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Blood Pressure Question
11-24-2014, 05:35 PM
While recording AM and PM BP readings for my pulmonologist, I noticed an anomaly in my readings. Whenever I am physically active, standing or totally reclining my BP is 120/79 average, going as low as 105/72. When I sit my BP increases to an average of 150/100, up to 176/105. My PCP said he's never heard of such a thing. Aside from the joke, "Don't sit!"; I am interested in anybody's ideas.
Variations in BP readings are often caused by being in different positions when the readings are taken. The accepted standard for BP measurement position is to be seated and have the arm extended in front, resting on a flat surface with the palm up and as close to the same height as your heart as possible.
Wide variations in readings can occur when small elevation differences take place. Please refer to the chart in the link below to help you understand all of the seemingly tiny variables that can make large differences in BP measurement readings. As you will see, an inch and a half, one way of the other, can make an 18 mmHg difference in BP reading.
11-24-2014, 08:00 PM
I've not heard of what the OP describes. There is Orthostatic Hypotension --- it is a drop in BP when a person stands from a seated or reclining position. Often O.H. is secondary to certain BP meds like alpha blockers. Sometimes it occurs in the elderly due to plaque in the carotid arteries. There are baroreceptors in the carotids that are supposed to adjust vascular tone upon standing to keep BP from falling.
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All these are good answers. However, I need to know - when taking the seated position, are you seated upright? Is the reading taken just after you have sat down or several minutes afterwards? Is the arm half extended at heart or just below heart level?Are your legs crossed anywhere, especially at the ankles? Are they extended or are they in a bent position, and if so, at 90 degrees or more or less? Do you get similar readings right and left? If not, is there more than a 10% difference between them? If you take a deep breath and let it out slowly, then take the reading, do you get a different value? If you take a reading three times on each arm alternating, do you see the same pressures on each arm or is there a decrease after the first reading? Is there a profoundly different sound to the blood flow between the standing and seated readings (this is if your doc uses the "old method" of taking a reading and not an automated cuff - trust me, the automated cuff is lousy way to get a good feel for a problem - a doctor's ears eyes and nose are as important as his fingers and his intellect). These are all the items I would have checked off before going to any other theory, even the very good theories mentioned above, all valid - each of the points I made affects the bp in a variety of ways.
The best way to solve the mystery, if there is one, after taking the above points I mentioned into account, is to do a 24 hour bp monitor - it is a bit inconvenient (it wakes you up when the cuff inflates at night, believe me), but it is automated so you don't have to do anything - it will determine if there is a real problem or not by following the course of your bp over a 24 hour period, to see if indeed these are isolated spikes or constant problems - consider the above when talking to your GP next.
11-25-2014, 09:02 AM
Thanks for the input. Winding up with a sleep study and a CPAP is a byproduct of my BP exploits. My PCP sent me to a cardiologist that preformed a battery of tests, including a 2 week monitor. All the tests came back "normal", except the hospital won't let me leave after the tests because my BP was so high. After all that, the cardiologist sent me to a pulmonologist for a sleep study.
An example of my wild BP is, on Sunday, I was moving and climbing a 28 foot ladder. My BP registered 110/72 while I was preforming this exercise. Later, while I was sitting at my desk, I took my BP and it was 171/108(legs not crossed). It's like something is in a bind and jacks up the pressure to keep the flow going. I just don't believe my particular problem can be that unique. Surely somebody has come across this before.
Once again, Thanks! for the input.
11-25-2014, 10:48 AM
How exactly are you getting these bp readings while active?
11-25-2014, 04:06 PM
I have an automatic unit that I can take outside. My PCP and I have tested the unit over the past 4 years and the data correlates with his office unit.
11-25-2014, 04:19 PM
Are you spot testing or are you taking constant readings?
11-25-2014, 04:35 PM
I'm not testing at regular intervals. I base the reading depending on the activity . . or there lack of.
11-26-2014, 12:59 AM
This is a wild out of the blue half educated guess. What are you sitting on? And how? If your legs are say resting heavily on the edge of a chair like a living room chair etc and your feet arent supporting their weight you can have what my Ambulance crew used to call MAST effect.
There are things called MAST trousers. Basically used for heavily bleeding victims being transported where life is being threatened by blood loss that cant be stopped during transport. They are simply a pair of pants that are slid on the patient and can be inflated to push blood from the legs into the torso, pretty much stop blood flow into the legs and raise BP in last ditch efforts to keep a victim alive until you can reach the ER.
Not something used often. I only used them twice both on gun shot victims with heavy internal bleeding. Kept them alive but they are dangerous to use.
If the blood flow is restricted to your legs when sitting such as chair digging into the back of your legs you can get a higher BP reading because of the restricted blood flow to your legs. Nothing like the effect of MAST but enough to skew BP reading.