The Blood Pressure Oracle – What is Your Real Blood Pressure?

I get quite often get the question: " I check my blood pressure every day and I keep on getting different results.

The answer is no, not at all, as long as you have a decent validated machine. BP (blood pressure) is not a constant body parameter. It changes all the time. For normal physiological reasons, your BP may fluctuate by up to 30 mmHg during a short time period. So it is perfectly normal for your BP to change between measurements. Even if you measure your BP repeatedly, you will almost always get different results. What is important is that you measure your blood pressure at the same time of day every time, under the same conditions, and that you then follow the trend of your BP by pluting it on a graph. Just remember that there are many outside factors that will affect your BP and you should try to avoid any unnecessary side factors such as talking, noise or movement while you measure it.

One of the best ways to get a reliable picture of your blood pressure is to apply the "rule of three". In the "rule of three" you measure your BP three times in a row at one minute interval, twice a day (morning and night), for three days 3 x in morning, 3 x at night, for 3 days). Average each set of three consecutive statements and then plot the results on a graph. You may notice a trend where your blood pressure is higher or lower at a given time of day. This is perfectly normal. After three days, calculate and average of all the readings. The result of these repeated measurements will best represent your blood pressure.

And what about White Coat Hypertension?

Sometimes, when you go to the doctor, your blood pressure is surprisingly high, compared to the readings that you get on your blood pressure monitor at home. Most people simply assume that their monitor at home is inaccurate, but this is not the case.

What it probably is is a phenomenon called "white coat hypertension". This happens when a patient is subconsciously made nervous by the doctor's presence (hence the name "white coat") and as a result his BP rises. Even if you think that you are perfectly relaxed, your BP can shoot up by as much as 15 points just like that.

Another possibility is that it is just a normal variation in daily blood pressure. Changes of up to 30 mmHg within a short time are perfectly normal, depending on what you are doing, especially if you are doing a physical activity such as sport or are under stress.

It might also be that your doctor is not measuring your BP correctly. He may be using antiquated equipment that is not calibrated or suitable for a modern day examination. More often than not, if two doctors measure the BP of a same patient using their own equipment, they will get different results. More often than not, doctors have a "digit preference", where they round up the result of the BP test to the nearest five, so 138/92 becomes 140/90. This is one of the undeniable advantages of digital BP monitors, in that they are much less dependent on user skill than the traditional devices.

Have a great day, Uwe DIEGEL
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