Is Your BP Really Normal?

[SafetyJ2006]

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.

[zip2play]

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!

[jtu91952]

Originally Posted by zip2play

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, 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. 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.

[SafetyJ2006]

Originally Posted by zip2play

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

[zip2play]

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!