Blood Pressure

[TomBAvoider]

I have this blood pressure monitor:

https://www.amazon.com/gp/product/B077CXGSJW/

It's FDA approved and supposedly accurate, but of course I don't know just how accurate. I tried validating it by bringing it to my doc's appointment and having a nurse get my BP using their equipment and then immediately trying my monitor, but I realized as I was doing it, that really this is not a valid comparison as both may be wrong and it's a pretty much a worthless experiment with too many variables.  

Nonetheless, I've had some questions about my blood pressure for many years now. Just going by having my blood pressure taken at the doc's, it's somewhat all over the place, and various home monitors I've had are somewhat more consistent, but then I have no way of knowing which is more accurate. Still, with all these caveats, my systolic is usually somewhere in the 90's, with very occasionally - rarely - going to like 88 or so. Same with my diastolic - usually below 60, hovering anywhere between 56 and 59 - occasionally 55. 

Now, with the caveat that accuracy might not be super great, I wonder about those numbers. Do I have hypotension? Technically I do - anything below 90/60 is hypotension, and while I rarely go below 90 on systolic, I'm consistently in the 56-59 range on the diastolic. So, diastolic hypotension. Looking up the symptoms, I don't really experience dizziness or balance problems, no exhaustion or falls, fainting or nausea, blurrred vision etc. So really, I don't have any classic symptoms of diastolic hypotension, except for one: occasionally I have very mild ankle edema. Looking at causes, I don't consume excess salt, I'm not typically dehydrated, not overweight, don't smoke. 

I brought it up with my PCP, and he waved it off completely. But numbers don't lie.

As an example, today my reading with my home monitor was 95/57 and pulse 64. My pulse in the last 2 years went from 55 to now 64 as I've eased off my running speed while exercising. But diastolic of 57 is below 60, and that's the cutoff number for diastolic hypotension.

What does this mean? Should I be concerned? What measures if any should I take? What is your BP, and how do you think of your BP? TIA!

[Sibiriak]

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I brought it up with my PCP, and he waved it off completely. But numbers don't lie.

 

As far as I can tell,  mainstream medicine does not consider chronic low blood pressure to be a problem if it is asymptomatic.

For example:

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In healthy people, low blood pressure without any symptoms is not usually a concern and does not need to be treated. [...] Chronic low blood pressure with no symptoms is almost never serious.

https://www.webmd.com/heart/understanding-low-blood-pressure-basics#1

 

 

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If you have consistently low blood pressure readings but feel fine, your doctor is likely just to monitor you during routine exams.

https://www.mayoclinic.org/diseases-conditions/low-blood-pressure/symptoms-causes/syc-20355465

 

So it may not be a case of your PCP ignoring the numbers,  but rather interpreting them as harmless.

I'm not a doctor,  so I wouldn't want to give you any advice myself.

 

[Ron Put]

1 hour ago, TomBAvoider said:

..

What does this mean? Should I be concerned? What measures if any should I take? What is your BP, and how do you think of your BP? TIA!

If asymptomatic, your doctor is likely right.

Avoid thinking about it 🙂

Or think how lucky you are you don't have high blood pressure....

[Gordo]

Like you I've had some concerns about low blood pressure, but as others have said, the medical field doesn't consider this a problem unless there are symptoms.  Occasionally if I'm working in the garden on a hot day and stand up fast, I can feel dizzy and see black spots but always return to normal within seconds.  I did though, actually pass out one and only one time, when I was hit with norovirus (a brutal "purging" 24 hour virus) - I face planted in my bathroom and was lucky I didn't have serious injuries (woke up just feeling like I'd been punched in the face).  I can't be sure this had any connection to low blood pressure though.

[mikeccolella]

My daughters in their teen years had BP READINGS QUITE SIMILAR TO YOURS TOM. Their pediatrician said it was quite normal. My only concern would be if you r having any cognitive issues. In aging low blood pressure can be an issue here if arteries in the brain are not squeaky clean as they would be in youth. The not totally clear arteries may, with lower pressures, not keep up the supplies of glucose, oxygen etc. to ideal levels which could effect cognitive abilities. 

Edited August 1, 2019 by mikeccolella

[Matt]

I don't think you should be concerned if you're not experiencing any symptoms. This is pretty normal for most of us on CR. 

My blood pressure is usually around 90/60 with a HR usually between 50-60 when I'm home. At the doctors, it can be quite a bit higher. I tend to get a bit anxious and I'm running around not relaxed. This is pretty common though...  When I first started doing CR I did get a little dizzy when standing but over time I seemed to just adapt to it. 

Low blood pressure is likely a good thing as long as you're not experiencing any bad symptoms from it. If the association between very low LDL cholesterol (common in CRONies) and hemorrhagic stroke is real, then having low blood pressure + low inflammation would be good at preventing any increase in risk IMO.

And if your arteries aren't clear, then as mike said, low blood pressure could be an issue. 

[mccoy]

I used to faint because of low BP when I was a teenager. Presently my BP has significantly increased, anywhere from 115 to 125 and ...I don't remember the diastolic, probably in the region of 80 mmHg.

AFAIK, just about every medic practitioner says that low BP is not an issue and that people must be thankful for it. This evidently because there are so many afflicted by high BP today.

Common sense rules though. Symptoms? In healthy individuals they are probably related to occasions like fasts, illness, very hot wheater, quick rising from a sitting posture and limited to fainting. This may not be trivial in some occupations like military airforce pilots, construction workers on high levels, construction workers and outside workers in general in very hot temperatures and so on.

@ Tombavoider: I wouldn't be concerned about household BP monitors, the recent ones seem to be pretty accurate and an high precision is not needed anyhow. I compared my device against the one used by the local pharmacist. Very similar values. Is it accurate? Probably yes. Does it need regular calibration? I don't know. If you have any doubts, you may measure your BP by 5 or 6 different devices, not forgetting that the real value is subject to variability itself, so differences might be due not to instrumentation but to the inherent variability of the parameter.

[TomBAvoider]

Thanks, everybody. I know about the concern with low blood pressure and brain health as you age. There is an interesting phenomenon, apparently, where for older people - and that means older than me - there is a survival advantage for those with high blood pressure (as there is seemingly for high cholesterol as well). The speculation is exactly that - higher blood pressure allows more oxygen and nutrients to reach the brain. So whereas high BP and blood lipids are bad in middle age, they start being neutral or even advantages at advanced old age. I think I still qualify technically as middle aged (late middle age), so I'm not in panic mode quite yet. How it will be in another 20-30 years remains to be seen.

I am hoping that regular exercise will ameliorate somewhat the problem of brain health with low blood pressure. Exercise transiently elevates BP, as does coffee and wine, and I do all three. I'm hoping that buys me something, but who knows. It seems the data says all three, or at least exercise seems beneficial to brain health. I'll continue monitoring my BP, but I've had lowish blood pressure all my life, so I feel at least it's not a novel development, as it appears that consistent BP is the best.

[Mechanism]

Edited

Edited July 20, 2020 by Mechanism

[TomBAvoider]

Thank you, Mechanism for your thoughts and feedback. All my blood work seems fine and my PCP appears unconcerned by the few numbers that are outside the range. I have slightly high blood potassium, bilirubin, vitamin B-12, and borderline low platelet count. Other than that, all seems within spec. I take a 10 mg daily dose of atorvastatin (for the past year or so) and therefore have been taking regular blood and urine tests every three months, monitoring kidney and liver function. All results are good. My PCP thinks that if these kidney and liver numbers continue to be good over the next 18 months, then we’ll revert back to just yearly physical instead of quarterly blood/urine panels, as that would indicate no problems with the atorvastatin (which, btw. I feel no side effects from that I can tell). My lipid numbers are now good as my LDL plunged from 128 to 72 thanks to the statin (HDL unchanged at 76). I went with the statin even though my “score” (per the ASCVD calculator) didn’t recommend it, because despite heroic diet/lifestyle efforts I could never get my LDL below 124. My PCP agreed, because it indicated that it wasn’t amenable to non-pharma interventions, possibly pointing to the usefulness of a statin as insurance. 

I might up my exercise slightly as I get older, to compensate for possible downsides to the low BP.

[Mechanism]

Edited

Edited July 20, 2020 by Mechanism

[TomBAvoider]

Thank you, Mechanism for your kind remarks. Regarding the link, I listen to Peter Attia's podcast regularly, so I was familiar with his multi-episode podcasts with Dr. Tom Dayspring where they discussed blood lipids extensively. In general Attia has a lot of interest in cholesterol, due to his own struggles with it. I think he frequently has very interesting guests and it's one of a handful of podcasts I listen to - ironically enough, my favorite time to do that is when I'm jogging. His show is one of the ones I listen to. Speaking of podcasts, I jog for about 200 minutes a week, and so I need a steady supply of interesting podcasts, and just the Attia one is not enough (usually good for 2 days of running out of the 4 a week). So I've been casting about for more interesting podcasts; my interest/preference at the moment are medical shows, but frankly I have not come across any decent ones except for Attia (who btw. does not focus on just medical issues, instead ranging over other stuff, not always of interest to me, YMMV). If you - or anyone - knows of any shows that I might be able to enjoy, I'd love to hear about it... in fact, I may start a whole new topic just on this request! TIA!

[Mechanism]

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Edited July 20, 2020 by Mechanism

[TomBAvoider]

Marvellous, thanks a lot, Mechanism. As for hiking in SoCal - almost anywhere, really! There is so much! Just in LA there is all of Griffith Park which is huge, and various explicitely hiking places, like Runyon Canyon, Bronson, and so many more. For NorCal, you already are planning on redwoods, so you absolutely must do Muir Woods, but really, my friend, one of the joys of living in Cal is that hiking is pretty much everywhere - when I visit SF, I walk everywhere, and given how hilly it is, it can be quite the workout!

Thank you for all the recs for podcasts, I'll check out as many as I can. I'm happy to say I don't think I'll run out of material too soon! 

[Mechanism]

Edited

Edited July 20, 2020 by Mechanism

[Ron Put]

Well, this inspired me to pick up a Qardio monitor a couple of weeks ago, to go with my recent acquisition of a little single-lead EKG gadget by Kardia (AliveCor).  My blood pressure is usually normal at the doctor's, but I figured that at my age there is no harm to check it at home and establish a baseline.

I am glad that AliveCor reports that I don't have irregular heart rate or rhythm abnormalities, other than the occasional declaration of bradycardia, since my heart rate dips below at times 50 when I am resting.

My average blood pressure based on readings several times a day, over three weeks, is 113/70, with average pulse of 54.  The highest systolic measurement was 125, while the lowest was 99.  The highest diastolic measurement was 80, the lowest 63.  I am 58.

I am curious if CR practitioners are uniformly at the low end, like Tom's rather enviable results.  Anyone else wants to chime in?

P.S. Tom, I assume you do this, but position appears to be very important for accuracy while checking blood pressure. Like being seated on a straight back chair, legs on floor, not crossed, etc.. 

https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home

Edited May 12, 2020 by Ron Put

[TomBAvoider]

Yes, I am very careful when measuring my BP, and try to do it correctly wrt. position, time and so on. 

Incidentally, from the other thread about foot issues - a poster suggested thin shoes or no shoes as strengthening the foot and possibly ameliorating foot issues. That made me remember claims about walking barefoot on stones or in general on grass being something of a tradition in Japan and supposedly lowering blood pressure. I like the idea of walking barefoot on pebbles, but in a controlled environment, like a Zen garden or simply out in nature (i.e. not on excrement-laden city sidewalks!), along sandy beaches and so on. I think that might indeed strengthen feet muscles/tendons, and although I don't need the BP lowering effect, it might have some other neural benefits from the feedback foot against surfaces.

I saw this wrt. walking on cobblestones:

Oregon Study Confirms Health Benefits Of Cobblestone Walking For Older Adults

Anyhow, I thought it was an interesting way of combining foot strengthening with BP :)

[Dean Pomerleau]

I take my blood pressure every so often at the same time of day seated in the same position. It averages around 107/61 with a HR of ~45 BPM. I'm 55 yo.

--Dean

[Ron Put]

Thanks, Tom and Dean.  These are impressive numbers (Tom, you are in your 50s too, right?)  I normally feel pretty healthy compared to those around me, but you guys are giving me a complex :)

Anyone else?

[TomBAvoider]

 Yep, late 50's (not being exact for privacy reasons). However, I'm still thinking about how people at older ages do much better with higher BP, and this seems very consistent, much more so than the data that shows people with higher cholesterol might do better at older age.

I do think it might have something to do with better blood circulation in the brain with higher BP. Again, my remedy is exercise, and I'm hoping that with enough fairly vigorous exericse I can overcome whatever the drawbacks of low BP are in my older age. 

At the moment I feel very good and experience no downsides - that I can tell - from my lowish BP.

[Ron Put]

2 hours ago, TomBAvoider said:

... However, I'm still thinking about how people at older ages do much better with higher BP, ...

Here is something to put your mind/brain at ease:

High blood pressure is linked to cognitive decline

"After decades of observational research, there’s general agreement that high blood pressure in middle age is a risk factor for later-life cognitive decline, including overall cognition, memory, and processing speed."
 

My admittedly limited understanding is that high blood pressure causes delicate capillaries to deteriorate and eventually circulation becomes less efficient.  If blood pressure in such already compromised system is reduced (usually with medication), circulation is further impaired, which would be one plausible explanation why older folks (at least those with compromised circulatory systems, which would be the majority) do better with a bit higher blood pressure.

[TomBAvoider]

Right. However, the scenario is different - NORMAL (or LOW) BP in middle age (i.e. not "high" as in the paper you cited) - and HIGH BP in old age. That's the conundrum. Because yes, of course high BP in both early and middle age is deleterious.

[Ron Put]

My guess is as you age and your arteries progressively stiffen and accumulate plaque, which given enough time they will, BP will go up accordingly.  In this case, the later the better.

Have you ever had a pulse wave velocity test?

Or, you can always start eating Big Macs and French Fries, with extra salt, a couple of times every day.... :)

[drewab]

This thread led me to actually quantify my last 18 blood pressure readings in memory on my at-home cuff, at OMRON HEM-741. It cost about $130 when I purchased it about a decade ago. It's been a reliable machine ever since. My systolic value isn't quite as low as some, but then again my level of CR isn't quite as low as others here (BMI = 21) and having had OHS 2x, I am happy with the value. When I don't consume caffeine (coffee more so than green tea) my systolic value is reliably lower by about 5-7 mmHg - the reading below are all caffeinated measures.  At times my RHR has been lower too, but I'm not exercising as much at the moment, which still means more than most people and I doubt there is much of a benefit from a reduction below 59. Considering there was a time well over a decade ago when I was on blood pressure medication in my 20's and had systolic readings in the 140-150's, I'll take my results!

[Ron Put]

drewab, these values are excellent, especially if without medication.

Mine seem to average 112/71 according to Qardio, since I started taking measurement about two weeks ago,.

As I average close to 2000 kcal per day, I don't know if I would place myself in the CR group, although my BMI is 18.5 today.