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Stress and your Blood Pressure: How to Read the Numbers!

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One of the top ten ways that stress can influence your health is via your blood pressure.I commonly have patients present with a surprisingly elevated pressure, and suggest that we consider the context before rushing to medicate. This is just one example of silent signals that your doctor can help you identify, as we discussed in another post.
 
WHAT IS BLOOD PRESSURE?
Blood pressure is expressed in mm of mercury, in a “fraction” format, eg 120/80.This is not really a fraction, just a listing of two pressures; the upper number reflects the pressure inside the heart during contraction, while the lower number measures the resting pressure between beats.
 
WHAT SHOULD THE NUMBERS BE?
In young athletes, the pressures might be around 120/80. As we age, we can easily cope with ten more mm on each number.With exercise or anxiety the upper number will rise as the heart beats faster.The lower number should stay below 90.
 
IF MY NUMBERS ARE HIGH DO I NEED MEDICATION IMMEDIATELY?
Usually not.A single episode of an elevated set of numbers usually means the patient is anxious about seeing the doctor (white coat hypertension), and this simply indicates that more data is needed.Your pressures are going to increase with exercise, stress, anger, frustration, and overeating.They can be lowered with rest, meditation, deep breathing exercises, and eating a good diet.Because medication is often a lifetime option (never without some chance of side-effects) I always suggest a BP diary so the patient can show me the range of highs and lows during a couple of weeks.
 
HOW DO BLOOD PRESSURE CUFFS WORK?
By encircling the limb, the inflated balloon compresses the underlying artery, shutting off all blood supply. With the stethoscope (or built-in microphone) listening over the artery beyond the blockage, the pressurein the balloon is slowly released.When the first sounds are heard (always at the rate of the pulse) the upper or systolic BP number is known.When the beats become inaudible as the pressure keeps dropping, then the lower diastolic BP number is known.One of the limitations of the upper arm cuff is that it takes a lot more pressure to squeeze the underlying artery in the arm if the muscles are toned from recent weight lifting, for example, or if the whole arm is encased in layers of fat, as in the morbidly obese.
ARE CUFFS IN DRUG STORES ANY GOOD?
Usually they are pretty accurate.The only limitation is that you have to be walking by the store to get the reading, so we are missing many of the rest of the highs and lows of your day.Also, some do not have super-sized cuffs to get around an extra large arm.
 
ARE HOME BP CUFFS ANY GOOD?
Actually yes, and, due to the absence of white coats, these numbers are usually more accurate than those taken in our medical offices.If you can, try one of the new wrist units, as the arm cuffs are not as accurate.
 
NOW THAT I HAVE MY RANGE OF PRESSURES, WHAT’S NEXT?
Take your readings along to your doctor for assessment.Also take along a diary of your food intake and exercise output.In the case of obesity, a proper weight loss can often take the spike out of the blood pressure, and obviate the need for any drugs.In the case of extremely high pressures, your doctor may have no choice but to start you on medications.In general, eat good natural foods, and stay away from “white death”, ie white sugar, flour, and salt.If you have weight to lose, then please get serious about doing so.We find that bringing our obese patients in for a weekly “health check” works wonders; we have our nurse record the weight and BP readings each week. I don’t need to see the patient unless their numbers are climbing!A good example of audience participation, this results in an impressive number of cases being able to get back to safe BP numbers, and dodge the drugs entirely.If not, then a carefully monitored course of medications can make life a lot easier.
Here is some extra reading you may find useful:

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