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High Systoic BP reading

I bought one that is extra large because I found at the office I was getting consistent high readings. My arm has shrunk down now, but it's still near the limit of a regular cuff. I think the higher readings I keep getting at the doctors office now are probably due to this still. The nurses never listen to me when I suggest larger cuff.

This man is on POINT today!
 
Mine was down around 100/65 and I felt pretty shitty. My doctors didnt seem too worried, but I told them I wanted to raise it because I felt like crap. Now I keep it around 120/80 and feel much better. I only take 5 mg/day lisinopril now because of it, and had to get off spironolactone too. When I was recovering from the heart attack in ICU my BP was around 65/45 or so, cant remember. Only that it was extremely low and they tilted the bed down at a steep angle to get increase blood flow to my head. I thought I was a goner.

I wouldnt be able to tolerate having BP at 80/50 and be able to walk around. In my case when it was real low, I was laying prone in my hospital bed.

That's called Trendelenburg position which allows gravity to assist with perfusing the vital organs (esp the brain). The magic Mean Arterial Pressure (MAP) = 65 mm Hg or higher. To calculate the MAP is easy if u follow these simple steps.

1) Systolic BP x 0.33 =1/3rd of MAP
2) Diastolic BP x 0.67 = 2/3rd of MAP

E.g. You said your BP was 100/65. The MAP would be 1/3rd of SBP + 2/3rd DBP. In this case, (100 x 0.33 = 33) + (65 x 0.67 = 44) = 77 mm Hg. The reason it's 1/3rd x SBP is b/c the heart spends ~1/3rd of its time in the cardiac cycle actually beating (aka systole) while it spends 2/3rd of its time in the cardiac cycle relaxing (aka diastole).

Q.E.D.
 
That's called Trendelenburg position which allows gravity to assist with perfusing the vital organs (esp the brain). The magic Mean Arterial Pressure (MAP) = 65 mm Hg or higher. To calculate the MAP is easy if u follow these simple steps.

1) Systolic BP x 0.33 =1/3rd of MAP
2) Diastolic BP x 0.67 = 2/3rd of MAP

E.g. You said your BP was 100/65. The MAP would be 1/3rd of SBP + 2/3rd DBP. In this case, (100 x 0.33 = 33) + (65 x 0.67 = 44) = 77 mm Hg. The reason it's 1/3rd x SBP is b/c the heart spends ~1/3rd of its time in the cardiac cycle actually beating (aka systole) while it spends 2/3rd of its time in the cardiac cycle relaxing (aka diastole).

Q.E.D.
Yeah, I used to remember how to calculate MAP. Another thing to look at is pulse pressure too. In ICU with my heart attack it was VERY low. Scary as hell.

The nurses told me the name of the position in the hospital but I forgot,lol. Makes sense to do that. I was like that for I dont know how long, maybe 24 hours.
 
@maldorf what was your heart attack a result from ? Do you know what caused it ? I think I remember readying your “heart attack at 34” thread.

was your BP normal when you had the attack ?

also, I take Lisinopril, 10mg /12.5 HTZC.. and it drops me from like 144-157 / 88
Down to like 125/78 along with my other meds
 
@maldorf what was your heart attack a result from ? Do you know what caused it ? I think I remember readying your “heart attack at 34” thread.

was your BP normal when you had the attack ?

also, I take Lisinopril, 10mg /12.5 HTZC.. and it drops me from like 144-157 / 88
Down to like 125/78 along with my other meds
I had a blood clot.

 
Okay...try this one...I took my BP first thing in the morning and it was 105/70 and pulse was 70...I wake up my girlfriend and pound the shit out of her pussy for 10 minutes...I blow a huge load...I immediately took my BP...it was 125/80...my pulse was 100...I was a swimmer in hs and college...pretty good sprinter....we would swim 4,000 yards in the am and at least 8,000 in the pm...we all had low BP...my pulse was as low as 40 at rest and I could hold my breath for almost 4 minutes....I was able to swim 100 yards underwater...now that was over 40 years ago...I have never had shoulder issues even while benching 450 raw at 6'2" and only 220 lbs because of the flexibility required from swimming,..the highest my BP ever was 130/80 while on a gram of T and 100 mg of Syntex anadrol... At 62 I am just getting old and youth doesn't last....
 
I always figured for me the BP was slightly elevated bc of the ridiculously uncomfortable chairs they use. It doesn't have to be a lounge chair but wow, dude...save my tailbone!
If you have relatively muscular arms, you’ll also get a false high reading if they use the cuff meant for normal people. If they step up to the fat person cuff the numbers always come down a decent amount. I had a reading of 155/119 once at the doctors, then they switched to the larger cuff and it came back as 139/105. Still high bp, but pretty different number
 
I always do at heart level too. I learned how to manually take my BP with a stethoscope, but don't recall instruction on how to place the arm. I'm pretty sure it should be laid out near heart level, but I can't say for sure.

I've never measured it with my arm going down with gravity
On a proper reading arm would be at 90 degrees(so relatively heart level) and fingers on wrist for pulse.
 
If you have relatively muscular arms, you’ll also get a false high reading if they use the cuff meant for normal people. If they step up to the fat person cuff the numbers always come down a decent amount. I had a reading of 155/119 once at the doctors, then they switched to the larger cuff and it came back as 139/105. Still high bp, but pretty different number
Oh yeah, I always get the obese cuff. It's close enough +or- 10mm what I get at home. Once it was way off but I was there with a pinched nerve that was radiating down my arm, hurt like a bugger. Gave me Flexeril and a methylprednisolone dose-pak. Week later I was back in business. Always something.
 
Yeah, I used to remember how to calculate MAP. Another thing to look at is pulse pressure too. In ICU with my heart attack it was VERY low. Scary as hell.

The nurses told me the name of the position in the hospital but I forgot,lol. Makes sense to do that. I was like that for I dont know how long, maybe 24 hours.

Unless you're an 85 year old with moderately severe aortic regurgitation or a 35 year old s/p AMI, a widened pulse pressure usually isn't at the top of the DDx when running down the list of major patient assessments and plans. That being said, it is wise to keep the finding when developing your DDx.
 

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