How to measure blood pressure & it's variability throughout the day | Peter Attia & Ethan Weiss

0:14: 🩺 Blood pressure varies throughout the day and is influenced by activities such as sitting, sleeping, exercising, and stress. 3:09: ! The optimal way of measuring blood pressure is to have the patient in a quiet room, take multiple measurements with breaks in between, and calculate the average. 6:30: 💉 The speaker discusses his fluctuating blood pressure and questions the accuracy of his readings. 9:50: 🩺 The speaker suggests using a 24-hour blood pressure monitor to get an accurate measurement of average blood pressure over time. 13:03: 💡 There is currently no accurate device available to measure blood pressure, but the speaker believes that it is possible to develop an intravascular device in the future. Recap by Tamm

You should always throw away the first reading because it’s universally wrong. As soon as that tension is created by the cuff, your body will go into overdrive to compensate for that pressure. And sometimes that reading is spectacularly high. This is really true in the clinic. Doctors take one reading and write it down. THIS IS WRONG. Calm down. You’re not dying. Simply sit there and causally take multiple readings with the cuff remaining on the arm. If you’re at home, take 6, 7, 8 readings. With this, you will get a better idea of what is your true BP. And btw, this may take several days to weeks to truly understand the dynamics of your personal blood pressure. And if you really want to deal with your “essential” hypertension, stop eating sugar. Because elevated insulin has a direct link to elevated hypertension.

It would be interesting if we measured BP when under a standard load (for active people) to see what the variability is with BMI/fitness/height/lean muscle mass etc.

69 YO female, type 1 diabetic and hashimotos - always had low BP, however, it only took one higher than normal ( rushed, talking) BP, around 133/75, at doctors visit and ever since he added ‘essential hypertension’ to my chart, I will invariably have similar white coat readings since then. Several months back, my systolic readings at home were higher than normal, similar to what Peter described. The only thing I can relate mine to was thyroid levels being off while experimenting with dosage and new thyroid meds. It has since leveled back off with averages of around 117/72, which is still higher than it used to be. I suppose inflammation from auto immune diseases (12 years now for both) contributes to my higher readings, that, and age.

The variability means determining the accuracy of BP meters is incredibly difficult to determine. Additionally, I take my BP using the SPRINT methodology pre-exercise then post-exercise. My BP is consistently low post-exercise which seems counter intuitive.

I think the best way to measure it is to do it like it's been done for many decades when the statistics were formed from that data. Changing the paradigm now means you can't then compare yourself to the data.

Why not take the BP reading during a stress test and compare it to BP measure at multiple time during the day?

I absolutely have the so-called "white coat syndrome." I don't know exactly why it started because I never used to have an issue. However, when I get my BP checked by someone in a clinical setting my BP skyrockets...at home by myself typically around 116/60ish...

I wound up on blood pressure meds because of high readings at the doctor and a drug store monitor I used at home that gave a bimodal distribution of readings. I got suspicious and bought the most accurate monitor from a new york times test of monitors and suddenly I didn't have a problem anymore. The data is only as good as the equipment! I take my pressure every day now with the same protocol and find it useful but when I got inconsistent readings when using poor equipment, it just drove me crazy.

Is measuring blood pressure the way we currently do on the same level as measuring ones BMI (close to worthless for fit individuals)? Something to think about…

The NIRS technology for measuring blood flow to the brain or specific muscles seems like a promising "digital" device. This kind of data might be easier to monitor and be more valuable than BP in many cases.

My BP tends to be about 10 below in the Drs office. 115 at home with 5 mins rest using omron and about 105 at docs with approx 5 mins rest. I heard the manual test is more accurate than the digital.

We use mobil- O Graph for ABP M for any patient over 60 to rule out nocturnal hypertension. 15% of hypotension goes undiagnosed r/t normal Bp during the day when it’s typically checked at the GP’s or self measured. ABPM is the gold standard. And yes it’s a drag to have to wear but having mean awake and sleep averages is invaluable.

Buy a blood pressure monitor and measure your BP in reproducible conditions. Like in the morning soon after you are awakened. I am 66. My BP is 102/68. RHR is from 54 to 58. When I was 18, my BP was 110/80 and my RHR was about 42-45 bpm. During recovery time my RHR can be above 60 bpm, and BP - 110/78. Three years ago when I was doing long and intense aerobic exercise (60 - 100 km by bicycle a day) my BP was 90/50 and RHR 46. Pulse pressure (SBP-DBP) correlates with your biological age or actually with your cardiovascular age. It is good to see that my PP now gets closer to the PP when I was young. So, it indicates the rejuvenation of my cardiovascular system. Cheers

If blood pressure is variable throughout the day and you get it checked once a year during your annual exam, should you use that as a reference point to actually be diagnosed and medicated to treat the condition?

Recap,pathology,physiology,3x 5 minutes in between,after resting.120/80-120/70.

I check my blood pressure every day. Sometimes even 3 to 4 times a day at different times. The measurement can range from 95/68 to 150/95. I have seen it as low as 87/58 ( in the morning after I wake up of course.) At doctor's office I have seen it as high as 165/105. Doctors cause high blood pressure. THAT IS CORRECT.

Seems like the question is what specifically are you trying to measure? Obviously different people are going to have different degrees of variation in BP. So are we looking at the ability to "breathe it down"? A lower aggregate number throughout the day? A less dynamic response to stressors? These are going to vary with different subjects.

What about aktiia non invasive BP bracelet? I believe it’s FDA approved to be accurate, does anyone have it, any opinion on that device? Thanks.

Question: could one relive or fix there blood pressure problem by stressing less, breathing more and exercising regularly?