”Why does my blood pressure fluctuate a lot? We often encounter such worried patients in outpatient clinics. For many patients with hypertension, this is a frequent and very headache, and what is even more distressing is that repeatedly adjusting medication according to blood pressure sometimes only aggravates blood pressure fluctuations. So, what is the problem? Here, let’s first clarify a few concepts. First, human blood pressure is constantly changing. Human blood pressure is regulated by a variety of internal and external factors, and is itself in a constant process of change to adapt to the internal and external environment. Generally speaking, the blood pressure is highest in the morning every day, because the brain has to wake up the sleeping human body from sleep to start the day’s work, at this time the human body secretes hormones and nerve activity to excite the body to wake up as soon as possible, so the blood pressure will rise accordingly; accordingly, the blood pressure during sleep is generally in the lowest range of the day. If we look at a larger span of time, blood pressure in winter is generally higher than in summer, which is due to temperature-induced vasodilation; blood pressure in the elderly tends to rise gradually and shows a trend of systolic pressure rising and diastolic pressure falling, which is the result of changes in vascular elasticity. Second, the office hypertension Such a class of patients, his blood pressure measured at home, pharmacy is often normal, but to the hospital but always measured high blood pressure, we collectively called the office hypertension. This is mainly due to psychological fluctuations. Patients are usually more likely to be nervous when they see a doctor (patients are often not aware of this, and there are many interesting clinical trials that confirm that for the same group of patients, the doctor’s blood pressure is often higher than the nurse’s); on the other hand, the high blood pressure previously measured in the office is likely to cause a psychological burden on the patient, thus forming a vicious circle. I once received a patient who was so nervous that she couldn’t sleep the whole night just thinking about going to the doctor the next day to have her blood pressure measured, and she was even more nervous and shaky when she saw the doctor the next day, so her high blood pressure could be imagined. In addition, the hospital environment is often noisy and prone to verbal altercations, and patients are more anxious when waiting in line, and other factors can lead to an increase in blood pressure. Third, the blood pressure test also needs some preparation before Yes, not any time you lie down the doctor can give you blood pressure measurement, that is often not allowed. Patients need to do a lot of things: do not drink stimulating beverages (such as coffee, cola, alcohol), do not hold urine before blood pressure measurement (I once met a patient with cerebral infarction who had no previous hypertension during the night shift with stubbornly elevated blood pressure to SBP
200mmHg or more, later found to be urinary retention, and the patient’s cerebral infarction could not express!) It is also necessary to dress appropriately (shivering in the cold or sweating in the summer), avoid exercise and relax before the blood pressure measurement. The blood pressure measurement environment should be the right temperature, no noise, and appropriate lighting. Fourth, the drug takes time to take effect So, if some pills are still poorly controlled after only three days of taking blood pressure, it may be because the drug has not yet fully taken effect. Adding medication in a hurry at this time may only lead to subsequent hypotension. Five, the treatment of other diseases drugs are also easy to have an impact on blood pressure Some drugs in the treatment of other diseases colleagues, will also have an impact on blood pressure. For example, alpha-blockers for prostate enlargement, ergometrine for migraine, sildenafil for pulmonary hypertension or ED, and nitrates for angina. etc., all of which can have a significant effect on blood pressure. Therefore, before using the medication, you should communicate with your doctor in detail about your medication. Six, people’s left and right hand blood pressure is different It is easy to overlook the point that right-handed people tend to have higher blood pressure in their right hand than in their left hand, and left-handed people tend to have higher blood pressure than in their right hand. Usually, the blood pressure should be measured on the high side, and later on, the blood pressure is measured on the same side as the standard. Due to my energy and knowledge limitations, the above is only a summary of my personal experience, not comprehensive and not in-depth, but I believe it will solve some of your questions. Blood pressure control is a “big project” that requires the support of patients, families, doctors, communities and other parties to participate together. I believe that under the same goal, hypertensive patients will be able to get the most optimal plan!