I’ll just start off my saying, I’m an otherwise healthy 32 year old. Exercise regularly, almost entirely pesto-Mediterranean diet, moderate drinking, weight/BMI are all well within limits. I’ve always had low BP, medicals at late as 2018 were all 110/70 range. In fact I didn’t even know what blood pressure ranges were or what the cuff really was. The only person in my family I know with high BP is my grandmother, but being overweight and having a poor diet are the causes, I’m sure. No other family members with BP issues.
Anyway, fast forward to this April, covid is flaring up and I’m starting to get anxious about health as the news was talking about underlying conditions, etc. So I make an appt to go to a PCP for a routine physical and blood work. I’ve never liked doctors offices or hospitals.
I get there, they take my BP and it was high. 135/90. Takes it again, same. Doc comes in and does exam, all well, but talks about BP and throws out meds, DASH diet, etc. so now I’m freaking out as I’ve never really had any health issues before. He suggests that I take my BP at home and log it. So I buy a monitor and take it. It ranges from 120/72 to 150/90. Now I feel like I have this irrational fear of BP and monitors and sometimes start to spiral when I even think about it. I recently went for my first class medical at my AME, and was really nervous leading up to it because I was worried about the BP. It was high, like I expect, around 145/90. He wasn’t concerned at all, said no way to meds and said it could be associated to stress and anxiousness.
I’m just curious what others may think? Anyone else have this issue? I’ve also cut out most excess sodium, and maybe sit around 500-1000mg a day.
It’s just so very frustrating at times and it’s hard to get it passed thinking about it often.
Nobody cares about my opinion, but my opinion is that blood pressure is likely best read with a nod to heart-rate-recovery numbers.
If you've ever been a serious athlete - and these days,
anyone with a Go-Pro, an Instragram account and an Apple watch
IS - you'll know that one of the most telling measures of aerobic fitness is comprised of two factors: 1. deltaBPM: BPM before a highly strenuous activity and BPM immediately after a strenuous activity, and 2. Recovery Time: The time it takes your body to return to resting pulse rate after your BPM peaks.
So, Delta and Recovery Time. If you start at 55bpm at the bottom of the hill, peak at 220 after an all out sprint to the top, and then return to 60bpm within 60 to 120 seconds, you are doing well.
Now consider diastole and systole as the bounds of blood pressure. Your diastole is a measure of your
low pressure - your "resting" pressure between beats. Your systole is your
max pressure - the pressure at the peak of your heart squeezing down and exerting max pumping pressure on your arteries.
Both measures are material. Typically, Docs are interested in both. And for much the same reason that athletes are interested in both. However, doc or athlete, one measure is more important that the other.
Your diastole gives an indication of a kind of base line pressure your arteries are experiencing
most of the time, or at least most of the time under "normal" conditions. Your systole is giving the max pressure to which your arterial system is exposed only at the transient moment of pump (albeit, no doubt, a frequently repeating transient moment).
As a general rule, if your systole is too high, you're pushing too hard,
acutely. If your diastole is too high, something is
chronically wrong with your body and you're in a continual state of lack of fitness, stress, and/or system degradation. You'll likely suffer an aortic aneurysm at some point.
Athletes seek to achieve the maximum delta between resting pulse rate at the bottom of the hill and and peak pulse rate at the top of the hill. Obviously, that delta will benefit from starting as low as possible, then rising as far as possible. Remember, it's the
difference between low and high in which we're interested; the ability to undergo a tremendous stress and recover from that stress as quickly as possible. But that
difference is most significantly influenced by
the low number - the starting point - the resting pulse.
That's the quick and easy mark of fitness. Just like buying real-estate, the deal is made on the buy, not the sell; As long as the buy is low, the sell can vary widely and still be profitable.
That measure of
ultimate stress is moderated -and even allowed - by
baseline stress. Resting heart rate.
One of the measures universally and almost religiously recorded daily by athletes is "resting pulse rate". It's the rate we
used to measure as soon as we woke up in the morning - preferably, before we even moved in bed. Nowdays, with Apple watches and such, one can measure pulse rates 24/7, so athletes are relieved of the stress of remembering to record pulse rates before moving after waking in the morning. Still, measured either way, the goal is to see as LOW a resting pulse rate as possible. Notwithstanding anomalous individual quirks, the resting pulse rate is the basic measure and tell of overall aerobic fitness. That's why you'll hear athletes make comments like "I woke up at 28 today, brah!"
Similarly, with blood pressure, you really want your resting pressure (diastole) to be as low as possible. Why? Because that's the base-line. The more important number. That's the more or less constant pressure (stress) to which the arterial pressure vessel is normally exposed. The systole peak pressure is important too, but not as significant a sign of base-line, general health as diastole.
OK, all
THAT said... Any moderately competent doctor knows that people
"stress out" during medical exams. Stress increases blood pressure. Why? 'Cause when our bodies anticipate fleeing or fighting, our autonomic nervous system is WAY ahead of our pea brains and has already started getting us ready for the increased oxygenation required to engage in fleeing or fighting. (Yeah, there are a bunch of hormonal cascades involved, but that stuff is just simply out of scope for this discussion.)
The take away is... when you anticipate getting your BP taken, it's very likely your BP will
already be much higher than normal - even if your pea brain knows all this!! (During Medical exams, my BP is usually about 20 points higher at both zenith and nadir.)
Solutions: 1. Measure and record your BP regularly. 2. Share your data with your Doc and tell him that you are a nervous examinee. 3. Eat real (whole - as caught or picked) foods with an emphasis on lots of small fish with their skins intact, and lots of leafy veggies. 4. Don't speculate in real estate... it'll give you high blood pressure.
ps. the more I think about the word "Watch" in terms of a device worn on one's wrist... the more I return to think about the word in terms of its other, more profound and true meaning... you know: the state of being under constant and continual observation and surveillance. Go Gen NeXXX! Products are good, m'kay! Allah is great and ALL KNOWING!! "Watches" definitely raise my blood pressure. But that's just me, I guess.
