Unvarying pattern of BP readings

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My blood pressure readings follow a regular sequence, as a result of which I’m unsure whether I have a serious problem or not, particularly with the systolic measurements. I take a series of readings each evening at 5 minute intervals. The first is typically very high such as 180/85; the second is typically 160/75; the third 140/70; if I take a fourth reading it’s commonly much the same as the third, occasionally lower.

This sequence is repeated on a daily basis. I’m wondering how one should interpret such readings. Does one take the highest and fear for the future, take the lowest and not worry overmuch, or take the average and think it’s a matter of concern.

I’m on a cocktail of lisinopril, lercanipidine, and bendromethiazide. Would appreciate your views.

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  • Posted

    George, I was told to take three readings, a few minutes apart, then record the average of the last two readings.  Rather than stick to following your routine at the same time every day, perhaps you could take the readings at different times each day to give you a better idea of how your BP is responding throughout the day.
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  • Posted

    Hello George.  I recently had to take BP readings for a week to provide info for my GP.  (I was a classic case of 'white coat syndrome').  I took two readings in the morning - usually before breakfast.  Then two readings later at night.  I had to leave at least 3 minutes between the two readings.

    When I recorded the readings I had to record the second reading on each occasion.  (The first reading was usually higher).  This gave a total of 14 readings over the week.  I then had to average the 14 readings which was the average of both morning and evening readings.  Result!  The average reading for the week was 123/62 - much lower than the BP reading at the GP surgery.  Also well below the 'alert' level.   I'm on Lisinopril which has just been reduced owing to my BP readings being much lower.

    Given that your BP readings are all over the 'alert' level of 135/85, it might be worth checking with your GP.  Also it might be worth you taking 14 BP readings in the mornings and evenings over a week and then averaging. 

    HTH

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  • Posted

    George, our BP readings are varying all the time and that is why you would be much better-off looking at the average readings taken ovber 3 or 4 days, having tested each day morning, mid-day and evening on those days.

    Avoid taking too many readings in close succession.

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  • Posted

    That the first reading is typically higher suggests that you are anxious about your blood pressure, we have all been there, it is not unexpected. It is the reason you are asked to take more than one reading at intervals allowing you to relax, so that you can obtain a more accurate reading, often you are asked to record the average. You may imagine and tell yourself you are not anxious, and may not recognise that you are, but it does not take much to skew our blood pressure readings.

    I am certainly no GP, but from your account, I believe anxiety is playing a part and skewing your results somewhat. That the blood pressure comes down over such a short period of time as you do begin to relax is good.

    I am sure you already know that your final diastolic reading is fine but your systolic is a little higher than ideal, but that could still be a result of anxiety; regardless, you should discuss it with your GP. If you recognise that you are anxious, do not be afraid to discuss that with the GP too, it is not unusual and they can help reassure you and provide useful information on ways to relax.

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  • Posted

    Anxiety certainly sends the BP high. When I go for a 6 monthly check up to the GPs she asks me to record the previous 8 days, 2 readings in the morning and 2 in the evening. I then do an average for the lot. When i first started out with hypertension 2 years ago I was told to take 2 readings morning and evening but only to record the lower of the readings and to do an average of them all. Nowadays I relax for several minutes and take several deep breaths before setting the monitor going. I can almost sense the arteries relaxing!

     

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  • Posted

    Thank you for the responses. My experience of  ‘white coat syndrome’ runs counter to the usual concept. My GP’s occasional readings are invariably lower than my home readings so I feel no conscious anxiety in his surgery. As my initial home reading is always very high I feel no conscious anxiety before taking it either; I expect it to be high and it is. If there is anxiety it must be at a subliminal level. I would add that I have a top-of-the-range Omron monitor that is periodically checked for accuracy.

    It is this regular drop of around 20–25 mmHg in every measurement over a short period that mystifies me. Perhaps I should push for one of these 24 hours monitors to be fitted and see what that reveals.

    George

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    • Posted

      Yes, if it makes you feel any happier that would seem to be a good idea.

      Having said this I still feel that maybe you are attaching too much significance to this, as any anxiety even at a subconscious level can cause unexpectedly higher readings than you might expect.

      But good luck anyway. 

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    • Posted

      George

       "It is this regular drop of around 20–25 mmHg in every measurement over a short period that mystifies me."

      It probably drops because you are sitting there relaxing between each recording. 

       

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  • Posted

    I agree with MrsO latest post.  BP usually falls at successive readings.  You're more relaxed each time.

     

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  • Posted

    The Blood Prssure Association recommends sitting still in a chair for five minutes then take the first reading with your feel flat on the ground and your back supported, arm resting on table, cuff at same height as heart, then take two more readings at one minute intervals. Presumably your monitor has a cuff, the wrist type are not generally recommended and I found one very unreliable. If you hve been exercising, eating or bathing you should allow 30 minutes before taking a reading.
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