Under Pressure

Ever blown your top? Flipped your lid? Everyone has their tipping point. 

Heavy traffic may be the perfect incubator. You’re already running late when your otherwise typical commute is jarringly interrupted. Cars suddenly come to a standstill. You can’t see why. The line of cars snakes off around the corner, a red serpent of brake lights, disappearing for who knows how long. The first physical sign of the agitation starts with your tapping foot, jiggling up the leg, an awkward shuffle, hands slap at the steering wheel. You’re like a kettle coming to the boil. All you need now is for someone to cut you off, not provide an apologetic wave and your car could suddenly become a convertible. 

Moments of intense anger and stress like this might be a rarity. Typically, you’re the picture of calm. No need to keep a blood pressure monitor in the glove box. Nothing a few deep breaths and the dulcet tones of your favourite track on the stereo can’t fix. A stressful situation can raise your blood pressure temporarily, causing your heart to beat faster and the blood vessels to narrow but in moderation this isn’t really a concern. However, there are lots of lifestyle choices that can raise your blood pressure in a more consistent and damaging way:

  • Diets high in salt, fat and cholesterol.
  • Family history of high blood pressure.
  • A lack of physical activity.
  • Older age (It gets progressively more common the older you get).
  • Being overweight or obsese.
  •  Certain ethnicities may be more prone to high blood pressure.
  • Tobacco and excessive alcohol consumption. 

The other two major reasons are:

  • Disease. Chronic conditions like kidney and hormone problems, diabetes and high cholesterol can all wreak havoc on your blood pressure.
  • Medecine. 

Now, you might already be doing all the right things to avoid high blood pressure. You’re managing your weight through eating well and exercising regularly. You’ve ditched the ciggies and the booze and are getting plenty of sleep and relaxation. Good on you! Keep it up! Your only date with a blood pressure monitor is likely to be when you visit the doctor on those rare occasions for a check up. They will place a band around your arm, tightening the velcro. This band will be attached to a small pump and meter. As the doctor begins to pump you will feel it tighten around your arm. At this stage you might begin to empathise a little with how your bicycle tyre feels when you visit the service station for a quick inflation. 

Once the doctor stops pumping they will begin to read the meter. They will be looking for two numbers. The first is your systolic reading. This is the peak blood pressure when your heart is squeezing blood out. The second, is your diastolic reading. This is the pressure when your heart is filling up with blood. What you hope they are going to read out is something like, “90 over 60”. This is the sweet spot as normal blood pressure is considered less than 120 on top and less than 80 on the bottom. There are special names for once you start cracking above those numbers:

  • Prehypertension levels are 120-139 on top and 80-89 on the bottom.
  • High blood pressure, stage 1 is 140-159 on top and 90-99 on the bottom.
  • High blood pressure, stage 2 is 160 or higher on top and 100 and over on the bottom.

The higher your blood pressure is, the more you’re going to have to monitor it. This is where your own blood pressure monitor can really be a wise investment. With regular blood pressure monitoring you will be doing yourself and your care provider a service in determining if the treatment you are receiving is correct. Like any ailment, early diagnosis is key when it comes to treating high blood pressure. This is especially true if your high blood pressure is being caused by another condition. Diabetes can damage the arteries, in turn causing high blood pressure. If left untreated this can damage blood vessels, cause heart attacks and even result in kidney failure. Not nice stuff. 

The benefits of having your own personal blood pressure monitor even stretch beyond the more obvious advantages of regular monitoring. Visiting the doctor is expensive. Self-monitoring is almost guaranteed to cut down on your medical visits. Not only that, by keeping a close eye on your own blood pressure you might suddenly feel motivated to up your level of exercise or choose the salad over the bowl of fries when next faced with the choice. 

If you’ve had your fair share of bad news in a doctor’s office before you may also feel a little nervous and experience a heart rate spike as the sound of that velcro begins to tear. This is known as ‘white coat hypertension’. Having your own blood pressure monitor at home can lead to a more accurate picture of your blood pressure.

Your health care professional will be able to advise you on whether or not it is suitable to monitor your own blood pressure and which machine will be right for you. Having said that, digital monitors that are fitted to the upper arm typically deliver the most accurate results. 

If you are in the market and if you’ve read this far then you probably are, a big thing to consider is size. Not only the cuff, which needs to fit properly in order to give an accurate reading but also the size of the monitor so you can accurately read it. As high blood pressure is typically the scourge of the elderly, this should certainly be considered. If you have any concerns about the results then make sure that you take your monitor along to an appointment and check your results against the monitor in the doctor’s office. This can also provide an opportunity for the doctor to walk you through best practice. There are a whole lot of actions that can really throw your results off kilter, some significant ones being:

  • Too much activity. Make sure you’ve been settled for a few minutes before taking your blood pressure.
  • Avoid stimulants and a full bladder when testing.
  • Make sure the cuff is on your bare skin and avoid tight clothing on the arm.

Keep these things in mind and your doctor and most importantly your heart will thank you for it.

Happy monitoring,

Floyd  - Senior Pharmacist 



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