Many Hypertension Diagnoses Are Wrong And Due To People Being Rushed

haidut

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I have long suspected that the so-called "epidemic" of hypertension in the Western world is overblown. Every time I have gone to see my doctor I felt like the visits were always rushed and the ambulatory measures like temperature, blood pressure (BP), weight, height, oxygenation, etc were taken almost as soon as the patient entered the office. Now, the doctor was always nice and professional and attentive but I always wondered if this rushed environment affected somehow the procedures being done and the results of those procedures.
This new study focused on the diagnosis of hypertension (high blood pressure) and reached the shocking conclusion that about 65% of the diagnosis are likely erroneous and those misdiagnosed people were actually normotensive. So, what is the reason for the misdiagnosis? Rushing of course, as apparently in order to get an accurate picture of the person's resting blood pressure that person has to be allowed to properly rest for at least 25 minutes. In most cases, the BP readings were taken within a few minutes after the patient arrived in the doctor's office. In this case, it is not the doctor to blame as apparently these are the official wait time recommendations from the health authorities.
According to the study about 3.5 million Americans are thus wrongly labelled as sick and aggressively treated with drugs, which are of course taken for life. I doubt this is done on purpose but it probably doesn't matter as the pharma companies love the outcome anyways.
And if this is not bad enough already, please consider that about 20% of the Western world population has the so-called "whitecoat syndrome", which leads to anxiety and adrenaline/cortisol rush in doctors' offices that of course also leads to high blood pressure. So, even if these 20% overlap significantly with the 65% of misdiagnosed people, we are probably still looking at several million more people who are wrongly diagnosed as hypertensives. I am bit confused about that figure though. If up to 65% of the hypertensive are wrongly diagnosed (extrapolating from the study) and if there are 75 million Americans with hypertension, wouldn't that mean that up to 50 million of them are misdiagnosed due to rushing?? I mean, 3-5 million misdiagnosed people is nothing to laugh at, but 50 million is a catastrophe!
Hey @aguilaroja, am I missing something here?

https://www.nature.com/articles/s41598-017-12775-9
http://www.realclearscience.com/qui...robably_isnt_as_high_as_your_doctor_says.html

"...One simple change could drastically lower rates of hypertension in the United States. No, it's not proper diet and exercise (though that would definitely make a dent); it's measuring blood pressure properly. According to a new study published in Scientific Reports, patients need 25 minutes of rest to ensure an accurate blood pressure reading."

"...Prestigious organizations like the American Heart Association, the European Society of Cardiology, and the European Society of Hypertension recommend allowing patients to rest at least three to five minutes before measuring blood pressure. However, researchers at the University of Rennes in France found that this isn't nearly long enough. Blood pressure quickly rises during activity, and takes time to deflate to baseline levels. Professor of Vascular Medicine Guillaume Mahé and his team measured the blood pressure of 199 resting patients (average age 66, 59% men) each minute over eleven consecutive minutes. They found that only half of subjects reached a stabilized blood pressure after five minutes. Extrapolating from their data, they determined that at least 25 minutes of rest would be needed to ensure an accurate resting blood pressure reading for 90% of them. (Below: Subjects' resting systolic blood pressure over time.)"

"...Obviously, allowing patients to rest twenty-five minutes before measuring blood pressure is impractical, especially considering the jam-packed schedules of most medical practitioners and the frenetic nature of everyday life. However, prescribing expensive hypertension medications to people who don't need them is equally insensible. According to Mahé's results, almost half of the study group would have been diagnosed with hypertension if permitted only three to five minutes of rest. He projects that the rate would've dropped to just 35% if subjects were permitted to rest fifteen minutes."
 

Wagner83

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I noticed this first hand as my doctor was good enough to first measure a very slightly elevated blood pressure, wait some to do it again and see that it had already reduced. Personnally I find the tightened arm-cuff to be really stressful (feeling of the compressed veins and strong heartbeat).
 

Quality

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Mild anticipatory stress can temporarily raise BP thereby giving a somewhat false picture of someones day to day blood pressure.
I have to say, taurine and citrulline has done miracles for my BP.
 

aguilaroja

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...
This new study focused on the diagnosis of hypertension (high blood pressure) and reached the shocking conclusion that about 65% of the diagnosis are likely erroneous and those misdiagnosed people were actually normotensive. So, what is the reason for the misdiagnosis? Rushing of course, as apparently in order to get an accurate picture of the person's resting blood pressure that person has to be allowed to properly rest for at least 25 minutes. ...
According to the study about 3.5 million Americans are thus wrongly labelled as sick and aggressively treated with drugs, which are of course taken for life. I doubt this is done on purpose but it probably doesn't matter as the pharma companies love the outcome anyways.
And if this is not bad enough already, please consider that about 20% of the Western world population has the so-called "whitecoat syndrome", which leads to anxiety and adrenaline/cortisol rush in doctors' offices that of course also leads to high blood pressure. So, even if these 20% overlap significantly with the 65% of misdiagnosed people, we are probably still looking at several million more people who are wrongly diagnosed as hypertensives. I am bit confused about that figure though. If up to 65% of the hypertensive are wrongly diagnosed (extrapolating from the study) and if there are 75 million Americans with hypertension, wouldn't that mean that up to 50 million of them are misdiagnosed due to rushing?? I mean, 3-5 million misdiagnosed people is nothing to laugh at, but 50 million is a catastrophe!
Hey @aguilaroja, am I missing something here?

A minimal resting time of 25 min is needed before measuring stabilized blood pressure in subjects addressed for vascular investigations
Why Your Blood Pressure Probably Isn't as High as Your Doctor Says | RealClearScience
...

The authors’s own extrapolation seems to be that about an estimated 4.6% in French might be over-diagnosed for hypertension. The equivalent for that percentage among an estimated 75 million with hypertension in the U.S. would be around 3.5 million. The methodology for their estimate does not seem obvious on first read. As stated, some data sets are not provided in the published report.

Clearly, just from this study alone, there is rationale for suspecting the blood pressure measurements much of the time do not accurately reflect a baseline. The same rationale might make hospital-based blood pressure measurements even more disturbed.

As @haidut points out, there are more confounding factors for measurement, including the “white coat” phenomenon, device and practitioner errors, diurnal variation, and more.

The hypertension dogma is so entrenched, it is hard for practitioners to take it on. Between cardiac drugs and cardiac procedures, it is a most lucrative sector of industry. Further there are risks and side effects from over-treating hypertension. I literally caught someone this week, at a social gathering, toppling over (at the top of stairs, no less) from low blood pressure with several blood pressure lowering medications.
- -
A minimal resting time of 25 min is needed before measuring stabilized blood pressure in subjects addressed for vascular investigations
“Finally, when we extrapolate our results in France where ~15 million patients are treated for a hypertension we can estimate that 696 000 patients could be over diagnosed for an hypertension.”
 
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yerrag

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This must explain why my first reading with my digital blood pressure monitor is usually high. I usually chuck it, and even though it's hard to rest for 25 minutes before taking readings, at least I find taking a 3-sample average, not including the initial reading, to be more acceptable to me.
 

tomisonbottom

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This must explain why my first reading with my digital blood pressure monitor is usually high. I usually chuck it, and even though it's hard to rest for 25 minutes before taking readings, at least I find taking a 3-sample average, not including the initial reading, to be more acceptable to me.

How much range do you usually see between the 3 readings?

Mild anticipatory stress can temporarily raise BP thereby giving a somewhat false picture of someones day to day blood pressure.
I have to say, taurine and citrulline has done miracles for my BP.

How much do you take?
 

yerrag

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rei

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Over here it is a very well-known problem and has it's own name, "doctor pressure". Professional doctors have started to order self-administered monitoring at home over several days before putting anyone on BP medication.
 

yerrag

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I googled on using automatic blood pressure monitors, and came across this: Reading Blood Pressure: Do It Wrong and It Will Be Too High :

Blood Pressure Paradigm Shift
Based on Dr. B's recommendations, ideally, it should be taken 3 to 5 times in succession until two pressures are the same.

When the blood pressure cuff is tightened on your arm, the brain receives a signal. That signal, increase the blood pressure to compensate for the blockage. It is not until you pump up and release the blood pressure cuff 3 to 5 times that you will get an accurate reading.

The difference in the first reading to the last could increased by 10 points or more.

Try It Yourself
If you have an automatic blood pressure cuff, take your blood pressure 5 times in a row. As soon as it deflates, re-inflate it. Write down the measurements each time. Note what the last three are. You will be surprised at the results.

------------
It just happened that this is close enough to how I've been using my automatic blood pressure monitor. So glad that it affirms what I've been doing.
 
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I suffer from WCH. One of my docs retook my BP using a manual cuff after obtaining an elevated reading with an automatic one. The manual one was normal. While I'm at it - is there a supplement (magnesium?)/food one could ingest 20-30 minutes prior to an office visit for those who suffer from this syndrome? Or perhaps an antihistamine for someone who suffers from stress induced histamine release that might be the main reason for their WCH?
 

yerrag

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I suffer from WCH. One of my docs retook my BP using a manual cuff after obtaining an elevated reading with an automatic one. The manual one was normal. While I'm at it - is there a supplement (magnesium?)/food one could ingest 20-30 minutes prior to an office visit for those who suffer from this syndrome? Or perhaps an antihistamine for someone who suffers from stress induced histamine release that might be the main reason for their WCH?

That's interesting, and it's something I've wondered about. I've had a few manual readings taken, and they've given me lower readings than from the automatic bp monitor I have. But I've never given it much consideration. Now, I may have to question my readings. I'm now wondering if there ia a population where the algorithm used by automatic blood pressure monitors is not suitable for determining accurately their blood pressure.

As to your WCH condition, I'm wondering if the way your breath would affect your blood pressure. Just a guess. It reminds me of what the aides tell me to do, without fail, when they draw blood from me for blood tests. They would always tell me to take a deep breathe. The deep breathe just makes me more nervous, and so I don't listen to them anymore. I just breath normally, shallow and relaxed. And I do better that way.
 

yerrag

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Here's an article from Arstechnica that reports on the findings pubished in the American Journal of Hypertension, regarding the inaccuracy of home devices used for meauring blood pressure:

Monitoring your blood pressure? Careful, 70% of home devices may be inaccurate

Assessment of the Accuracy of Home Blood Pressure Monitors When Used in Device Owners | American Journal of Hypertension | Oxford Academic

Of 85 devices tested, about 70% were off by 5mm or more, and nearly 30% were off by 10mm or more.

"The researchers had hints from previous data that many blood-pressure monitors were not spot on. Their skepticism was heightened by how the devices have been tested and regulated. Companies often validate their devices by testing them on healthy adults, Padwal and his colleagues point out. But the people using them at home often have conditions that make measuring blood pressure particularly tricky, like obesity, stiffened arteries, or widened pulse pressure. Nevertheless, the devices can be cleared by regulatory agencies, such as the US Food and Drug Administration. And that, too, can be misleading."

I have widened pulse pressure. So, it's possible that the algorithm used by automatic blood pressure monitors could fail to factor in my condition, and the readings given could be off consistently.

I would probably need to learn to take my own blood pressure with a sphygnomanometer and a stethoscope, if that is possible.
 
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haidut

haidut

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I suffer from WCH. One of my docs retook my BP using a manual cuff after obtaining an elevated reading with an automatic one. The manual one was normal. While I'm at it - is there a supplement (magnesium?)/food one could ingest 20-30 minutes prior to an office visit for those who suffer from this syndrome? Or perhaps an antihistamine for someone who suffers from stress induced histamine release that might be the main reason for their WCH?

Taurine, GABA and possibly theanine may decrease blood pressure. Taurine is even used in some countries for that purpose and has quite a few human trials behind it. Vitamin K/D may also work but may need to be taken for longer.
Human Study - Taurine Effective For Blood Pressure And Maybe Even Cvd
https://raypeatforum.com/community/...ood-as-drugs-in-lowering-blood-pressure.5087/
Vitamin D Rapidly Reduces Arterial Stiffness In Humans
 
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yerrag

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I googled on using automatic blood pressure monitors, and came across this: Reading Blood Pressure: Do It Wrong and It Will Be Too High :

Blood Pressure Paradigm Shift
Based on Dr. B's recommendations, ideally, it should be taken 3 to 5 times in succession until two pressures are the same.

When the blood pressure cuff is tightened on your arm, the brain receives a signal. That signal, increase the blood pressure to compensate for the blockage. It is not until you pump up and release the blood pressure cuff 3 to 5 times that you will get an accurate reading.

The difference in the first reading to the last could increased by 10 points or more.

Try It Yourself
If you have an automatic blood pressure cuff, take your blood pressure 5 times in a row. As soon as it deflates, re-inflate it. Write down the measurements each time. Note what the last three are. You will be surprised at the results.

------------
It just happened that this is close enough to how I've been using my automatic blood pressure monitor. So glad that it affirms what I've been doing.

These are readings of blood pressure and pulse I took with my electronic bp monitor Omron HEM-711 (already at least 8 years old), in succession:

204/121
191/116
186/110
190/112
187/109
179/114
190/111
185/111

The first reading, even with sufficient rest already prior, is very far from the rest of the readings.
 
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There's so much stuff like this, stuff that isn't obvious at all but has huge far reaching effects. The only people who can even realize what's going on in cases like these are the super OCD.
 

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