Sunday, June 28, 2009

Blood Pressure Changes from Common Activities

Everybody knows that certain things--lifting heavy weights, rage, anything connected with Rush Limbaugh--can raise blood pressure levels. (Limbaugh is an interesting case in that he seems to raise the blood pressure of people who can't stand him--but also seems to raise the blood pressure of his fans. Some media personalities need to be taken with a grain of salt, but Limbaugh is apparently the equivalent of about a handful of salt.)

What few people know--and scientists didn't know until the advent of ambulatory blood pressure monitoring--is how much blood pressure can be increased by normal, everyday activities. Chances are your doctor isn't aware of these facts, either (otherwise they wouldn't talk to you when they are taking your blood pressure).

Below is a table that lists the average change in blood pressure from everyday activities. Perhaps you won't be surprised that attending a meeting can raise your blood pressure by 20/15 (I've been to some that surely raised my blood pressure more than that). But the process of eating raises blood pressure by about 9/10. Getting dressed jumps it up by about 12/10.

Merely talking to someone raises blood pressure on average by 7/7 (and talking to doctors and nurses is probably a little more stressful than talking to, say, your grandmother). Talking on the telephone is even worse--a jump of about 10/7, even if you aren't talking to a telemarketer.


Unfortunately there is no data on what happens to your blood pressure when you have to listen to someone else yammering on their cell phone, but I'm guessing this gets as high as 30/20.

This underlines three major points. First, your blood pressure fluctuates a great deal during the course of a normal day. The idea that any single measurement tells you your average blood pressure is clearly incorrect. Blood pressure jumps around from moment to moment.

Second, since all of the scientific recommendations on hypertension are based on relaxed, resting blood pressure, without any of the seemingly innocous activities listed above, you need to be aware that blood pressure measurements taken without full relaxation, or while talking, or reading, or watching television, are probably too high to reflect the scientific benchmark.

Third, given all this varability, it is wise to be very suspicious of "trends" identified by your doctor. If your blood pressure is up, say, five points from your previous visit, does it really mean anything? Was your reading taken perfectly this time? Did you have time to relax, and five minutes without any distractions such as conversation?

This is the reason home monitoring is so important; a handful of measurements made under imperfect conditions at your doctor's office shouldn't be allowed to determine everything about the course of your treatment.

But it's your responsibility to make sure those home measurements are taken correctly.

15 comments:

  1. This comment has been removed by the author.

    ReplyDelete
  2. yeh, a person activity will surely change his blood pressure especially if it is extreme.

    every one should relax if he wants his blood pressure medicine to work.

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  4. Hi, my 88 year-old father was a physicist and has had a keen interest in hypertension for many years as he's been told he suffers from it - he can prove that there is no mathematical relationship between heart rate and blood pressure, not because there is no such relationship but because quite simply there is no such parameter as 'blood pressure'.
    However, there is a very accurate relationship between heart rate, pulse pressure and stroke volume which provides the answers to many of the paradoxes besetting the medical profession.
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  5. I heard that a diet high in sodium and low in potassium can cause high blood pressure, so cutting down on salt and eating foods high in potassium could help control or even reverse this disease.

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  9. Thank you so much! I feel shame and embarrassment because of my WCS... medical people usually have little patience with it and stupidly tell me to relax or breathe.
    There is nothing fun or fulfilling about going to the Dr. I take my BP it at home. They will just have to trust me. They love being in a hurry. I read from a reliable source that most office readings are incorrect due to what has been mentioned already, they are in a hurry! Would love some kind of online support group. Maybe it would help all of us.
    Have to find a Dr. In my new town, which means more explaining and embarrasment, just to get my RX refilled...mortifying on top of being embarrassing!

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