Q: One of the tips from RESPeRATE is to average three checks of blood pressure. Sounds good to me. So why, when I go to the doctor, does he only take one measurement and makes decisions on this one measurement?
A: When an initial blood pressure reading is normal at a doctor visit, for the sake of time, it is usually just recorded on the chart. With repeated visits, multiple blood pressure readings end up being recorded so the doctor has a clear idea of what your blood pressure is doing. With an abnormal initial reading, doctors have their own protocol. Some will wait 15-20 minutes to recheck your pressure. Others will want you to schedule several return visits just for a blood pressure check.
(1 votes, average: 4.00 out of 5)
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Do not take decisions yourself. Depend upon doctor’s advice.
The doctor can take BP readings ‘until the cows come home’
but if they keep you coming back just for BP checks, each time you walk in, sit down and get your BP measured, you’re repeating the same old same old! You’re walking into the ofc., waiting, anticipating goodness knows what, being escorted into a room for a quick reading of your BP. It becomes a self-fulfilling prophecy of apprehension, not allowing you to sit and relax for 10 minutes or so. Be reminded that you are possibly over-focusing on the BP issue now. Also be reminded of how human a response this is. My instincts tell me that there are only two means by which a truly accurate average BP measurement may be obtained. The first is by home monitoring if BP, with a monitor and an appropriate cuff size, and perhaps a little in-service training by a cnp, pa or RN inyour doc’s ofc. The other would be a BP monitor that the pt wears 24 hours a day for about 72 hours to cover a more normal range of activity and exposure to times of relaxation, activity and stress.
This business of taking BP repeatedly in the dr’s ofc is the perfect example of the definition of insanity. That would be; repeating/duplicating the same gesture/action and expecting a different response/result. FOR HEALTH’S SAKE if you doctors don’t wake up – with all your dedication to the science AND to the spirit if making people well! – then, PEOPLE wake up and be responsible enough to help your physicians SEE a better way! We are more responsible to consider and take our own health care into our hands than many of us are willing to commit to.
My position is that these ‘isolated’ BP readings, without considering a more wholistic and FUNCTIONAL approach to the root cause of hypertension in ANY patient is nothing more than an exercise in ” whistling in the dark!”
I couldn’t agree more with this statement. Home BP monitoring is the true measure of BP. Holter monitoring is probably very accurate as well but possibly not as accessable more most. For most folks a daily log of readings should be sufficient. I now use an application downloaded via my iPhone called BP Companion which tracks the data and allows me to send to my physician. The key point to remember is BP fluctuates ALWAYS. It will never be the same, that’s why it’s important to track the data for about 30 days and then come up with an average reading. That’s about as accurate as one can do.
You are spot on with this assessment on readings in the GP surgery’s etc.
I was suffering severe anxiety and stress through problems with family and huge pressures at work.
I ended up working from intensive care as my wife and son were in hospital as my employer expected me not to take time off work. I did this for almost 3 months and ended up nearly having a nervous breakdown.
My health authority do routine health screening when you turn 40 and I was called in during this time, surprise surprise my blood pressure was up, everything else, including cholesteral was fine.
My GP agreed BP could be due to anxiety etc, and I was given Beta Blockers to reduce BP and alleviate anxiety.
However, trying to get off these tablets has proved difficult and the side effects have been horrible (exercise stifled due to reduced heart rate, dizzy spells on standing, tiredness etc).
I had a couple of visits to the doctors where elevated readings were found after the inital one, but I was still feeling poorly at this time so it was not a surprise.
I thought that every time I was sitting in the doctors I was thinking about why I was there and it seemed impossible to relax.
I started monitoring my BP at home and taking three readings 1 minute apart (I read a consultants article and they advised to take BP readings like this), ignoring the first reading and averaging the last two and recording that.
Over months my BP was then fine on every reading, and I was taking a reading each day at approximately the same time as recommended by the monitor manufacturer.
I recorded the results in an app and took it to show my GP who agreed the readings were fine (average of 120/80).
I was asked to wear a permanent monitor to corroborate the results I had acheived, and to wear it for 12 hours.
I was told not to drive when wearing the machine and to take the day off work, I live about 3 miles from the doctors and thought I would have a nice walk there, walk back and chill out for the day.
When I got there I was strapped up to a machine and one nurse thought the cuff was too tight. The person fitting it (more senior) said it wasn’t and I was sent out (although she said at the same time she had never fitted the machine before).
I walked back home (3 miles uphill) and tried to relax but each time the machine went off every half an hour my arm was going blue it was that tight.
I nearly gave up and rang the doctors to say it was no good but I did not want to have to take another day off work.
I left it on for 10 hours which was all I could stand, I took it off 2 hours before I was supposed to.
I went back for the results and my average reading was now 138/85 so GP said I could not come off medication and told me to go back in a year!! She said although the average was just under max guidlines, the machine had recorded some peaks above that during the day).
Two things with this, I walked a 6 mile round trip to get monitor fitted, so I am sure my BP will have been up for a few hours after which would influence the average results and create spikes, and, could a cuff far too tight cause it to be higher, either through how it records the reading, or due to my increasing irritation as the thing was going off every half hour?
I feel like the medical professionals just want you on medication as its easy/covers their backsides.
I have bought resperate and am hoping to get my BP down further again when I go back as I have asked for non beta blocker medication so need to get BP checked again in 4 weeks time, but it will then go to getting checked again in a year.
Before suffering anxiety my BP was fine and I had even been in hospital not long before and I was told I was really fit for my age based off readings from full health check before surgery.
I am convinced the high BP readings were anxiety based and due to the “adrenaline effect” that I have read about.
However, once you are noted to have high BP then the chances of getting anyone to change things based on 1 reading in a GP surgery is difficult, in my experience anyway.
My home readings have been totally ignored and they look at me as if I am just making the figures up.
I exercise regularly, eat healthily but was really suffering with anxiety/stress when the initial high reading was detected.
I have no idea how I am now supposed to come off the medication as I have no confidence in the people I am seeing but hoepfully resperate will give me even further reduced numbers and hoepfully help with stress and I will go back to my GP again (who I think groans when I walk in now).
Hypertension cannot be diagnosed on the basis of one reading in a doctor office. Textbooks say it should be measure on a 3 separate visits, but that isn’t exactly accurate either necessarily. What happens if the patient is nervous everytime and gets an elevated reading. I think the best approach is to analyze the patient home blood pressure log and draw conclusions based on that data. My doctor ignores the office reading and uses the home BP log.