Blood Pressure

[BigRed389]

I've gotten desperate enough that I'm wondering if anybody knows a good, reasonably doable "cure" for white coat syndrome. Basically, my diastolic stays under the limit of 90 every time, but the systolic fluctuates wildly from day to day. I've even had blood drawn and EKGs...nothing to indicate cardiovascular problems.

But my bp is absolutely all over the place. I've had readings ranging from 131/77(good-within limits) to 155/84 within the space of a few days.

My university health center sometimes gives me a second reading if the first one is unreasonably since I've been in enough that they know what's fairly "normal" for me. But I still seem to have trouble trying to 'relax' it to anything under the low 140s for the systolic.
I've been told I need 3 readings within limits before I can get shipped off to MEPS. I've got 1 so far, but I'm driving myself up the wall waiting for the next 2.
I already upped the time I PT, cut sodium, etc., and I really don't know what else I can do.

Any informed advice would help, since the health center won't tell me anything beyond what I already know(eat better, work out more).

 

[joboy_2.0]

I would say get it checked out by a doc or something. Perhaps you need to work on your cardiovascular endurance or your BP is just really sensetive to acute stress or something. All I know is at MEPS I was MAD nervous and had to do the BP test again cuz my first one was 144. It needs to be under 140.

 

[BigRed389]

I would say get it checked out by a doc or something. Perhaps you need to work on your cardiovascular endurance or your BP is just really sensetive to acute stress or something. All I know is at MEPS I was MAD nervous and had to do the BP test again cuz my first one was 144. It needs to be under 140.

I've been getting it TAKEN by a doc/nurse.

 

[joboy_2.0]

I've been getting it TAKEN by a doc/nurse.

No I understand. But you said your health services office? I've been to my health services office, and although it may be different at different universities, mine is a joke. If yours was like mine, I'd go to a legitimate doc. If he can't figure it out, but says it's fine, you may have to have him write a letter for you when you go to MEPS. If he thinks it's an issue, maybe he'll send you to a cardiologist? I had to get a doc to write me a letter for meps. If you can only go to health services, ask them what the next step should be to figure this out, or what they think about it.

 

[feddoc]

Used to be that 'white coat syndrome' was thought of as being stressed out only when visiting the doc. Some folks are now suggesting that stress...any stress...is causing the elevated BP.

You might consider asking your physician for a 24 hour ambulatory blood pressure monitor test. IF I were in your position, I would ask him/her for suggestions towards a definitive diagnosis.

 

[BigRed389]

Yeah, health center =/= real doctors.

Doc, they ran an EKG, drew blood, and a whole lot of other what turned out to be unnecesary tests as they all came back normal. Overall stress isn't something I'd rule out since school just started back up, but I do 'feel' tense everytime I go in if that makes sense. I don't normally go, it's just that I won't even get to MEPS without clearing this.

Their guess on the white coat thing is because it always goes down from the unreasonably high numbers(150+) after they give me 5 minutes alone to just relax. On a retest it usually goes down ~10 pts. Also the diastolic is rarely over 80, maybe twice over the last week...

Anyway, I'll see if they can hook me up with the ambulatory monitoring. And even more PT I guess. More cardio oriented training I'd assume?

 

[joboy_2.0]

Yeah, health center =/= real doctors.

Doc, they ran an EKG, drew blood, and a whole lot of other what turned out to be unnecesary tests as they all came back normal. Overall stress isn't something I'd rule out since school just started back up, but I do 'feel' tense everytime I go in if that makes sense. I don't normally go, it's just that I won't even get to MEPS without clearing this.

Their guess on the white coat thing is because it always goes down from the unreasonably high numbers(150+) after they give me 5 minutes alone to just relax. On a retest it usually goes down ~10 pts. Also the diastolic is rarely over 80, maybe twice over the last week...

Anyway, I'll see if they can hook me up with the ambulatory monitoring. And even more PT I guess. More cardio oriented training I'd assume?

The thing that lowered my BP and heartrate the most was LONG runs. When I routinely (and hopefully will very soon again) run 3+ miles, my blood pressure dropped from 130-140/70 to like 115-120/60 and heartrate also went from like 75 to 60. PT PT PT. That's the name of the game (unless of course there is something organic going on with your BP).

 

[FLY_USMC]

If it makes you feel any better, I had to get a waiver going into the Marines because at my physical my BP was like 150/70 or something......though I had just ran a marathon. Same thing now, if it works for you, great, if not, sorry but heres what I do. Just had it taken last week, was first 147/80 and I was smoking and joking with the nurse, she said she'd take it again and I told her what I do, she didn't believe me. I don't talk, close my eyes, take deep breaths(holding them make it go up) and try to just chill, 15 seconds later it was 117/67 and she was amazed. Good luck.

 

[FastMover]

I have had problems with my BP as well. I've seen it as high as 160/80. Why it was high is beyond me. I've always watched what I ate and excersice at least three days a week.

I had blood work done and everything came back better than normal, so my doctor put me on 5mg Altace per day. That didn't really help, so he upped the dose to 10 mg and that brought it down. I haven't seen it over 130/80 since I started taking the 10mg dose.

Hopefully once I'm off the medication it will stay down on its own before I apply for OCS...

 

[insanebikerboy]

Try a bigger arm cuff, assuming you have bigger arms. Even if not, still ask for the bigger cuff, less constrictive, works every time.

 

[Slammer2]

Try a bigger arm cuff, assuming you have bigger arms. Even if not, still ask for the bigger cuff, less constrictive, works every time.

During my flight physical dental portion, he took my pressure with this tiny ass cuff that hurt. the other docs took it about an hour later with a bigger one. The difference was about 20 points.

 

[Catmando]

While cardiovascular conditioning has a major positive impact on blood pressure, I don't believe it quite overcomes "white coat hypertension."

Over many years, on those occasions where my blood pressure has really spiked (possibly due to the young and voluptuous nurse taking it or possibly because I feared my flying career might be jeopardized by a high reading) I ask for a retake.

I then do something similar as FLY_USMC suggests in his post:

. . Same thing now, if it works for you, great, if not, sorry but heres what I do. Just had it taken last week, was first 147/80 and I was smoking and joking with the nurse, she said she'd take it again and I told her what I do, she didn't believe me. I don't talk, close my eyes, take deep breaths(holding them make it go up) and try to just chill, 15 seconds later it was 117/67 and she was amazed. Good luck.

For me, I just take one deep breathe, exhale slowly and concentrate on totally relaxing the individual muscles in my arms and legs. For me, it's good for at least a 20/10 drop or more in my blood pressure, and almost immediately.

One caveat. If you really do have high blood pressure, it should be treated. But if you are young, in shape, and don't live too far in bacchanalian excess , I hope this helps.

 

[nittany03]

Over many years, on those occasions where my blood pressure has really spiked (possibly due to the young and voluptuous nurse taking it or possibly because I feared my flying career might be jeopardized by a high reading) I ask for a retake.

The highest blood pressure I've ever given the medical folks was when I had to go and get a prescription filled right after the API Nav exam. For some reason they wanted to do vitals, etc as well. I no kidding set off an alarm on the machine. Needless to say, 10 minutes later, my BP had probably dropped 25 points.

 

[BigRed389]

Thanks for the suggestions.

At this point I'm almost POSITIVE it's nerves.
1)When I take it myself at pharmacies, the gym, etc. I've gotten the readings ranging from as low as 118/66-130-72.
2)When I go into the health center, I "feel" my heart pumping. That never happens during a normal day.
3)I've been "treating" it for almost a month now from a baseline of 149/81. Over break I boozed, ate holiday foot, and took a break from PT so I didn't think it was unreasonable. So I radically changed diet, drinking, and exercise habits. There's no way my readings should be going UP. THAT seems unreasonable. And I've even had 131/81 once at the health center, when I was just too damn tired to care.

As for PT, I wasn't running for a bit b/c I hurt my leg...I ramped up real quick to 5 mile intervals daily. Not smart, but I've been rehabbing and been erging and running the elliptical for 35-40 minutes of cardio a day in addition to some other, more "fun" stuff.

Mainly this is just public ranting due to frustration. I'm just getting really sick of the health center, and they're getting sick of seeing me. Anyway, thanks for the suggestions, I'll give em all a whirl.

 

[Penguin]

I feel your pain. I too had the high blood pressure at the doc's office. I was already a Naval Officer, but I was trying to switch to aviation, and obviously had to meet the NAMI standards. Like you, my systolic was always the culprit. I'm sure better cardiovascular conditioning will lower resting BP/ heart rate, but I don't think you'll see much difference if you are freaking out when they take it. I still hear the blood rushing in my ears whenever I get it taken for the first time. I went as far as seeing a hypnotherapist about it. Don't laugh, they don't wave a watch in your face or anything. It's more about taking proactive steps toward making yourself relax when YOU want to. It's tough, but you basically train your mind to let go of your surroundings and focus on something else (or nothing at all) From a practical standpoint, I did two other things that have really helped. 1. Always ask for them to take your pressure manually. For me, the bleeping and pumping of the damned machine is a big part of the problem. 2. buy yourself a manual blood pressure cuff for $15 at the drug store and have one of those hot nurses teach you how to use it. If you're short on hot nurses, find someone in your school's ex phys dept. to show you. Being able to take your own BP at home at all different times of day will help convince the little spot in the back of your mind that you are perfectly normal, and a silly thing like a BP measurement isn't going to stop you.
I know these last two sound like mental games, but really, unless you are actually sick, your problem IS a mental game, right? Buy a book on meditation, get a BP cuff, and RELAX!