?? What Blood pressure level is normal

The all-class aeromedical standard is systolic <155 diastolic <95. I find it incredible that I have numerous pilots who repeatedly check at 150/90 and they think it's just fine and their sole goal is to "get under". Sigh. :(
 
Doc Bruce is telling you what is legal to pass the physical..

Now.. the reason for the sigh:
140/80 USED to be the goal for BP control, and docs would medicate you to get it under that number.

NOW, 120/80 is the target being promoted in the medical community - it has better outcomes for your heart, kidneys, stroke risk, etc.. So if you are consistently above that number its not a bad idea to see a doc.. Especially if you are younger - sooner you get it under control, the less risk you have for the rest of your life.
 
bbchien said:
.....yup.........
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And for those of you that are a little on the heavy side (or like me, a lot on the heavy side), you can save a lot of money and require a lot less medicine by losing weight. When I weighed 260 my BP was higher than 150/95. My cholesterol was high and my blood sugar was high (pre-diabetic was the doctor's term). Through exercise and diet I have lost half my goal of 60#. By losing those thirty pounds I have cut out all blood sugar medicine, cholesterol medicine and I have cut my BP meds down by 50%.

And now that I weigh less, even working out seems like a lot more fun and I can go longer for even better results.

I am saving about $90/month on meds and more than that on food. And I really feel better every time I look in the mirror and every time I meet someone new or have to stand in front of an audience. And that 172 doesn't seem near as small as it used to. Even the coach seats on Delta didn't seem so bad last weekend. The only downside is that money that I am saving on food and medicine is now spent buying new clothes. Fortunately, my wife loves to shop, and she especially likes buying me smaller clothes.

I know this didn't really answer the original question, but I just thought/hoped that a little pep talk may get someone else to try to make the effort. It is really worth it. If not for yourself, then for the ones you love.
 
Amen to that, John! I'm currently working my way BACK down, but a while back I had lost around 26# from my highest point of bloatation. :) Through moderate exercise I was able to vastly improve my cardio, drop some weight and replace a lot of fat (mostly around the middle) with new muscle (mostly NOT around the middle). I felt better, looked better, and WAS better in many ways. My cholesterol was down 40 points (290 to 250) and due to some dietary changes, I no longer need antacids regularly like I used to.

It kind of creeps up on you. I not only have a desk job, but I telecommute and have a sideline business -- so it's really easy to fall back into old pattens. I haven't completely reverted, but it's definitely time to get back into shape again. I'm back into the swing of regular workouts, the bike gets regular use, and I'm back on the road to "less is more". I have a long way to go, but once you get started it gets much easier to continue. The key I have found is to make small, incremental changes over time -- trying to do it all at once might work, but usually doesn't last. My worst state now isn't nearly as bad as where I started from.
 
Just as there's no reason not to have an oximeter, there's no reason not to have a $40 bp monitor. Measure in the morning and evening for a month, stick the results in a spreadsheet, and it's pretty easy to establish a baseline and trend, free of white coat hypertension...
 
GeorgeC said:
Just as there's no reason not to have an oximeter, there's no reason not to have a $40 bp monitor. Measure in the morning and evening for a month, stick the results in a spreadsheet, and it's pretty easy to establish a baseline and trend, free of white coat hypertension...
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Best time to take your resting Bp is in the morning. In bed. Before you sit up/get up.
 
My bp seems to increase when they come at me with those automatic electric BP machines, I don't know why.... But even increased from what is usually is it's better than the cut off. I had the nurse take my BP the old fashioned way with a stethoscope and cuff and it was 104/61 ... So I'm not worried. Just wanted to know what would flag if that electric machine shot me up and they didn't believe me that it's normally quite normal.
 
Jeanie said:
My bp seems to increase when they come at me with those automatic electric BP machines, I don't know why.... But even increased from what is usually is it's better than the cut off. I had the nurse take my BP the old fashioned way with a stethoscope and cuff and it was 104/61 ... So I'm not worried. Just wanted to know what would flag if that electric machine shot me up and they didn't believe me that it's normally quite normal.
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I hate those machines! Always at the upper range, 140+/90+.
ask the nurse/med tech to do it manually, 128/82,avg, many times in the last two months. Now to lose these extra 15-20 lbs I don't need.
 
BillTIZ said:
I hate those machines! Always at the upper range, 140+/90+.
ask the nurse/med tech to do it manually, 128/82,avg, many times in the last two months.
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Interesting. I wonder if there are any published studies on that?
 
Palmpilot said:
Interesting. I wonder if there are any published studies on that?
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What's really happneing here is BillTIZ knows the $69 Walgreen's machine is more uncomfortable, so his BP IS higher when the machine takes it.....:wink2:

Therefore he hates the machine esp. because it does not give him the desired answer.

MEN with BP machines are like WOMEN with scales. :(
Palmpilot said:
Well, that answers that!

One thing I'm puzzled about in the first study is why the discordance they mention doesn't seem to show up in the numbers presented in the abstract. Or is there something in those numbers I'm not seeing?
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Yes. The actual discordance is very small, on the order of 2mms, unless something of the above sort is happening.

PS. The OMRON evaluated is a $2,000 office model, not the $69.99 Walgreen's 6V DC model.....
 
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bbchien said:
What's really happneing here is BillTIZ knows the $69 Walgreen's machine is more uncomfortable, so his BP IS higher when the machine takes it.....:wink2:

Therefore he hates the machine esp. because it does not give him the desired answer.

MEN with BP machines are like WOMEN with scales. :(
Yes. The actual discordance is very small, on the order of 2mms, unles something of the above sort is happening.

PS. The OMRON evaluated is a $2,000 office model, not the $69.99 Walgreen's 6V DC model.....
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The cheap Omron and similar devices work pretty well. Bring it to your doctor's office and compare the reading (same arm) within a few minutes. The arm cuff should not be too tight before the machine inflates. Do not use a wrist cuff BP device. Sit quietly at least 10 minutes before taking a BP reading and take readings at different times of the day. Limit readings to 2 or 3 times a week unless your physician asks for a different frequency. It can be overwhelming when somebody takes readings many times a day and wants the physician to look over a couple of months of numbers.
 
Doggtyred said:
Best time to take your resting Bp is in the morning. In bed. Before you sit up/get up.
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Is that 120/80 standard meant to be a resting BP? I would have thought a better idea of your BP would be to check it through out the day (after resting for at least a few minutes before), averaging the numbers.
 
ajstoner21 said:
Is that 120/80 standard meant to be a resting BP? I would have thought a better idea of your BP would be to check it through out the day (after resting for at least a few minutes before), averaging the numbers.
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Resting BP is used for most purposes. There should be at least 20 mmHg increase in systolic BP with significant exercise.
 
ajstoner21 said:
Is that 120/80 standard meant to be a resting BP? I would have thought a better idea of your BP would be to check it through out the day (after resting for at least a few minutes before), averaging the numbers.
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Yes. It's meant to be a resting bp. With activity or stress it will be higher.

The key is measuring in a similar fashion day in day out so that you can see if there's a trend. First thing in the morning after restorative sleep is a prime opportunity to get the data.

Measuring throughout the day after various periods of rest, after various exertion, various stimulants ingested (caffiene), different things on your mind. Etc. May give good data, may not be consistent. Might indicate the need for meds when you really don't.

What you suggest isn't wrong or bad and you will likely get good data. Unless you never check it unless you are feeling bad. Then it may be skewed.

Think of what I said as an Advisory Circular. An acceptable means, but not sole means, of accomplishing the task.
 
Correction to AC-DoggityRed 11/01. The MRFIT study recommends BP reduction to less than 130 systolic (120 does indeed qualify) and 80 diastolic, at rest.
 
Controversy persists on the proper target BP when treating hypertensive patients. Persons who have a BP of 115/70 have the lowest heart attack and stroke risk but there is no hard data that using medication to lower BP below 130/80 is beneficial. A recent study looked at many other studies and concluded that lowering BP below 140/90 in most individuals offers no benefit but most physicians still treat diabetics and those with chronic kidney disease to 130/80.

Arguedas told heartwire that they reviewed seven trials with more than 22 000 subjects comparing lower or standard diastolic BP targets, but they were unable to identify any studies comparing different systolic BP targets. "We found there is no evidence that reaching a target of below 90 mm Hg diastolic BP will provide additional clinical benefit, but we can't say whether lowering systolic BP below 140 mm Hg will be beneficial or not; there are no data."
Dr Franz Messerli (St Luke Roosevelt Hospital, New York, NY), who was not involved with this review, told heartwire that there is no question that the 140/90-mm-Hg BP limit is "absolutely arbitrary, and the benefits of antihypertensive medications are most obvious in patients with the highest BP. The closer we get to 'normotension,' the more difficult it becomes to show benefits of BP lowering.
http://www.theheart.org/article/985113.do
 
So. High blood pressure is bad. But we have no conclusive data on where exactly to draw the line. And the lower we shoot for, the harder it is to show if it's beneficial or not. But lower is better than higher.... Sorta.

Got it.
 
Doggtyred said:
So. High blood pressure is bad. But we have no conclusive data on where exactly to draw the line. And the lower we shoot for, the harder it is to show if it's beneficial or not. But lower is better than higher.... Sorta.

Got it.
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I hope you're not expecting cut and dried numerical criteria in biological systems.
 
Palmpilot said:
I hope you're not expecting cut and dried numerical criteria in biological systems.
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You might be surprised on how government standards require strict adherence to binary or numerical criteria in the practice of medicine.
 
Gary F said:
You might be surprised on how government standards require strict adherence to binary or numerical criteria in the practice of medicine.
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With government, nothing surprises me!
 
Palmpilot said:
I hope you're not expecting cut and dried numerical criteria in biological systems.
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Oh... not at all.. I get the big picture.. Some little old ladies who weigh 100 lbs may live their entire lives with a blood pressure of 90/60.. and do just fine. Whereas I would likely be in a shock state at those numbers.

Practically everything is multifactorial.. butterfly effect.. I dont fixate on numbers when I work as a nurse in a critical care unit. I look at how the patient is doing, and what trends the numbers are showing. Changing one thing can cause 4 other things to change in varying degrees.

Sometimes if you get too tangled up chasing numbers you get the biologic equivilent of Pilot induced oscillation, where you cause things to go up and down until you either stop and let it equilibrate... or something bad happens..

But all things being equal, the push is towards treating blood pressure to lower targets, and as you approach those targets, all the bad data associated with higher numbers in large sampled studies begins to disappear, to the point that they (the bad data) are not statistically significant. Which accounts for why there is no "benefit" associated with the lower numbers - they are identical to the folks who live there already.
 
My Friend has Sleep Apnea that is under control and has a 3rd class SI medical, valid for at least 6 more months until renewing the SI portion of the medical. He was recently diagnosed with mild high BP (130-145/86-94 average over 30 days). He's been perscribed medication and has started to take the medication (on the FAA approved list). The additional tests (EKG, LIPID, Creatitine (SP?) )have been scheduled but are a month away.

Three Questions pertaining to this subject:

1) How much hassle is added to a existing SI (Sleep Apnea, Under control) 3rd class medical does High BP cause?

2) Does a letter need to be sent to the Aero medical center to inform them of this change in status? Should the letter wait until the tests have been run, or sent before hand with a comment that the additional test results will be included in followup communiction in x days?

2) While waiting for the tests to come back after being diagnosed with with mild high BP, (which is still below the FAA max 155/95 in daily morning and evening measurements) is his Medical invalid/grounded? (Assuming that all other factors pertaining to the SI and general well-being are OK, no cold, not sick, no other meds, etc.)

My friend thanks the Doc's on here for help!
 
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