Blood presser

[Peter Drouin]

Is it 120 over 80? And what is high presser?

[WV Sawmiller]

   I'm no doctor or expert but best I remember they start to get concerned when top number reaches or exceeds 140 or bottom number reaches or exceeds 90 but probably different for different body types and such.  Hopefully @doc henderson or others in the know will chime in. As I remember 120/80 sounds pretty good/normal. Stay well.

   BTW - check it after dealing with a problem customer and see what it is and let us know.

[Old Greenhorn]

Not sure if you are saying that 120/80 is your pressure, but if you are that isn't too bad for an adult male. The 120 (systolic pressure) is spot on perfect, but the 80 (diastolic pressure) is a bit high. Your pressure is affected by MANY things, including a cup of coffee or anger that are very temporary (hopefully). However, if your pressure is always at those numbers, it might deserve a deeper look. B/P is relied on by a lot of lay folks and medical pros as a strong indicator of health, however, if the readings are not taken correctly they can be very mis-leading. Using the wrong size cuff for instance will give incorrect numbers, by a significant amount. Automatic units can also be erroneous for a number of reasons. SO it's best not to hang your hat on a single reading, but to look further if there is an indication something might be up. Start by taking readings regularly and recording them to see if there is a trend, this gives a better picture. Many Docs will prescribe B/P meds based on a single reading and I have always had a problem with that.
120/70 is considered pretty close to perfect for an adult male, females a little lower. I know few who have this. Some think 130/70-80 is pre-hypotensive (early stage of high blood pressure) and most will prescribe meds for it, there is debate on this and it changes as knowledge grows. If a person is above those last numbers, certainly there is something to look into and learn what is going on.
High B/P can also be treated without meds through diet, exercise, and stress reduction. but in many cases meds are required. I am NOT a doctor, there are a few here who cold chime in and give you much better information. DO not use this information to make any decisions, it's just background for you.
Did that answer your question?

[BradMarks]

Old Greenhorn may not be a doctor, but he is spot on. Readings vary all the time, and there is no one number that fits all. 120/80 is said to be the target, maybe one day I'll get to the 120 part, probably not. Forever it seems at 140-155 on the high end for me, after my Doc prescribed HBP pills (which I didn't take - I hate pills) a year later I was down in the 130's, good for me. Less stress I guess(reduced work load), lost a few pounds (not overweight) and probably one less cup of coffee before the pressure reading!  All I am saying is readings vary and one test is not enough to diagnose HBP.  

[doc henderson]

everyone is correct!  yeah.  It is debated and there is also a pendulum as to what is recommended.  i think of the heart like a piston or reciprocating machine.  get a heart beat (contraction of the muscular L ventricle) with a spurt of blood(ejection fraction) x heart rate or beats per minute = cardiac output (volume per minute total.)  HR and EF can change based on needs for blood flow.  the old fight or flight get activated in the office setting and bp can go up even though it is no longer needed like it was with dinosaurs ect.  or maybe on your walk to your car in the parking garage after dark in the big city.  If our arteries were copper pipes, when the heart would beat our pressure would go sky high, and between beats drop to zero.  But our arterial system is elastic with interior and exterior walls and muscle in-between.  if your pressure is always high, the muscles have to work hard to contain the pressure and you get hypertrophy of the muscle layer (think of Arnold Schwarzenegger).  this enlargement of the muscle will make the arteries more rigid and decrease the interior lumin, further leading to high blood pressure due to increased resistance.  As we get older we also get calcium deposition and the arteries naturally get more rigid (hardening of the arteries) and more like the copper pipe.  The system is designed to operate like a locomotive changing the reciprocal motion (heart beat) to a more continuous motion (circular) .  when the volume of the ejection fraction enters the aorta and other arteries, they expand to contain the volume.  so the pressure goes up but not too high.  this is how you can feel a pulse with the expansion felt through the skin.the systolic bp is the highest attained after each heart beat.  the bp cuff exerts a pressure on the artery like a tourniquet and as the pressure is released, we can hear or feel the pulse when the arterial pressure exceeds the cuff pressure.  we keep releasing until we do not hear it anymore and that is the diastolic pressure of the lowest pressure prior to the next heart beat.  You will feel fine with a bp of 150 over 90 but studies show you will live longer with a pressure of 120/70.  If you catch it early.  People come to the Er with a pressure of 140/80, and I tell them it will probably kill them,... in about 30 years.  some will take it and it is borderline, so they have a family member take it, then go to walmart, then a fire station and by the time they get to me it is 180/100.  i put them is a room and let them sit, and in 2 hours with nothing it is back sown to 140/80 and i send them to their Dr.  240/140 is an emergency, and others should not be ignored, but i do not want to prescribe a 200 dollar Rx. that you doc may change in 2 days for a medium high bp.  If you are in your 90s you will have hardening of the arteries and we will let your top number go higher, as the bottom goes lower.  if we try to lower the top, it may drop the bottom to close to 0, and you will have dizzy spells or fainting.  Kidney problems and other health issues can raise your pressure, and we need to address the main problem, rather than just treat the bp.  The cardiovascular complications of long standing under-treated bp, is heart attack and stroke.  some things are worse than death.  hope i did not go on too long, but you are mechanical folks and thought this might be a way for you to think about it.  @Peter Drouin if your new car makes your bp high, I know a few guys who would take it off your hands.  it probably lower it.  @Magicman i used to say 75 was old, but in your honor i made it 90.  daily physical activity is healthy.

[Southside]

Pain will also increase your BP. When a chip broke free from my L4 a couple years back and wedged into a nerve root my BP at the ER was 290/195, and I don't have high BP, well I kept telling the folks something was wrong as the cuff was way too tight. Turns out the chart    only goes to 300. 

[Old Greenhorn]

everyone is correct!  yeah.  It is debated and there is also a pendulum as to what is recommended. ......

Thanks Doc, I was hoping you would come in with a more comprehensive explanation than I had. I relate most of the body systems to mechanical, it is much easier to learn and also makes a working diagnosis come quicker when required.
 The highest one I ever measured was on a 30 y/o male. 220/180. He was at a live burn drill and I saw him and he failed my look test. I sat him down. Checked him out, and took him out of the evolution, much to his protests. I gave him 1/2 hour and did it again, very tiny improvement. He said 'this is normal for me', I'm fine. I talked to his Chief who took him off active duty until he had a Doc check him out. He got checked on Monday and was in the cath unit Monday afternoon.  Several blockages. He was ticked at me, but likely he would not have lived long had we not pulled him out of the game. He was about 120 pounds overweight and a lovely shade of crimson most of the time.
 I am sure you know the mortality rate of folks with a cardiac event at age 30 better than I do, but they are not good odds.
 Eventually he forgave me, nice fella that he was.

[doc henderson]

If he had 2 energy drinks that am, he prob would have died that day.  that is why we ask the impossible (military)  from only the youngest and healthiest recruits.  you prob. saved him from a life of disability and or early death.  had a roofer die of MI after several energy drinks for breakfast at that same age, could not get a heart beat long enough to get into the cath. lab.  with all the stimulants it may have been spasm without true heart disease.  fortunately most FF members are too stubborn to succumb!!!  @Southside  

[doc henderson]

to make sure I answer your question, 120/70 is great but you still won't live forever.  some at that level will be dizzy when they stand up of have no energy.  as you get older, we allow a higher top number as we discussed.  it doesn't help if you cannot get out of bed.  some argue the bottom number is not as important.  it is complicated and why you have to see your doc.

[Peter Drouin]

With 7/1/2019 started
I'm going to take my BP in the morning and at night
Today
sys  171
dia  105
pul  69

tonight
sys 172
dia  92
pul  75
I have an arm one from wall mart name is Relion with a cuff fits good.
So what I'm going to do is do it for 2 or 3 weeks and find an average. I'm on lisinopril 5mg one a day now. And see what the Doc will say.

[ljohnsaw]

If you want a professional to take and record your BP over time, do what I do - give blood!  Actually, I give Platelets every two weeks (you can only give whole blood every 8 weeks).  I have RNs or phlebotomists do it right and I have a pretty good record over the last 4 years.  

 
The beginning of the graph where there are some long breaks is where I was giving whole blood.
The last one was about the highest top number (138) because I went in after 12 noon.  Normally I'm there at 7 am and my BP is 110/60.  I don't drink coffee and I rarely use salt.

BTW, if you are healthy, Give Life, Give Blood! (or even better, Give Platelets!)

[doc henderson]

peter, take your cuff with you to your doctor and check to see that is accurate.  If it is, you need a bit more med most likely.  No point in doing it half way.  your cuff may be off.  the home automatic cuffs can help with a trend but may be off.  sounds like a low dose, and it may not be the best choice for you if it does not get it down at higher doses.  my 2 cents at no extra charge!!  

[Peter Drouin]

Check the cuff. Good idea. Thanks.


Platelets,    at 64 I might need them all.  When I go to see the doc, I'll ask. Thanks 

[Old Greenhorn]

What the Doc said Peter, those cuffs are getting better, but can still be off. There are just too many variables. Even the ones in hospitals can give 'off' readings if not applied properly. So on your part, using it the same way every time, putting it in the same right location and orientation each time. Take your readings after you have sat for a while but not laying down. Same position each time. If you know your unit reads higher than the Doctors unit, that's fine, just know that and adjust in your head. Soon you will notice connections between your daily activities and your B/P.
 As Doc said, you are looking for a trend, it's not always about the straight numbers, but how they trend.
 Those home automatic cuffs are actually pretty neat. A friend of mine ( a DDS with extensive outdoor medical background) and I did an ad-hoc study on using them in firefighter re-hab during high stress incidents. We got a few different brands of the wrist type and tried to correlate them to standard units. During a major incidents it is much faster to do a B/P on the wrist than to have them strip off their SCBA and coat. We were going to write a paper on it, but he was killed in a diving accident before we finished and we were still trying to nail down some pesky anomalies. Also, the opportunities to do tests and record results during high stress incidents was a little limited, so the study stretched out over time. Bottom line was we found a lot of variation in the different brands and how they were applied. consistency matters a lot.
 I started on the same dosage and med as you, years ago and that worked for me, but eventually I stopped because I made diet and exercise improvements that worked for me as well as changing jobs, which REALLY worked. Haven't taken them in many years.
 The more info your Doc has about your daily trends the better he can set the dosage. By giving him that info, you are helping him take better care of you instead of a good educated choice based on one B/P taken in the office.
 By the way, your daily water intake also has a big effect on your B/P. if you do heavy work and don't drink enough water, you will have issues. That was hard for me to work on and improve, it's now a habit to drink water regularly through the day, everything is better. I try to drink at least a gallon on a normal medium stress day, more when it's hot and doing heavy work.
 You are on the right track, just keeping an eye on it. Keep pluggin'

[doc henderson]

low platelets, use caution with asprin and your doc may weigh in.  under 50 could not have surgery, under 20 would need a transfusion of platelets.  Many reasons for this so keep that appointment.

[Peter Drouin]

Next Monday at 4,30, Going to check the A1C too.

[ljohnsaw]

low platelets, use caution

I have no idea what my platelet count is other than I do clot up pretty quick.  Must be enough since they take 3 units from me every 2 weeks.

[doc henderson]

john, you should be ok since they are check to make sure you can afford to loose some.  the number we use is actually x 1000.  so 60 is typically 60,000 and average normal is about 350,000.  under 20,000 puts you at risk.  the key is to find out why they are low.  If you do plasmapheresis they are checking.  Peter, just like your favorite car, I am glad you are looking after maintenance in yourself!  

[Peter Drouin]

I do want to be around to drive the wheels off the thing.
But, I think it might boost up my BP some, At about the time I get in it. I know my heart races some.
You just can't bleve the fun it is to drive. Pore old Harley just setting.

[Old Greenhorn]

How are you making out Peter? Is it starting to make sense to you? Hope it went well with the Doc.