Here There and Everywhere

Expat wanderer

Blood Pressure: Self Monitoring

Many people in the US take their own blood pressure once or twice a day to be sure they are not experiencing overly high readings.

I have done this, but I also find that just taking my blook pressure makes me anxious enough to cause a rise in the pressure. I take it two or three times to get an accurate idea, and when I have it checked in a doctor’s office, I ask them to do it manually, as those results – at least for me – are more accurate than the automatic models. And did you know you can get different readings depending on which arm they use?

BBC Health News has an article today on self-monitoring blood pressure, which contains the following information:

Taking control or worrying yourself sick?
There are several reasons why your GP might be sceptical about self-monitoring.

It could be a hangover from earlier times when it meant doctors training patients in the complicated art and science of using a manual blood pressure device. Modern devices pose much less of a challenge.

Even automatic machines are open to bias: it’s easy to round figures down or simply ignore unusually high results. In my experience, this can apply equally to doctors, and some modern machines memorise readings so you can’t fiddle the records.

More simply, doctors worry that patients will worry. They worry some people will develop an obsessional and unhealthy interest in every peak and trough of their blood pressure. I’ve certainly seen people panicked unnecessarily by a one-off high reading.

But perhaps the main reason is that most automated blood pressure monitors on sale to the public haven’t been properly validated, or have been shown to be inaccurate. The National Institute for Health and Clinical Excellence, which issues guidance for doctors, says using home-monitoring devices as part of primary care needs more research.

Golden rules of self-monitoring
Other doctors may have a different view, but if a patient of mine wanted to buy one of these devices this is what I hope they would do.

First, discuss it with me. We can talk about how to use the machine properly, how often and when to take readings, and how to interpret them. For example, the threshold for high blood pressure is generally lower using home monitors (more than 135/85 is high) than in the clinic (more than 140/90 is high).

Without getting too obsessive, when it comes to long-term monitoring I’ve found the European Society of Hypertension advice works well – take two morning and evening readings each day for one week every three months. Alternatively, you could take readings on one day every week.

Things that temporarily affect blood pressure

Anxiety
Exercise
Meals
Tobacco
Alcohol
Pain
Time of year – blood pressure’s generally lower in summer
Time of day – blood pressure’s usually lower when you’re asleep
Second, before my patient handed over their hard-earned cash, I’d strongly advise them to check up-to-date information on which devices have been properly validated.

Just because a monitor is on sale – and even if it has a ‘CE’ mark (indicating it meets European standards) – it doesn’t necessarily mean it’s accurate or reliable.

Luckily, this job is done for you by the British Hypertension Society.

Third, choose an upper arm monitor as these have been shown to be the most reliable, but always make sure you have the right sized cuff to fit your arm – too small or too large and the reading can be inaccurate.

In general, wrist and finger devices aren’t recommended because they’re easily influenced by changes in circulation, and the measuring cuff is not always at the level of your heart, which it should be.

Benefits of self-monitoring
Despite some doctors’ reservations, the tide seems to be turning.

Self-monitoring can be useful in detecting white coat hypertension. This is a phenomenon affecting up to one in five adults, in which blood pressure measurements taken at your doctor’s or in a clinic are high even though your blood pressure’s normal the rest of the time.

You can read the whole article at BBC Health News.

August 11, 2007 Posted by | Health Issues, News | 2 Comments

Prosper the work of our Hands!

In todays readings, Psalm 90, verse 17 says:

17Let the favour of the Lord our God be upon us,
and prosper for us the work of our hands—
O prosper the work of our hands!

So this is my prayer – for myself, for my friends, for my readers. Today, may God prosper the work of our hands!

August 11, 2007 Posted by | Blogging, Community, Cross Cultural, Spiritual | 1 Comment

Chevy’s Fresh Mex

At one time Adventure Man worked in Saudi Arabia, and came home every three months craving Mexican Food. His all time favorite restaurant was Chevy’s, which specializes in FRESH FRESH Mexican food.

Mom may be 84, but she is always up for a new experience. I asked her if she would like to try Chevy’s, and she was sure she would like to try it. You ROCK, Mom!

00chevys-interior.jpg

Mom’s Tostada Salad with beef:

00chevys-taco-salad.jpg

My Spicy Salmon Fajita:

chevysspicysalmonfajitas.jpg

Totally delicious, but too much food! We brought home enough food for two or three more meals!

August 11, 2007 Posted by | Eating Out, ExPat Life, Generational, Health Issues, Photos, Saudi Arabia, Seattle, Travel, Uncategorized | 6 Comments