Pre-hypertension--- systolic BP 120-139?

Nurses General Nursing

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

I just got back to a trip to town and while I was waiting for my neighbor (who had ridden with me) finish her shopping, I sat down in front of the pharmacy and did my BP on the free machine there. My BP was 123/64, which according to the guidelines posted on the machine means that I have 'pre-hypertension'.

For one thing, who came up with that as a guideline? The drug companies? Secondly, I take my BP at work occasionally, and my systolic is always in the 110s there. Do they rig those supermarket machines in front of the pharmacy to trick healthy people into 'asking their doctor' for drugs? The conspiracy theorist in me has bells going off in her head. That must indicate a psychiatric condition, no doubt. :bugeyes: I must need a psyche med too, but ya'll probably already deduced that... :lol2:

Lol! I took my bp on one of those machines at a Wal-mart recently. I can't remember the exact numbers but the machine kindly informed me that I had hypertension! I sincerly doubt that I have hypertension. My bp's have always been fine when I go to my regular doctor but on this machine it skyrocketed.

Coincidentally, I got my bp done by an automatic cuff in an emergency room also recently (just sprained my hand, nothing major). This cuff also showed me being up over 150 systolic, and somthing like 95 diastolic? It was ridiculous! The cuff hurt me so badly, and I told her it wasn't my normal reading and she didn't care, nor did she try to take it again (probably since I was there for my hand and not for my heart).

What I'm trying to say in this ramble is that I don't trust automatic cuffs, I think they are stupid. It just doesn't take that much time to do a reading yourself, and from personal experience it's much more accurate!

I doubt it's a conspiracy theory ;) but I do think those machines in the grocery store or wherever are not a great reading, and are apt to make people nervous when they need not be!

Specializes in LTC, Med/Surg, Peds, ICU, Tele.

What do you think about over 120 systolic being 'pre-hypertension'? Doesn't that seem like a presumptuous and exaggerated proclamation?

Specializes in ER/ICU/Flight.

I do think that's an exaggerated proclamation. How far could that be taken? It wouldn't surprise me about the conspiracy theory...I see those commercials for drugs (which is one of the main reasons they cost so much) and they always say "tell your doctor if you have liver problems, or cancer, or high blood pressure, etc...." and I think, why wouldn't your doctor already know about that???!?!

I guess it's because of the prevalence of doctor shopping. I"ve been bored and taken my pressure in those machines and for me, they usually come out around my norm (110/70). Next thing we'll see is a machine in WalMart that will test your cholesterol and write you an auto-script for Zocor (whether you need it or not!).

and maybe for you....some Prozac. But you should talk to your doctor first, it's the least you can do.

Specializes in Community Health, Med-Surg, Home Health.
What do you think about over 120 systolic being 'pre-hypertension'? Doesn't that seem like a presumptuous and exaggerated proclamation?

Absolutely. Many people have been around 132/84 (example) and for years and are living healthy lives. When I see an overweight person with that sort of pressure, I think that is great. I hate doing HTN teaching because of stupid guidelines like this. It makes me feel that I am encouraging needless fear to patients.

Specializes in OB/GYN, Peds, School Nurse, DD.

I'm pretty sure those grocery store machines are not calibrated. It's something fun to do while you're waiting for you meds, but I wouldn't put much stock in the numbers.

Specializes in Psych..

I'm still just a student, but I too was surprised when I heard about the new guidelines in one of my Pharmacology classes. But I'll give you some quotes from my textbook Pharmacology and the Nursing Process. (5th Ed.)

"The Seventh Report of the Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) (May 2003) introduced further changes to the previous recommendations regarding identification and treatment of hypertension."

"Some of the major points in JNC-7 can be summarized as follows: Normal blood pressure readings are considered to be a systolic blood pressure (SBP) of less than 120 mm Hg and a diastolic blood pressure (DBP) of less than 80 mm Hg. An SBP of 120 to 139 mm Hg or a DBP of 80 to 89 mm Hg is no longer considered to be "normal" or "high normal" but is identified as prehypertensive and requires lifestyle modifications to prevent cardiovascular disease and subsequent complications."

Specializes in CVICU.

I don't know, but every time I have my BP taken manually, I'm usually 110s... however, get me on a Dynamap, and I'm like 130-140! Moral of the story, don't trust the automatic machines.... if the numbers seem a bit out of whack, have someone take a manual pressure. I see this type of thing at work all the time, with level/zeroed art line pressures vs the digital cuff ones... They can vary by as many as 50 points.

Specializes in Nursing Professional Development.

Like it or not, the research supports the 120/80 standard. That's why practice guidelines have changed in the past few years. It has been established that people whose BP is higher than that are at greater risk for strokes and heart attacks.

Are there people walking around with BP's higher than that? Of course there are -- but those people are at higher risk for strokes and heart attacks. If their BP continues to creep up to higher levels over a period of years, they will probably experience problems someday due to cardiovascular disease. It just hasn't become apparent yet.

Certainly, I would not recommend treatment based on 1 reading on a drugstore machine ... but if your BP is frequently over the 120/80 standard, it's probably worth discussing with your PCP. A few lifestyle changes may be in order -- to prevent significant BP problems in the future.

llg -- middle-aged, hypertensive, and pre-diabetic

I read up on HTN (for the first time in years, lol) for a community presentation last winter, and the NIH is using the "prehypertension" category now, also. As a psych nurse, I rarely second guess the experts on medical issues like BP, so I have no opinion on how important a distinction it may be. :)

Having said that, though, I echo the others who say "don't trust the supermarket BP machines." I'm sure they are about as accurate and valid as fortune cookies (maybe less so!)

this can't be a new concept...

i learned about this in nsg school, 15 yrs ago.

never really paid attn to the 'pre' phase however.

too many labels for everything.

leslie

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