardless, I think that you sound far too fixated on both BP and positioning. The most important factor is how you FEEL, not what a machine says. Even GP surgeries don't always get an accurate reading due to the patient having 'white coat syndrome'. Try if you can to divert your brain away from this concern, by keeping busy and occupied with stuff you enjoy, rather than stuff like this that is just head wrecking for you. I know it is easier said than done, but it isn't impossible.

[Mugs]

Hi
I was a cardiovascular nurse for many years and this is what we taught our patients.
Sit upright comfortably at your dining table, feet flat in the floor. Wait 2 minutes.
Rest your arm straight out on the table, no need for pillows.
Check your blood pressure.
If you want to check it again wait another 2 minutes before doing so.
Relax between readings.
If you want you can do 3 readings and then average them.
Best to use the same arm each time.
Many things can change BP, anxiety, having to go to the bathroom, just ate a big meal, time of day, so try and keep things consistent.
Sure hope this helps.
Mugs

[Newbie Chris]

Thanks for your replies. I totally agree and understand what you all say and I'll do my best to try and stop the obsession.

Mugs, That's exactly what I do. I take three readings and average the three. What I am saying though is that there is up to a 10 point difference in both systolic and diastolic depending on the height of my arm (ie cushion or no cushion). So that is just intriguing to me. Of course everyone's dining table is a different height!!!

There are obviously so many variables which can sway it one way or another but I was just intrigued as how much of a sway could occur purely down to how high or low an arm can be positioned.

[Mugs]

Can you lay down with your arm just laying beside you and then check your BP?
This would put your arm exactly level with your heart.:)
No worries.

[Fishmanpa]

Best bet is to just ditch the machine. Unless medically necessary/ordered, there's no need to be checking.

Positive thoughts

[Holds1325]

I used to struggle with BP and worried that I'd drop dead from a heart related problem.

For some reason I'm not sure, maybe its my arm composition or something, the machines they use hardly give me accurate readings.

The doctor I had based this on the machine they used and gave me diuretics and told me to change my diet. He also prescribed me a low dose aspirin and told me to come in every 2 weeks to check on this. I was 25 at the time.

Once I came in and it was a whopping 160/100, and the doctor freaked out. I remember not feeling any different but obviously nervous. He had a nurse come in and check me the old fashioned way every 5 minutes or so and each time it came out 120/80, 123/79, etc. all normal. So instead he decided to do that with each visit. Every visit it came out normal with some days being slightly higher due to stress most likely. Had an ECG done and all that with bloodwork and everything was normal so he let me get off the aspirin and diuretic and its been fairly normal ever since, this was years ago.

Fun Fact: A month or so after my last doctor visit they had to remove or repair all their BP machines due to faulty readings, go-figure.

Even still though the kiosks always give me wrong readings as well.

[countrygirl]

Everyones blood pressure fluctuates wildy over a day. The only thing that matters according to my GP is persistantly high bp. So if you take your bp 5 times in a day for 2 weeks and its always above 140/90 then this is high bp but if you get 4 normal reading and one higher this is not high bp. He said huge numbers of people are wrongly prescribed bp drugs that cause more harm than good.
The 24 hr bp machines surgeries use usually do a reading every 2 hrs and then they average it over the 24 hrs.

[Newbie Chris]

Some interesting replies thank you. I must add that I saw my pharmacist again today when I picked up a prescription and we had a chat and he said that "resting" BP and heart rate should be done first thing in the morning before you even leave your bed. He said that even standing up and walking downstairs raises both as does caffeine, food, nicotine, household chores etc etc. It was quite reassuring because generally mine first thing is pretty good. He did however say that watching my football team on television will do my blood pressure no good at all !!! I do like a medical professional with a sense of humour!