Blood Pressure Readings

[Eph289]

Hello, I would like to know if there are others who have blood pressure readings that vary quite a lot during the day and even night? I can get 114/81 in the evening after eating, and then before bed it can get to 152/105? I have also had problems sleeping sometimes, and taken my bp, and get these rather high readings, also sometimes when I awake. Most of the other times it is the lower reading, with some as low as 96/72. My GP does not seem to concerned about this. I am on meds for my bp, and have diabetes, and sleep problems for may years. Thanks very much. Andy

[Blackcatsooty]

Dear AndyIf we cant get good sleep then everything else struggles.

I made an enormous effort to get the right sleep.

I will not take my BP readings too often, as i am sure i get stressed by the readings which then makes them worse.

If my GP isn't concerned, then I wouldn't be bothered.

[Eph289 in reply to Blackcatsooty]

Hi thanks very much. You are right my sleep problem does not help with the bp numbers

[Bingo88 in reply to Eph289]

Hi there Eph289. Just a thought. I know it sounds stupid but I had trouble sleeping since i retired because of not being so active. And I was having an hour after lunchtime. That i found was not helping at all. So I now keep busy doing things during the day. And usually got to bed at 11 30. And up by 7. Hope you get it sorted and you're blood pressure. Brian

[Eph289 in reply to Bingo88]

Hi Brian, you are right about keeping active. However, I also suffer from chronic fatigue syndrome, which makes me extremely tried throught most days, and I don't have the energy to do much. I also have IBS with stomach spasms, day and night, again reducing my sleep time. thanks for your time in sharing. Andy

[Bingo88 in reply to Eph289]

Yes I can understand that. I just meant like doing things in the garden and general stuff. I have copd so struggle doing too much as well. Take care. Hope you get some answers and stability

[Eph289 in reply to Bingo88]

Thanks, wish you well

[Pandorella in reply to Eph289]

I also suffer from ibs. I wonder if you take any medication for it. I feel hopeless when I get it as it drains my energy and all I can do is sit down or ly down. Any help would be appreciated. Take care.

[Eph289 in reply to Pandorella]

Hi, I am taking Buscopan 10mb 2 tabs, morning and evening. They do help to some extent, but if I took the full dose that the Dr says, 2 tabs, 4 times a day, then I notice that my palpitations get much worse, especially at night. Cutting out or down on caffeine will help. Andy

[Pandorella in reply to Eph289]

OH, Thank you very much for your reply. I am not sleeping well so I think because I feel tired that I get it. I only drink herbal teas in the evening, I wonder sometimes if they do any good. I do take Buscopan too but only when I need them. Take care and stay safe. thanks again

[Hidden]

My understanding is that BP does naturally vary both throughout the day and with activity or stress, and if they were being monitored, many perfectly healthy people would get odd readings each day that would be classed as on the high side if occurring consistently, but what they’re actually concerned about is when average BP is high overall. I get odd highs throughout the day (and I also have definite white coat syndrome) but I’m considered to have normal/low-normal blood pressure, even though I’ve had an on waking BP of around 140/90, in spite of taking verapamil to manage my arrhythmia, which is also used for blood pressure management. The advice I was given by my GP was to do 3 readings a minute apart, then average it, and repeat 3 times a day e.g. very first thing (before getting out of bed), lunchtime, and just before bed. I’ve been told to do 7 days of readings like that every 2 or 3 months just to see what’s happening. Doing it that way, I do still have some readings that are a bit on the wonky side, but the three readings does generally bring the average down a lot in my case, and therefore my daily average down with it. I suspect this is partly because I have an extremely reactive heart rate: simply talking often increases my hr by 20-30 bpm, and I easily hit 110+ walking across the room, so even just putting the bp cuff on leads to a significant increase in both pulse and bp for me. It’s also advisable for blood pressure to be checked after resting and sitting quietly for a few minutes, not as soon as sitting down. Hence why the docs don’t immediately slap a blood pressure cuff on you the minute you turn up.

Am I reassured that my bp is ok overall? Honestly? No, I’m not. I have high cholesterol, and there is terrible cardiac history in the family, and I’ve struggled to get them to take my heart issues seriously from the outset even though I do have a cardiac diagnosis. I’ve also had several fairly major missed diagnoses, and misdiagnoses, generally, in recent years, which makes me (understandably, I think) a little more wary these days. But, the only way to know for absolutely sure what your blood pressure is doing would be an ambulatory bp monitor for a day or two, and these don’t seem to be particularly common on the nhs unless there is a very high index of suspicion that you do have hypertension. So, in the interim, I’m following the doctor’s advice regarding periodic monitoring, and just watching to see which way it goes over time. A daily average BP of 140/90 or more is the NICE threshold for diagnosing someone with hypertension and starting treatment. As with most things, NICE have produced guidelines for the diagnosis and management of hypertension, which if you’re interested can be found here:

nice.org.uk/guidance/ng136/...

They essentially say that in the absence of ambulatory BP monitoring, a diagnosis is made on the basis of an averaged reading of 140/90 or above, obtained from two averaged measurements taken one minute apart whilst seated, every morning and evening for at least 4 but ideally 7 days.

Hope that helps.

[Eph289 in reply to Hidden]

Hi Charlie, thanks for taking the time to share so much very interesting info. Am I right in thinking, that if my bp was high every time I took a reading, like 150/100, for example, then this could be a problem? Generally I get about 110-140/75-95. the strange thing is, as I also have IBS, I have noticed that when there is increased activity in my stomach, that shortly after, my bp goes up. I read somewhere on line that these two can be linked. Cheers Andy

[Hidden in reply to Eph289]

Hi Andy,

I believe you’re talking about the gastrovascular reflex: studies have shown that there is a definite link between gastrointestinal processes (or problems!) and a temporary increase in blood pressure, so what you’re suggesting is entirely possible. It’s also been found that there are other links between what’s going on in the digestive system and things like palpitations owing to the vagus nerve: the bottom line is that we actually understand far less about medicine and the human body than most people think. But this is why they advise only checking BP a couple of times a day, because there are so many things that can impact on fluctuations in the readings. If you know that there’s a link between your gut activity and your BP, any associated high possibly ‘doesn’t count’ if that makes sense? Entirely out of curiosity, I did multiple readings a day for a few days last year, and although there was no obvious rhyme or reason, even on days where my daily average BP came out below 120/80, I would still have 2 or 3 readings out of 10 that averaged at about 140/90. The highest I had was an average of 148/95. The other averages across the day were low enough to drag the daily average down.

With regards to your BP: as per the NICE guidelines, if you took 2 readings first thing, a minute apart, and they were both around 140/95, that would only be of concern if your evening measurements also came out as an average above 140/90, AND if it was persistent over the course of a week. If you had one of 140/95, but the evening was 110/75, your daily average BP would be 125/85. My understanding is that this would be considered high-normal, but still normal. However, if most or every averaged reading (and it’s actually the averaged bit that they deem important, so two readings each time, and then the average of each day over several days), was above the threshold, then yeah, that’s an obvious red flag. I missed in your original post that you already take BP meds? I think if you follow the NICE guidance, so average the readings twice a day for a week, and found you were persistently coming out high end normal, which is above 120/80 but below 140/90, I would be speaking to the GP about the medication you’re on and whether or not it’s doing the job. The whole point of BP meds is to lower your bp to a healthy level, and although the threshold for treating hypertension is 140/90, you already have hypertension, and healthy bp is currently defined as being between 90/60 and 120/80. That said, I’m not medically qualified, so it is just my thoughts and opinion based on what I understand! 🤷‍♂️

Edited to add: the NICE guidelines I linked to will probably specify what ‘well controlled’ hypertension looks like, so might be able to guide you.

[Eph289 in reply to Hidden]

Hi Charlie, thanks again. I am on Ramipril 5mg twice a day, Bisoprolol 1.25 also twice a day, and Bendroflumethiazide 2.5 in the morning. I do also get ectopic heartbeats sometimes that can last from a few hours, to a couple of days. Even this I found to start after some gut disturbance. All very strange. I have been to the hospital and have a few tests done, and all fine. The cardiologist said the he also had the ectopics that lasted a while, and there was no problem. I have seen a study that you mention, which is very interesting. Cheers Andy

[Brokenheart19 in reply to Eph289]

Hi AndyAlways take two readings - the second is usually lower. My mum has white coat syndrome and her bp skyrockets in the surgery. She now finds her bp different in both arms 🙄 just to add to the confusion. Take it twice is the general advice. Take care

[Eph289 in reply to Brokenheart19]

thanks. can I ask what sort of numbers does your mums bp get to, when it "skyrockets"? Andy

[peterjones105 in reply to Eph289]

Almost up to stroke level but since I packed up caffeine my BP is far more stable.

[Eph289 in reply to peterjones105]

Am I right in saying, that for "stroke levels", the bp is high, like 180+/110+ for hours? Does a one off reading of this, also cause strokes?

[peterjones105 in reply to Eph289]

In my particular case my insane BP readings were a spike; AFAIK (and I am not a doctor) if they were maintained for hours they could well present a stroke danger however if they return to less insane levels the immediate danger passes.

[Eph289 in reply to peterjones105]

what numbers are you talking about here? thanks

[peterjones105 in reply to Eph289]

Normally my BP is around 125/65

[Brokenheart19 in reply to Eph289]

One arm is within normal limits ie 120/80 other arm and white coat she can be 220/130 so she really struggles!

[Eph289 in reply to Brokenheart19]

When I first had crazy bp numbers, I thought that my then Microlife bpm was faulty. So I contacted the company, and was told that their testing showed that a person can have a reading of 170/110 and then 2 minutes later, 130/90! Our bodies are very strange.

[peterjones105]

Just a couple of comments from my experiences: anxiety about BP monitoring can have the undesired effect of temporarily increasing your BP by as much as up to +50 mm.hg.I agree with the others that BP can vary throughout the day depending on your activities

I had to give up caffeine entirely even decaf drinks as I found that caffeine made my BP increase dramatically, this may not apply to you however recent consumption of caffeine may cause your BP to spike unrealistically.

Good luck, Peter.

[Eph289 in reply to peterjones105]

Hi Peter, thanks. Do you mean that even decaf drinks can be bad? Andy

[peterjones105 in reply to Eph289]

Even decaf affected me but of course it may not affect you

[Hidden in reply to peterjones105]

Hi Peter yes me too! I found my systolic shot up to 150 just on normal black loose leaf tea and took an hour to drop down to 130. So decaf for me too. And salt. And alcohol : (

[peterjones105 in reply to Hidden]

It very much depends on you, most people probably don’t react to caffeine as I do, decaf drinks have about 10% caffeine and even they affected me, why not try giving up caffeine entirely for say a week or ten days and see if it has any effect on your BP?Good luck,

Peter.

[peterjones105 in reply to peterjones105]

PS seemingly alcohol doesn’t have the same effect on me as caffeine.

[Eph289 in reply to peterjones105]

I do like the diet fizzy drinks, which I have heard are not that healthy anyway, and can also increase bp?

[Eph289 in reply to Hidden]

are you saying that salt does not increase your bp? Thanks

[Hidden in reply to Eph289]

no - I think it does increase your B/P and it is easy enough to go without - we cook from scratch and I am avoiding bread at the moment as I am trying to get BMI down to 23. It is the hidden salt that is a problem, when you start looking at the labels it seems to be in everything. I put the salt cellar on the table for the rest of the family who don't need to be so careful. I get unsalted butter, very low salt stock cubes etc.

[Ianp66]

Hi Eph, I have varying BP throughout the day and suffer white coat syndrome, basically anytime I go the the doctors or they put a cuff on mine goes up. Stress or even slightly feeling anxious can impact BP quite a lot. I don't take it so much now and try deep breathing for 60secs or so that normalises it usually.The more you worry and become anxious the more itl become erratic, it's hard but try relax and if your GP is happy with it try not to think about it so much and stop checking it so many times, it certainly helped me. Hoept that makes sense, mines 138/75-85 typically but can change depending on situations etc.

Ian.

[Eph289 in reply to Ianp66]

Hi Ian, thanks for taking the time to share. I also find that worry and stress are a big factor in my bp, as well as what I eat and drink. Also, my lack of any decent sleep most nights does not help. Andy

[Ianp66 in reply to Eph289]

Poor sleep also as you say Andy doesn't help at all . Im much the same, very reactive to outside events like stress, lack of sleep etc.Magnesium has helped me enormously with the sleep part and also relaxation works wonders for both for me . Worth a look if you haven't already, and its supposedly helps with BP I've read .

[Eph289 in reply to Ianp66]

I will check to see if a Magnesium suppliment would cause any problems with my other meds, thanks

[Hidden]

Hi. 3 weeks ago I did a 24 hour ambulatory blood pressure monitor. My GP wanted to medicate me on the strength of 3 readings done at the GP surgery. I needed more evidence that this was the right thing to do mainly because I usually don't do well on meds - Paracetamol is about the only thing I'm ok on.I got the results of my 24 hour monitor and it was very interesting. So the monitor takes 2 readings every hour until 10pm then 1 reading an hour overnight. Every reading was different with a couple of highs of 150 which seemed to link in with caffeine.

I got an average reading and a minimum maximum reading plus a print out of every reading.

I don't know if my readings indicate an unstable B/P or if there is such a thing, I understand it is normal for blood pressure to fluctuate all the time but I have a phone consultation booked with the Dr Gupta who will take me through the results.

I paid privately for the monitor and consultation but it is well worth it for the expertise of the cardiologist.

I think I can say on this forum that I found, and used, York Cardiology through this forum.

Dr Sanjay Gupta of York Cardiology, has some great talks on utube as well, well worth having a look.

I certainly think your GP will pounce on you if you need medication!

[Eph289 in reply to Hidden]

Hi, thanks for replying. Do you ever get the highs of 150 at night, or early in the morning? I have a few times, though mostly it is quite normal. It is these spikes that I am concerned about, but been told by the Dr that it is quite normal. I too like Dr Gupta's Youtube channel, well presented and easy to follow. Andy

[Hidden in reply to Eph289]

hi - just looking at the readings. I got 09.08 150/88. 11.39 153/87. 18.08 156/76 and these timings tend to coincide with having a cup of tea or coffee; the minimum reading was 110 and the max 156. and my average 130/73, so I feelmore confident about not taking the meds the GP gave me. But if the cardiologist says I need to take them I will.

[Eph289 in reply to Hidden]

Hi, your lower numbers look good. I can get some crazy numbers like 152/107! but not for long. I often wonder about these home bpm's. I keep two, one by A&D Medical and Microlife

[Hidden in reply to Eph289]

Can you get your pharmacist or the nurse at the GP practice to check your monitor against theirs?

[Hidden]

Oops sorry didn't realise you are already on meds.