Contents
- 0.1 What time of day is your true blood pressure?
- 0.2 Should I take my blood pressure in the morning or at night?
- 0.3 When is the best time to check blood pressure?
- 1 What time of day is blood pressure the worst?
- 2 What is stroke level blood pressure?
- 3 What is a good blood pressure by age?
- 4 Why is blood pressure lower the second time I take it?
- 5 Can I take 2 blood pressure pills if my blood pressure is high?
- 6 Why wait 5 minutes before taking blood pressure?
- 7 Can a tight blood pressure cuff cause a high reading?
- 8 Can anxiety cause high blood pressure?
- 9 What happens if you take your blood pressure several times in a row?
- 10 Is 180 over 80 high blood pressure?
- 11 What is a normal blood pressure during sleep?
- 12 Can drinking water lower blood pressure?
Is it normal for blood pressure to be higher in the morning?
Lifestyle factors – Certain lifestyle factors can also increase the risk of hypertension. Examples include:
smokingheavy alcohol consumptioneating a diet high in salt and saturated fatnot getting enough exercise
Blood pressure refers to the force with which the heart pumps blood around the circulatory system. Several factors can influence blood pressure, including:
stress or anxiety physical activitydiet
When a person measures their blood pressure, the reading will appear as two numbers. The top number denotes systolic blood pressure, which is the pressure when the heart contracts. The bottom number shows diastolic blood pressure, which is a measure of the pressure when the heart relaxes.
A blood pressure monitor uses a unit of measurement called millimeters of mercury (mm Hg) to measure the pressure inside the blood vessels. Normal blood pressure is less than 120/80 mm Hg, Readings between 120/80 mm Hg and 139/89 mm Hg indicate that a person is at risk of developing hypertension, while readings of more than 140/90 mm Hg signify hypertension.
Blood pressure rises and falls throughout the day and night. During sleep, blood pressure falls by 10–30%, It then increases around the time of wakening. In some people, this increase may be significant, resulting in morning hypertension. People who have an abnormal blood pressure pattern may be at risk of complications, such as heart attack and stroke.
being over the age of 65 yearsbeing of African or Caribbean descenthaving a relative with high blood pressurehaving overweight or obesity drinking alcohol smoking anxiety or excessive stress insufficient sleepdisturbed sleep, for example, working night shifts
Regular use of a home blood pressure monitor can help people better understand their blood pressure fluctuations. It can also allow people to identify episodes of morning hypertension. The American Heart Association (AHA) recommend using a cuff-style blood pressure monitor.
Empty the bladder.Rest comfortably and quietly for 5 minutes before measuring blood pressure.Avoid smoking, drinking alcohol, or exercising within 30 minutes of measuring blood pressure.
When measuring blood pressure:
Take readings at the same time each day.Sit with the back straight, legs uncrossed, and feet flat on the floor.Rest the arm on a flat surface so that the upper arm is at heart level.Place the cuff on the arm so that the bottom of the cuff is directly above the elbow crease.Take two or three readings approximately 1 minute apart and calculate the average value.Keep a record of all readings, as this can help a doctor determine the best course of treatment.
High blood pressure typically does not cause symptoms, even when levels are dangerously high. Certain symptoms are more common in people with hypertension. However, they do not necessarily occur as a direct result of hypertension. These symptoms include:
blood spots in the eyes facial flushing dizziness
The diagnosis of high blood pressure in the morning typically relies on a person’s self-reported readings. Depending on what these readings show, a doctor may recommend a 24 hour blood pressure monitoring test. This test involves wearing a device that takes regular blood pressure readings throughout the day and night.
an echocardiogram, which is an ultrasound of the heartan electrocardiogram (EKG) to trace the heart’s electrical activityblood testsurine tests
People with morning hypertension are at higher risk of cardiovascular events than those with normal morning blood pressure readings. Getting morning hypertension under control can reduce the risk of heart attack and stroke, among other cardiovascular events.
- The treatment for morning hypertension involves addressing its underlying cause.
- If an underlying medical condition is responsible, treating the condition may help reduce morning hypertension.
- If morning hypertension is due to issues with blood pressure medications, a doctor will need to fix this problem.
Doing this may involve changing the dosage or the time of the day that the person takes the medication. In some cases, a doctor may recommend taking additional medications. Some people experience morning hypertension as a result of certain lifestyle factors.
People can ask their doctor for information and specific advice on diet, exercise, or quitting smoking, Anyone who is not already on antihypertensive medications may need to begin taking these drugs. Following a healthful lifestyle can help control hypertension in the morning and at other times of the day.
Managing hypertension will help lower the risk of complications, such as heart attack and stroke. Healthful lifestyle behaviors include :
eating a balanced diet that is low in sodium, refined sugar, and saturated fatlimiting alcohol intakeavoiding tobaccoexercising for 90–150 minutes each weekachieving and maintaining a body mass index ( BMI ) of between 18.5 and 24.9practicing stress management and relaxation techniques, such as yoga or meditationtaking blood pressure medications according to the prescriptiontreating any underlying medical conditions that may contribute to hypertension
Blood pressure fluctuates throughout the day and night. It naturally increases in the hours around waking. However, abnormally high blood pressure readings in the morning can indicate that a person is at increased risk of cardiovascular events. Careful monitoring of blood pressure can alert people to instances of morning hypertension.
What time of day is your true blood pressure?
Five tips for at-home blood pressure monitoring – Measuring your blood pressure at home is easy, and providing your doctor with a sheet of blood pressure readings gives a fuller picture than a single reading in the office once every three months.
Relax: Measure your blood pressure when you are relaxed, not when you’re running late or on the go. Proper timing: Blood pressure is often highest early in the morning – 5 a.m. or 6 a.m. – so choose another time to take it. Be consistent: Take your blood pressure at the same time of day. Discuss with your health care provider how often you should measure your blood pressure. Average your readings: Hypertension specialists recommend taking three readings and then averaging the last two for the most accurate measurement. Know the recommendations: Ask your doctor what is a safe target blood pressure for you.
Blood pressure machines are widely available for purchase at drug stores and online, and many machines keep track of the measurements for you. Measuring your blood pressure at home can help you work with your physician to keep your blood pressure within a “normal” range between appointments.
Should I take my blood pressure in the morning or at night?
Bedtime BP meds may cut heart risk by almost half : large randomised study Blood pressure medication may confer a larger benefit if taken at night, rather than in the morning. A ‘robust’ Spanish study of more than 19 000 patients found that taking the medication so that it works overnight cuts the risk of heart-related death and disease nearly in half.
The same medication ingested at different times of the day actually has different pharmacological properties, behaving like totally different medications,’ said the study’s lead author, Ramon Hermida, director of the Bio-engineering and Chrono-biology Labs at the University of Vigo in Spain. NBC News reports Hermida and his research team randomly selected half of the study participants to take their blood pressure pills upon waking up in the morning.
The other half made the medication part of their bedtime routine. The team then tracked the patients for six years, periodically monitoring their blood pressure levels continuously in 48-hour blocks. The differences in outcomes were striking: compared with the group who took their pills in the morning, the nighttimers had a more than 40% lower risk of experiencing a heart attack, heart failure, stroke or needing procedures to open clogged coronary arteries.
What’s more, their risk of dying from heart problems during the study period was cut by 66%. By taking your blood pressure medications before going to bed, you’re preventing high blood pressure during sleep, which is a significant risk factor for cardiovascular disease, Hermida is quoted in the report as saying.
Normally, a person experiences ‘nocturnal dipping’ while asleep at night. Blood pressure ‘dips’ by about 10 to 20%. But that doesn’t happen in some people, and others may even experience an increase in blood pressure during sleep, said Dr Luke Laffin, a preventive cardiologist at the Cleveland Clinic who was not involved in the research.
‘It makes sense that if we give blood pressure medicines at night, we may catch some of those people who have the non-dipping patterns, or elevated blood pressures at night,’ said Laffin, ‘and protect them from more cardiovascular disease.’ The report says previous studies had hinted that better blood pressure control at night might offer a benefit.
‘This was the piece that was missing,’ Dr Renato Lopes, a professor of medicine at Duke University School of Medicine, said. ‘For the first time in a very large, randomised fashion, this study really gave us impressive results,’ said Lopes, who was not involved in the research.
The report says while the results are encouraging, researchers say patients with high blood pressure should speak with their doctors before making any changes to their blood pressure medication routines. ‘It is important to understand that this may not apply to medications that need to be taken more than once a day, or for blood pressure medications that are being prescribed for other problems such as angina,’ Dr Tim Chico, professor of cardiovascular medicine at the University of Sheffield, said.
And there are other caveats, the report says. The new research had participants take all of their blood pressure medications at once, either at night or in the morning, rather than some in the morning and some at night. But some cardiologists say many patients may need a more tailored approach.
‘For most people, a combination of a couple medicines in the morning and a couple in the evening means you’re going to do better, eliminate side effects and generally have better control of your blood pressure over 24 hours,’ Laffin said. And people may not want to take certain kinds of blood pressure medications at night, such as diuretics, because they increase urination.
The report says the study included only white participants, so it’s unclear whether the apparent benefits would be as effective for African Americans, who have consistently higher uncontrolled blood pressure and heart disease death rates. The findings also may not apply to people who are awake all night, such as shift workers.
- Meanwhile, simply making sure to take your blood pressure medications overall has been shown to reduce the risk of heart attack and stroke significantly.
- Anyone with a measurement over 130/80 mmHg is considered to have high blood pressure, according to guidelines from the American Heart Association and the American College of Cardiology.
The time of day a person measures his or her blood pressure may also be key. Readings tend to be higher first thing in the morning, so many doctors recommend those keeping track of blood pressure at home take measurements once in the morning, and once in the evening.
Commenting on the research, Professor Paul Leeson, professor of cardiovascular medicine, at the University of Oxford, said in a report in The Daily Telegraph: ‘This study has the potential to transform how we prescribe blood pressure medication. The findings are likely to be relevant to most people who take tablets for high blood pressure.
Dr Richard Francis, head of research, Stroke Association added: ‘We’re pleased to see this research, which could potentially change the way we prevent strokes in the future. This is a robust study that shows that people who take their blood pressure medication at night have better blood pressure control and have reduced risk of a cardiovascular event such as a stroke or heart attack.
Hopefully we can see studies like this recreated in the UK and combined with existing evidence, this could lead to a review of current guidelines on treating high blood pressure.’ Vanessa Smith, from the British Heart Foundation, said in a BBC News report: ‘Although this study supports previous findings in this area, further research among other ethnic groups and people who work shift patterns would be needed, to truly prove if taking blood pressure medication at night is more beneficial for cardiovascular health.
If you’re currently taking blood pressure medication, it’s important to check with your GP or pharmacist before changing the time you take it. There may be specific reasons why your doctor has prescribed medication in the morning or night.’ : Bedtime BP meds may cut heart risk by almost half : large randomised study
How long after waking up should I take my blood pressure?
Factors that can affect your readings – There are a few general rules to be aware of when it comes to timing your blood pressure reading. For example, it’s not a good idea to take your blood pressure immediately after you wake up, as this may not give you the most accurate reading.
Instead, aim to check it when you’ve been up for about half an hour. It’s also best not to wait until after breakfast and your morning coffee since both food and caffeine can raise your blood pressure. Ideally, a morning blood pressure can be taken after you brush your teeth, shower, and get dressed but before you eat or leave for work.
Food and caffeine aren’t the only things that can cause your blood pressure to spike. There are several other everyday things that can make your blood pressure rise. No matter what time of day you take your blood pressure, it’s best to avoid these things for at least half an hour before you take a reading:
smoking or using tobaccoexercisingconsuming alcohol
It’s also a good idea to take your blood pressure with a recently emptied bladder. There are a few different ways to get a blood pressure reading. Each way has advantages and drawbacks. For many people, a combination of different methods can provide the most accurate picture of their blood pressure.
When is the best time to check blood pressure?
Tips for accurate use – No matter what type of home blood pressure monitor you choose, proper use requires training and practice. Take the device to your health care provider to make sure the one you’ve chosen is the best fit for you. Learn to use the monitor correctly. To help ensure accurate blood pressure monitoring at home:
- Check to be sure your device is correct. Before using a monitor, have your health care provider compare the readings from your monitor with the readings from the monitor in the medical office. Also have your provider watch you use the device to see if you’re doing it properly. If you drop the device or damage it, have it checked before using it again.
- At the beginning, measure your blood pressure at least twice daily. Take it first in the morning before eating or taking any medications. Take it again in the evening. Each time you measure, take two or three readings to make sure your results are the same. Your health care provider might recommend taking your blood pressure at the same times each day.
- Don’t measure your blood pressure right after you wake up. You can prepare for the day, but don’t eat breakfast or take medications before measuring your blood pressure. If you exercise after waking, take your blood pressure before exercising.
- Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a reading. Also, empty your bladder first. A full bladder can increase blood pressure slightly.
- Sit quietly before and during monitoring. When you’re ready to take your blood pressure, sit for five minutes in a comfortable position with your legs and ankles uncrossed. Your back should be supported against a chair. Try to be calm and not think about stressful things. Don’t talk while taking your blood pressure.
- Make sure your arm is positioned properly. Always use the same arm when taking your blood pressure. Rest your arm, raised to the level of your heart, on a table, desk or chair arm. You might need to place a pillow or cushion under your arm to raise it high enough.
- Place the cuff on bare skin, not over clothing. A rolled-up sleeve that’s tight around your arm can affect the reading. You may need to slip your arm out of the sleeve.
- Take a repeat reading. Wait 1 to 3 minutes after the first reading, and then take another. If your monitor doesn’t keep track of blood pressure readings or heart rates, write them down.
Blood pressure varies throughout the day. Readings are often a little higher in the morning. Also, your blood pressure might be slightly lower at home than in a medical office. Contact your health care provider if you have any unusual increases in your blood pressure or if your blood pressure stays higher than usual. Ask your provider at what reading you should call the medical office right away.
Does drinking water in the morning lower BP?
If blood pressure becomes elevated due to dehydration, it may be possible to help lower it by drinking water. Dehydration causes the blood to have higher than normal levels of sodium. High blood pressure ( hypertension ) occurs when the force of the blood pumping through the arteries is consistently too high.
High blood pressure ( hypertension ) is 140/90 mmHg or more Elevated blood pressure levels between 120/80 and 139/89 are considered prehypertension and mean a person is at higher risk for developing high blood pressure Normal blood pressure is less than 120/80 mmHg
If blood pressure becomes elevated due to dehydration, it may be possible to help lower it by drinking water. Dehydration causes the blood to have higher than normal levels of sodium.
When this happens, the brain sends signals to the pituitary gland to secrete vasopressin, also called antidiuretic hormone. The vasopressin tells the kidneys to reabsorb more water, and in high enough concentrations, it can cause narrowing of blood vessels (vasoconstriction), which leads to increased blood pressure.
One study also found that adding calcium and magnesium to drinking water potentially could help lower blood pressure levels, especially in those who do not get adequate amounts of these minerals from their diets.
Does walking lower blood pressure?
1.10 minutes of brisk or moderate walking three times a day – Exercise lowers blood pressure by reducing blood vessel stiffness so blood can flow more easily. The effects of exercise are most noticeable during and immediately after a workout. Lowered blood pressure can be most significant right after you work out.
What time of day is blood pressure the worst?
Does blood pressure have a daily pattern? I’ve noticed that my blood pressure is always lower in the morning than in the afternoon. – Answer From Francisco Lopez-Jimenez, M.D. Blood pressure has a daily pattern. Usually, blood pressure starts to rise a few hours before a person wakes up.
- High blood pressure during the night
- High blood pressure early in the morning
- Less than 10% drop in blood pressure overnight (nondipping blood pressure)
A rise in blood pressure overnight to early morning has been linked to an increased risk of heart disease. An irregular blood pressure pattern could also mean that you have:
- Poorly controlled high blood pressure
- Obstructive sleep apnea
- Kidney disease
- Diabetes
- Thyroid disease
- A nervous system disorder
Poor diet, lack of exercise and certain lifestyle factors can affect blood pressure pattern, including:
- Night-shift work
- Smoking
- Overweight or obesity
- Stress and anxiety
- Not taking medications for blood pressure or sleep apnea as directed, or ineffective treatment
Your health care provider can tell you if an irregular daily blood pressure pattern needs treatment. Sometimes, a person’s blood pressure rises simply when seeing a care provider. This is called whitecoat hypertension. A 24-hour blood pressure monitoring test can be done to measure blood pressure at regular time periods over 24 hours.
What is stroke level blood pressure?
What’s a hypertensive crisis? If I notice a spike in my blood pressure, what should I do? – Answer From Francisco Lopez-Jimenez, M.D. A hypertensive crisis is a sudden, severe increase in blood pressure. The blood pressure reading is 180/120 millimeters of mercury (mm Hg) or greater.
A hypertensive crisis is a medical emergency. It can lead to a heart attack, stroke or other life-threatening health problems. Severely high blood pressure can damage blood vessels and body organs, including the heart, brain, kidneys and eyes. During a hypertensive crisis, the heart may not be able to pump blood effectively.
Hypertensive crises are grouped into two categories.
- Urgent hypertensive crisis. Blood pressure is 180/120 mm Hg or greater. There are no signs of organ damage.
- Emergency hypertensive crisis. Blood pressure is 180/120 mm Hg or greater. There is life-threatening damage to the body’s organs.
Causes of a hypertensive crisis include:
- Forgetting to take blood pressure medication
- Suddenly stopping certain heart medications, such as beta blockers
- Medication interactions
- Tumor of the adrenal gland (pheochromocytoma)
Symptoms of a hypertensive crisis may include:
- Anxiety
- Blurred vision
- Chest pain
- Confusion
- Nausea and vomiting
- Not responding to stimulation (unresponsiveness)
- Seizures
- Severe headache
- Shortness of breath
If you get a very high blood pressure reading at home and don’t have any symptoms, relax for a few minutes. Then check your blood pressure again. If it’s still very high, seek medical care. Call 911 or emergency medical services if your blood pressure is 180/120 mm Hg or greater and you have chest pain, shortness of breath, or symptoms of stroke.
What is a good blood pressure by age?
What is Normal Blood Pressure by Age?
Women | Men | |
---|---|---|
18-39 years | 110/68 mm Hg | 119/70 mm Hg |
40-59 years | 122/74 mm Hg | 124/77 mm Hg |
60+ years | 139/68 mm Hg | 133/69 mm Hg |
Why is blood pressure lower the second time I take it?
The lowdown – High blood pressure is among the leading causes of death worldwide, but diagnosis can be challenging because it rarely causes symptoms. You will have your blood pressure taken during most medical appointments so your doctor can keep an eye on it and identify any changes.
Your first blood pressure reading will almost always be higher than the second due to a wide range of factors, both environmental and psychological. These factors include white coat syndrome, stress, and having a full bladder. You can take steps to get a more accurate blood pressure reading, including being mindful about the time of day you take it.
Your doctor will take two readings to get a more accurate picture of your blood pressure. If you measure your blood pressure at home and get a reading of 180/100mm Hg or higher, get emergency medical help right away.
How accurate are home blood pressure monitors?
Some home blood pressure monitors aren’t accurate – Harvard Health More and more experts now recommend that people with regularly check their blood pressure at home. Doing this gives people an idea where their blood pressure stands in between office visits and can motivate them to care more about their health. It also helps doctors make quick medication adjustments to keep blood pressure in the healthy zone.
But home blood pressure monitors aren’t always as accurate as they should be. “Home blood pressure monitors may be inaccurate in 5% to 15% of patients, depending on the threshold for accuracy used,” according to Dr. Swapnil Hiremath, a kidney specialist at Ottawa Hospital in Canada. Because many doctors do rely at least in part on home measurements to guide treatment, such inaccuracies could end with some people taking too much or too little,
“We are going down that road of asking people to measure their pressures at home,” Dr. Hiremath says. “We want to empower patients, but we also want to make sure the measurements are accurate.” Dr. Hiremath says the finding emerged from a program to teach people with kidney disease on how to use home blood pressure monitors.
- Untreated or inadequately treated high blood pressure is the main cause of kidney disease today and contributes to its complications.
- Starting in 2011, people with kidney disease were asked to bring their home blood pressure monitoring equipment to the kidney clinic at Ottawa Hospital to have it checked for accuracy against a standard office device.
“I was taken aback by how inaccurate some of the machines were,” Dr. Hiremath says. “They were sometimes 15 or 20 mm Hg off.” Dr. Hiremath and his colleagues pulled together blood pressure records for 210 clinic patients. For 30% of them, the systolic pressure—the first number of a blood pressure reading—was 5 mm Hg or more different from the office reference measurement.
- The diastolic pressure (second number) was similarly inaccurate.
- In one patient, the pressure was off by 21 mm Hg,” Dr.
- Hiremath says.
- The fact that blood pressure measurements vary is no surprise.
- Blood pressure wanders all over the map throughout the day.
- It’s generally lowest first thing in the morning, after a person wakes up, and then steadily rises.
Blood pressure responds dynamically to movements, meals, and moods. “Blood pressure is variable even when measured by precise methods,” says Dr. Christian Ruff, a cardiologist at Harvard-affiliated Brigham and Women’s Hospital. “To get a more accurate assessment of blood pressure, regardless of blood pressure monitor used, people should perform multiple recordings and average them.” Dr.
- Ruff strongly encourages home monitoring to help keep a person’s blood pressure within healthy boundaries.
- Home monitoring allows patients and their physicians to jointly engage and optimize treatment of hypertension in a more rapid manner.” Before starting routine, Dr.
- Ruff says, it’s important to bring your home blood pressure monitor into your doctor’s office to test it against a known, accurate instrument.
It’s also a good idea to redo the test every year. The best device for most people is a device with an automatically inflating arm cuff and large digital readout for easy reading. To get the most accurate blood pressure readings at home, follow these steps:
Avoid caffeinated or alcoholic beverages, and don’t smoke, during the 30 minutes before the test. Sit quietly for five minutes with your back supported and feet on the floor. When making the measurement, support your arm so your elbow is at the level of your heart. Push your sleeves out of the way and wrap the blood pressure cuff over bare skin. Measure your blood pressure according to the machine’s instructions. Leave the deflated cuff in place, wait a minute, then take a second reading. If the readings are close, average them. If not, repeat again and average the three readings. Don’t be too concerned if a reading is high. Relax for a few minutes and try again. Keep a record of your blood pressure readings and the time of day they are made.
xx As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. : Some home blood pressure monitors aren’t accurate – Harvard Health
Can I take 2 blood pressure pills if my blood pressure is high?
Finding the right blood pressure medications for you – How blood pressure medicines work Your body is constantly working to keep your blood pressure under control. There are receptors in your blood vessel walls which detect when your blood pressure is too high or low.
- In response, your nerves, hormones and kidneys all play a role in bringing it back to a safe level.
- Over time, your blood pressure can creep up for a number of reasons, including an unhealthy lifestyle, and medications can help to bring it back down.
- They do this by acting on the ways your body controls blood pressure.
Some affect the nerves or hormones which send signals to your blood vessel walls, telling them to relax or contract, while some affect the kidneys, causing them to remove excess salt and water from the blood. Taking more than one medicine Taking a combination of different medicines can work better than taking one, because they work in different ways.
- Taking a low dose of two medications rather than a high dose of one, can also help to avoid side effects, as side effects can sometimes be caused by the dose.
- Sometimes a medication will work well to begin with, but with time your blood pressure might creep up again.
- You may then need to take another medicine alongside it which works in a different way.
Choosing a medicine to suit you Which medications will be suitable for you depends on a number of things, including your:
age ethnic background any other health problems you may have, such as kidney disease or angina any other medications you’re taking any blood pressure medicines you have tried in the past your preferences.
There are steps your doctor or nurse can work through to find the right medications – have a look at the table below. If one step doesn’t work, they will review your treatments to see if the right doses are being used, then move onto the next step. You will probably start with a low dose of a medication, and your doctor will gradually raise it, so they can keep an eye on how your blood pressure is responding while keeping side effects to a minimum. Dowload our Combined blood pressure medicines information sheet, Simplifying your medicines If you need to take more than one medicine and it’s difficult to manage, speak to your doctor about simplifying the dose. It’s sometimes possible to have two medicines in a single tablet, sometimes called a combination tablet.
These can mean you can take fewer tablets. They are available for some combinations of blood pressure medicines but not all, your doctor, nurse or pharmacist will be able to advise you on whether there’s one that’s suitable for you. You can also use compartment boxes to get your medicines ready for the week.
Getting the most from your medicines,
Why wait 5 minutes before taking blood pressure?
Wait A Few Minutes: Blood Pressure Readings Lower When Patients Slow Down After rushing to make your appointment, your name is called to be seen by the doctor. You are escorted to a room, where you sit on a table wrapped in crinkly white paper to have your temperature and blood pressure measured.
Although a familiar scene, nurses at the University of Virginia Health System have confirmed a major problem with this scenario. According to a new study from a team of nurses headed by Melly Turner, R.N., systolic blood pressure can be an average of 14 points higher when taken immediately after arriving in the exam room and sitting on an examination table rather than sitting in a chair with your back supported and feet flat on the floor.
In fact, all study participants had lower systolic and diastolic blood pressure measurements when seated in a chair versus the exam table. With a desirable blood pressure reading around 120/80, and the American Heart Association’s definition of hypertension as 140/90 or greater on two consecutive tests, a 14-point difference can mean the difference between a clean bill of health and an inaccurate diagnosis.
“Currently, most patients get called back for their appointment, sit on the table, and immediately get their blood pressure measured,” Turner said. “Our study reaffirmed the American Heart Association’s technique that patients should sit in a calm environment with feet flat on the floor, resting their back against the chair for at least five minutes before taking a blood pressure measurement on a bare arm at heart level.
All too often, this doesn’t happen. ” In the first study of its kind conducted by nurses, the group found that taking a blood pressure reading in a chair after at least five minutes of waiting provided more accurate results than the traditional approach.
- Turner’s team even factored in anxiety when seeing a doctor, or the “white coat syndrome” into their research.
- White coats did not result in any statistically significant differences as compared with health care personnel wearing scrubs or street clothes.
- Patients should know what their blood pressure is.
If they have a diagnosis of high blood pressure, they need to know what the goal of their blood pressure should be, and how to get it there. This requires making necessary lifestyle changes, such as eating a balanced diet, lowering fat intake, lowering salt and sodium intake, in addition to incorporating at least 30 minutes of physical activity into their schedule most days of the week,” Turner said.
- The American Heart Association estimates that nearly one-third of Americans have high blood pressure, which can lead to stroke, stiffness of the heart over time, and an enlarged heart if untreated.
- Turner and one member of her research group present the results of their study at the April 21 national conference of the Preventative Cardiovascular Nurses Association in Denver, while two other members of the research team present at the 5th Annual Medical Surgical Conference at Virginia Commonwealth University in Richmond on the same day.
: Wait A Few Minutes: Blood Pressure Readings Lower When Patients Slow Down
Can drinking lots of water lower blood pressure?
Final thoughts – While drinking more water isn’t going to lower high blood pressure overnight, it’s useful to understand why staying hydrated is so important to our overall health. A healthy fluid intake, alongside a balanced diet and active lifestyle, could make a big difference to those looking to better manage hypertension.
Can a tight blood pressure cuff cause a high reading?
Wrong BP Cuff Size May Lead to Wildly Inaccurate Readings A cuff that is too snug or too loose on the mid-upper arm can lead to greatly exaggerated blood pressure measurements, results of a community-based study show. “If you need a large adult cuff and you use a regular adult cuff, the blood pressure on average is overestimated by 5 millimeters of mercury systolic,” said Tammy M.
Brady, who presented the findings yesterday in a poster session at the American Heart Association’s Epidemiology and Prevention | Lifestyle and Cardiometabolic Health (EPI|Lifestyle) Scientific Sessions 2022, told TCTMD that they highlight the potential for patient harm, especially if the incorrect measurements are acted upon by physicians. “This has big implications, particularly for populations where there is significant overweight and obesity, because those are the people who tend to need those larger cuff sizes,” she added. Pamela Lutsey, PhD, MPH (University of Minnesota, Minneapolis), co-chair of the EPI|Lifestyle program committee, told TCTMD that while the study is small, the results are compelling and speak to the importance of improving the quality of BP measurements.
“These data absolutely drive home the point that the wrong size blood pressure cuff can have serious consequences that are going to lead people to be managed inappropriately for their blood pressure,” she said. In 2019, the AHA issued an on appropriate BP measurement that highlighted the steps necessary for accuracy, including proper cuff sizing and placement. Undercuffing and Overcuffing Brady and colleagues conducted the trial in 165 community-dwelling adults (mean age 55 years; 67% female; 68% Black). More than 40% of the study group had a BMI ≥ 30 kg/m 2, For each study participant, two sets of triplicate BP measurements were obtained using a regular-size adult automated BP monitor cuff and the cuff that fit their arm best after sizing. Prior to each set of readings, participants were asked to walk a similar distance from a waiting area to the room where BP was measured. Patients were seated and BP measurements were started 5 minutes after cuff placement, with no speaking during measurements. Each of the three sequential automated measurements were taken 30 seconds apart. In individuals whose arm measurements indicated they required a small adult cuff, the regular cuff resulted in a nearly 4 mm Hg-lower systolic pressure and a 1.5 mm Hg-lower diastolic pressure. For those whose arm measurements indicated a large cuff was required, systolic readings were nearly 5 mm Hg higher than with the appropriate cuff and diastolic readings were about 2 mm Hg higher ( P < 0.001 for both comparisons). Finally, in those requiring an extra-large cuff, using a regular-size adult cuff overestimated systolic pressure by 19.7 mm Hg and diastolic pressure by 7.4 mm Hg compared with the appropriate cuff ( P < 0.001 for both comparisons). Among participants with a BP ≥ 130/80 mm Hg as measured by their correct cuff size, overestimation of BP due to undercuffing resulted in a misclassification in 39%, while underestimating BP due to overcuffing missed 22%. "We know that there are a lot of low- and middle-income countries where there is often only one cuff that's available at the time of the healthcare encounter," Brady said. "That was really our motivation to see how big of an impact the makes. We expected that there was going to be a difference, but we didn't expect to see this magnitude of difference." Even in North America, Brady said many clinics and offices likely don't have multiple cuff sizes readily available without a staff member or physician having to hunt them down. The issue takes on additional significance for patients who record at-home BP measurements. "This was a big struggle with the pandemic trying to conduct telemedicine with my patients, because I had to guide them in which cuff or which device to purchase so that they were appropriate for their arm," Brady noted. "If you need an extra-large cuff, often the regular devices that are just sitting on the shelf in the pharmacy do not accommodate those arms, and you have to buy either a special device or you have to pay an additional $25 to $50 dollars to get the cuff that's appropriate." Lutsey stressed that arm size is a fluid dynamic that should be measured with frequency during BP checks, since patients can gain or lose weight from one healthcare encounter to the next for any variety of reasons. "I think this is very pragmatic in terms of thinking about how we can change the quality of care in the community getting more accurate measurements so that blood pressure can be managed better," she added. : Wrong BP Cuff Size May Lead to Wildly Inaccurate Readings
Can BP fluctuate within minutes?
Ask the doctor – Image: © LordHenriVoton/Getty Images Q. I have high blood pressure and have been checking my blood pressure more often since my doctor added another drug. But lately, my readings have been all over the place. For example, one morning it was 127/70, but then it was 170/100 in the late afternoon.
- What’s going on? A.
- You may have a condition known as labile hypertension, which refers to blood pressure that fluctuates far more than usual.
- Everyone’s blood pressure rises and falls many times during the course of a single day, sometimes even within minutes.
- Many factors contribute to these changes, including physical activity, emotion, body position, diet (especially salt and alcohol intake), and sleep deprivation.
However, there is no clear definition or standard criteria to distinguish between normal and abnormal fluctuations. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
Can anxiety cause high blood pressure?
Dear Doctors: I have been having anxiety, and now my blood pressure is getting high, too. Are they related? I understand that medications might become necessary, but I would prefer to try nonmedical treatments first. Can you recommend supplements that can help to reduce these issues? Dear Reader: You’ve asked about two topics that will be of interest to a large number of people.
- Health data show that close to half of all adults in the United States have high blood pressure.
- According to the latest guidelines, this is defined as systolic blood pressure (that’s the top number) readings of 130 mmHg or more, or diastolic blood pressure (that’s the bottom number) greater than 80 mmHg.
When it comes to anxiety, that is a condition that is estimated to affect close to one-fifth of us, making it the most common mental health issue in the U.S. And while anxiety doesn’t always lead to high blood pressure, it can be a contributory factor for some people.
Surges of anxiety can cause blood pressure spikes, but these are typically temporary. Over time, however, chronic anxiety can begin to have an adverse effect on someone’s baseline blood pressure. We understand your desire to manage each of these conditions without the use of medication. At the same time, we are glad you understand that in order to safeguard your long-term health and well-being, medication may become necessary.
To that end, we think it’s important that you bring up your concerns about anxiety and blood pressure with your medical care provider. If your blood pressure isn’t dangerously or chronically high, they can offer guidance as you make lifestyle changes to improve it and accurately assess and track the results.
- These include regular exercise, improving diet and avoiding stress.
- They will also advise if delaying medication might become a health risk.
- Regarding supplements, there are several that can be potentially helpful.
- For anxiety, these include magnesium, ashwagandha, lemon balm, chamomile, l-theanine and valerian root.
Supplements such as garlic, green tea, magnesium and l-arginine can be useful in improving blood pressure. But don’t go it alone. Always check with your doctor when adding supplements to your daily regimen. Some can interact or interfere with medications, or they can have adverse side effects.
Getting guidance with dosages is important, as well. When talking about these issues with our own patients, we emphasize that supplements, however natural, should never be the sole approach. This holds true for both anxiety and blood pressure. With anxiety, it’s important to identify any specific triggers that lead to that feeling.
This awareness can then help you understand the root cause. With this knowledge, you can make the appropriate changes in your life that can begin to bring relief. Additional natural approaches can include meditation, mindfulness, deep breathing, yoga, weightlifting, running or other aerobic exercise.
Each of these have been shown to help. Sleep is also extremely important. Studies have linked poor sleep to both anxiety and elevated blood pressure. And please don’t discount therapy or, if needed, appropriate medication. (Send your questions to, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024.
Owing to the volume of mail, personal replies cannot be provided.)
What happens if you take your blood pressure several times in a row?
International hypertension societies recommend taking multiple blood pressure measurements over several days. International hypertension societies recommend taking multiple blood pressure measurements over several days, under comparable conditions, and at the same time of day (morning and evening), and then calculating the mean value of these measurements.
- Individual blood pressure is represented by this average value. Even when at rest, blood pressure fluctuates constantly. As a result, doctors and hypertension society advise taking at least two readings each time and averaging the results.
- A series of measurements provides far more reliable information about blood pressure than a single measurement. Blood pressure averaging methods have long been used by physicians to determine the need for and adjust the treatment of hypertension in their patients.
- Your true blood pressure is the average level over time. However, traditionally, averaging has meant either taking the average of specific systolic and diastolic blood pressures from a 24-hour ambulatory blood pressure reading or asking patients with hypertension to take multiple readings at home and averaging those readings.
A growing body of research suggests that taking a series of sequential in-office blood pressure measurements and then averaging those measurements is the most effective method of averaging.
Is 180 over 80 high blood pressure?
What is high blood pressure? – Blood pressure is defined as the force of blood pushing against the walls of the arteries as the heart pumps blood. High blood pressure – also known as hypertension – is a disease in which blood flows through blood vessels (arteries) at a higher than normal pressure.
Blood pressure is measured with two numbers. The first, or top number, is the pressure in your blood vessels when your heart beats, called the systolic pressure. Systolic pressure is the higher of the two numbers. The second, or bottom number, measures the force of blood in your arteries while your heart is relaxed between beats.
The bottom number is the lower of the two and is called the diastolic pressure. Normal pressure is 120/80 or lower. Your blood pressure is considered high (stage 1) if it reads 130/80. Stage 2 high blood pressure is 140/90 or higher. If you get a blood pressure reading of 180/110 or higher more than once, seek medical treatment right away.
What is a normal blood pressure during sleep?
Twenty-four–Hour BP Pattern – The 24-hour systolic and diastolic BP values showed normal distribution (Kolmogorov-Smirnov test for normality p =,980), and the average values were 129 ± 14 and 71 ± 7 mm Hg, respectively. Systolic and diastolic BP values during daytime ranged from 104 to 168 mm Hg and 54 to 87 mm Hg, with a mean of 132 ± 15 and 72 ± 7 mm Hg, respectively; night-time systolic and diastolic BPs ranged from 91 to 161 and 53 to 84 mm Hg with a mean of 124 ± 16 and 67 ± 8 mm Hg, respectively.
Can drinking water lower blood pressure?
If blood pressure becomes elevated due to dehydration, it may be possible to help lower it by drinking water. Dehydration causes the blood to have higher than normal levels of sodium. High blood pressure ( hypertension ) occurs when the force of the blood pumping through the arteries is consistently too high.
High blood pressure ( hypertension ) is 140/90 mmHg or more Elevated blood pressure levels between 120/80 and 139/89 are considered prehypertension and mean a person is at higher risk for developing high blood pressure Normal blood pressure is less than 120/80 mmHg
If blood pressure becomes elevated due to dehydration, it may be possible to help lower it by drinking water. Dehydration causes the blood to have higher than normal levels of sodium.
When this happens, the brain sends signals to the pituitary gland to secrete vasopressin, also called antidiuretic hormone. The vasopressin tells the kidneys to reabsorb more water, and in high enough concentrations, it can cause narrowing of blood vessels (vasoconstriction), which leads to increased blood pressure.
One study also found that adding calcium and magnesium to drinking water potentially could help lower blood pressure levels, especially in those who do not get adequate amounts of these minerals from their diets.