A funny thing happened to me on the way to getting my chest cracked for coronary bypass surgery. I learned that my severely blocked coronary arteries were not the cause of the chest tightness I was experiencing during exertion.

Thankfully, I found out 12 hours before my scheduled operation, the surgeon who was to do the surgery was not in network with Tricare, my health insurance carrier. This caused the postponement and eventual cancelling of my surgery when I did some research and found out a bypass would not only have been unnecessary, it would have been detrimental to my health.

It turns out that while I had CAD, it was not the cause of my symptoms (see the "My Experience with Cardiologists" thread on the "Heart Disorder" message board). I had high blood pressure.

Now I am 56 years old and NEVER had an abnormally high blood pressure reading, until a cardiologist in San Diego took my BP. He had me lay down on the exam table and took my BP. It was 125/70. Normal, right? Well, then he gave me an instrument that measures the strength of the hand grip and told me to hold it above my head and squeeze it as hard as I could for one minute. My blood pressure skyrocketed to 140/110. The doctor said if my primary care physician had not put me on a beta-blocker a couple of weeks before, it would have been 200/150.

Has anyone else reading this post had their BP checked in a similar manner? If not, quite possibly you have high blood pressure that you don't even know about. My doctor says most people do not learn of their HBP until it is elevated at rest and by then, often the damage to the cardiovascular system has been done. I strongly urge everyone going for a physical exam to request their doctor take their blood pressure in the manner I have described in this post. It's quick, simple and may save your life.

:jester:

Jeff,

Do you think, then, we can say that blood pressure goes up with exertion? Do you think that while raising the ball in the air and standing on one foot would get it higher...perhaps hopping for a minute or two?
Maybe take BP only after a stress test (with or without an overhead squeezed ball) and assume that is a standard for the population? Does that leave out people who cannot run for 12 minutes up an incline? Now how would you measure them and compare them to the population?

Should a measurement at maximum stress be used to determine normal blood pressure?
If not, what degree of stress should be the standard? Why would squeezing a ball overhead for a predetermined length of time be anything but random selection for a very few and thus yield only completely anecdotal information?

0r should this method be used only to measure the BP of those who have been told they have major heart blockages...Is there a standard reference for comparison with other heart impaired patients? Should degree of impairment be a criterion in the validity of the pressure rise over the resting standard BP?

What I'm asking is what is the usual BP rise for a heart impared patient's blood pressure measured while squeezing a ball overhead compare with resting?
At what level of BP should the "squeeze ball" BP rise be treated with drugs...to what desired effect?
If a huge difference, does that imply a drugs only therapy?
Does a slight difference apply a need for surgical intervention?
Or is the test superfluous in that, no matter the result, only drug therapy for hypertension (and coronary heart disease) is ever deemed needed?

My strong feeling is that squeezing a ball overhead while taking a blood pressure reading will overcomplicate an already complicated picture for those trying to control blood pressure. Only an extraordinary amount of evidence will convince me that this technique is anything but tediously silly...and HARD to do!

Jeff,

Do you think, then, we can say that blood pressure goes up with exertion? Do you think that while raising the ball in the air and standing on one foot would get it higher...perhaps hopping for a minute or two?
Maybe take BP only after a stress test (with or without an overhead squeezed ball) and assume that is a standard for the population? Does that leave out people who cannot run for 12 minutes up an incline? Now how would you measure them and compare them to the population?

Should a measurement at maximum stress be used to determine normal blood pressure?
If not, what degree of stress should be the standard? Why would squeezing a ball overhead for a predetermined length of time be anything but random selection for a very few and thus yield only completely anecdotal information?

0r should this method be used only to measure the BP of those who have been told they have major heart blockages...Is there a standard reference for comparison with other heart impaired patients? Should degree of impairment be a criterion in the validity of the pressure rise over the resting standard BP?

What I'm asking is what is the usual BP rise for a heart impared patient's blood pressure measured while squeezing a ball overhead compare with resting?
At what level of BP should the "squeeze ball" BP rise be treated with drugs...to what desired effect?
If a huge difference, does that imply a drugs only therapy?
Does a slight difference apply a need for surgical intervention?
Or is the test superfluous in that, no matter the result, only drug therapy for hypertension (and coronary heart disease) is ever deemed needed?

My strong feeling is that squeezing a ball overhead while taking a blood pressure reading will overcomplicate an already complicated picture for those trying to control blood pressure. Only an extraordinary amount of evidence will convince me that this technique is anything but tediously silly...and HARD to do!
:wave: Zip, I think the poster is telling his experience. Not all doctors peform the same tests or have the same degree of knowledge. I too had what was thought to be CAD, i also had that test mentioned with the balls. But and I mean BUT, before anybody even dreamed of cutting, lasering or even giving me meds for CAD, they would have to give me a good reason why this would be necessary. I insisted on and got tilt table exam, stress test, heart imaging and many, many sessions of consultation. :rolleyes: A dr can make alot of Lexus pymts doing heart surgery. My first question would be is there a food, herb or pill I can take to cure, heal or slow this down. Secondly, how long can I wait before I am in trouble or what if I don't have this surgery. However, i think what
Wood,is saying before having surgery, explore all options.

Jeff,

Do you think, then, we can say that blood pressure goes up with exertion? Do you think that while raising the ball in the air and standing on one foot would get it higher...perhaps hopping for a minute or two?
Maybe take BP only after a stress test (with or without an overhead squeezed ball) and assume that is a standard for the population? Does that leave out people who cannot run for 12 minutes up an incline? Now how would you measure them and compare them to the population?

Should a measurement at maximum stress be used to determine normal blood pressure?
If not, what degree of stress should be the standard? Why would squeezing a ball overhead for a predetermined length of time be anything but random selection for a very few and thus yield only completely anecdotal information?

0r should this method be used only to measure the BP of those who have been told they have major heart blockages...Is there a standard reference for comparison with other heart impaired patients? Should degree of impairment be a criterion in the validity of the pressure rise over the resting standard BP?

What I'm asking is what is the usual BP rise for a heart impared patient's blood pressure measured while squeezing a ball overhead compare with resting?
At what level of BP should the "squeeze ball" BP rise be treated with drugs...to what desired effect?
If a huge difference, does that imply a drugs only therapy?
Does a slight difference apply a need for surgical intervention?
Or is the test superfluous in that, no matter the result, only drug therapy for hypertension (and coronary heart disease) is ever deemed needed?

My strong feeling is that squeezing a ball overhead while taking a blood pressure reading will overcomplicate an already complicated picture for those trying to control blood pressure. Only an extraordinary amount of evidence will convince me that this technique is anything but tediously silly...and HARD to do!

Zip,

Not really hard to do. Took about two minutes to do both a resting and "squeezing" BP. Dr. Wayne says people with normal BPs will have around a 10mm rise in systolic and diastolic blood pressure. Doesn't it make sense to treat high blood pressure when it is noted to be high during minor exertion yet still normal at rest than to wait until it becomes high at rest and higher still during exertion?

I am sure my cardiologist has the answers to your silly questions. I do not. I only know that I believe what he says when he says HBP is underdiagnosed and treated. How will I measure the results of his exam and treatment? Simply by whether or not his treatment affects my symptoms or not.

Isn't it interesting that many people make fun of what they don't understand. However, I don't mind if naysayers think this sounds silly as long as Dr. Wayne's protocol works. And if it does, who will have the last laugh? And if it doesn't, I will still have other alternatives available to me including bypass. But considering two doctors (my interventionalist cardiologist in Indiana and my noninvasive cardiologist in San Diego) agree my heart is healthy but my coronary arteries are not, I am confident that the doctor who told me my collateral vessels are keeping my heart healthy thus there is no need to mess with a bypass, is the right one for me to listen to.

But I do appreciate your questions, even if I find them somewhat capricious. Please continue the dialogue.

Jeff :jester:

I only know that I believe what he says when he says HBP is underdiagnosed and treated.
...

I truly find that a truly bizarre concept. It seems that nearly everyone on the planet is being diagnosed with the disease...at rest.
Looking for ways to increase the percentage to 100% by more stringent non-standard testing seems the height of silliness.
Using these powerful drugs on people with normal resting BP is like using a cannon to kill an ant...that no lo longer exists!

...

I truly find that a truly bizarre concept. It seems that nearly everyone on the planet is being diagnosed with the disease...at rest.
Looking for ways to increase the percentage to 100% by more stringent non-standard testing seems the height of silliness.
Using these powerful drugs on people with normal resting BP is like using a cannon to kill an ant...that no lo longer exists!

Dr. Zippy,

The great thing about this country is we can believe anything we wish to and are still free to be treated with almost any protocol we think will work. Dr. Wayne says the following about Hypertension:

Hypertension

(high blood pressure) as a cause of chest pain in both men and women is listed first because it is the single most common cause of chest pain, including coronary artery disease itself. In other words, more people suffer from chest pain due to high blood pressure than those who have chest pain because of obstructive coronary artery disease. Considering the fact that 64 million people in this country have hypertension, and approximately 75% of them are either unaware of its presence, or are not adequately treated, it is not hard to understand why so many individuals with high blood pressure are having chest pain.

Although it is a long known fact that hypertension can cause chest pain, it is not a commonly known fact. Indeed, most doctors including cardiologists seem to be completely unaware of it. Complicating this lack of awareness on the part of doctors is the fact that hypertension may exist for years with both patient and doctor being unaware of its presence. This is because typically such patients will have a rise in their blood pressure only during periods of stress or extraordinary physical activity. At rest, or in the absence of stress, their blood pressure is normal. Thus, their blood pressure is apt to be normal during a routine office examination in which blood pressure is typically taken while the patient is at rest. Eventually the blood pressure of such patients will become elevated even at rest, but not until there has been extensive damage to the kidneys, heart, vascular system and brain. This is why hypertension has been called the "silent killer."

The mechanism of an elevated blood pressure causing chest pain is similar to the changes that occur when a blood pressure cuff around the arm is inflated. The pressure within the cuff is transmitted to the arm itself, and directly to the brachial artery within the arm. When the pressure within the cuff becomes greater than the pressure within the artery, the artery will collapse and blood flow will stop. In the case of the heart, when the blood pressure is elevated, that pressure is transmitted back to the cavity of the left ventricle. The increase in pressure is transferred to the heart muscle itself. When the transmitted pressure within the heart wall is great enough, it will cause the small coronary arteries within the muscle, that are branches and smaller in diameter than the surface coronary arteries, to collapse. Therefore, blood flow within the muscle will be reduced or cease altogether, and chest pain will result.

It should be apparent that if an individual is having chest pain, and a resting blood pressure is normal, and that patient is made to undergo angiograms, coincidental coronary artery disease may well be found. The cardiologist is likely to conclude that it is the coronary artery disease that is responsible for the patient's symptoms. In such a situation, the patient should purchase a blood pressure cuff, and take his own blood pressure during episodes of his chest pain. If he finds his blood pressure is elevated, then he should insist that his blood pressure be brought down to normal with medications. Obviously, if medication causes his blood pressure to return to normal, and his chest pain disappears, then he doesn't need angioplasty or coronary artery bypass surgery. Finally, it would make sense to investigate the cause of your chest pain before undergoing angiograms.

I happen to believe him. You don't. I won't lose any sleep oveer your incredulity and I hope you won't lose any over what you must consider my stupidity.

Finally, Dr. Wayne is a fellow of the Academies of Cardiology, Chest Physicians and Physicians. I believe his credentials are somewhat more prestigious than yours. Or are they? What are your credentials, Dr. Zippy?

Jeff
:jester:

You know, it isn't the naysayers and skeptics who are responsible for the advances in science, technology and medicine that make our lives easier and longer. It is the innovators and those inquisitive souls who take a concept to the limits. They study all aspects of a problem or issue and make bold attempts to understand and solve it.

We can trust them or not. But to disbelieve them without studying their pronouncements is as foolish as blindly following the staus quo.

Jeff :jester:

Let's please not attack each other, we are all here to help one another. I can see both sides, but yet some can read too much into it, and think that exertion BP should be 120/80, and then take BP meds at higher dosages, causing fainting or collapse.

We all have to be carefully reading into the posts-which it seems your angina was detected by your physician, or you had been already diagnosed with some high blood pressure two weeks prior

The doctor said if my primary care physician had not put me on a beta-blocker a couple of weeks before, it would have been 200/150.

So from what I'm reading, you did have high or elevated readings to have been put on a beta blocker. Luckily you investigated further, either by doctors referral, saving you the surgery. But you have to understand not the population as a whole that upon exertion, having spikes in BP does not constitute automatic diagnosis of hypertension, otherwise we would assume that the medical society would start to put people on medications to keep their BP levels around 100/60 at relaxation, so upon exertion it would still be within normal range.

My primary care physician put me on the beta-blocker because I had CAD. She was not aware that I had a problem with my BP. However, I do agree with you that there is more than one treatment protocol to treat most medical problems and we need to appreciate the ones we are not familiar with as possible solutions, despite the fact that we do not understand how they work.