Friday, July 31, 2009

Hypertension Update

When I went to the doc in May, my BP at the office was crazy high -- like 170/110. They only took one reading, took it while I was standing, and generally had me talking throughout -- all of which are things that I've since learned can send the numbers up as well as provide inconsistent results.

As a result, I bought a home BP monitor and I've been taking my blood pressure daily for over two months now. It's interesting to watch the patterns and try to figure out what's what.

Normally, when doing a scientific test, you only want to change one variable at a time. For example, if you change a half-dozen things about your diet and your weight plateaus, what caused your weight to stabilize? It's much easier to find what works by doing one thing at a time; cut out this food, eat more of that, etc.

Except the problem in diet studies is that food isn't simple. Eating more bananas (say) means not just getting the potassium and other nutrients from the fruit, but also getting more fructose and more calories. Replacing one food with another is better, but still a non-trivial change. Was the old food good or is the new food bad? Is it calories? Sugars? Micronutrients? Or even something you're not paying attention to -- like the fact that you're eating breakfast now?

And if you're working out at the same time, a change in workout or diet might produce a change in body composition -- more fat & less muscle, or more muscle & less fat, or maybe you're gaining water weight, or all that fiber is just sitting in your gut.

Blood pressure is a bit easier. It's just a number. And my goal is really to get that number to go down.

A few things I've learned:

* Taking several measurements throughout the day has shown me how crazily volatile BP is. If I take a BP measurement then wait a few minutes and take it again, that second number can be much lower. I don't usually take two readings, and I think I'll start to -- and use that to see how the minute-to-minute volatility changes with time of day.

* Taking a measurement first thing in the morning is great for consistency. My morning routine is the most consistent time of my day and I think that reading (even though I'm normally in a rush out the door and don't have time for a second reading) has been the most consistent.

* I don't think I'm salt-sensitive, but I might be. Cutting out the salt didn't have a big effect on my BP, but adding it back in seemed to send it up. So I'm I'm going to go very-low-salt again for a couple weeks to check.

* Walking on a consistent basis (five or six times a week) has helped my heartrate a lot, and my BP some.

* Alcohol and working out will both push my BP and heartrate up; alcohol for maybe a day, while sometimes just an hour after working out those numbers will normalize.

* Being sick does crazy things to the numbers.

My numbers now, at least at home when I can sit down and rest for the few minutes it takes to get a couple readings, are back into prehypertension range: around 135/80, plus or minus 10 points for both numbers. My heartrate has also come down, from the high eighties to 70, sometimes in the 60s.

I'm going to continue what I've been doing: no sugar, no grain, no fructose, work out once every 4-7 days, and walk/run five or six times a week. Also, for the month of August, I'll be cutting down on caffeine and potatoes -- no more fries with those lo-carb burgers!

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