THE HIGHS & LOWS OF YOUR BLOOD PRESSURE READING
A couple of weeks ago I went in for my yearly physical with my physician. Before I saw her, a nurse took my readings including my blood pressure. The top (systolic pressure) number read 155. “Wow!” I said, “It’s usually a lot lower than that.” Because I normally have to wait for 15 minutes before seeing the doctor, this day I arrived just at my appointment time. And wouldn’t you know—the nurse took me right back to the examining room, sat me down and took the measurements.
I thought that maybe my blood pressure reading was high because I’d been rushed. In any case, my doctor had the nurse take it again at the end of the appointment and it was down to 130. Not terrific, but acceptable.
Afterwards, I began to wonder if other folks get the wrong readings. Then, by chance, I came across an article by Christa Sgobba in the July 29 online Silver Sneakers Newsletter, 6 Surprising Reasons Your Blood Pressure Spikes. Here are excerpts:
“Among people 65 and older, at least 75 percent meet the criteria for hypertension or high blood pressure, defined as a blood pressure reading greater than 130/80 mmHg, according to the American Heart Association.
But how do you know if your blood pressure is actually a problem?
If you get a higher-than-normal reading, the first thing you should do is make sure it’s actually indicative of what your blood pressure really is, since there are some behaviors and situations that can elevate it temporarily, says John Bisognano, M.D., Ph.D., director of the University of Rochester Comprehensive Hypertension Center.
You can do that by doing two things:
- Take your reading after sitting and resting quietly for five minutes.
- Check your blood pressure regularly at home. By recording all of the readings, not just the highs or lows, you’ll get a more complete picture of your blood pressure to share with your doctor.
Regularly checking your blood pressure reading at home also means you’ll be more likely to spot an anomaly that may be due to factors that can temporarily cause spikes.
Seemingly harmless situations can temporarily raise your blood pressure. Here’s how to make sure your reading is accurate. Here are 6 examples:
Blood-Pressure Booster #1: You Drank a Lot of Caffeine
A big cup of coffee can bring a wake-up-now jolt, so it’s not surprising that caffeine can give your blood pressure a boost too. What you may not know is that the type of coffee you’re drinking can play a role in upping your readings.
Caffeine levels vary widely in different kinds of coffees and with different roasting techniques, Dr. Bisognano says, and blood pressure can spike up to 20 mmHg after drinking kinds with more caffeine.
Also, pay attention to the sizes you’re drinking. A regular mug you brew at your house may be just eight ounces, but if you’re grabbing coffee on the run, you may pick up one that’s twice as large—which means twice as much caffeine.
To be safe, finish your coffee more than one hour before you’re set to take your blood pressure.
Blood-Pressure Booster #2: You Have to Pee
According to a 2017 review in the Journal of Hypertension, getting your blood pressure taken with a full bladder can lead to an inaccurate reading. Drinking large amounts of fluids within an hour of a test can lead to a 33 mmHg bump in systolic pressure or the top number, and a 19 mmHg bump in diastolic pressure or the bottom number.
“First of all, it’s uncomfortable, and whenever someone is uncomfortable, their blood pressure goes up,” Dr. Bisognano says. “There are also nerves in the bladder that, when activated, can raise blood pressure.”
Play it safe and make a pit stop at the bathroom before you get a reading done.
Blood-Pressure Booster #3: You Ate a Salty Meal
An overall high-salt diet can lead to the development of hypertension. But even one high-salt meal can cause a temporary jump in blood pressure, says Karen Alexander, M.D., a professor of cardiology at Duke University School of Medicine.
“A high-salt meal causes you to hold on to more water,” she explains. That can be a problem, since blood vessels tend to get stiffer and less flexible with age. These “stiff pipes” can’t stretch as well to accommodate the extra volume, and your blood pressure can increase.
Restaurant meals tend to be high in sodium and can lead to a reading about 10 mmHg higher than normal, Dr. Alexander says. This may last between 24 to 48 hours and should go back to baseline after you start eating a more normal diet.
Blood-Pressure Booster #4: Your Arthritis Is Flaring
Any kind of pain can lead to an increase in blood pressure—and the more intense the pain, the more your blood pressure can rise, Dr. Alexander says. It all comes down to something called catecholamines, which are a type of stress hormone
“When you are in pain, your catecholamines and stress hormones are high, and that acts on blood vessels and raises blood pressure,” she explains. Depending on the amount of pain, you can see increases in your blood pressure of 10 to 20 mmHg. If you have an acute injury and your blood pressure is running high, your doctor should work with you to get the pain under control and then check your blood pressure again to get a more accurate reading.
Blood-Pressure Booster #5: You’re Stressed
“White coat hypertension” refers to blood pressure that runs high at the doctor’s office—think of a doctor’s white coat—but normal outside of it. In fact, white coat hypertension can cause an older person’s reading to spike by as much as 30 to 40 points, Dr. Bisognano says.
“Some people think of coming to the doctor’s office like taking a standardized test or an evaluation,” he says. “They get anxious.” That anxiety can lead to the release of stress hormones. Combine that with other stressors, like rushing in from the parking lot or worrying about something in your personal life, and you can be talking about a pretty substantial spike, Dr. Alexander says.
If your blood pressure is unexpectedly high at the beginning of your appointment, your doctor may retake it at the end of the visit to see if it leveled off. If it stays elevated throughout your visit, your doctor may suspect white coat hypertension and ask you to start checking your blood pressure at home to get a more accurate representation.
Blood-Pressure Booster #6: You Crossed Your Legs
If you’re at a doctor’s office, the doctor or nurse taking your reading will probably instruct you not to sit this way, but if you’re taking it yourself at home, it can be easy to revert to this habit.
“Crossing your legs compresses an artery in your leg, so there is less blood flow,” Dr. Bisognano says. “When you compress the arteries, the pressure goes up.”
For an accurate reading, sit comfortably with your legs uncrossed and feet flat on the floor.
So, When Should You Worry?
If your doctor has given you any instructions for measuring your blood pressure at home, follow those exactly, including when you might need to call for an appointment or get emergency care.
In general, for people who haven’t yet been diagnosed with hypertension, blood pressure readings of 130/80 mmHg on more than two occasions would warrant an appointment with your doctor, Dr. Alexander says.
In some cases, one-off readings may mean you need to get medical care sooner. If your systolic pressure or top number is 180 mmHg or higher, or your diastolic pressure or bottom number is 100 mmHg or higher:
- But you are not experiencing any symptoms: Call your doctor for a same- or next-day visit.
- And you are experiencing symptoms like shortness of breath, chest pain, or numbness: Go to the emergency room.
And in the long term, while any of the factors above can elevate your blood pressure temporarily, you shouldn’t use them to explain away consistently high readings, Dr. Bisognano says. If your blood pressure reading is regularly coming back high, even after taking it accurately and avoiding behaviors that can spike it, you need to loop in your doctor. Controlling high blood pressure with lifestyle changes like diet and exercise, medication, or a combination of both is vital to reducing your risk of health complications.”
Also, check out these 2 previous posts: Your Blood Pressure: Where Do You Place in the New Guidelines? And, Lowering Your Blood Pressure—Foods that Help & Foods to Avoid