22 ms·

Blood pressure should be measured lying down: study

252 points by Vaslo 3y ago

cableshaft 3y ago
Well....that sucks. Maybe I don't have normal blood pressure. Doctors never test me lying flat. Closest I've gotten is laying at an angle in a hospital bed. I'm a middle-aged heavyset guy as well, so I know I'm at greater risk for these things.
- Aurornis 3y ago
  An at home blood pressure cuff is relatively cheap if you’re concerned about it.
  - lowercased 3y ago
    Seconded. Got one and tested myself a couple times a day for a few weeks. I'm not necessarily sure it's 'accurate', but having repeated readings from same device, same arm, same position, same times of day seemed to at least show consistency and identify when things were out of whack (a couple times). Got one for about $25.
    - squeaky-clean 3y ago
      I was able to bring mine to my cardiologist appointment to double check I was using it correctly and then to check the results against the one in-office. Mine also cost about $25 at CVS.
- bpoyner 3y ago
  I've only once had a doctor test my blood pressure lying flat. I had a suspected GI bleed and he wanted to see the difference between flat and sitting up. Then he called up the hospital and got me a spot reserved in the ICU.
- Broken_Hippo 3y ago
  My doctor's office sent me home with a monitor for 24 hours. It tested every 15 minutes during the day and every 30 minutes during the night. I generally went about my day at home and eventually even slept. This seems pretty normal in Norway - but I don't think it was in the US (Am from the US, father had heart problems). Perhaps your doctor would be able to do something similar, though.
  - WWLink 3y ago
    Yea they do that in the US as well. But not very often.
umeshunni 3y ago
Saved you a click: Our findings suggest people with known risk factors for heart disease and stroke may benefit from having their blood pressure checked while lying flat on their backs
- deleted 3y ago
  [deleted]
Gys 3y ago
> Sixteen percent did not have high blood pressure — a reading greater than 130/80 mm Hg — while seated. However, these same people did show high blood pressure when researchers measured their BP while lying flat on their backs.
wing-_-nuts 3y ago
TLDR: Doctors need to check blood pressure while the patient is laying down. I do wonder about recent changes that suggest anything beyond 120 / 80 is above 'normal'. You would think that something like blood pressure would be highly regulated in the body but it varies throughout the day, month and year. They also say that salt is seriously bad for high blood pressure but I find little effect for myself personally. I do wonder how much sensitivity varies from person to person.
- lawlessone 3y ago
  I think if you get a decent amount of water and potassium your body is able to more easily expel the excess sodium
  - vitorgrs 3y ago
    I have hypertension and take my med everyday... If you drink watermelon juice, it makes wonder to incredible lower it.
- Aurornis 3y ago
  > They also say that salt is seriously bad for high blood pressure but I find little effect for myself personally. I do wonder how much sensitivity varies from person to person. You’d be shocked at how much salt some people consume. A little bit with your vegetables or steak isn’t going to move the needle, but some processed foods have unbelievable amounts of sodium relative to how they taste. Salt definitely impacts blood pressure. Salt supplements are used with good effect in certain conditions of low blood pressure/volume.
  - btilly 3y ago
    Most would be shocked at how much salt they consume. That healthy prepackaged salad option at the grocery store? Often has more salt than a burger!
    - wing-_-nuts 3y ago
nmz 3y ago
I went to a cardiologist and was tested while lying down. This was an extensive test though.
idoubtit 3y ago
The original media release[^1] is much clearer, with a 3 points abstract followed by a detailed summary. I don't know if this derived article was written by a human or by an AI, but I think it's junk like this that contributes to makes the web a mess of noise and echo. [^1]: https://newsroom.heart.org/news/high-blood-pressure-while-lying-down-linked-to-higher-risk-of-heart-health-complications?preview=aea1 https://newsroom.heart.org/news/high-blood-pressure-while-ly...
- dang 3y ago
  Changed from https://studyfinds.org/measuring-blood-pressure-wrong/ https://studyfinds.org/measuring-blood-pressure-wrong/ above. Thanks! Submitters: "Please submit the original source. If a post reports on something found on another site, submit the latter." - https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
deleted 3y ago
[deleted]
TechBro8615 3y ago
I think the bigger issue with measuring blood pressure is that, aside from diagnosed diabetics, it's a measurement done infrequently and at mostly arbitrary times. Your blood pressure reading on the day of a doctor's appointment, right after you've driven to the appointment, made your way through the intake pipeline, and finally sat down in the chair, is not representative of its reading during a typical day in your life. Other factors like recency of coffee or alcohol consumption, exercise and sleep, all combine to make blood pressure a fairly variable statistic with limited diagnostic power when it's only measured infrequently. Regardless of whether you're lying down, standing up, or sitting in a chair, it would be beneficial to take more frequent blood pressure readings, throughout the day and during typical routines, than it would to only take them every time you visit the doctor. This seems like common sense, and you can even buy blood pressure sensors for $20 on Amazon, but how many people take their blood pressure on a regular basis? Once you're a diagnosed diabetic, then maybe you start measuring it every day - but wouldn't it be better to start such a habit before you become diabetic? After all, if you're continuously measuring a variable then you can notice patterns and anomalies, and take steps to mitigate them - possibly avoiding becoming diabetic before it's too late. It seems the limiting factor is sensor technology, which is obviously lacking compared to wearable sensors for tracking heart rate. Any health-conscious person with an Apple Watch or similar wearable device can easily track their pulse throughout the day. But no similarly accurate and seamless sensor exists for measuring blood pressure (as far as I know?), so nobody measures it as frequently as they do their pulse. Once we have the technology to accurately and passively measure blood pressure throughout the day, preventive medicine will become much easier, and people will have a better feeling for how their blood pressure responds to small changes in their environment and lifestyle.
- zwieback 3y ago
  Yeah, I have a machine and unless I take measurements very frequently (different times of day, etc.) it's really hard to make sense of the numbers. You really need to get a long term chart to weed out the noise. I've been getting much better readings at the doctors but then I realized I always ride my bike there, sit in the waiting room for a while and then get a low reading. Not representative!
Gualdrapo 3y ago
I don't know about you but getting somewhat concise readings for my blood pressure at several facilities has been difficult in here. When I went to the medical exams to get my drivingllicense one year ago I was told my blood pressure was a bit high - maybe due to the nervousness of being checked, but it was better to ask my doctor - both of my parents suffer from high blood pressure. So I did. He told me my blood pressure was high and gave me that famous table to fill up with daily readings for two weeks. My sister (physiotherapist) has a sphygmomanometer at home but she will scream at me to be perfectly still and seated for at least 5 minutes before doing the reading - and it _always_ was 120/80. Went several days to a nearby pharmacy and they gave me a little chair to be sat for 10 minutes before standing up and going to a small cubicle where they did the measurement with an electronic sphygmomanometer. Measurements there always were fairly inconsistent and above 131/87 - going up to 150/87. Also went to several other points to get my blood pressure measured and they always had a different method and (unsurprisingly) yielded different results. But for some reason when they measured with analogic/traditional sphygmomanometers, the measurements always were lower compared with electronic ones. Fortunately could afford a decent electronic sphygmomanometer for myself and started doing my own measurements, which are fluctuating between 117/77 and 122/82.
- pixl97 3y ago
  When you say you went to the pharmacy and doctors office, did you drive? BP level seems to highly correlate with the environment you're in, stressful driving can bring it up and keep it high for a while.
- gaetgu 3y ago
  This is an interesting point. I know for sure that I have been taught in school to never trust the electronic BP machines, since they can be pretty far off for some (but not all) people. Instead, using a sphygmomanometer is much more likely to give accurate results. Anecdotally, I always have a super weird initial blood pressure reading when I go to the doctor and they use the electric machine (one time it was 112/95), but when it is rechecked with a sphygmomanometer it tends to level out at somewhere around 130/85.
  - 3y ago
clumsysmurf 3y ago
Seems like it might also be important to check the difference in pressure between the two arms https://www.uclahealth.org/news/why-you-should-have-your-blood-pressure-checked-in-both-arms https://www.uclahealth.org/news/why-you-should-have-your-blo...
cm2012 3y ago
I hate getting my blood pressure taken. It feels invasive when the coil squeezes my arm. I'll do it but only when necessary.
- hwillis 3y ago
  invasive?
  - goostavos 3y ago
    I'm with this OP. I absolutely cannot stand it. I have no good "logical" reason for why, but it's the most stressful part of the doctors office for me. I've been as high as 170 at the doc due to sheer stress of getting the measurement taken. I've tried "exposure therapy" by just doing it at home every day, multiple times per day. It never stopped being stressful. I've also fainted during a blood draw. I wish I wasn't this guy... but alas. I am begrudgingly this guy.
    - Ductapemaster 3y ago
      I have the same set of experiences. It is incredibly frustrating to both myself and my doctors since I have a family history of high blood pressure, and it is impossible for me to get a baseline measurement. Only time I have ever had normal blood pressure is when I was in the best shape of my life a decade ago, and was considerably more relaxed due to life circumstances — but I distinctively remember not being afraid during the measurement, rather than feeling any different with regards to my overall health. Also I've fainted, or almost fainted, in an array of circumstances related to needles. My experiences range from moderately humorous to dangerous (I fainted after my first COVID shot at the wheel of my car...thankfully I knew it was coming and put it in park just in time). Don't feel too bad about being "that guy" — while the experience is incredibly personally uncomfortable, it's actually fairly common. I've just resorted to always having someone with me who knows what may happen and informing all the people involved about my history. Not fun, but it keeps me safe.
  - cm2012 3y ago
    Yes, it makes me feel trapped.
Mobil1 3y ago
Any disparity between interarm BP—especially when large and persistent—should prompt consideration of diseases known to be the cause: coarctation, dissection, or aneurysm of the thoracic aorta; Takayasu (pulseless) disease; and various types of intra- and extra-arterial obstruction in an upper extremity.1,9,11,23,24 These diagnostic considerations become much more likely if the arm with the lower BP also has a grossly diminished radial pulse.
Mobil1 3y ago
A recent study confirms a link between different arm-to-arm blood pressure and an increased risk for heart attack, stroke and death.
Blammar 3y ago
Am I correct in interpreting this study that your recorded BP should be the MAX of sitting BP and supine BP?
deleted 3y ago
[deleted]
giantg2 3y ago
We also need people who are knowledgeable on how to take blood pressure. Seems like half the time the nurse uses a machine and has that thing cranked up to 200mm so they don't have to redo it if the patient is high. No shit my blood pressure is elevate - I can feel my pulse get stronger because my arm isn't getting any blood flow. Similar thing with my petite old grandma. Always measured high if an unknown person did it because they would overinflate. But when someone would just put it 20 over her previous known good reading, then her blood pressure was fine. But nobody cares. In, out, get paid.
- ac2u 3y ago
  Same.... when the machine hurts like hell... and there's the awkward pause while it decides to re-inflate.. you know you're in for a high reading.
  - hinkley 3y ago
    Those cuffs are so fucking tight I'm certain that's spiking my blood pressure. Try measuring my BP while pinching me, don't be surprised what you get.
mongol 3y ago
I have low blood pressure, and it has caused me to faint, twice. I was fortunate to not hurt myself severly, but it was close. But it feels like the blood pressure is a symptom of something else. But no answers yet.
myshpa 3y ago
https://www.youtube.com/watch?v=Ig_ZWdpriC4 https://www.youtube.com/watch?v=Ig_ZWdpriC4 How to Lower Blood Pressure Naturally with Lifestyle Changes https://www.youtube.com/watch?v=fZc5Is98yDc https://www.youtube.com/watch?v=fZc5Is98yDc Healthiest Foods for Your Heart | Dr. Neal Barnard
TrackerFF 3y ago
When I first stared measuring at home, I'd get these crazy variations. The first time I measured, I was <- this -> close to driving to the ER, as I had something like 150/110 3-4 times in a row. "Fortunately" the measurements were done pretty poorly - I was sitting in a slouched chair, my arm / measurement point was way too low, and a bunch of other things. I redid the measurements after reading the manual, sitting straight up, feet on ground, measuring at heart level, etc. Suddenly I got 100/110 over 80/85, and while that wasn't ideal, it obviously calmed me down a good bit.
nelblu 3y ago
I have white coat hypertension and probably also some borderline hypertension, and my readings are off the chart (or used to be). I really hated the first doctor who diagnosed it, he straightaway gave me prescription (don't get me started on the whole prescription business in the US). I never picked the prescription. I decided to work on it and see if I can "fix it naturally". I did 2 main things : first one was extremely easy (for me), I dropped more than 29kgs (approx 60lbs) which was 34% of my body weight over more than 15 years (techinally the first 20 kg was pretty quick, last 9 kg took a few years and experimenting with food and eating habits). Secondly, I started practising meditation. That's a hard one, takes me a lot of effort but I'm doing it quite consistently now. Anyway, I barely check my blood pressure now and last I checked it was 118/75. I can't emphasize how important it is to eat well and live a stress free life to keep your heart healthy. Of course it worked for me because mine was just borderline high (on the best days it used to be 135/85), it won't work if you have severe hypertension but there's no harm in trying, it will definitely drop a few points on the meter and your heart will thank you.
- nine_k 3y ago
  I'm unironically applauding you, Mr. Superhero. Most people though, even being technically capable of similar feats, are not in a position to do so, because of the time and attention expenditures required. Rebuilding large chunks of your life to accommodate for a new lifestyle is the harder the more other people depend on you. Keeping your resolution for many years also.becomes harder.
- shepherdjerred 3y ago
  Kudos to you! Both weight loss and meditation are not something that everyone can do, though. I'm not sure of your circumstances. I'm pretty lucky being young, single, and having no kids, so maybe I could manage a similar feat in your position. I don't think it's the norm, though, which maybe is why medication is the default.
  - CPLX 3y ago
    > weight loss and meditation are not something that everyone can do, though Why not? Serious question not an attack. Outside of catatonic states and so on what would make those things impossible?
GoodOldNe 3y ago
This is an oral presentation by a medical student at a meeting. I wouldn't change your life or approach to ASCVD risk reduction based on it.
beefman 3y ago
Surely clinics will update their practices in light of this new information.
atahanacar 3y ago
Comments are full of disinformation. Don't take medical advice from HN.
- somsak2 3y ago
  any specifics that you can provide? in general I'm pretty skeptical of this idea that only medical professionals are useful for such information, but I'd like to hear concrete examples you have
  - atahanacar 3y ago
    Please see my other replies in this thread for some examples. I wanted to correct every false information but realized it was almost all comments that were either missing some nuances or clearly incorrect. Human body is a combination of multiple very complex systems. These are so complex that you can't even begin to grasp the complexity without diving pretty deep. Majority of non-MDs (especially non-MD health workers like nurses ironically - Dunning Kruger maybe?) heavily underestimate the knowledge required to graduate medical school. This complexity of human body brings with it lots of tiny nuances. So much and so tiny that even specialists with decades of experience can miss them. Add to this the mechanisms we still don't completely understand, you get the perfect recipe for "dangerous bad advice from non-medical professionals". Some of the misinformation is a direct health hazard, like claiming "your body can get rid of what it doesn't need so your salt intake is not an issue". Some of them aren't directly harmful to your health but damages the healthcare, either by breaking the trust like "blood pressure measurement during visits is incorrect and leads to misdiagnosis", or by putting extra pressure to spend healthcare resources unnecessarily like "measuring your bp during the day is useful". If you want to do any further reading on any of these problems I mentioned, especially the last one which is hard to grasp and counterintuitive, I can link you some resources. Edit: by MD I mean also DO for Americans.
iancmceachern 3y ago
I like their domain, very cool
NotGMan 3y ago
My blood pressure went from ~145/95 to ~120/75 just be lowering carbs/sugar drasticaly. Salt has zero effect for me, I ate ~15g + salt and it had zero effect on blood sugar. Carbs though...oh boy.. It may take a month or two for the change to become noticable.
giardini 3y ago
The paper referenced does NOT state that "Blood pressure should be measured lying down" as the OP posted here on HN. It states instead: “Our findings suggest people with known risk factors for heart disease and stroke may benefit from having their blood pressure checked while lying flat on their backs ... Efforts to manage blood pressure during daily life may help lower blood pressure while sleeping. Future research should compare supine blood pressure measurements in the clinic with overnight measurements.[emphases mine]”

252 points by Vaslo 3y ago

Well....that sucks. Maybe I don't have normal blood pressure. Doctors never test me lying flat. Closest I've gotten is laying at an angle in a hospital bed. I'm a middle-aged heavyset guy as well, so I know I'm at greater risk for these things.

Aurornis 3y ago
An at home blood pressure cuff is relatively cheap if you’re concerned about it.
- lowercased 3y ago
  Seconded. Got one and tested myself a couple times a day for a few weeks. I'm not necessarily sure it's 'accurate', but having repeated readings from same device, same arm, same position, same times of day seemed to at least show consistency and identify when things were out of whack (a couple times). Got one for about $25.
  - squeaky-clean 3y ago
    I was able to bring mine to my cardiologist appointment to double check I was using it correctly and then to check the results against the one in-office. Mine also cost about $25 at CVS.
bpoyner 3y ago
I've only once had a doctor test my blood pressure lying flat. I had a suspected GI bleed and he wanted to see the difference between flat and sitting up. Then he called up the hospital and got me a spot reserved in the ICU.
Broken_Hippo 3y ago
My doctor's office sent me home with a monitor for 24 hours. It tested every 15 minutes during the day and every 30 minutes during the night. I generally went about my day at home and eventually even slept. This seems pretty normal in Norway - but I don't think it was in the US (Am from the US, father had heart problems). Perhaps your doctor would be able to do something similar, though.
- WWLink 3y ago
  Yea they do that in the US as well. But not very often.

umeshunni 3y ago

Saved you a click: Our findings suggest people with known risk factors for heart disease and stroke may benefit from having their blood pressure checked while lying flat on their backs

deleted 3y ago
[deleted]

Gys 3y ago

> Sixteen percent did not have high blood pressure — a reading greater than 130/80 mm Hg — while seated. However, these same people did show high blood pressure when researchers measured their BP while lying flat on their backs.

wing-_-nuts 3y ago

TLDR: Doctors need to check blood pressure while the patient is laying down. I do wonder about recent changes that suggest anything beyond 120 / 80 is above 'normal'. You would think that something like blood pressure would be highly regulated in the body but it varies throughout the day, month and year. They also say that salt is seriously bad for high blood pressure but I find little effect for myself personally. I do wonder how much sensitivity varies from person to person.

lawlessone 3y ago
I think if you get a decent amount of water and potassium your body is able to more easily expel the excess sodium
- vitorgrs 3y ago
  I have hypertension and take my med everyday... If you drink watermelon juice, it makes wonder to incredible lower it.
Aurornis 3y ago
> They also say that salt is seriously bad for high blood pressure but I find little effect for myself personally. I do wonder how much sensitivity varies from person to person. You’d be shocked at how much salt some people consume. A little bit with your vegetables or steak isn’t going to move the needle, but some processed foods have unbelievable amounts of sodium relative to how they taste. Salt definitely impacts blood pressure. Salt supplements are used with good effect in certain conditions of low blood pressure/volume.
- btilly 3y ago
  Most would be shocked at how much salt they consume. That healthy prepackaged salad option at the grocery store? Often has more salt than a burger!
  - wing-_-nuts 3y ago

nmz 3y ago

I went to a cardiologist and was tested while lying down. This was an extensive test though.

idoubtit 3y ago

The original media release[^1] is much clearer, with a 3 points abstract followed by a detailed summary. I don't know if this derived article was written by a human or by an AI, but I think it's junk like this that contributes to makes the web a mess of noise and echo. [^1]: https://newsroom.heart.org/news/high-blood-pressure-while-lying-down-linked-to-higher-risk-of-heart-health-complications?preview=aea1 https://newsroom.heart.org/news/high-blood-pressure-while-ly...

dang 3y ago
Changed from https://studyfinds.org/measuring-blood-pressure-wrong/ https://studyfinds.org/measuring-blood-pressure-wrong/ above. Thanks! Submitters: "Please submit the original source. If a post reports on something found on another site, submit the latter." - https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

deleted 3y ago

[deleted]

TechBro8615 3y ago

I think the bigger issue with measuring blood pressure is that, aside from diagnosed diabetics, it's a measurement done infrequently and at mostly arbitrary times. Your blood pressure reading on the day of a doctor's appointment, right after you've driven to the appointment, made your way through the intake pipeline, and finally sat down in the chair, is not representative of its reading during a typical day in your life. Other factors like recency of coffee or alcohol consumption, exercise and sleep, all combine to make blood pressure a fairly variable statistic with limited diagnostic power when it's only measured infrequently. Regardless of whether you're lying down, standing up, or sitting in a chair, it would be beneficial to take more frequent blood pressure readings, throughout the day and during typical routines, than it would to only take them every time you visit the doctor. This seems like common sense, and you can even buy blood pressure sensors for $20 on Amazon, but how many people take their blood pressure on a regular basis? Once you're a diagnosed diabetic, then maybe you start measuring it every day - but wouldn't it be better to start such a habit before you become diabetic? After all, if you're continuously measuring a variable then you can notice patterns and anomalies, and take steps to mitigate them - possibly avoiding becoming diabetic before it's too late. It seems the limiting factor is sensor technology, which is obviously lacking compared to wearable sensors for tracking heart rate. Any health-conscious person with an Apple Watch or similar wearable device can easily track their pulse throughout the day. But no similarly accurate and seamless sensor exists for measuring blood pressure (as far as I know?), so nobody measures it as frequently as they do their pulse. Once we have the technology to accurately and passively measure blood pressure throughout the day, preventive medicine will become much easier, and people will have a better feeling for how their blood pressure responds to small changes in their environment and lifestyle.

zwieback 3y ago
Yeah, I have a machine and unless I take measurements very frequently (different times of day, etc.) it's really hard to make sense of the numbers. You really need to get a long term chart to weed out the noise. I've been getting much better readings at the doctors but then I realized I always ride my bike there, sit in the waiting room for a while and then get a low reading. Not representative!

Gualdrapo 3y ago

I don't know about you but getting somewhat concise readings for my blood pressure at several facilities has been difficult in here. When I went to the medical exams to get my drivingllicense one year ago I was told my blood pressure was a bit high - maybe due to the nervousness of being checked, but it was better to ask my doctor - both of my parents suffer from high blood pressure. So I did. He told me my blood pressure was high and gave me that famous table to fill up with daily readings for two weeks. My sister (physiotherapist) has a sphygmomanometer at home but she will scream at me to be perfectly still and seated for at least 5 minutes before doing the reading - and it _always_ was 120/80. Went several days to a nearby pharmacy and they gave me a little chair to be sat for 10 minutes before standing up and going to a small cubicle where they did the measurement with an electronic sphygmomanometer. Measurements there always were fairly inconsistent and above 131/87 - going up to 150/87. Also went to several other points to get my blood pressure measured and they always had a different method and (unsurprisingly) yielded different results. But for some reason when they measured with analogic/traditional sphygmomanometers, the measurements always were lower compared with electronic ones. Fortunately could afford a decent electronic sphygmomanometer for myself and started doing my own measurements, which are fluctuating between 117/77 and 122/82.

pixl97 3y ago
When you say you went to the pharmacy and doctors office, did you drive? BP level seems to highly correlate with the environment you're in, stressful driving can bring it up and keep it high for a while.
gaetgu 3y ago
This is an interesting point. I know for sure that I have been taught in school to never trust the electronic BP machines, since they can be pretty far off for some (but not all) people. Instead, using a sphygmomanometer is much more likely to give accurate results. Anecdotally, I always have a super weird initial blood pressure reading when I go to the doctor and they use the electric machine (one time it was 112/95), but when it is rechecked with a sphygmomanometer it tends to level out at somewhere around 130/85.
- 3y ago

clumsysmurf 3y ago

Seems like it might also be important to check the difference in pressure between the two arms https://www.uclahealth.org/news/why-you-should-have-your-blood-pressure-checked-in-both-arms https://www.uclahealth.org/news/why-you-should-have-your-blo...

cm2012 3y ago

I hate getting my blood pressure taken. It feels invasive when the coil squeezes my arm. I'll do it but only when necessary.

hwillis 3y ago
invasive?
- goostavos 3y ago
  I'm with this OP. I absolutely cannot stand it. I have no good "logical" reason for why, but it's the most stressful part of the doctors office for me. I've been as high as 170 at the doc due to sheer stress of getting the measurement taken. I've tried "exposure therapy" by just doing it at home every day, multiple times per day. It never stopped being stressful. I've also fainted during a blood draw. I wish I wasn't this guy... but alas. I am begrudgingly this guy.
  - Ductapemaster 3y ago
    I have the same set of experiences. It is incredibly frustrating to both myself and my doctors since I have a family history of high blood pressure, and it is impossible for me to get a baseline measurement. Only time I have ever had normal blood pressure is when I was in the best shape of my life a decade ago, and was considerably more relaxed due to life circumstances — but I distinctively remember not being afraid during the measurement, rather than feeling any different with regards to my overall health. Also I've fainted, or almost fainted, in an array of circumstances related to needles. My experiences range from moderately humorous to dangerous (I fainted after my first COVID shot at the wheel of my car...thankfully I knew it was coming and put it in park just in time). Don't feel too bad about being "that guy" — while the experience is incredibly personally uncomfortable, it's actually fairly common. I've just resorted to always having someone with me who knows what may happen and informing all the people involved about my history. Not fun, but it keeps me safe.
- cm2012 3y ago
  Yes, it makes me feel trapped.

Mobil1 3y ago

Any disparity between interarm BP—especially when large and persistent—should prompt consideration of diseases known to be the cause: coarctation, dissection, or aneurysm of the thoracic aorta; Takayasu (pulseless) disease; and various types of intra- and extra-arterial obstruction in an upper extremity.1,9,11,23,24 These diagnostic considerations become much more likely if the arm with the lower BP also has a grossly diminished radial pulse.

Mobil1 3y ago

A recent study confirms a link between different arm-to-arm blood pressure and an increased risk for heart attack, stroke and death.

Blammar 3y ago

Am I correct in interpreting this study that your recorded BP should be the MAX of sitting BP and supine BP?

deleted 3y ago

[deleted]

giantg2 3y ago

We also need people who are knowledgeable on how to take blood pressure. Seems like half the time the nurse uses a machine and has that thing cranked up to 200mm so they don't have to redo it if the patient is high. No shit my blood pressure is elevate - I can feel my pulse get stronger because my arm isn't getting any blood flow. Similar thing with my petite old grandma. Always measured high if an unknown person did it because they would overinflate. But when someone would just put it 20 over her previous known good reading, then her blood pressure was fine. But nobody cares. In, out, get paid.

ac2u 3y ago
Same.... when the machine hurts like hell... and there's the awkward pause while it decides to re-inflate.. you know you're in for a high reading.
- hinkley 3y ago
  Those cuffs are so fucking tight I'm certain that's spiking my blood pressure. Try measuring my BP while pinching me, don't be surprised what you get.

mongol 3y ago

I have low blood pressure, and it has caused me to faint, twice. I was fortunate to not hurt myself severly, but it was close. But it feels like the blood pressure is a symptom of something else. But no answers yet.

myshpa 3y ago

https://www.youtube.com/watch?v=Ig_ZWdpriC4 https://www.youtube.com/watch?v=Ig_ZWdpriC4 How to Lower Blood Pressure Naturally with Lifestyle Changes https://www.youtube.com/watch?v=fZc5Is98yDc https://www.youtube.com/watch?v=fZc5Is98yDc Healthiest Foods for Your Heart | Dr. Neal Barnard

TrackerFF 3y ago

When I first stared measuring at home, I'd get these crazy variations. The first time I measured, I was <- this -> close to driving to the ER, as I had something like 150/110 3-4 times in a row. "Fortunately" the measurements were done pretty poorly - I was sitting in a slouched chair, my arm / measurement point was way too low, and a bunch of other things. I redid the measurements after reading the manual, sitting straight up, feet on ground, measuring at heart level, etc. Suddenly I got 100/110 over 80/85, and while that wasn't ideal, it obviously calmed me down a good bit.

nelblu 3y ago

I have white coat hypertension and probably also some borderline hypertension, and my readings are off the chart (or used to be). I really hated the first doctor who diagnosed it, he straightaway gave me prescription (don't get me started on the whole prescription business in the US). I never picked the prescription. I decided to work on it and see if I can "fix it naturally". I did 2 main things : first one was extremely easy (for me), I dropped more than 29kgs (approx 60lbs) which was 34% of my body weight over more than 15 years (techinally the first 20 kg was pretty quick, last 9 kg took a few years and experimenting with food and eating habits). Secondly, I started practising meditation. That's a hard one, takes me a lot of effort but I'm doing it quite consistently now. Anyway, I barely check my blood pressure now and last I checked it was 118/75. I can't emphasize how important it is to eat well and live a stress free life to keep your heart healthy. Of course it worked for me because mine was just borderline high (on the best days it used to be 135/85), it won't work if you have severe hypertension but there's no harm in trying, it will definitely drop a few points on the meter and your heart will thank you.

nine_k 3y ago
I'm unironically applauding you, Mr. Superhero. Most people though, even being technically capable of similar feats, are not in a position to do so, because of the time and attention expenditures required. Rebuilding large chunks of your life to accommodate for a new lifestyle is the harder the more other people depend on you. Keeping your resolution for many years also.becomes harder.
shepherdjerred 3y ago
Kudos to you! Both weight loss and meditation are not something that everyone can do, though. I'm not sure of your circumstances. I'm pretty lucky being young, single, and having no kids, so maybe I could manage a similar feat in your position. I don't think it's the norm, though, which maybe is why medication is the default.
- CPLX 3y ago
  > weight loss and meditation are not something that everyone can do, though Why not? Serious question not an attack. Outside of catatonic states and so on what would make those things impossible?

GoodOldNe 3y ago

This is an oral presentation by a medical student at a meeting. I wouldn't change your life or approach to ASCVD risk reduction based on it.

beefman 3y ago

Surely clinics will update their practices in light of this new information.

atahanacar 3y ago

Comments are full of disinformation. Don't take medical advice from HN.

somsak2 3y ago
any specifics that you can provide? in general I'm pretty skeptical of this idea that only medical professionals are useful for such information, but I'd like to hear concrete examples you have
- atahanacar 3y ago
  Please see my other replies in this thread for some examples. I wanted to correct every false information but realized it was almost all comments that were either missing some nuances or clearly incorrect. Human body is a combination of multiple very complex systems. These are so complex that you can't even begin to grasp the complexity without diving pretty deep. Majority of non-MDs (especially non-MD health workers like nurses ironically - Dunning Kruger maybe?) heavily underestimate the knowledge required to graduate medical school. This complexity of human body brings with it lots of tiny nuances. So much and so tiny that even specialists with decades of experience can miss them. Add to this the mechanisms we still don't completely understand, you get the perfect recipe for "dangerous bad advice from non-medical professionals". Some of the misinformation is a direct health hazard, like claiming "your body can get rid of what it doesn't need so your salt intake is not an issue". Some of them aren't directly harmful to your health but damages the healthcare, either by breaking the trust like "blood pressure measurement during visits is incorrect and leads to misdiagnosis", or by putting extra pressure to spend healthcare resources unnecessarily like "measuring your bp during the day is useful". If you want to do any further reading on any of these problems I mentioned, especially the last one which is hard to grasp and counterintuitive, I can link you some resources. Edit: by MD I mean also DO for Americans.

iancmceachern 3y ago

I like their domain, very cool

NotGMan 3y ago

My blood pressure went from ~145/95 to ~120/75 just be lowering carbs/sugar drasticaly. Salt has zero effect for me, I ate ~15g + salt and it had zero effect on blood sugar. Carbs though...oh boy.. It may take a month or two for the change to become noticable.

giardini 3y ago

The paper referenced does NOT state that "Blood pressure should be measured lying down" as the OP posted here on HN. It states instead: “Our findings suggest people with known risk factors for heart disease and stroke may benefit from having their blood pressure checked while lying flat on their backs ... Efforts to manage blood pressure during daily life may help lower blood pressure while sleeping. Future research should compare supine blood pressure measurements in the clinic with overnight measurements.[emphases mine]”