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Blood pressure monitoring 

Measuring most health parameters requires an M.D. and often involves lab tests.  

Blood pressure monitoring is an exception to that. In fact, this important health factor is often best measured and tracked over time by an informed patient.

There are several problems with relying on having your blood pressure checks done only by an M.D.

First, how frequently will it measured? People often have it checked by their doctor only once every couple years, or longer. Many people should have it measured at least every few months. High blood pressure is not only a serious health problem in itself, but can also be a sign of other developing medical problems.

Second, blood pressure is highly variable during the day, and from day to day. For instance, blood pressure tends to go up on Mondays when people return to work. The day of your check up you may feel stressed by the examination and give a higher than normal reading (this is common enough to have been given the term "white-coat hypertension"). 

Even worse, what if you normally DO have high blood pressure (or "hypertension" as it's called), but happen to give a lower than usual reading on the day of your infrequent testing? That means you have a problem that goes unrecognized and untreated for months or years.

Here's a plan for checking and monitoring your blood pressure. 

Estimate if you have a blood pressure problem. The quickest cheapest way to do this is to use the blood pressure testing machines found in many supermarkets and drug stores. These machines are only semi-accurate, but they're good enough to identify your approximate blood pressure level. You need to wear a short sleeved shirt so the machine's cuff can go directly over your arm without being padded by clothes. Follow the directions on the machine closely, avoid doing anything physically strenuous for about 30 minutes before,  and try to be emotionally relaxed. If you had to fight aggravating traffic getting there, give yourself some time to let the effects of that wear off.

You need to take a piece of paper and a pen because you should take 3 or 4 runs on each machine, and should use 3 or more different machines over several days. On a given machine throw out any widely anomalous reading and use the ones that group together to calculate your average value. Do several tests on several machines on different days and you should get a pretty good idea of where your blood pressure lies. If you find a machine that that seems to giving erroneous levels, find another to use.

Here's how blood pressure levels are classified for adults. Currently (120 systolic/ 80 diastolic) is considered the upper boundary of healthy blood pressure levels, but that may be revised by some recent medical research down to 115 / 75. 

If your blood pressure from these machine measurements is in the Stage 1 or 2 category, then do two things. 

First, make an appointment with a physician and tell them you have reason to believe you have high blood pressure. 

Second, buy your own blood pressure measuring equipment. The problem, or its potential for reoccurrence, will be with you from now on, and you need to keep close track of it both during your initial treatment phase and beyond.

If your results indicate your BP is in the "Pre" high blood pressure category, then I suggest you get your own measuring equipment to more accurately verify it's level, and if your own equipment also indicates you're in the "Pre" high blood pressure category, start your own program for reducing it, or go to a physician to get help planning one. 

Here's some information that may help you reduce your blood pressure without taking prescription drugs designed for that purpose.

• What medications do you take, both prescription and over-the-counter? Are any of them associated with high blood pressure? Even common OTC decongestants and allergy pills can raise your blood pressure. A quick Google, or Google Scholar  or Yahoo "Web" and/or "News" search of a drug's name and "blood pressure" (include the quote signs) might turn up some relevant stuff. 
          Obviously, don't stop taking drugs prescribed by your physician without discussing the situation with him first.

• Eliminate alcohol, other such drugs and tobacco.

• Reduce salt (sodium chloride) intake both in table salt and high salt foods.

• Many canned / processed foods have a surprisingly high salt content and therefore promote higher blood pressure. Avoid canned and processed foods.

• If you're overweight, lose weight.

• Caffeine tends to raise blood pressure.

• Physical exercise often leads to lower blood pressure, especially cardiovascular exercise.

• Fruits and vegetables contain nutrients that can lower blood pressure over time.

• Potassium may help. Some recent research indicates that potassium can lower blood pressure significantly, over time. Potassium gluconate tablets are commonly available but you have to take a lot of them just to  equal what one banana gives you. Bananas are a good "food supplement" for potassium.
          As with any food supplement, if you have any existing medical conditions, check with your physician before you take them, and only take them in moderate dosages and keep records as to when you started, dosage and any reactions, good or bad, that may correlate with the usage.

• Fish oil supplements supply "good" fats that can reduce plaque buildups in your circulatory system.

• Folic acid supplements may help. 

• Calcium supplements may help. 

• Magnesium supplements may help. 

• One-hundred milligrams of aspirin before going to bed at night may help. That's about 1/3 of the usual pill dosage.

• Mental relaxation. If you feel upset or stressed a lot of the time, that's probably a large part of your high blood pressure problem - maybe even all of it. The things that create relaxation in people varies a lot. A good approach would be to do a web search on "relaxation techniques". You'll get a lot of returns. Take some time going through them and find some methods that work for you personally.
         Having a daily routine of taking ten minutes to relax and "meditate" might have a surprisingly good effect on blood pressure.

Blood pressure measuring equipment

If you want to buy your own blood pressure measuring units (or "sphygmomanometers" as they're called), they can be purchased online, or from pharmacies. Prices range from $25 to $200+. 

The conventional mercury type units are more  accurate and don't need periodic recalibration, which is a big advantage. However, mercury is toxic and if your kids (or you) break the glass mercury tube, or if a pressure seal breaks, you'll have a difficult toxic cleanup job ahead of you. 

The newer aneroid and electronic units are good, but periodic recalibration is recommended. It's sometimes suggested you use your physician's office mercury unit to do that yearly (or if you drop or bang the device). I can see that process wearing out the welcome fast. 

Another alternative is to buy two monitoring units of different design (or manufacturer). Then keep track of your BP using both units. The two units should track within 5 or 10 mm/hg in their measurements until one of them goes out of calibration, which might take quite a while. Don't expect two blood pressure devices to give the exact same readings. There are too many variables involving your body, the equipment and  the accuracy in detecting the arterial blood flow sounds.

There's some skill involved in accurately detecting the arterial blood flow sounds that are used for determining the systolic and diastolic blood pressures. That's the part that involves the stethoscopes that MDs wear. It's also not necessarily easy for someone concerned or worried about the results, to be objective and accurate when they're doing the measurement. 

A good solution is to buy a unit that automatically detects the arterial blood flow sounds and displays your blood pressure numbers digitally. That way, the unit itself will be giving you objective results. These units are surprisingly low in price, and are usually quite accurate. Keep the results in a log so you can see changes over time and see what degree of measurement variations are normal for you over time.

Here's some links with more info on monitoring your blood pressure.

http://www.americanheart.org/presenter.jhtml?identifier=4495

http://www.americanheart.org/presenter.jhtml?identifier=4470

http://www.americanheart.org/presenter.jhtml?identifier=576

http://www.medphys.ucl.ac.uk/teaching/undergrad/projects/2003/group_03/devices.html

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