[HN Gopher] Blood pressure should be measured lying down: study
___________________________________________________________________
Blood pressure should be measured lying down: study
Author : Vaslo
Score : 148 points
Date : 2023-09-11 18:20 UTC (3 hours ago)
(HTM) web link (newsroom.heart.org)
(TXT) w3m dump (newsroom.heart.org)
| idoubtit wrote:
| The original media release[^1] is much clearer, with a 3 points
| abstract followed by a detailed summary. I don't know if this
| derived article was written by a human or by an AI, but I think
| it's junk like this that contributes to makes the web a mess of
| noise and echo.
|
| [^1]: https://newsroom.heart.org/news/high-blood-pressure-while-
| ly...
| dang wrote:
| Changed from https://studyfinds.org/measuring-blood-pressure-
| wrong/ above. Thanks!
|
| Submitters: " _Please submit the original source. If a post
| reports on something found on another site, submit the latter._
| " - https://news.ycombinator.com/newsguidelines.html
| cm2012 wrote:
| I hate getting my blood pressure taken. It feels invasive when
| the coil squeezes my arm. I'll do it but only when necessary.
| hwillis wrote:
| invasive?
| goostavos wrote:
| I'm with this OP. I absolutely cannot stand it. I have no
| good "logical" reason for why, but it's the most stressful
| part of the doctors office for me. I've been as high as 170
| at the doc due to sheer stress of getting the measurement
| taken. I've tried "exposure therapy" by just doing it at home
| every day, multiple times per day. It never stopped being
| stressful.
|
| I've also fainted during a blood draw. I _wish_ I wasn 't
| this guy... but alas. I am begrudgingly this guy.
| cm2012 wrote:
| Yes, it makes me feel trapped.
| genman wrote:
| This description actually kind of makes sense.
|
| What could help (or could have no effect) is taking the
| blood pressure with the electronic device. There nobody
| could be next to you (entrap you) and you would have a
| complete control over the strap - you could take it off any
| time you felt uncomfortable if you just wanted to.
|
| I have an electronic meter at home and I use it time to
| time to check my pressure. I can be much more relaxed and I
| indeed usually lay down first.
| hwillis wrote:
| Hmm, fair enough. It is possible to measure BP at the ankle
| (while lying down, legs flat), although it is usually
| higher. If you do want to test it yourself, that's an
| option. Your doctor probably won't really want to bother
| but it's certainly worth asking if you think that would be
| more comfortable.
| [deleted]
| sdo72 wrote:
| I went through 2 high blood pressure periods in my life (~10
| years apart), and I think measuring blood pressure like this is
| very wrong to know the root causes of fix the problem. Here are
| my solution (at least to the young folks like myself):
|
| 1. Avoid triggering factors like: the cold, salt, large meals,
| sour/sugary food, alcohol, even holding up urine, etc... I found
| these are not causes, they just make it worst.
|
| 2. Breath, breath, and breath: learn to breath properly and the
| body will regulate the blood pressure. You can immediately test
| this by close your eyes and breath for 10-15', your blood
| pressure will go down, sometimes very significantly.
| TechBro8615 wrote:
| I think the bigger issue with measuring blood pressure is that,
| aside from diagnosed diabetics, it's a measurement done
| infrequently and at mostly arbitrary times. Your blood pressure
| reading on the day of a doctor's appointment, right after you've
| driven to the appointment, made your way through the intake
| pipeline, and finally sat down in the chair, is not
| representative of its reading during a typical day in your life.
| Other factors like recency of coffee or alcohol consumption,
| exercise and sleep, all combine to make blood pressure a fairly
| variable statistic with limited diagnostic power when it's only
| measured infrequently.
|
| Regardless of whether you're lying down, standing up, or sitting
| in a chair, it would be beneficial to take more frequent blood
| pressure readings, throughout the day and during typical
| routines, than it would to only take them every time you visit
| the doctor. This seems like common sense, and you can even buy
| blood pressure sensors for $20 on Amazon, but how many people
| take their blood pressure on a regular basis? Once you're a
| diagnosed diabetic, then maybe you start measuring it every day -
| but wouldn't it be better to start such a habit _before_ you
| become diabetic? After all, if you 're continuously measuring a
| variable then you can notice patterns and anomalies, and take
| steps to mitigate them - possibly avoiding becoming diabetic
| before it's too late.
|
| It seems the limiting factor is sensor technology, which is
| obviously lacking compared to wearable sensors for tracking heart
| rate. Any health-conscious person with an Apple Watch or similar
| wearable device can easily track their pulse throughout the day.
| But no similarly accurate and seamless sensor exists for
| measuring blood pressure (as far as I know?), so nobody measures
| it as frequently as they do their pulse. Once we have the
| technology to accurately and passively measure blood pressure
| throughout the day, preventive medicine will become much easier,
| and people will have a better feeling for how their blood
| pressure responds to small changes in their environment and
| lifestyle.
| moffkalast wrote:
| > it would be beneficial to take more frequent blood pressure
| readings, throughout the day and during typical routines, than
| it would to only take them every time you visit the doctor
|
| It would be, if the most reliable way to get BP data wasn't to
| apparently violently compress the upper arm until it physically
| hurts and leave it like that for a minute. How people can do
| that on any kind of regular basis completely escapes me, and
| I'm not convinced it's not actively harmful. The wrist monitors
| are tolerable but seem to be very sensitive to wrist height.
| scythe wrote:
| One time a doctor at the on-campus clinic looked at my blood
| sugar reading said I might be prediabetic. This was an early-
| morning appointment at a time in my life when I wasn't very
| used to that and had rushed out of my dorm while scarfing down
| a bagel that had been hastily topped with the only thing in the
| cabinet that was in a squeeze bottle -- honey!
|
| No blood test over the next decade showed even a hint of
| elevated blood sugar.
| zwieback wrote:
| Yeah, I have a machine and unless I take measurements very
| frequently (different times of day, etc.) it's really hard to
| make sense of the numbers. You really need to get a long term
| chart to weed out the noise.
|
| I've been getting much better readings at the doctors but then
| I realized I always ride my bike there, sit in the waiting room
| for a while and then get a low reading. Not representative!
| _ph_ wrote:
| I am not sure, while the values obtained this way might
| require calibration, it sounds like very controlled
| conditions to me. The exercise should bring your body into a
| very controlled state, beyond the physical load very relaxed.
| So after a short rest, this should be a good time to get
| reliable readings. But I am not a doctor.
| zwieback wrote:
| Yeah, agreeed, and I think the BP is a bit lower because
| I'm warmed up and then rested a bit. My worst BP is in the
| mornings after getting up and sitting and drinking coffee.
| gryfft wrote:
| I've been using Google Fit to track my blood pressure over
| time. I've been measuring every other day. The charts really
| are helpful.
|
| The biggest correlation with my blood pressure is how regular
| my sleep is. Once I started militantly waking and sleeping on
| a set schedule, the numbers came down. They seem to spike for
| a few days if my sleep gets messed up badly somehow.
|
| I also have been trying to standardize my measurement: same
| time of day, after sitting quietly alone for five minutes.
| inglor_cz wrote:
| There is a device called "holter" that you wear for a day and
| it measures your BP repeatedly, even during the night.
|
| https://my.clevelandclinic.org/health/diagnostics/16330-24-h...
|
| I have worn a holter several times. I had better results than
| in a doctor's office. It seems to be a classical case of white
| coat syndrome.
| m463 wrote:
| I have a garmin watch and one wonderful thing it does is show
| me my resting heart rate, which is a nice indication of my
| level of fitness (and correlates with good sleep, sickness,
| etc)
|
| It also does nice things like a detailed check of my sleep, how
| I'm acclimatizing to altitude when visiting the mountains, the
| number of steps I walked and pulse-ox.
|
| I don't know how these correlate to what blood pressure tells
| you, but I blood pressure will be directly measured in the same
| way in a few years.
| ipqk wrote:
| > Your blood pressure reading on the day of a doctor's
| appointment, right after you've driven to the appointment, made
| your way through the intake pipeline, and finally sat down in
| the chair, is not representative of its reading during a
| typical day in your life.
|
| This is a known thing called White Coat Syndrome
| [deleted]
| Gibbon1 wrote:
| That's actually different. The stress of being at the doctors
| causes blood pressure to elevate vs more mundane things like
| running, walking, driving stress. The difference is someone
| without white coat syndrome will have a lower blood pressure
| reading at the end of the doctors visit.
| pixl97 wrote:
| Honestly I think in most US cities the driving stress would
| drive ones BP far higher. I know one time just right before
| I got to the Drs office some one almost ran into me, I mean
| just missed, and my BP was way high still.
| serial_dev wrote:
| People mentioned the white coat syndrome, but that's not the
| only issue.
|
| I am not nervous when they measure my blood pressure, but I
| might have been late to my doctors appointment, so of my 25 min
| walk to the doctor, I was running half of it. I had non-optimal
| blood pressure values at the doctor, because I was running not
| to miss the appointment, and as I arrived, I had to immediately
| go get my BP checked.
|
| After the incident, I religiously measured my BP at home
| various times a day for a week and my numbers looked okay.
| BaculumMeumEst wrote:
| I was late to an optometrist appointment a few weeks back.
| Sprinted up six flights of stairs and into the office. The
| literal second I got in they called my name and immediately
| measured BP. The tech looked like they were going to shit
| themselves.
| vonnik wrote:
| Fwiw, OMRON produces high-quality blood-pressure monitors for
| consumers.
|
| https://omronhealthcare.com/blood-pressure/
|
| Even these, though, tend to overestimate your actual blood
| pressure, sometimes by as much as 10 points.
|
| But having one in the home makes it easy to take several
| readings throughout the day, since each one hardly lasts a
| minute.
| llm_nerd wrote:
| I suffer from hypertension (which pushed as high as 170/120)
| and went through a period where I was measuring my blood
| pressure many times a day to try to essentially hack what the
| problem was to try to find a natural solution.
|
| What I learned is that, for me,
|
| -salt intake had zero impact
|
| -coffee had no impact
|
| -stress level had almost no impact
|
| -alcohol had no impact
|
| -exercise / activity levels had no impact
|
| The single and only controllable factor I could find, short of
| drugs, was that if I was cold my blood pressure spiked
| significantly. I had much higher BP in the winter than in the
| summer, and could improve it by wearing layers, gloves, etc.
|
| My body decided to go full ham on blood pressure and it was
| destroying my kidneys. I would be constantly annoyed by the
| sound of my own heartbeat doing things like trying to sleep.
|
| Telmisartan + Caduet (which is amolodipine + lipitor) and now
| my blood pressure averages 100/60. And courtesy of the lipitor
| my cholesterol and triglycerides dropped 60%, from high to
| normal. Many thanks to the very brilliant people who work in
| that field and developed those drugs.
|
| Anyways, thanks for coming to my TED talk on the magic of
| modern medicine.
| itissid wrote:
| > I would be constantly annoyed by the sound of my own
| heartbeat doing things like trying to sleep.
|
| Wait what? explain more please.
| llm_nerd wrote:
| Pulsatile tinnitus (didn't know this name before but just
| looked it up), which is when blood pressure is so high that
| in quiet you hear your own heartbeat and the whooshing of
| blood in your veins.
| hwillis wrote:
| Ever run real hard and felt your heartbeat in your ears?
| Like that but always. It can also happen if you have valve
| or other heart defects that cause enlargement, but that
| isn't loud in your ears. It's just so loud in your chest
| that you can hear it. Sometimes other people can as well.
| ungruntled wrote:
| Myself being someone who suspects that they have high blood
| pressure (based on infrequent measurement), would you mind
| sharing if you had any recurring symptoms (outside of hearing
| heartbeat) when your blood pressure was at its peak?
| rapfaria wrote:
| Pain on the back of the head constantly, specially at the
| end of the day.
|
| Been on Olmesartan since then and couldn't be happier
| llm_nerd wrote:
| My initial decision to seek treatment was recurring massive
| migraines that would wake me up in the middle of the night
| and last for hours. I had known that I had high blood
| pressure but didn't really track it closely at all, always
| attributing the few really high readings I did get to white
| coat syndrome (which is a very real, but it also can be an
| easy dismissal as well). During one of those migraine
| sessions I hopped on Amazon and ordered a unit.
|
| It came and I was sure it was defective because it kept
| measuring 170+ / 120+, which seemed impossible. A few days
| later I stopped by a pharmacy with one of the big units,
| and it read the same thing. So I visited my doctor.
|
| He put me on 5mg of amolodipine and it did very close to
| nothing. Then it was upped to 10mg and still little
| benefit. It was the addition of telmisartan that completely
| changed everything for me. The effect was overwhelming.
|
| It's hard for me to really identify the symptoms because I
| lived with it, I suspect, for many years. It was my norm. I
| will say this: at my current blood pressure I constantly
| feel _way_ more relaxed, physically. Like my body doesn 't
| feel in a constant fight state.
| ungruntled wrote:
| Thanks. This is very helpful to me. I have weekly
| migraines. I never thought to attribute it to high blood
| pressure.
|
| For the record, my blood pressure is not nearly as high,
| but its typically 140/85 as infrequently measured. I've
| never measured during a migraine, but I will now.
| hwillis wrote:
| dizziness can also be a symptom.
| hwillis wrote:
| Raynauds?
| llm_nerd wrote:
| Secondary Raynaud's absolutely. In any below room
| temperature setting my fingers would be incredibly cold to
| the point of being debilitating. I ended up being a glove
| wearer in situations where it looked pretty goofy.
|
| This has dramatically improved/disappeared under the
| medication listed above.
| url00 wrote:
| Wow, it sounds so familiar to myself! I have all the same
| symptoms and went down the path of testing BP and blood
| glucose with similar results. How did you get the doctor
| to prescribe the drugs? Or was it a pretty
| straightforward diagnosis?
| llm_nerd wrote:
| To add to the great reply by hwillis, I just went to my
| doctor with a concern about my blood pressure and he
| prescribed amlodipine with follow-up bloodwork to make
| sure there aren't other factors. When the amlodipine
| wasn't effective he upped the dose with another set of
| bloodwork, and then he added telmisartan and lipitor
| (coupling it in with the amlodipine for convenience)
| given cholesterol issues with my bloodwork.
|
| There are a lot of different blood pressure medications
| (like a ridiculous array of options) and I let my doctor
| decide. There are side effects but I have suffered zero
| of them, and now that the blood pressure is under control
| my bloodwork across the board has been improving
| significantly.
| hwillis wrote:
| Definitely does not sound straightforward given all the
| things they tested and excluded. It also very atypical
| and medicating specifically for this would be unusual.
| That said it sure sounds like it perfectly treats the
| root problem.
|
| If you have symptoms like Raynauds and POTS (note that
| POTS can be hard to demonstrate, so may be less
| convincing to a doctor) then Amlodipine or similar may be
| helpful. If you take it and you feel lightheaded when
| standing up, or have trouble with exercise or fatigue,
| you probably don't need it and it isn't good for you.
|
| You may have more consistently high blood pressure rather
| than transient spikes if you don't have POTS, or if you
| don't react immediately to cold temperatures. In that
| case an angiotensin blocker like Telmisartan may help. It
| can take weeks to become effective, vs Amlodipine should
| show effects in just a few days.
|
| If you have high blood pressure then just telling your
| doctor you want Amlodipine or something will probably be
| enough- convincing insurance will be harder. Amlodipine
| can be used off-label for Raynauds. If you don't have
| particularly high blood pressure and haven't
| systematically tried to exclude causes it will be harder
| to convince your doctor. They might let you try it for a
| bit to see if it helps, and the generic isn't too
| expensive.
| xattt wrote:
| Amlodipine is a calcium-channel blocker which lowers
| blood pressure by promoting systemic vasodilation. This
| would have a beneficial side effect of counteracting
| idiopathic vasoconstriction caused by Raynaud syndrome.
|
| If the drug is taken with food (when drug absorption is
| highest), some folks will develop edema in their legs for
| several hours.
| BaculumMeumEst wrote:
| Wow, that sounds like quite an ordeal. Glad you landed okay!
| I had no idea medication could have that strong of an effect.
|
| I also have been checking my levels a little obsessively,
| unsuccessfully trying to find ways to drop them. And like
| you, I noticed that I spike during cold weather. I'm probably
| particularly sensitive because I have very low body fat.
| manmal wrote:
| You probably tried potassium chloride/bicarbonate already?
| BaculumMeumEst wrote:
| I just tried upping dietary potassium with more bananas
| and avocados and reducing sodium, haven't looked in to
| potassium chloride/bicarbonate
| aantix wrote:
| What's your potassium level?
|
| Potassium relaxes the walls of the blood vessels. It's a
| counterbalance to sodium.
|
| Doctors will say 3.5 is fine, but there are several studies
| demonstrating that as you approach 4.5, the risk of cardiac
| events drop.
|
| Doctors get very tense about potassium supplementation in
| fear of hyperkalemia.
|
| But the RDA for potassium use to be ~4200mg. I'm guessing
| most don't remotely approach the new or old RDA.
|
| If you're taking potassium sparing medications, things are
| further complicated. K levels would have to be checked more
| often.
|
| I supplement with potassium citrate. My blood pressure has
| normalized.
| llm_nerd wrote:
| 4.5 mmol/L. Coincidentally just got a blood test six days
| ago (this is in Canada and Lifelabs lets you see your own
| results). I don't go out of my way to consume potassium at
| this point, but my potassium has been 4.5 steady for all
| the tests I've gotten over the past year. My sodium has
| been rock solid at 139 mmol/L as well.
|
| I didn't add it as one of my listed items, but I did try
| supplementing with potassium before starting with
| medication and for me it wasn't beneficial, though it
| certainly would be for people with deficiencies.
| aantix wrote:
| Hyperaldosteronism.
|
| If someone has a consistently low potassium level, you
| should see an endocrinologist and get tested for
| Hyperaldosteronism.
|
| Surplus aldosterone causes the body to retain more salt,
| which in turn increase blood pressure.
|
| Consistently low potassium, early onset of hypertension,
| taking three or more BP medications (one of which is a
| diuretic), all red flags.
|
| Hyperaldosteronism should be pursued.
|
| I had my left adrenal gland taken out to address it.
| hwillis wrote:
| Potassium and sodium are also excreted together, so
| decreasing sodium/increasing potassium typically results in
| beneficial impacts on the other.
|
| > Doctors get very tense about potassium supplementation in
| fear of hyperkalemia.
|
| Supplementing with potassium is not recommended because
| it's not very effective. 99 mg of potassium citrate gives
| you only 38 grams of potassium- *you need ~100 pills to get
| your daily value!* You will see much better results from
| changing your diet to include more potato (note: 1/4 of the
| potassium is in the skin), beans, and spinach (although a
| _lot_ of spinach- 10oz has as much as a large potato). One
| large potato can give you 900 mg of potassium.
| jliptzin wrote:
| Are you confusing blood pressure and blood sugar? My boyfriend
| is type 1 diabetic, he measures his blood sugar multiple times
| a day, but I have never seen him measure his blood pressure.
| Buttons840 wrote:
| What you say is true, but at the end of the day blood pressure
| readings in the flawed doctor's office setting are still
| correlated with medical outcomes.
|
| I just want to speak against a trend people have to dismiss bad
| medical news by finding excuses. "The blood pressure reading
| doesn't count because I was nervous in the doctors office";
| it's true, but the guidelines have probably accounted for that.
| "That medical study doesn't apply to me because it was done on
| the general population, but the general population is
| overweight and I'm not"; "that study doesn't apply to me
| because I do yoga, they didn't study people who do yoga"; etc.
|
| I know it's hard, I'm in the middle of excusing some bad
| medical news of my own right now, trying to decide what's best
| for me.
|
| Medicines have risks, untreated conditions have risks, choose
| your risk, but don't live in denial that the risk exists.
| kalensh wrote:
| My issue is that blood pressure is being used by many
| corporations/health insurance plans to determine your
| premiums. So adding yet another layer of nervousness - you
| will be paying extra money over the course of the next year
| if your blood pressure is a little high (threshold is
| 120/80).
| pkaye wrote:
| In the US, your health or medical history can't affect your
| health insurance premiums.
|
| https://www.healthcare.gov/how-plans-set-your-premiums
| anonuser123456 wrote:
| >but the guidelines have probably accounted for that
|
| They have not. The guidelines are against controlled studies
| with strict protocols on how to take the measurement.
|
| To know your blood pressure relative to the guidelines, you
| want to be as close to the guideline protocols and possible.
| That can be a 20/10 point difference or more.
|
| The average physicians office doesn't follow those protocols
| unless you deviate significantly. e.g you walk in with 140/90
| and they aren't going to bother. 160/95 and they will recheck
| you with more care given to the proper measurement technique.
|
| This isn't to say one should dismiss the numbers when taken
| properly; I'm just pointing out that calibration is
| necessary.
| nomel wrote:
| I'm a nervous person. There have been several times where
| they had to recheck, because my rate was so high. My watch
| says my resting rate is 40 to 50 lower. Whatever protocols
| probably didn't have me in mind.
| Buttons840 wrote:
| We're talking about blood pressure. Does your watch
| measure blood pressure?
|
| I think this might be an example of what I was talking
| about: you think blood pressure guidelines might not
| apply to you because of something your watch says.
| redox99 wrote:
| At least in my country, to diagnose you with high BP they'd
| have you wear a holter monitor for 24 hours.
| readthenotes1 wrote:
| That's standard in the US as well.
| ljosifov wrote:
| You are spot on. Random once a year BP measurement is not good
| enough. Doctors are being asked to provide life altering advice
| while being effectively blind in this case. I have no idea why
| we don't try harder to make their (tough) job easier rather
| than just accepting the current (sorry) state. My cars and my
| computers have more sensors on them than I have on me! That's
| crazy - I have to drop nearly dead and only then will I go to
| doctors' for diagnosis and treatment. My car preventative
| maintenance is miles better.
|
| After being diagnosed with elevated BP, I googled and read what
| I could and concluded: 1) Cheap "BP monitors" on Amazon just
| show random readings or the same readings so they are worse
| than useless: someone may actually use them and believe their
| readings. 2) There are only few smart watches that have BP
| measuring function.
|
| I am currently using Samsung Watch Active2, and it seems to do
| the job. There is calibration that is good for 30 days only.
| After 30 days it expires and I calibrate it again. Calibration
| involves making 3 measurements in parallel, watch on one hand
| and manual BP monitor on the other. After each measurement on
| the manual BP monitor, I tell the watch App what was measured.
|
| After each calibration I do another 3 measurements in parallel,
| again using both the watch and the manual monitor. I compare
| the watch (post calibration) readings with the manual BP
| readings. Usually the difference is small within few percent.
| If it is more than 8-10% I redo the calibration. This has
| happened 2 times in the 25 odd calibrations I have done.
| Usually the reason is noise instead of perfect silence (person
| coming in the room and talking, TV being turned on).
|
| I have tried using the watch on Person2 after being calibrated
| on Person1 - and Person2 got crazy BP readings. So the
| calibration really does something, it is not nothing.
|
| The watch measurements also approximately agreed with
| measurements taken over 24h period when I wore BP holter
| (automated BP cuff that inflates every 30 mins and measures and
| records the BP).
|
| Over time I have become more lazy with the re/calibration: now
| several days pass before I re/do it. So I'm acutely aware that
| any non-100% automated data collection will eventually be
| abandoned on long enough time horizon. Redoing the same is
| boring and becomes more so with time.
| _ph_ wrote:
| You are so right. Earlier this year I had to spend a week in
| hospital and they took a variety of measurements every day. It
| was interesting to see how much variation there was, especially
| in blood pressure. But one thing was especially interesting,
| pulse. As I was wearing my Apple watch, I had the values for
| blood and blood oxygene before they took them. And with pulse,
| you could clearly see with the graph, how much systematic
| variation there was. So their single measurement was not great.
| Best example, the last measurement was taken before I was about
| to be released, awaiting the doctors sign-off visit. Of course
| my pulse was off. But the doctor was quite interested to see my
| pulse for the last couple of hours.
|
| People underestimate how valuable a medical tool the Apple
| watch already is and how game-changing it can get if they
| manage to extend the sensor suite - as you say, blood pressure,
| perhaps also body temperature and glucose level.
|
| Another fun fact from the visit, they did monitor glucose level
| and one morning they did so directly after waking me up. Which
| caused the nurse to run to get me an early breakfast as it was
| very low. Not as if I hadn't known for decades, that I need a
| slow start and at least a small bite for breakfast to get into
| gears...
| hwillis wrote:
| > so nobody measures it as frequently as they do their pulse.
| Once we have the technology to accurately and passively measure
| blood pressure throughout the day
|
| It's surprisingly tricky. The way a BP cuff works (the
| auscultatory method[1]) is that the pressure is continuously
| decreased and you listen for the sound of a pulse. When the
| cuff pressure is higher than your systolic (peak) pulse,
| bloodflow is blocked and you don't hear a pulse. When the cuff
| pressure is lower than your diastolic, the cuff is no longer
| blocking bloodflow at all, and the pulse suddenly becomes much
| quieter because it's not restricted. It's only between the two
| pressures that you hear it extra clearly.
|
| So the problem with a sensor is that you can't just measure
| pressure against the skin. At minimum, it really should
| actually impede a large artery. You can squeeze the arm as
| tight as you like but if the brachial artery is not affected
| then your measurement will be very poor.
|
| You can do fancy computer vision etc to look at special
| veins/arteries, and coupled with some demographic assumptions
| you can infer somewhat accurate measurements- but they really
| miss out on outliers, which is really a lot of the point of
| taking measurements. This also generally will require an upper
| arm strap or something, and be fairly tight. Not great to wear
| always
|
| At some point, I think we will probably see implantable blood
| pressure monitoring. We do something similar with implantable
| glucose monitors- which need regular replacement,
| unfortunately. BP probably wouldn't. Problem is that direct
| pressure measurement is usually done by tapping off an artery-
| something that will never be routine. You'd want to do some
| combination of acoustic and pressure measurement, and it'd need
| to be calibrated from a base station regularly.
|
| [1]:
| https://en.wikipedia.org/wiki/Blood_pressure_measurement#/me...
| alphanumeric0 wrote:
| Yes, the most accurate method is via arterial catheter. It's
| basically a needle directly into the artery.
| jkingsman wrote:
| Worth mentioning that BP is about _arterial_ , not venous
| pressure. Venous pressure is an order of magnitude lower than
| arterial pressure; usually 0-10mmHg.
| hwillis wrote:
| ty, edited. oopsies!
| boringuser2 wrote:
| I'm confused.
|
| The technology already exists and is approved by the EU.
|
| https://aktiia.com/
| TechBro8615 wrote:
| I wonder if there are methods that could take advantage of
| natural movements throughout the day, where your body
| naturally emulates what the cuff forces it to do. For
| example, when you transition suddenly from sitting to
| standing, is it possible for a sensor to measure some proxy
| metric that, combined with an accelerometer, can be used to
| infer blood pressure? If there is some method like this, even
| if it has large margins of error, maybe cumulative
| measurements could converge on a fairly accurate reading?
|
| (I'm not a medical professional nor do I know much about
| sensing, or even really the basics of how blood pressure is
| measured or what it indicates.)
| tguvot wrote:
| take a look at aktiia. tracks blood pressure through the day.
| currently under trials in usa to get fda approvalm but you can
| buy it from eu
| Mobil1 wrote:
| Any disparity between interarm BP--especially when large and
| persistent--should prompt consideration of diseases known to be
| the cause: coarctation, dissection, or aneurysm of the thoracic
| aorta; Takayasu (pulseless) disease; and various types of intra-
| and extra-arterial obstruction in an upper extremity.1,9,11,23,24
| These diagnostic considerations become much more likely if the
| arm with the lower BP also has a grossly diminished radial pulse.
| Blammar wrote:
| Am I correct in interpreting this study that your recorded BP
| should be the MAX of sitting BP and supine BP?
| giantg2 wrote:
| We also need people who are knowledgeable on how to take blood
| pressure. Seems like half the time the nurse uses a machine and
| has that thing cranked up to 200mm so they don't have to redo it
| if the patient is high. No shit my blood pressure is elevate - I
| can feel my pulse get stronger because my arm isn't getting any
| blood flow.
|
| Similar thing with my petite old grandma. Always measured high if
| an unknown person did it because they would overinflate. But when
| someone would just put it 20 over her previous known good
| reading, then her blood pressure was fine.
|
| But nobody cares. In, out, get paid.
| Gualdrapo wrote:
| I don't know about you but getting somewhat concise readings for
| my blood pressure at several facilities has been difficult in
| here.
|
| When I went to the medical exams to get my drivingllicense one
| year ago I was told my blood pressure was a bit high - maybe due
| to the nervousness of being checked, but it was better to ask my
| doctor - both of my parents suffer from high blood pressure.
|
| So I did. He told me my blood pressure was high and gave me that
| famous table to fill up with daily readings for two weeks.
|
| My sister (physiotherapist) has a sphygmomanometer at home but
| she will scream at me to be perfectly still and seated for at
| least 5 minutes before doing the reading - and it _always_ was
| 120/80.
|
| Went several days to a nearby pharmacy and they gave me a little
| chair to be sat for 10 minutes before standing up and going to a
| small cubicle where they did the measurement with an electronic
| sphygmomanometer. Measurements there always were fairly
| inconsistent and above 131/87 - going up to 150/87.
|
| Also went to several other points to get my blood pressure
| measured and they always had a different method and
| (unsurprisingly) yielded different results. But for some reason
| when they measured with analogic/traditional sphygmomanometers,
| the measurements always were lower compared with electronic ones.
|
| Fortunately could afford a decent electronic sphygmomanometer for
| myself and started doing my own measurements, which are
| fluctuating between 117/77 and 122/82.
| pixl97 wrote:
| When you say you went to the pharmacy and doctors office, did
| you drive?
|
| BP level seems to highly correlate with the environment you're
| in, stressful driving can bring it up and keep it high for a
| while.
| [deleted]
| Mobil1 wrote:
| A recent study confirms a link between different arm-to-arm blood
| pressure and an increased risk for heart attack, stroke and
| death.
| cableshaft wrote:
| Well....that sucks. Maybe I don't have normal blood pressure.
|
| Doctors never test me lying flat. Closest I've gotten is laying
| at an angle in a hospital bed.
|
| I'm a middle-aged heavyset guy as well, so I know I'm at greater
| risk for these things.
| bpoyner wrote:
| I've only once had a doctor test my blood pressure lying flat.
| I had a suspected GI bleed and he wanted to see the difference
| between flat and sitting up. Then he called up the hospital and
| got me a spot reserved in the ICU.
| Aurornis wrote:
| An at home blood pressure cuff is relatively cheap if you're
| concerned about it.
| lowercased wrote:
| Seconded. Got one and tested myself a couple times a day for
| a few weeks. I'm not necessarily sure it's 'accurate', but
| having repeated readings from same device, same arm, same
| position, same times of day seemed to at least show
| consistency and identify when things were out of whack (a
| couple times). Got one for about $25.
| Broken_Hippo wrote:
| My doctor's office sent me home with a monitor for 24 hours. It
| tested every 15 minutes during the day and every 30 minutes
| during the night. I generally went about my day at home and
| eventually even slept.
|
| This seems pretty normal in Norway - but I don't think it was
| in the US (Am from the US, father had heart problems). Perhaps
| your doctor would be able to do something similar, though.
| WWLink wrote:
| Yea they do that in the US as well. But not very often.
| umeshunni wrote:
| Saved you a click: Our findings suggest people with known risk
| factors for heart disease and stroke may benefit from having
| their blood pressure checked while lying flat on their backs
| [deleted]
| Gys wrote:
| > Sixteen percent did not have high blood pressure -- a reading
| greater than 130/80 mm Hg -- while seated. However, these same
| people did show high blood pressure when researchers measured
| their BP while lying flat on their backs.
| clumsysmurf wrote:
| Seems like it might also be important to check the difference in
| pressure between the two arms
|
| https://www.uclahealth.org/news/why-you-should-have-your-blo...
| wing-_-nuts wrote:
| TLDR: Doctors need to check blood pressure while the patient is
| laying down.
|
| I do wonder about recent changes that suggest anything beyond 120
| / 80 is above 'normal'. You would think that something like blood
| pressure would be highly regulated in the body but it varies
| throughout the day, month and year.
|
| They also say that salt is seriously bad for high blood pressure
| but I find little effect for myself personally. I do wonder how
| much sensitivity varies from person to person.
| UncleOxidant wrote:
| > but it varies throughout the day, month and year.
|
| yep. I've taken my BP laying down and it's generally lower than
| when I'm sitting up, but then again, I usually do that after
| going to bed, blood pressure is generally going to be lower at
| night so maybe I'm just noticing that difference vs during the
| day.
| [deleted]
| SirMaster wrote:
| Technically 80 diastolic is considered hypertension stage 1
| under the current guidelines.
|
| https://www.heart.org/en/health-topics/high-blood-pressure/u...
|
| The highest you can be and be considered "normal" is 119/79.
|
| Elevated is 120-129/<80
|
| Stage 1 hypertension is 130-139/80-89
|
| Stage 2 hypertension is 140+/90+
| noman-land wrote:
| Did you mean to say stage 2 in your last line?
| themagician wrote:
| *in the US.
| lawlessone wrote:
| I think if you get a decent amount of water and potassium your
| body is able to more easily expel the excess sodium
| vitorgrs wrote:
| I have hypertension and take my med everyday... If you drink
| watermelon juice, it makes wonder to incredible lower it.
| Aurornis wrote:
| > They also say that salt is seriously bad for high blood
| pressure but I find little effect for myself personally. I do
| wonder how much sensitivity varies from person to person.
|
| You'd be shocked at how much salt some people consume. A little
| bit with your vegetables or steak isn't going to move the
| needle, but some processed foods have unbelievable amounts of
| sodium relative to how they taste.
|
| Salt definitely impacts blood pressure. Salt supplements are
| used with good effect in certain conditions of low blood
| pressure/volume.
| btilly wrote:
| Most would be shocked at how much salt they consume.
|
| That healthy prepackaged salad option at the grocery store?
| Often has more salt than a burger!
| wing-_-nuts wrote:
| I mean, I make my salads to be both nutritious AND tasty,
| and yeah, salt's an important part of that. I'm not eating
| just raw veggies with a light sprinkle of balsamic
| btilly wrote:
| And if I ate like you do, I'd wind up in the hospital.
| Again.
|
| We've discovered that humans respond really well to a
| particular mixture of sugar, fat and salt. Basically
| every prepared food has about the same mix of those
| three. That mix is lethal for me.
|
| In the case of salads they do that by using the veggies
| as a salad dressing delivery mechanism. If I can't add
| the oil and vinegar myself, I can't eat the salad.
| black6 wrote:
| Salt is water soluble and your body peepees and sweats out
| what it doesn't need. Most people don't consume too much
| sodium; they consume too little water and don't get enough
| exercise.
| croes wrote:
| According to this
|
| https://news.ycombinator.com/item?id=37355083
|
| Sodium isn't the problem
| pdonis wrote:
| I think a better take would be: sodium isn't the _only_
| possible problem.
| hwillis wrote:
| > You would think that something like blood pressure would be
| highly regulated in the body
|
| Counterpoint: a 6' (1.83 m) tall column of blood has a pressure
| of 142 mmHg at the bottom- higher than your normal blood
| pressure. When you change posture from prone to sitting to
| standing, your blood pressure is basically swinging 100%. Hell,
| the diastolic blood pressure at your feet is almost double what
| your arms are at.
|
| Plus, the oxygen consumption of various body parts is hugely
| variable. More oxygen requires more blood and more blood
| requires more pressure. With that kind of variance all over
| your body it's not a shock that it's also generally pretty
| variable.
| nradov wrote:
| The issue with salt and blood pressure is not so much the
| quantity but rather the osmolality. You can mitigate the
| effects by drinking more water.
|
| https://peterattiamd.com/rickjohnson2/
| bryanlarsen wrote:
| AFAICT and INAMD, but it's generally accepted that potassium is
| good for your heart. Sodium may or may not be bad for the heart
| by itself, but it also limits potassium absorption. So the
| differences in sodium sensitivity between individuals might be
| more about potassium than sodium.
| btilly wrote:
| Sensitivity varies by a lot.
| https://www.heart.org/en/news/2021/04/26/salt-sensitivity-ma...
|
| I'm at the extreme end of sensitivity. If I want my blood
| pressure medications to work, I need to eat something like half
| the recommended daily allowance of salt. Let's just say, eating
| out is a challenge.
| zingababba wrote:
| Salt absolutely does not matter for me. I eat a ridiculous
| amount of salt. Caffeine on the other hand == day long 10-20
| point increase in my systolic BP regardless of if I'm using
| chronically or not. Ultimately one of the primary reasons I
| quit caffeine.
| Try1275 wrote:
| Do you drink decaf?
| zingababba wrote:
| I don't :)
| nmz wrote:
| I went to a cardiologist and was tested while lying down. This
| was an extensive test though.
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