blood pressure measurement

New guidelines from the American Heart Association and the American College of Cardiology mean that about half of all Americans will be classified as hypertensive. Prior to this decree, the CDC stated that 75 million citizens (1 of every 3 adults) had high blood pressure. Now that everyone with a BP reading of 130/80 is considered hypertensive, it is over 100 million people, or 1 out of 2 adults. We’ll bet you have had BP readings higher than 130/80 on occasion. The guidelines now urge you to lower your blood pressure.

BP Measurement: Much Harder Than You Think!

Before you start taking medicines to lower your blood pressure under 130/80, we have an important question for you. Did the doctor, nurse or technician measure your blood pressure correctly?

Measuring blood pressure seems like such a simple thing. You stick your arm in a cuff and a device reads your BP automatically. Old timers may still use a stethoscope to listen to the sound of blood flowing through your brachial artery (in the crook of your elbow). Whichever method is used, it usually takes less than a minute. But wait, a lot can go wrong during this seemingly simple procedure.

Measuring Blood Pressure Correctly:

The guidelines reinforce long-standing best practices for blood pressure measurement that seem more often honored in the breach. Many clinics and hospitals rely on technicians rather than nurses for such measurements. They may not have been trained adequately. But even a seasoned health professional frequently makes mistakes.

1) Were you given time to relax?

Going to a clinic, hospital or doctor’s office can be stressful. You may have to deal with traffic. The checkin process can be annoying. You may be asked to fill out forms that no one ever seems to read. Ultimately you may be asked to put on one of those stupid gowns that has ties in the back that are impossible to reach. Plus it leaves your naked butt hanging out. All this can raise your blood pressure.

2) Were you seated properly?

Did the person taking your blood pressure provide you with a comfortable chair? Did it allow you to put both feet flat on the floor? Was there good back support? Some techs take your blood pressure while you are sitting on the exam table with your feet dangling off the edge. Bad technique leads to faulty BP readings.

3) Was your arm in the right position?

The arm on which the measurement was made should have been supported at the same height as the heart. This is really important. We have seen many highly regarded hospitals and clinics completely ignore this AHA guideline for proper BP measurement. Some techs let your arm hang to the side without any support. Take a look at the photo at the top of this article. It is a clear example of several glaring mistakes.

4) Did you keep your mouth shut while your BP was being taken?

Did the person taking your blood pressure allow you to sit quietly, without talking, for at least five minutes before the measurement was taken. Did the doctor, nurse or technician stop talking and keep you from speaking while your blood pressure was being taken? Talking during this procedure can raise BP 10 to 40 points. Do not speak while your BP is being measured, even if the nurse or doctor asks you a question. Always remain silent!

5) Was the BP cuff the right size?

Some people have very small arm circumference. An older frail woman, for example, will have a totally different arm size than a middle aged man who lifts weights. The cuff should be the correct size and it should be applied to the bare arm, not over a sleeve. The wrong sized cuff can produce false positive or false negative results depending upon the circumference of your arm.

6) Was your blood pressure measured at least twice?

Doctors should not rely on a single measurement. At least two BP readings should be taken during the visit. Measurements taken on two separate visits should be averaged before diagnosing a person as hypertensive.

7) Did you pee prior to your BP measurement?

You can improve the accuracy of the measurement by making sure your bladder is empty and you have not had any caffeine or tobacco within half an hour before the measurement.

Straight from the AHA:

We did not make up these recommendations. They come from the American Heart Association, though we have embellished them a bit to make them more understandable.

American Heart Association Meeting Report Poster Presentation M2040, Nov. 13, 2017

Home Blood Pressure Measurement Is Critical!

Many health professionals hate the idea of “white coat hypertension.” For decades they have argued about the significance of blood pressure that is higher in the doctor’s office than in a person’s home. We suspect that doctors do not like to contemplate the idea that they make patients nervous or uncomfortable and that raises their blood pressure.

Studies have demonstrated, however, that when a doctor walks into an exam room a person’s blood pressure can jump 10 to 20 points. And it can stay elevated for quite awhile. Some people see their BP rise 4o points or more because of a doctor’s visit.

That’s why home blood measurement is so critical now that the AHA has lowered the cutoff to 130/80. For one thing, blood pressure is not one number. Although your doctor will write a number into your medical chart, blood pressure varies dramatically throughout the day, week, month and year.

If you are stuck in rush hour traffic on your way to your doctor’s office, your blood pressure will likely rise. Get into a fight with your neighbor or your boss and your blood pressure will zoom. Get a scary diagnosis and your blood pressure will reflect your anxiety.

That is why it is so important to measure you blood pressure two or three times a day if you find that it varies a lot over time. If it is rock steady, this might not matter as much. We recommend mid morning, mid afternoon and in the evening while you are comfortable. Do not take it if you are watching television. An adrenaline rush from a scary show or a political commentary could make your BP skyrocket.

Is 130/80 the New “Normal”?

We wonder how many middle-aged physicians are diagnosing themselves as hypertensive if their blood pressure is greater than 130/80. People in their 50s or 60s rarely have “normal” diastolic blood pressure below 80. It happens, but in our experience it is not the norm.

The new guidelines would have anyone with a blood pressure reading of 132/85 worrying about the label ‘hypertensive.” That alone could be enough to make someone’s blood pressure go up. And if it doesn’t come down with diet or exercise, the chances are good that a prescription will be written.

We suspect that if we were to measure the blood pressure of 100 doctors between the ages of 40 and 60, far less than half would register below 80 diastolic. Are the doctors’ doctors prescribing meds for their colleagues who show up over 130/80? We’d love to see that study!

Drugs To Lower Your Blood Pressure:

Doctors love thiazide diuretics. They are usually the first line treatment for hypertension. While we appreciate meds like hydrochlorothiazide (HCTZ, HCT) found in dozens of BP combo pills, they do have a surprising number of serious side effects. Here is a link to learn more:

Hydrochlorothiazide (HCTZ) Side Effects, Complications and Gout!

Beta blockers such as atenolol, metoprolol and propranolol are also prescribed in huge quantities to lower your blood pressure. Many health professionals have not gotten the message that such drugs should rarely be prescribed as first-line treatments for hypertension.

Back Pedaling on Beta Blockers (Atenolol, Metoprolol, Propranolol) for Hypertension

How to Lower Your Blood Pressure Naturally:

Lose a Few Pounds:

OK, we know this sounds simple. It isn’t. But here’s the point. Every time you lose 2.2 pounds your blood pressure goes down at least a point. Lose 11 pounds and your blood pressure should go down around 5 points. That’s as good as some BP medications.

Move Your Body:

If you exercise 20 to 30 minutes a day five days a week you could see your BP readings drop by another 5 points. Again, that’s as good as some meds. These are achievable goals.

What About Foods or Supplements?

We have written extensively on natural ways to lower blood pressure. Here are just a few of the approaches we think have some validity. Many are supported by scientific studies.

Do the DASH (Dietary Approaches to Stop Hypertension):

Here’s a link to learn why this is important:

DASH Diet Plus Exercise Lowers Blood Pressure

Boom B. offered this thought on Doing the Dash:

“The DASH Diet plan is great for people who are on a special diet due to health concerns. This is great for the overweight and for the diabetics. I also believe this diet plan is a good option for the vegans since it majorly encourages the eating of fruits and vegetables.”

Snoozie shared this story:

“I am now 60. At age 58 I was determined to get off BP medication, after taking it for 15 years. l modified my diet to be primarily fresh vegetables, fruit, nuts, grains, with small portions of protein, primarily fish. I try not to eat in restaurants and if I’m there I order food that can’t be tampered with, for example salad with the dressing on the side. I rarely use any dressing.

“Also, we try to cook at home using whole, fresh food so that we know how it is prepared. I have been able to keep my BP in line, except when I eat in restaurants! If I find I’ve eaten things I have not prepared myself my BP goes up! I believe it has a lot to do with the salt that is added in processed and restaurant food.

“In addition, I use the app Trackmyrun and am delighted to report that I walk the dog about 1.5 miles in the morning, 2 miles at night and I walk to and from the gym three times a week where I lift weights. So, life is good! I am delighted that I don’t have to take medication.

“When I ask doctors why they don’t help people cure themselves through eating healthfully and exercise, instead of simply prescribing drugs, they say it would drive them out of business. This is a serious economic problem for our country. If saving the lives of people will drive our economy into the ground, there is little incentive to really help people to become healthy. I don’t know the answer to that!

Znoozie’s dietary regimen sounds very much like she is Doing the DASH!

Eat Dark Chocolate:

Dark Chocolate to Help the Heart

An anonymous reader shared this story:

“I started eating Hershey’s dark chocolate when it was on sale a few weeks ago. I enjoy about five of the little squares twice a day. Both my systolic and diastolic blood pressure numbers went down about 15 or 20 points each.”

We doubt that most people will get such a helpful response from dark chocolate. We also worry about too much sugar. That’s why we often put unsweetened cocoa in our coffee. It provides the benefits of chocolate without the sugar. There may be one other benefit of cocoa: “Can You Improve Your Memory With Cocoa Every Day?”

Drink Beet Juice:

Can Beet Juice Really Lower High Blood Pressure?

Mia in Wisconsin had a rather dramatic response to beets:

“I was made aware of my hypertension just recently and was prescribed HCTZ along with a reduction in my thyroid med (levothyroxine). I exercise regularly (3 days a week yoga and 3 days stationary bike).

“My BP stayed up and when I got a home reading of 205/98, I knew I had to get really serious and really fast. So, I looked for help in PP articles. I read that beets had a BP lowering effect. I had a can of sliced beets (not pickeled) and now have 5 – 10 slices everyday. BP is now averaging about 130/80…. Now, it’s time to get my weight down.”

Samuel in Ohio had a beneficial blood sugar response:

“I’ve been on a beet juice product for a year and my HbA1C results have lowered from 10.6 to 6.7. My Dr. is thrilled because not only have my blood sugar testing results wildly improved, other markers improved as well.

“I can’t say why beet juice use correlates with the reductions but beet root juice is the ONLY difference I have made in my diet/supplements during that period of time. Possibly the beet root juice is making my medications more effective? Maybe the increased energy it is providing is helping me become more active? Maybe the beet root juice is just working for me individually as an aberration?

“I don’t make any claims other than my incredible improvement. Both my Dr. and my wife (a laboratory medicine professional) remarked that my blood tests must have gotten mixed up with someone else’s because the improvement was far too large and surprising. When I had a second set of tests done matching the first they became believers.”

Cindy in Northern California had a truly impressive response:

“I am so very pleased at the effect of lowered blood pressure produced by beet juice. I keep daily records. Systolic pressure is down by about 20 points. Diastolic varies but about 5 to 10 points lower. I also actually feel better.

“I am looking into powdered beets but with the right type of juicer making juice about every other day is not a problem. Since the taste is not pleasant I guzzle it down but if you add a bit of fruit into the mix or carrots it improves considerably. I take about 5 ounces twice a day.”

Drink Pomegranate Juice:

Pomegranate Juice for High Blood Pressure

Sip Hibiscus Tea:

Hibiscus to Help Lower Blood Pressure

J.G. in Toronto, Ontario had an impressive reaction:

“I am a 71-year-old woman and have had very high blood pressure for about 10 years. I get unpleasant side effects from medications (and I’ve probably been on most). Just offhand: coughing until I vomit; swelling of face and/or throat, sometimes ankles; insomnia; constipation; etc., etc. To say nothing of falling-down dizziness and extreme fatigue.

“I’ve seen various doctors and a cardiologist, who have told me that I just have to live with the side effects. They have nothing else to offer.

“In my desperate attempt to find natural alternatives I’ve tried many things, but nothing much worked until I discovered hibiscus tea. Three cups a day brought my systolic number down by almost 30 points.”

Sadly, even though it lowered her BP, J.G. cannot tolerate hibiscus tea. It gives her insomnia. The tea keeps her awake all night. Most people do not seem to experience this complication though.

Alemu in Knoxville, TN also saw benefit:

“I started drinking hibiscus tea; sometimes iced and other times hot. I drink about 2 cups a day. Occasionally my BP comes down to 116/70 from 226/90. I am still on my medications (metoprolol and losartan). If hibiscus results in a sustainable lowering of my BP, I will consult my cardiologist. However, for now I like to maintain both.”

Do You like Grapefruit?

How Did Grapefruit Lower Blood Pressure So Fast?

Have You Ever Heard of Olive Leaf?

Can You Lower Blood Pressure with Olive Leaf Extract?

Hate Eggplant? How About Essence of Eggplant?

Will Eggplant Water Lower Blood Pressure?

Leni wrote to share his cultural experience with eggplant water:

“This is an ancient remedy used in my country of origin (Cuba) and I’ve known about it since childhood. I heard the adults talk about it. I have a friend who lowered her BP by drinking eggplant water.

“I had totally forgotten about this natural way to help lower high BP, cholesterol, triglycerides as well as excess body weight and fat. I’ve seen it with my own eyes.

“My people would ‘drink it as you would regular water throughout the day.’ In other words, you can drink most or all of your daily water intake in the form of eggplant water. It’s also a natural diuretic.”

People’s Pharmacy Perspective:

No one of these natural approaches is likely to lower your blood pressure under the magical 130/80. Many people will need medicines to control hypertension. And no one should ever stop medicine without careful BP monitoring and consultation with the prescribing physician.

But if you were to combine regular daily aerobic exercise while you Do the DASH diet, you will likely lower your blood pressure enough to impress your doctor. Add hibiscus tea, pomegranate and/or beet juice and you may see additional benefit. Yoga, meditation or some other relaxing activity could mean the difference between a label of hypertension and “normotension.”

It is possible to lower your blood pressure naturally. You will find more practical tips about doing the DASH diet in our book, The People’s Pharmacy Quick & Handy Home Remedies. It has a number of other strategies for getting BP under control. Readers rate this book very highly: 4.9 out of 5 stars. Share your own BP story below in the comment section.

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  1. Tom Higgins
    Schenectady, NY
    Reply

    Cuff placement can be an issue. The bladder is “unbalanced” relative to the two tubes coming out of it, thus an improperly placed cuff will effectively cause the bladder to compress an area of the arm that is not over the artery.

  2. Janet
    Elk Grove, CA
    Reply

    I don’t DIET – fad diets don’t work. I eat whole foods, plant based. I exercise every day – walking everywhere. I use my car only when necessary. I drink WATER, no juices, just water and herbal teas. Absolutely no artificial sweeteners. Organic when possible. Nothing Genetically Modified. It’s as simple as that.

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