Waking up in the early hours of today, like any other human being with a digital addiction, I went through my phone and boom! I stumbled on this down here 👇 and in a way it motivated me to write something which I have not done for a long time now , I think it now close to 4 months, if not more . A lot has happened in the past 4 months causing me to take a break from a lot of things I love doing. In short depression is real and it can happen to anyone ... Anyways thats just a digression, lets focus on the main reason behind this post which is what you see below 👇
Now, you know what, let me be honest here, even as a medical practitioner, some of the info contained in the image above was a surprise and the major reason behind that was, we were not taught this, neither were we told, neither were we corrected. But guess what!? I am sure our superiors, the ones with years of experience and more specialized training, never knew or maybe, just maybe, they knew but ignored for the purpose of convenience, who knows . They did it over and over again and I asked with silent whisper within me "could this be right ?" , " wouldn't this affected the readings ?"
Now the fact is, I have always suspected some of these things, trying to understand and question the logic behind it, but in the end, I waved it off, why? Well because then it was the easiest thing to do and a sure way to avoid opening a can of worms, but seeing this, I am reminded of what I onced questioned both consciously and subconsciously but never actually asked direct questions about it especially from our superiors in the field. Mind you , something tells me that if I asked they would have said something along the lines of "Yes! It doesn't affects it" most likely.
Now the inferable truth about the information present in the above image is simple and clear, a lot of people have been erroneously diagnosed with High Blood Pressure and they never knew. They have been given medications for a disease condition they never had and here by analysing from the content and of the image we look into that.
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Going in a counterclockwise manner in the first image above, lets focus on those things which are mostly ignored while taking blood pressure reading;
Now the first phrase we stumble on implies that the first cigarette of the day may increase blood pressure by up to 20mmHg most likely due to the presence of nicotine in cigarette, trust me, we most times don't take this into account as health practitioner. Essentially this can lead to erroneous diagnosis especially if the person is a chronic smoker . A factor that can make a difference in reading by as much as 20mmHg should always be taken into account. Additionally the mechanism with which Nicotine spike blood pressure is a whole post on its own which I would have to talk about separately later on .
The second statement on our radar which we mostly dont take into account is a full bladder. According to the image, a full bladeer (mind you, not a pressed bladeer) can increase blood pressure readings by as much as 4-33mmHg. Now that is not something to be ignored, and frankly, most times, it is ignored. Now a full bladder to an extent can mildly and moderately trigger the flight and fight response (the sympathetic nervous system) which can increase the rate and pressure of blood flow causing an inaccurate reading in blood pressure at the moment. To mitigate this, just ask whoever in question to empty their bladder especially if the first reading is towards the abnormal range which indicates high blood pressure provided that every other factors has been accounted for and ruled out .
In addition , another statement in the diagram says "taking caffeine 30 minutes to measuring blood pressure can increase blood pressure by blocking the production of Adenosine, a brain chemical that helps with relaxation and dilitation of blood vessels. In essenece the activation of the sympathetic nervous system causes a temporary spike in Blood pressure. This can cause a spike to as much as 15mmHg . Now if that also not concerning, I dont know what is and something to not be ignored, I dont know know what is .
One other thing to take note is using a cuff size too small and also taking reading over the clothing of the arm can lead to erroneous reading. Yeah with that I wrap things up as this post feels like its stretching out too long which wasn't my initial plan .
So before you concluse that you have high blood pressure, make sure all this has been ruled out.
Thanks for reading, stay safe and high blood pressure free.
References
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U.S. Department of Health and Human Services. (2010). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention (US). Available at: https://www.ncbi.nlm.nih.gov/books/NBK53017/
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Mahmud, A., & Feely, J. (2003). Acute effect of smoking on arterial stiffness and pulse pressure amplification. Hypertension, 41(1), 183–187. https://doi.org/10.1161/01.HYP.0000047464.66901.60