“You have a doctor’s appointment in a week. Take your blood pressure each day before you go.” So, I did. I also took the monthly Cedarhurst blood pressure and heartbeat measurements.
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| Cedarhurst Blood Pressure and Heartbeat |
The Mayo Clinic reports the Pulse Pressure is a fair indicator of heart health. Any thing over 60 is bad news. Mine, measured by Cedarhurst, my meter, and the doctor’s office in October was 160 – 77 = 83!! But in July it was 60, when I was in my best health for the year 2019 with a near normal blood pressure; working about an hour a day on the Monarch Butterfly Sanctuary.
The verdict was to add a second blood pressure medication, Lisinopril, 10 mg, and add more physical activity to my wintertime life. [Daily fitness classes have resumed.]
Measuring blood pressure is like counting sparrows under a bird feeder. I used our old Omron BP785 meter. I used a number of ways to make the measurements. Finely, I hit upon a system of measurements that could sort out the small differences during measurement and the huge differences made by stress and anxiety.
A best fit then, was to start with a five-minute meditation after putting the cuff on my arm and verifying it was placed correctly by hitting Start/Stop and hitting it again when the OK symbol showed. After the five minutes to reduce distraction; hit Start/Stop for the first reading.
My arm rested on a small pillow on our dining room table. That put it at the right height and made it comfortable for the time to get five readings. As soon as the unit turned off (two minutes), I hit the Start/Stop to get the next reading.
In general, the sets of five readings show a small steady decline for all measurements. The occasional outlier can be attributed to having to reset the cuff. I got better at this as time passed. An outlier can also be produced by unexpected activity in Memory Care One and to trying to use a timer; both can trigger the startle reaction.
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| Thirteen Day Blood Pressure and Heartbeat |
This chart shows that nutrition, exercise and physical therapy, during a 13 day, less stressful environment, can produce marginally normal results without medication. But the diastolic pressure is getting too low for good perfusion of the heart muscles. Day time is about OK.
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| Six Samples over One Day |
Six samples taken on November 8, with a high stress condition (the third monthly bill for therapy still in error by over a $1,000 and the only copy of the bad bills lost somewhere after our move out of the apartment for two weeks and back; along with other factors) show a very different story.
My blood pressure (red) was dangerously high over 180 mm Hg. My skill at taking the readings yielded almost uniform heartbeat counts (grey).
My diastolic pressure (green) fell below normal. It fell too low on November 9 after taking the first Lisinopril the previous evening. It remained there for the next three days. Lisinopril works. It relaxes blood vessels, they enlarge, and blood pressure falls; with little effect on heart rate.
My systolic pressure did not remain low but rebounded about 20 mm Hg. Stress. Without Lisinopril it might have rebounded twice as high.
November 7 and 11 are somewhat comparable. Each has one blood pressure in or near normal. The values are lower for both on the 11th. The systolic pressure (red) is still a bit high but the diastolic pressure (green) is now too low.
The persistent high pulse pressure (systolic – diastolic) is not good. I have been examined twice over the years for heart attack with no definitive conclusions. I do not recall, or never knew, why this was done.
I am willing now to let the meter do what it is designed to do: sum three samples, one minute apart, each day. We will never know the actual readings, and the highs, and the lows. But, in general, that single average is about all the doctor needs to know to manage blood pressure. It only takes eight minutes (including five for meditation to remove distractions) instead of 15-20 minutes and a spreadsheet chart.
It appears that from now on, this will be a balancing act:
1. Too high systolic invites ruptured vessels.
2. Too low diastolic invites poor perfusion of the heart.
3. Too great a difference between the above two overworks the heart.
4. Any combination of the three is worse.
5. An hour a day physical work is recommended (not including daily fitness classes).
6. Reduced stress and anxiety are essential.
