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Old 11-12-2004, 01:13 PM   #1
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Which BP reading is correct?

I was asked by my Physician to monitor my BP at work(white coat). It never fails, when I take it, the first reading is higher. Normally the first one will be something like 138/85 +/-....If I wait a couple of minutes it will be in the range of128/82 +/-. I'll sometimes take it three of four times a couple of minutes apart. It's never the same, but the last two or three are always lower than the first. I've even tried waiting a couple of minutes before the first test and it's still higher. Thoughts? How do you determine which to use?
This is early in the A.M. at my office. If I take it at home in the evenings it's even lower, around 120/78

 
Old 11-12-2004, 02:02 PM   #2
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Re: Which BP reading is correct?

Perfectly normal. You sound exactly like me. It will usually be lower at night for most people. The 1st reading is higher, because of anxiety+. No worries. I usually average the 2nd & 3rd readings.

 
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Old 11-12-2004, 02:40 PM   #3
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Re: Which BP reading is correct?

Quote:
Originally Posted by Lillians Axe
Perfectly normal. You sound exactly like me. It will usually be lower at night for most people. The 1st reading is higher, because of anxiety+. No worries. I usually average the 2nd & 3rd readings.
Thanks. I didn't realize how much you BP fluctuates. I still don't understand how they can say your have high blood pressure if it's not high all the time.
If I'm running around the office or having a conversation on the phone, it might be over 140 a couple of readings. My Dr. is concerned about a half dozen readings of 140 and 141 systolic when the many dozen others are less.
Makes no since, guess that's why I'm not a Dr.

 
Old 11-12-2004, 02:43 PM   #4
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Re: Which BP reading is correct?

I agree with Lillian's Axe. The very first reading for many, if not most people is always higher than the subsequent readings done in one sitting. (probably a little anxiety coupled with the "oddness" of feeling the initial cuff inflation.)

Like Axe, I take three readings (two minutes apart). THROW OUT THE FIRST ONE, then average the last two.

[By the way, a lot of people get slightly different average readings between one arm or the other. If this is the case, most doctors suggest picking the arm that give the HIGHER readings in general and staying with that arm only, to monitor your BP over time.]

Sounds like you're FINE though.

zuzu xx

 
Old 11-12-2004, 02:51 PM   #5
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Re: Which BP reading is correct?

Sndsysltd,

BP is supposed to fluctuate all day. True hypertension is diagnosed only when your BP is elevated and stays elevated even at rest and while relaxed. It's the sustained high numbers that are cause for concern.

zuzu xx

 
Old 11-14-2004, 02:25 PM   #6
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Re: Which BP reading is correct?

Quote:
Originally Posted by sndsysltd
I was asked by my Physician to monitor my BP at work(white coat). It never fails, when I take it, the first reading is higher. Normally the first one will be something like 138/85 +/-....If I wait a couple of minutes it will be in the range of128/82 +/-. I'll sometimes take it three of four times a couple of minutes apart. It's never the same, but the last two or three are always lower than the first. I've even tried waiting a couple of minutes before the first test and it's still higher. Thoughts? How do you determine which to use?
This is early in the A.M. at my office. If I take it at home in the evenings it's even lower, around 120/78
Without a doubt, my FIRST reading (at home) is always higher....around 145/85. The second is usually around 132/80...and the next 3-4 drop further to mid 120's/75. I could never understand WHY..even if I sit longer for the first reading

 
Old 11-14-2004, 03:07 PM   #7
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Re: Which BP reading is correct?

Quote:
Originally Posted by rahod
Without a doubt, my FIRST reading (at home) is always higher....around 145/85. The second is usually around 132/80...and the next 3-4 drop further to mid 120's/75. I could never understand WHY..even if I sit longer for the first reading
It doesn't seem like that always happens to me, many times it's normal first-shot, but I do have this sometimes as well. If any high readings are to be seen in my testing session, it is likely to be the first one. For me, it's because I am anxious and until I get that first one out of the way I remain anxious (and get more and more anxious waiting). As soon as I get the first reading out of the way, I get much less worried regardless if it was high or not.

If you don't feel worried and feel relaxed and always get high readings the first time, I would go by the first reading.

Last edited by naes; 11-14-2004 at 03:09 PM.

 
Old 11-15-2004, 06:23 AM   #8
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Re: Which BP reading is correct?

Why should it be high at the docs???

1) Someone else is taking your B/P

2) You are in a different setting than you are used to.

3) You know that they will advise you to get a script for meds.

You walk into the office, after a 30 minute drive. Fill out insurance paperwork. Sit in the waiting room for 20-30 minutes thinking about the appointment. Have your weight checked. You are then brought into another room, walking+. They take your B/P right away.... Of course it is going to be higher. The rush in-rush out mentality is horrible. My doc. was talking to me for 5 minutes before taking my B/P. Of course it is going to be elevated. If I have white-coat what does he figure??? Did he talk to me about anxiety? No. Did he ask about the side-effects without me complianing to him for the 100th time? No. He just said that my stomach is upset in the morning, because of anxiety. He said that he has the same thing. What about my weight doc. I'm 5' 11" 150... "you are perfect. I have the same problem with anxiety & my weight is always on the thin side as well." Great! A doc. that has everything that I have without any answers.

 
Old 11-15-2004, 06:33 AM   #9
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Re: Which BP reading is correct?

I take 3 readings and many times my first is always higher. Before I was put on Diovan my readings at the doctors office were always over 140/90. I took them at home and they were in the normal or high normal range. I had a physical and the doctor checked it and it was 160/100. That is when he decided I needed medication. Now my readings average 115/75 most of the time. I have also noticed that after exercise my readings are always lower. I guess that is why they recommend aerobic exercise daily. I have a two glasses of red wine about 4 or 5 nights a week. Can this lower or raise BP??
I also sometimes wonder if I truly have hypertension or just "WHITE COAT" ??

 
Old 11-15-2004, 06:56 AM   #10
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Re: Which BP reading is correct?

Lots of posts about white-coat. If your normal reading away from the doc. are in a good range, I wouldn't worry about it. I can take B/P meds & it still doesn't work at the doc. It will still be 156/86. I can take it through the week (like I have done for 21 months) & it will be 108-116/64-76 depending upon the day. When my systolic drops 34 points & my diastolic drop over 11 points 1/2 hr. after the doctor, I believe that white-coat is the reason. It's obvious. They will say that if it high at the doc. what about when you drive in rush hour traffic or dealing with something stressful. How often does that happen compared to what happens on a normal everyday basis? It is just an excuse not to treat the underlying problem, which is anxiety & the B/P is a secondary cause. The problem is that a lot of GP's don't understand white-coat. They will do the blood tests, EKGS, thyroid tests+, but let them try to come to your house when you are relaxed & measure it. It will never happen, but they prescribe to cover there you know what. I say treat the anxiety 1st & everything else will be fine in the process. Why doesn't that make sense to them? 1/4 of all HBP patients have white-coat. This tells me that 1/4 of them may be medicated when they don't need to be on B/P meds. If anxiety is the cause, treat the anxiety 1st.

 
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