Blood pressure

[Tableview]

I came across this chart of blood pressure parameters,

http://www.vaughns-1-pagers.com/medicine/blood-pressure-chart.gif

which indicates optimal BP in the band from 120/80.

I thought that after exercise one's BP would go up, but according to this chart, BP after strenuous exercise is at the lower end of this scale, at 110/70.

If this is correct, and I assume it is, why?

[gingernut]

Oh gawd. where do I start ?

[Loose rivets]

Start by telling me how I felt fine with an 80 over 40.


To save time, I'll say they bought in another electronic device cos of their incredulity. It read the same. Incredulity is a bit like denial, it requires lots of prods with someone else's stick. They got a fine old barometric device out - I bet it even had a sylphon somewhere in its works - and yep, 80 over 40.

My goodness, I don't suppose I've written sylphon for 50 years.

I'll stop now, cos the wine is probably making me silly on a sensible forum, but I promise you, it was 80 over 40.

[AdamFrisch]

I have white coat syndrome. Means my BP goes up whenever I'm near a doctor or anyone in a white coat. I know, because I've measured it at home over time. I hate being around them and hospitals. So I normally read too high unless I come in right after exercise. What I normally do is jump on my bicycle and cycle to the medical whenever I need to renew. Works well.

[homonculus]

Loose rivets

You are normal. Unusual but normal. And not that rare. Put bluntly, unless you have been run over by a bus and are bleeding to death, a low blood pressure is GOOD and nothing to worry about (OK there are some very rare diseases such as Addisons but they make you very unwell and kill you very quickly - you havent got them)

the chart is c@@@. Some people have more time than sense. If the lower blood pressure - diastolic - starts with anything up to an 8 (so 74, 87 etc) that is fine. A 9 or more needs a doctor. Some big studies have shown a benefit of treating high 80s but .......

The only bit of the chart worth taking note of is

reduce salt
lose weight if overweight
moderate exercise may help

so do this and take your blood pressure at home if you have white coat syndrome. We dont mind if it goes up and down - it is the LOWEST reading when you are resting that is important

otherwise see your doctor and if he puts you on a tablet or so and controls your blood pressure your risk factors come back almost to normal.

That is about it!

[obgraham]

Another MD here, completely agreeing with Homonculus.

That chart is for the obsessive-compulsives. "The personal thoughts of the author" as the footnote states.

Be happy when BP is not high, take some Rx if it's a too high. And get on with life.

[screwballburling]

I wish you wouldn't put these charts up. Since digesting it, I have had chest pains and heart palpitations!!!

Reminds me of the time, years ago when I was on a bush contract in Africa. Someone bought a comprehensive medical book down with him. We all read ourselves sick within a week!!

[OffshoreHeli-Mgr]

Eat one stalk of celery a day. Look it up on the internet on the how/why it works.

[gingernut]

It's important to take elevated blood pressure seriously, but it is only part of the cardiovascular risk bigger picture, (lipid's/smoking/weight/exercise etc).

The chart is useful Tableview, and contains some useful stuff around lifestyle. Pilot's will love it, the figure looks like something out of a PPL training manual.

I'm not sure if it's that useful to place "classifications" on levels. (Although NICE do.) And how useful is a "snapshot" figure? Average home reading's or ambulatory reading's are probably more useful.

The stuff around low blood pressure is confusing to say the least.

Celery anyone...pass the salt.:)

[bluecode]

Well I was edging into the severe until I put on a couple of drugs for it. Now it's comfortably within the optimum. Irritating that particularly since my lifestyle didn't reflect the usual causes. I hate to think how bad I'd have been if I had been smoking and overeating fatty and salty foods for all those years.

Such is life.

[BabyBear]

Interesting to see the chart in this format. It backs up what my AME indicated at my last medical less than a month ago, that under EASA anything above 140 was an automatic fail (class 2).

[zero1]

This looks more like a W&B for a PA28... :ok:

[Echo Romeo]

Interesting to see the chart in this format. It backs up what my AME indicated at my last medical less than a month ago, that under EASA anything above 140 was an automatic fail (class 2).

I thought it was 160?

[BabyBear]

I don't know what it is other than what the AME said, curiously it coincides with the chart going in to the red region.

Any AME wish to verify?

[Pace]

It used to be your age over a TON! Nice the Ton bit as that coincided with the speed you loose your licence on a motorway ;)
Then it all changed as the drug companies wanted more and more people on blood pressure lowering drugs for life and employed scientists to build their case.
Really its still not understood! Is not a constant thing and GPs love to have something to measure :ok:
Exercise dilates tight, stressed, blood vessels and hence after the exercise the pressure goes lower.
A natural pill which does work (If you can afford it is Alistrol) Taken for six weeks before your medical and you will be amazed at the readings you get.
The highest blood pressure readings I ever got was when I was 28, through the roof!!! 30 years later still get first class meds drug free!
Wish the drug companies would put more of their $Billions into finding cures and understanding conditions rather than turning out yet more damaging drugs for us to take and for them to sell!

[Hydromet]

If this is correct, and I assume it is, why?
I don't know why, but it is correct.
Years ago I was cycling 200-300km/week. My resting heart rate was 45 and bp was 140/90. I was extremely fit. My cycling mate's wife, a nurse, started testing our bp immediately on our return and diastolic was always lower - 70-80. My mates was much lower, as he has almost hypotension - feints if he stands up quickly.

When my bp was in its normal range, my GP always kept an eye on it, because "it's borderline high for a bloke your age." When I retired (from both work and cycling), diastolic dropped slightly, but sadly, he informed me that they'd also redefined normal.

[dirkdj]

Pace: Wish the drug companies would put more of their $Billions into finding cures and understanding conditions rather than turning out yet more damaging drugs for us to take and for them to sell!

Self-defeating business case?

[homonculus]

Pace

Drug companies exist to develop drugs. Major medical research centres exist to find cures. Do stop this silly campaign - drug companies have saved far more lives than doctors, albeit making a lot of money along the way. We would all love to find more cures just as I would like someone to develop a helicopter I ncan fly for less than the cost of a car, or a way to live to be 200

As for allistrol - the FDA are going bonkers about illegalities etc. Can you show me any clinical trials, any studies into side effects and riskes etc? By all means take what you like but please dont encourage others without showing us the evidence

[Phororhacos]

UK CAA Rules here..

http://www.caa.co.uk/docs/2499/Hypertension%20FC.pdf

so no, >140/90 is not a fail, but does need a follow up 24 hr ambulatory BP for class 1 within 2 months. Home readings may be acceptable for class 2.

>160/95 means you don't go away with your certificate on the day.

[DX Wombat]

Can you show me any clinical trials, any studies into side effects and riskes etc? By all means take what you like but please don't encourage others without showing us the evidence Also, if you are taking it solely prior to your medical and if it is bringing down your blood pressure then that implies that for the rest of the time you are hypertensive with all the nasty possibilities that implies, including collapsing with a stroke whilst flying. :*

[Pace]

Wombat

I never said it was high but always rides the higher side of normal.
Alistrol brings it well down into normal which also means I relax more when getting it taken.

H Please excuse my style of posting which can be challenging of conventional practice and is designed to encourage discussion I use the same style in the flying forums ;)

Yes I agree the drug companies are there to develop drugs I just wish scientific research had the same budgets then understanding and cures could possibly come faster and yes I do not think drugs are the answer to all our ills yet a pill is expected for every ill.

[gingernut]

About 11% of what drugs companies pedal is based on solid evidence.

Antihypertensives make up part of this 11%, unfortunately, aristrol doesn't.

[homonculus]

Which drug company sells Allistrol Gingernut?

[Airclues]

homonculus

Alistrol claims to be all natural, containing herb, fruit and seed extract. However the US fda disagrees Alistrol Health 6/26/12 (http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2012/ucm310957.htm) .
I regularly monitor my BP and four Alistrol a day reduced it by 25/15, with all other factors remaining constant.

[gingernut]

point taken.

[obgraham]

Alistrol claims to be all natural, containing herb, fruit and seed extract. Does that somehow make it better or safer? Peach pits are all natural too, and are touted as curing many things. Must be the cyanide in them.

Looking at the web site for Alistrol, it looks all nifty-sciencey. Even has a "clinical" section. But clicking on several of the references to research yields just more opinions and anecdotal reports. No true scientific study results.

I don't know if the stuff works or not. Neither does anybody else. And nobody is counting up the adverse effects. If you take it, you are engaging in your own private research study.

Like most of the "alternative" treatments.

[homonculus]

And like the kids taking designer drugs in night clubs on Saturday night.

The difference is they are young and naive

A couple of years ago we had several deaths in London from people taking natural herbs the Chinese had been using for years. Only problem was that they contained lethal doses of heavy metals.

At least you can sue your doctor........

[gingernut]

So, the motto is..... don't put anything in your body that doesn't have a product license:)

[Pace]

Only a month ago sleeping tablets churned out for years were discovered even if taken 15 years ago to dramatically increase your chances of developing dementia.
As for Statins ??? ;(
On too regular a basis drugs that we are reassured are safe are discovered to be far from safe so its not just alternative medicine which is questionable

[homonculus]

No we are NOT getting onto statins again - which are quite safe and possibly offer the opportunity of saving more lives than any other drug

Nor am I going to rise to the bait on benzodiazepines where there is NO evidence of anything dramatic merely a possible rise

But the difference compared to non prescription chemicals is very important - benzodiazepines and statins were both rigorously tested before anyone was prescribed a single tablet. And the research never stops so very subtle potential links that can only be identified after millions of doses are marked up so we can take account of them. Non prescribed drugs are not tested before, during or after people have taken them

[Fliegenmong]

Gingernut

Celery Anyone? Pass the salt?? What do you mean I thought Celery had a rather salty taste, yet it lowers blood pressure???

[beetlebomb]

I've always maintained 115/75 on every medical although I don't really do nothin' to
deserve it - bumming OP smokes at pissups (and pissing up more than I should),
minimal exercise, late nights, bugger-all sleep associated with crappy rosters. But me
own pressure went down yonks ago (from 130/85) after I decided not to bottle up
emotions ever again. In other words spill your guts, say your piece, then forget it....
and the poonce who caused the distress.

That and losing some weight.

Regular shagging is supposed to help too but I haven't a bloody clue how - I'd blow
the mercury clean off the top if one was to measure mine in mid-bonk!

Table I wouldn't put too much faith in that chart - read the author's comments.

[gingernut]

It is sometimes possible to spot the "coital blip" on the 30minute/ 24 hour tape. I was a little saddened to find it didn't show up on mine !

I'm not against alternative/natural remedies. My reservations are probably born out of the fact that I peddle enough rubbish, and I'm not keen on anyone else peddling more wares that aren't evidence based.

I do have some sympathy with the celery brigade- after all, there's no mileage in spending money on multi-centred, double blind, randomised control trials.

Unfortunately, before we can recommend things, we have to be fairly certain that the intervention makes a difference to the outcome. We have to, we're spending your money at the end of the day.

I reckon, on the scale of things, I'm fairly certain that a third of the stuff I dole out, the other third is dubious, the other third........:)

[ricymardona]

I think according to this chart your BP is normal so nothing to worry. If you feel you are not well then visit doctor or do regular exercise. Exercise really help in controlling your BP.

[gingernut]

Unfortunately, a raised bp often doesn't result in feeling unwell.

Which is why asking patients to take tablets which can potentially make them feel unwell can be difficult:)

[airjet]

I think that when the "powers that be" keep lowering the bar, they make us all the more certain that this is all about money, eg for years it was 120/80 normal, now i hear its 115/75???:confused: i`m retired now(67) and since age 45 have struggled with my weight (5.10 and 240/250 lbs) have been on 20 mgs lisinopril since age 40, BP approx 125--145/55--70 over the years, after i retired i developed "prax atrial fib" the docs put me on metroprolol, which slows the heartrate, and has brought the BP down slightly,--bottom line is as you get older it seems normal that your BP should increase a little bit.

[Shack37]

Are there any issues with that? I understand the flying whilst under
medication rules etc. But If my GP suggests medication to get it nicely under the current 160/95 (CAA medical) threshold, and I agree, How long would it take to "prove" that the GP prescribed (CAA friendly drugs) treatment was effective, and that there were no side effects?
I'm just trying to work it all into line with my next medical, (if required) to try and break the cycle of continuing borderline (BP) passes.


I've been on anti hypertensives since age 30. Not aircrew but my job depended on passing an annual medical.

1.Are you getting lower readings with self monitoring? (See White Coat Syndrome)
2.All drugs have side effects, some people are affected more than others.
3.Personally if I was struggling to stay below 160/95 I think I'd prefer to have my BP controlled medically. Especially the 95.
4.Ask your GP to have you fitted with a 24 hour mobile monitor which will provide a round the clock record through a variety of situations. I've used this device on two occasions and both times the highest readings were recorded in the hospital on fitting it and removing it.

Good luck

[OFSO]

A good friend - retired German surgeon - with 65 years of experience, said it's not the BP per se provided it's within aceptable limits, but the changes over a period of time.

My BP has always been 145/95, now that's over 50 years, and he said "so that is your BP and your cardio vascular system has developed with that as the norm, i.e. it's been built to take it.

Whereas another person with, say 120/70 who suddenly goes to 145/95, is at risk. Or Mrs OFSO who normally has a BP of 110/60 and who when ill and measured by an un-knowing doctor at 135/80 is told "you are fine". No, she isn't, you burke.

The same thing - he said - applies to trigylcerides, uric acid levels, and just about everything else, which is why a once-a-year medical (as opposed to going to the same doctor all your life who knows you well) is a waste of time. In order to make a correct assessment your stats have to be compared with you, compiled when you are healthy. And how many of us go to the doctor to draw up a nominal plan when we are healthy ?

Having said that I now take beta-blockers which have reduced my BP, but that's me "being careful", along with taking garlic, zinc, omega-3 and pau d'arco, and red rice yeast/benecol for cholesterol. Steaming healthy into old age, where no doubt I will get run over by a bus.

[dubbleyew eight]

Just occasionally in the list of medical examiners you will find the name of a woman. as it happens also my closest medical examiner is a woman.
I'll shop locally I thought.
let me just make the comment that Olga is lovely, she really is.

"ok strip to your jocks and lie on the examining table"

well for some odd reason my blood pressure during this medical was significantly higher than usual. high enough to get pinged.:ok:

later my GP was taking my blood pressure as a prelude to upping the blood pressure dosage. for some odd reason he started laughing at me.
"she really is gorgeous isnt she".

moral of the story. pick the grumpiest balding old fart you can. never submit to a medical standing next to a honey in your jocks.:=

[Shack37]

My BP has always been 145/95, now that's over 50 years, and he said "so that is your BP and your cardio vascular system has developed with that as the norm, i.e. it's been built to take it.

Hi OFSO, interesting post. As I mentioned previously I've been on BP medication for about 40 years. In those days medics were reluctant to inform patients of numbers, they would only say "it's a bit high" (for your age eg). In my case his actual words were "if you were 10 years older it would be acceptable".
As a result I have no idea what my BP was back then when first prescribed medication.

The bottom line is, I know I do need medication to control my BP now but how can I know that my BP level then was "Normal" for me and I was medicating unnecessarily? On the other hand, had I refused the medication I would certainly have been unemployed and possibly not reached my present grand old age.

The only record I have is from a release medical from the RAF, three years earlier, at age 27 which was 140/80, a touch higher than "Normal"

[OFSO]

"it's a bit high" (for your age eg).

Times have changed. Pulling out my Pschyrembel Klinisches Wörterbuch for 1986 - and this is the ultimate authority for German Medical Practicioners, even today in the latest published version - we find the following table:


BP in mmHg Normalwerte (note that - Normal Values !)

Newborn: 60-80 systolic
Breastfeeding: 80-90 systolic
Up to 10 years of age: 90/60
10-30 years of age: 110/75
30-40 years of age: 125/85
40-60 years of age: 140/90
Over 60: 150/90

This table reflects average hardening of arteries pushing the blood pressure up as a person gets older.

Today doctors tell people it should be around 135/80 for all age groups. Well, were the doctors of 30 years ago wrong ? Are the present doctors wrong ? Who knows ! Yers pays yer money and yer takes yer choice.

True story: about 35 years ago a urologist recommended an 'essential' operation on my uretha to increase the flow of pee, this operation being so awful to think about it that to this day my nuts clench in horror at the recollection of what he suggested doing (hint: it involved a catheter and a very sharp blade).

I didn't have it done. I still pee OK, flowrate unchanged.

[Capetonian]

We have 'average' values for parameters such as bodyweight, and we have 'healthy' values, and I believe these are often confused and abused especially when people are trying to make a point.

I am below average weight for my height, and probably anorexic by USAmerican, SA or even UK standards, but am probably a healthy weight as so many people are obese and thus slew the statistics. A few weeks ago I was in Amsterdam and was shocked by the size of many, if not most, of the people I saw around me, and I'm referring to their bulk, not height.

My BP is 120/85. According to OFSO's figures, it should be 150/90.

[cavortingcheetah]

The answer for those advancing in years is of course to have, hand in hand with a base line colonoscopy, an angiogram. This one off and walk in procedure will enable your cardiologist to determine the extent of any heart disease that might be present. This result, coupled with that of a twenty four hour ambulatory blood pressure survey, will enable a quite precise diagnosis to be made and long term medication prescribed, as applicable, to either raise or lower the blood pressure. It's not just the spot readings that matter. The cycle is important as well. 135/85 seems to be the preferred target figure these days with, increasingly, the blood pressure being taken immediately on walk in not after a nice long rest on the examination couch.

[OFSO]

My doctor will not do a colonoscopy as long as all other tests are negative (no blood in stool, certain enzymes OK). I have heard of a couple of perforated intestines recently (both in the UK) so I go along with this. My doctor will also not do a manual examination of the prostate provided the PSA is normal, no blood/proteines in urine, the patient is not having urinary trouble, and the ultrasonic exam is OK. (He loves his ultrasonic machine, whichg is switched on all day and ready to go. Gets me on it every time I'm there. Hopefully one day his lovely assistant will be allowed to apply the jelly.)

And never forget the most important question a doctor should ask a patient: "What did your parents die of ?"

[cavortingcheetah]

The thought of either procedure being quite sufficient to raise the tempo of the blood pressure to a rate which could cause a heart attack or stroke?

[Shack37]

BP in mmHg Normalwerte (note that - Normal Values !)

Newborn: 60-80 systolic
Breastfeeding: 80-90 systolic
Up to 10 years of age: 90/60
10-30 years of age: 110/75
30-40 years of age: 125/85
40-60 years of age: 140/90
Over 60: 150/90

This would tend to confirm my experience in 1974 if the examining doctor got a similar reading to that recorded in my RAF discharge medical (140/80) of three years earlier.

That said, I had a medical on joining that first civilian employer in 1971 and BP was not mentioned so must have been ok............or different doc?

[Radgirl]

I am afraid the diastolic pressures (the lower number) in this table are really too high by current standards. There have been a number of MASSIVE studies involving thousands of patients over many years which have shown the diastolic needs to start with an 8 and be closer to 80 than 90 until maybe well into the 60s.

I am aware that suggesting the word DRUGS will bring forth a torrent of claims from the flat earth brigade, and it is true that antihypertensive drugs can produce side effects, but again objective controlled studies show that drug therapy where necessary to achieve these targets prolongs life and reduces heart attacks and strokes.

As for an angiogram, I dont like the walk in comments as in fact it is a significant operation with both morbidity and mortality. It should not be done lightly - only if there is clear evidence of a risk of coronary artery disease or valvular damage or congential heart disease. Many of us have a few narrowings of the coronary vessels which should be left well alone - doctors do like to fiddle.

Nowadays CT or MRI angiography is the safe alternative especially for pilots who merely need boxes ticked for the regulator.

[OFSO]

Interesting post, Radgirl, thanks.

antihypertensive drugs can produce side effects,

Such as betablockers affecting one's libido. Trouble in analysing their effect is that older people tend to suffer high BP, get prescribed betablockers, have been married/with the same partner for many years, hence libido is usually reduced anyway even before popping the pill.

(My apologies for bringing up this subject which I am sure doesn't affect all you healthy young aircrew out there !)

Other frequently prescribed drugs to lower BP are diuretics, but with management (i.e. time of day when you take 'em) trips to the wc can be scheduled at convenient times.

Anyone know of any new developments in medication for reducing BP ?

[cavortingcheetah]

10mg of Cialis daily will reduce the size of an enlarged prostate while at the same time helping to counteract the unwanted side effects of a Betablocker.
If one were to combine a little Cialis with a trifling dose of 50mg Viagra, why, then the blood pressure would most surely be manifested in a more desirable place than usual. Manufacturers have not yet designed a cuff sufficiently small to encompass such an appendage.

An angiogram is a walk in procedure under UK NHS guide lines. Walking out though, earlier than the carefully monitored post procedural waiting period, could lead to a messy and bloody death, probably in the hospital car park which might give the Zimmer framers something to skid on.

[OFSO]

a cuff sufficiently small to encompass such an appendage.
If this were Jet Blast I would answer that remark !

[cavortingcheetah]

Had this been Jet Blast I would have been more a little more descriptive but found myself here constrained by the requirement for medical nicety, a quality enthusiastically lacking in every party I've ever attended involving medical students and nurses.

[Radgirl]

I do indeed have such a cuff but I am not sure I should publicise it.

Many years go some researchers at a teaching hospital not far from parliament did indeed measure penile blood pressure. Therein lies a good after dinner tale

Diuretics and beta blockers are a little passé. We now use ACE inhibitors and calcium channel blockers as front line drugs, which depends on race. However the advice is not to change if You are already on something else

Thanks for telling me what the NHS considers. The NHS also considers it provides one of the best healthcare systems in the world. I rest my case

[Shack37]

Diuretics and beta blockers are a little passé. We now use ACE inhibitors and
calcium channel blockers as front line drugs, which depends on race. However the advice is not to change if You are already on something else


That's encouraging, currently taking three of the four mentioned including the two that are passé.:( ACE inhibitors made me cough.

[cavortingcheetah]

Here in the modern day is what always used to be the sovereign remedy for agues and pressures of the blood in the old. Well, actually, up until quite recently in the UK. It's not known how many of the doctors in the following illustrations have translocated to the British NHS. But one reads, perhaps more than occasionally in the press, reports to indicate that many may have done so.
In Pictures: Bloodletting in Delhi - In Pictures - Al Jazeera English (http://www.aljazeera.com/indepth/inpictures/2013/07/2013717144941958107.html)
Companies and business organisations which consider that they provide the best of all service, especially when so richly funded by their shareholders, usually have the wrong business ethos for sustained growth and customer service. A little more of the striving and a trifle less self congratulation goes a long way to reducing the inevitable consequences of the Greek concept of hubris.

[wondering]

Regarding high blood pressure, I met a 92 year old the other day. Due to high blood pressure he was not selected for airforce pilot training at the age of 18. I reckon, it´s genetics in his case. Anyhow, considering his age, he is still going strong. Makes me wonder what negative effects if any high blood pressure has with some ppl.

[OFSO]

now use ACE inhibitors

My doctor tried this on me. Caused a persistant leakage of fluid down the back of the throat, like having a heavy cold. This caused me to have a violent cough, so bad I ended up at the ENT doctor - who after a long series of tests determined it was the Ramipril. Told me about 20% of patients who take ACE inhibitors get this side effect. What with me plus members of the wife's family, it was 100%. So stopped it. Side effects of the beta blockers more tolerable, or at least no pain involved.

Therein lies a good after dinner tale

Suggest you pop down to Jet Blast and tell it !

[Whirlybird]

Anyone with borderline high bp might want to google Ivy's Muktavati. Many people find it lowers bp without side effects.

I'm merely passing on information; I don't want to get into any discussion on whether it's tested etc.