The blood pressure is fickle

We typically think of the blood pressure as a pair of numbers that are measured in the doctor’s office once in a while.  If the numbers are persistently too high, you have “high blood pressure” (also known as hypertension) and that’s a concern for the future.  If untreated, hypertension can lead to serious complications, including heart, kidney and brain damage.

But we know that people can get a little nervous when they’re at the doctor’s office, so the blood pressure may be high there but be normal the rest of the time.  That is called “white coat hypertension,” because the stress of seeing a doctor in a white coat is enough to raise the blood pressure!

And we also know that the opposite can occur: the blood pressure may be deceptively low at he doctor’s office, but much higher during the day when the stress of work or of taking care of the household is in full force.  That is called “masked hypertension,” because the doctor only sees normal blood pressure numbers in the clinic and is unaware that the numbers are actually higher most of the time.

The blood pressure changes all the time, so it’s quite challenging to make a determination about hypertension on a few sets of numbers taken here and there.

A new way to measure BP

A few years ago, medical device manufacturers developed ambulatory blood pressure monitors (ABPMs), which are simple blood pressure machines, the size of a WalkMan tape player (does anyone remember those?!).

The device can be worn over a period of 24 to 48 hours and which automatically obtain a large number of measurements while you’re out and about during the day, and even at night when you sleep!Read more

A gym in our neighborhood has a big sign that challenges the passerby to “Make your body your machine.”  Another one a few blocks away entices potential customers with a poster that says “We don’t use machines.  We build them.”

These are clever and funny points.  There is certainly a sense in which bodies are like machines, with parts that work on each other to accomplish things.  And, for all practical purposes, those parts can be described the same as engine parts:  There is a fuel system (digestion and metabolism), a plumbing system with a pump (the heart and blood vessels), an electrical system (the nerves), a system of pulleys and joints (the muscular system), etc.

But the metaphor can go a little too far.Read more