Blood pressure readings with different body positions.

[jack2964]

I've spoken to my Thai GP about variations of my BP when taken at home with an Omron model M5 device.

He says the true reading is when taken while seated in a chair. I am not doubting him but would like to hear from others.

I am considered hypertensive with regular readings of 140+/90+ when readings are taken sitting down. However if I were to lie on my

right side on the bed the readings are good at 110+/70+. Lying on the left or on the back in bed gives 130+/80+.

Before I consult another GP, anyone here has noticed these variations or know what position to adopt for a 'true' reading?

Thanks.

[FBN]

One of the reasons for different readings in different positions is purely gravitational; quite a large volume of blood gravitates to the legs in the standing position which usually accounts for lower readings in this position.

Supine positions may be higher for the same reason but, with a normal heart and vascular system, the body compensates for each in different ways; increasing heart rate, constricting selected blood vessels etc.

Seated positions could then be considered an average for BP.

Readings between left and right arms may also differ by 5 - 10mmHg. Slightly higher differences may still be normal between standing and supine positions. Don't take readings while lying on the side; these will not be accurate and don't take readings immediately after changing positions. Allow 3-4min for the body to compensate to get a representative reading.

Consistent elevated pressure readings above 140/90 usually indicates hypertension which then needs to be investigated further.

[jack2964]

I've posted this mainly because I am on the verge of starting medication and I believe once started I'll have to continue for the rest of my life.

Seeking information on websites led to this interesting article http://www.nature.com/jhh/journal/v17/n7/full/1001573a.html#bib2.

It would appear there are many variables for a truly accurate reading of BP; be it arm/body position or device type.

Sitting upright with legs uncrossed and left arm at heart level does seem to be the standard though...not good for me!

[Sheryl]

If your BP when seated is >140/>90 there is no getting around the need to lower it.

If you are reluctant to take medication, can try:

- weight loss - will almost always reduce BP

- reduced intake of sodium (salt and preserved foods)

-increased regular exercise

These will often be enough to bring people with mild hypertension down to normal range.

However if they are not -- or if realistically you are not willing/able to take these steps - then go on the meds. The alternatives (stroke, incapacity, deaths etc) are a whole lot worse.

[Lefty]

Even simple things like crossing your legs while taking blood pressure will make a difference in readings..

Lefty

[Lazy Sod]

Whenever i go to Samitivej they take my blood pressure whilst sitting down BUT the arm is not supported (wrist left dangling down to my lap). I thought the arm is supposed to be supported so that the velcro pressure sleeve is level with the heart (well that's what the instructions that came with my machine say).

[jack2964]

If your BP when seated is >140/>90 there is no getting around the need to lower it.

If you are reluctant to take medication, can try:

- weight loss - will almost always reduce BP

- reduced intake of sodium (salt and preserved foods)

-increased regular exercise

These will often be enough to bring people with mild hypertension down to normal range.

However if they are not -- or if realistically you are not willing/able to take these steps - then go on the meds. The alternatives (stroke, incapacity, deaths etc) are a whole lot worse.

Yeah it is inevitable, with age the old arteries are not what they used to be. I believe genetics is a major factor on one's longevity or lack of.

Time to get the runners out again.

[jack2964]

Whenever i go to Samitivej they take my blood pressure whilst sitting down BUT the arm is not supported (wrist left dangling down to my lap). I thought the arm is supposed to be supported so that the velcro pressure sleeve is level with the heart (well that's what the instructions that came with my machine say).

This goes to show even the hospitals do not adopt a uniform standard. I remember I've even had my BP taken from my right arm by a clinic.

[CaptHaddock]

For an accurate BP reading you should be seated on a chair with both feet on the floor and your back supported by the chair. Your arm should be supported at the level of your heart. Don't speak or move while the reading is being taken. My experience with BP readings taken at hospitals here in Thailand is that the nurses do it correctly much more often than the doctors I have seen in New York. On one occasion the machine a nurse was using would have put me in a position leaning forward rather than sitting up straight. So, I insisted they use a sphygmamometer instead. Which they did.

[rak sa_ngop]

Even simple things like crossing your legs while taking blood pressure will make a difference in readings..

Lefty

Sometimes an irritating itch when taking a home measurement seems to increase my b.p. (note spelling of itch!)

[maxx58]

I also notice that when I take my BP at home with my Omron device my BP is great, but when I go to see the doctor and they measure me it is high. This happens every time I go to see the doctor. It was making me wonder if the device was faulty, so I brought my Omron device with me on my last visit and sure enough the reading was high. This was a relief in that I now now that I suffer from "white coat syndrome" whenever I visit the doctor.

[canman]

I also notice that when I take my BP at home with my Omron device my BP is great, but when I go to see the doctor and they measure me it is high. This happens every time I go to see the doctor. It was making me wonder if the device was faulty, so I brought my Omron device with me on my last visit and sure enough the reading was high. This was a relief in that I now now that I suffer from "white coat syndrome" whenever I visit the doctor.

I would reccomend everyone who uses a home device do the same thing every time they visit the doctor. Once you see that the error (if any) is repeatable then you can make the corrections to the numbers with some confidence.

[Rsquared]

I concur with the "white coat syndrome" as I have taken medication all my life for high blood pressure......had all the tests done, never smoked in my life, not overweight and always been active.

Conclusion was that I just got dealt a bad hand with genetics as far as BP goes. When I measure myself at home....all good, then no matter how much I try to relax when a white coat takes my BP.....through the roof!

Cheers.

[CaptHaddock]

White coat syndrome does not mean that your health risks are normal:

Participants with white-coat hypertension at the start of the study had more than double the risk of having sustained hypertension a decade later, compared to those with normal blood pressures. Those with masked hypertension had a 78% higher chance of developing sustained high blood pressure readings over time.

The study is the first to show that white-coat hypertension and masked hypertension are associated with clinically meaningful high blood pressure, which is a major risk factor for heart attack and stroke.

"This means that these conditions are by no means clinically innocent, as they have often been thought to be," study researcher Giuseppe Mancia, MD of the University Milan-Bicocca says in a news release.

http://www.webmd.com/hypertension-high-blood-pressure/news/20090629/white-coat-hypertension-not-benign