Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
3 Jun

Makes My Blood Boil

blood boilI had a medical scare two weeks ago that shook me up quite a bit. No, not because there was anything wrong with me, but because if I had been someone else and didn’t know what I know, I might be suffering the side effects of blood pressure meds as I write this today. And that’s a slippery slope I never want to ride. Yet this scenario plays out in most doctors’ offices every day.

I had a slight skin thingy on my always-in-the-sun arm. I thought it might be prudent to get it checked out, and I had an hour before my next meeting, so I took an impromptu opening in my doctor’s schedule to have him take a look. In my naïveté, I thought I could waltz in, have him scan it for 15 seconds and send me home with a clean bill of health and a xylitol lollipop. But this being LA and that being a doctor’s office and needing to follow protocol (so as not to get sued for malpractice AND to be able to bill me full pop), the nurse ushered me into a waiting room and took my weight (still 165), height (still 5’10”) and my blood pressure, which I had no reason to suspect had changed since I qualified for the lowest rates possible on my in-home life insurance physical just a few years ago. It had been 122/82 that day. Cha ching.

Imagine, then, my mortification when the nurse casually announced that my BP was 140/100.

Now, in the not-too-distant olden days, if you were 100 plus your age for systolic (the first number) you were considered to have normal BP. Then the powers that be started to opine that 120 over 80 was more normal and that 140 over 90 was hypertensive. Recently, the medical industry (always looking for a way to get you medicated) has started to suggest that a “normal” 120/80 is in fact “pre-hypertensive.” Hey, the more drugs they can sell to healthy people the faster our economy will turn around, right? So at 140/100 I was a little taken aback. I sat there for ten more minutes waiting and going over all the possibilities in my mind: jet lag? (I had just gotten back from NYC the day before and hadn’t slept well), dehydration? (as you know, I don’t drink much water), white coat syndrome? (being in a doctor’s office automatically jacks up some peoples’ BP as much as 20 points), stress? (yeah, I do have stress, and I don’t handle it like I should). All these things can artificially elevate BP. I was going through all the other impossible reasons why I might test high when the doctor strode in, looked at my arm for five seconds and proclaimed the skin thingy nothing. Then he looked at my chart.

“Your blood pressure is a bit high” he says, with eyebrows raised behind his glasses.

“Yeah,” I respond, “let’s check it again, because I don’t believe it.”

So he checks it himself, and now it’s 140 over 101. He says, “ordinarily, because I am big on prevention, I would start you on medication right away, but you look pretty healthy, so let’s check it again here in three weeks, and if it’s still in this range, I’ll prescribe something. Meanwhile, try to eat better and cut back on salt. And maybe we should schedule you for a complete physical.” Well. OK, then. That’s sound advice. He was in and out in six minutes, too. Good thing he didn’t check the BP one more time, because it would likely have been 170/130 after that comment.

I had never really thought much about my own blood pressure until that moment. I’ve always had impressive stats when it comes to heart rate, BP, blood sugar, cholesterol and all the other markers we/they use. Not that I get tested much, because I try to stay away from doctors. Hey, I’m Primal. Why shouldn’t I? But something was wrong here and I needed to take control.

I decided it was time for another “experiment of one.” I drove down the street to CVS and, after a brief seminar on the benefits of all the available blood pressure monitors, wound up buying one of the coolest little home-testing devices I’ve ever seen. It’s an Omron 711-DLX with a pressure cuff that inflates automatically and outputs a big-ass digital reading every time. They say it’s as accurate (or more so) than a nurse or doctor. Consumer Reports rated it number one.

Over the next six days, I tested my blood pressure during 10 different sessions under various circumstances. At each session, I performed and recorded five tests, with about two minutes rest between tests. So the total number of “data points” I got was 50. Here is a brief summary of my results:

  1. In 50 readings, there were no repeats. Every single reading was unique. Not once was my blood pressure repeatable from one test to another or one day to another. I think that defies even common laws of probability.
  2. I never got up to 140/100 in any of my tests. The closest I got was the very first test I did the following morning (which was closest to when I had left the doc’s office). That was a single first reading of 133/92. But even then, my five-test-average for that session was 128/90 with a low of 127/83.
  3. That same night, after dinner (including two glasses of wine) I recorded a low reading of 102/66 and a five-reading average of 108/66! So in one 28 hour period, I had gone from “mild stage-1, give’em drugs” to “low-normal.”  That’s a huge variation.
  4. Almost invariably, the first reading in any session was the highest of the five tests. So if you throw that first one out, the average drops even more. I didn’t, though.
  5. Over the next several days, I tried to look for patterns. The closest I got was that in the evening I generally settle at around 110/67. I guess dinner is relaxing. Otherwise I’m up at times and down at times.

If you plot my results, they are all over the place. It’s a scattergram that only remotely correlates to time of day and/or circumstance. It turns out that blood pressure in most people (as in me) is a very dynamic metric. One solitary reading is about as useful for diagnosing hypertension as one piano note is for identifying a song. Yet, historically, the medical profession has recommended you test for BP once a year, and as recently as 2004 Dr.  William M. Tierney concluded that “a single elevated blood pressure reading – particularly an elevated systolic reading – is a reliable predictor of future problems and should not be dismissed as a fluke.” Start the drugs, nurse.

It’s only now beginning to change. Here’s a very cool article well worth the read. In it Dr. Norman M. Kaplan admits, “Of all the procedures done in a doctor’s office, measurement of blood pressure is usually the least well performed but has the most important implications for the care of the patient.” It also acknowledges that readings in doctors’ offices are notoriously bad and should not form the basis for a diagnosis, and further suggests multiple readings in the home throughout the day as the only reliable method.

Here’s what I know: The body is constantly seeking homeostasis and must make adjustments to blood pressure, heart rate, breathing, immune function, cholesterol and a hundred other parameters literally minute by minute, day-to-day based on input from you. Every time you take a bite of food, move around, decide to sleep or not, react to stress or perform any number of other normal human functions, hormonal and gene signals are sent to readjust and bring you back into balance. As long as you are eating well (Primally), exercising moderately and controlling stress, there’s a very good chance your blood pressure will be exactly where it needs to be. I was 140/100 for a reason that day. Just like I was 102/66 a day later for a different reason. Not that it had a chance in hell of happening, but what makes me sick is the idea that I might have been prescribed a diuretic and/or an ACE inhibitor to artificially lower my blood pressure had I been someone else and just accepted the good doctor’s advice without truly investigating this. And believe me, this happens every day in doctor’s offices throughout the country. Based on a government medical committee assessment that 120/80 (formerly normal) is now “pre-hypertensive,” some 50 million Americans are in line to be on blood pressure lowering meds. Some might actually benefit. Most would be far better off living Primally and letting the body do what it needs to do naturally to achieve balance.

Of course, all this begs the next question: I’m 8% body fat…does that make me “pre-obese”?

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. The last time I had a physical to qualify for my life insurance, they had me lay down for about half an hour before they actually took the reading — it seems they were well aware of the variations. The last time I was at the doctor, they rushed me in and took it immediately and of course it was a bit on the high side. No matter who’s checking it, they know the tricks to get a number that will benefit them.

    Chris wrote on June 20th, 2011
  2. This situation just happened to me. GGGRRRR

    bradley wrote on June 24th, 2011
  3. I had high bp readings alot then had one nurse use a bigger cuff and got normal readings….since losing 130lbs I am now able to use regular size bp cuff. Funny how that is….I am on HCTZ because in 3 days I can gain 12lbs in water weight and have all sorts of issues breathing and chest pains. MY bp now averages 108/60 at night and 120/86 during the day

    Teresa Parkman wrote on October 12th, 2011
  4. I’m at a loss.
    After 1.5 years of eating primally, and for the last 2 weeks ditching all dairy I seem to be at a high risk of developing heart disease and whatnot…because get this…my Fat chart results just came out at 26.5% !!!!

    I am 5’10” female, weighing in at 136 american lbs.
    My BMI is less than 20, it said 19 something.
    I’m skinny as a rail with long legs and a long neck, I don’t see any fat on me other than ~ 5 lbs of vanity chub on my belly.
    Where am I schlepping around 35 lbs of FAT???

    Do I have to lose weight? I’m gonna be sick.

    Issabeau wrote on November 4th, 2011
    • Oh and my Blood Pressure is 107/70.

      Issabeau wrote on November 4th, 2011
  5. I had a physician prescribe me 10mg of Lisinopril once a day based on two readings. Do you think I should take it? I feel like I would like more readings before I start on medication but my physician scared me into thinking I really need it. Not sure what to do…

    I am 34 with no previous high BP readings. My BMI is too high but I have lot 12 pounds over the last year and am trying to make lifestyles changes.

    Summer Henderson wrote on November 23rd, 2011
  6. hey guys, I would appreciate any advice. My grandma is in her eighties and has been taking high blood pressure medication for years. Today I sat down with her and taught her the benefits of eating primal and she has come around! I gave her a food plan and all the rest, etc. I am doing research for her in regards to ways to reduce high blood pressure naturally, and I have found many. I want to tell her with confidence to ditch the high BP medication all in one go, but I am worried if she stops them straight away she might have problems? I thought maybe go down to every second day for the first week week, next week every third day, etc. Any thoughts or knowledge in this specific scenario? Eternally appreciated!! Thank you very much!

    Sylvia wrote on December 5th, 2011
  7. I’ve a doctor’s appointment in just a couple of days and the dread of having her lecture me again has sent my already high–according to them–BP through the roof. And yes, I’m old. So I do remember the 100+ your age which, according to that, mine is a perfect 160. By today’s standards, well, I died yesterday. Yes, I think the medical community is indeed armed with great intentions. In my life’s experience, however, they are simply doing what they’ve been told and acting on the education they’ve received. And if nothing else can be said about Americans, most have indeed been educated well beyond their intelligence. So, no, I won’t take their drugs. She can write the prescription and I’ll either throw it away or have it filled and throw away the pills.

    Randy Vaughan wrote on February 6th, 2012
  8. i have the same thing when the doct. told me i have 170/ 94 , i was shock he sent me out to all kind of test and give me some sample med to, it ‘d was so nice of him??? time go by all the test found nothing, i test it in many drugs store a litle high but not that high, test at home too but the number was every where until it broke , then i found a new job that require a test that include bp test , no surprise to me it was 150/ 95
    then i decided to buy a new machine it’s was the ***HOMEDICS***
    Manual Inflate Blood Pressure Monitor
    this solve everything , it’s is acurate and the number does not jump all over the place
    one thing you have to make sure is the tube have to be level of your heart , my blood pressure right now is very normal please try that bp monior

    HoangTuNhiNhanh wrote on June 28th, 2012
  9. Butters needs to take his pom-poms and cheerlead somewhere else, maybe at his favorite hospital. lol This group doesn’t need conventional coaching.

    GoodStew wrote on June 12th, 2013
  10. I know this is an old thread, but I thought I would put in a good word for my doctor. My blood pressure was measuring a little high, (I don’t remember the exact numbers). My doctor was not particularly worried about it, but my father had high blood pressure troubles, and he had a heart attack in his mid-fifties, so my doctor sent me home with a blood pressure monitor to wear for 24 hours that took my blood pressure every fifteen minutes or so. Based on the chart, which showed my blood pressure followed a good cycle, (dropping down to 98 over something in the middle of the night), my doctor told me not to worry too much.

    BTW, after my mother’s death, I was going through some old paper’s, and I saw that my father’s blood pressure was astronomically high. I don’t remember the exact numbers, but it was 200 something over 100 something. I didn’t even know that was possible. My seems to average about 134 over 83.

    Paul wrote on February 24th, 2015
  11. This happened to me today. I had scheduled an appointment for something entirely different and when all was said and done the doctor had spoken to me more about my blood pressure than about the reason I originally booked the appointment. I walked out with a prescription for some very yucky blood pressure medication that I WONT be taking. Given that I was in pain, stressed and had drank the night before (which I never do) I was not shocked that my BP was slightly above normal. Did the doctor ask me if I had drank? Acknowledge that my pain could be elevating my blood pressure? Inquire about my diet? NOPE. Here’s a pill. Take it or you’re going to die! Unbelievable!

    mslovely wrote on January 7th, 2016
  12. I have three blood pressure monitors at home and the readings are normal. A week ago I went to the dentist and my BP was 138/94. As soon as I got home I measured and it was 113/74. I went back to the dentist the very same day and my BP was 140/93. I have been measuring at home even when I feel stress and the reading are still normal. Once I go to a medical setting and see the monitor, my body associates it with death and dying and I have a reaction. I am not being stubborn. I simply refuse to take medication because I don’t need it.

    Inory wrote on August 5th, 2016

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