Iffy Patient Education on Hypertension

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Unfortunately, the details of this are a little vague because I wasn't there and I am relaying this information second hand.

My husband recently had a health screening and fasting labs with an insurance affiliated clinic. His blood pressure at the time was in the 140s/90s; he usually runs around 125/75. She looked at the reading and said that it's normal for someone who has been fasting.

I know I've been out of med-surg for a couple years, but I was taught that anything over 120/80 was at the very least considered prehypertension. I've never heard of someone's blood pressure being higher due to fasting (unless we're talking postparandial hypotension). I can't find anything online that supports her statement.

Is this a real thing? Have any of you heard of this?

Slightly related side note: I taught my husband how to take a blood pressure--because it's rather hard to take one on yourself and I thought I was having hypotension issues a while back. He said this nurse walked him back to the exam room and immediately took his blood pressure. I'm thinking, if her technique is iffy, is her education really on point? And what does this mean for the other patients coming in for exams and getting educated by her?

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Unfortunately, the details of this are a little vague because I wasn't there and I am relaying this information second hand.

My husband recently had a health screening and fasting labs with an insurance affiliated clinic. His blood pressure at the time was in the 140s/90s; he usually runs around 125/75. She looked at the reading and said that it's normal for someone who has been fasting.

I know I've been out of med-surg for a couple years, but I was taught that anything over 120/80 was at the very least considered prehypertension. I've never heard of someone's blood pressure being higher due to fasting (unless we're talking postparandial hypotension). I can't find anything online that supports her statement.

Is this a real thing? Have any of you heard of this?

Slightly related side note: I taught my husband how to take a blood pressure--because it's rather hard to take one on yourself and I thought I was having hypotension issues a while back. He said this nurse walked him back to the exam room and immediately took his blood pressure. I'm thinking, if her technique is iffy, is her education really on point? And what does this mean for the other patients coming in for exams and getting educated by her?

Your husband's use of the term "nurse" may refer to a female in scrubs who comes within 5 feet of a patient.

I recently got a call from my periodontist office from a women who may well be referred to as a nurse. She told me to take four 800 mg tablets of ibuprofen prior to surgery.

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It's good to have a relationship with a PCP.

I've been taught (over and over) not to make too much of a singular set of numbers.

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Specializes in Critical care.
It's good to have a relationship with a PCP.

I've been taught (over and over) not to make too much of a singular set of numbers.

I was just about to say that hypertension isn't diagnosed until there is a consistent pattern. White coat syndrome is also a real thing- one of the reasons I always encourage my patients to take their BP daily.

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Specializes in Emergency, Telemetry, Transplant.
Your husband's use of the term "nurse" may refer to a female in scrubs who comes within 5 feet of a patient.

And this is likely not your husband's fault. At my last PCP visit, I had an individual wearing a "Medical Assistant" badge say to me "I am Sarah [name changed to protect the guilty], I'm going to be your nurse today." I wouldn't be surprised if some of these MAs are giving some sort of "education" on BP, etc.

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I also had a BP of 140s once when I was 16.... I was taking the AP bio exam the next day and was so nervous. I did not have hypertension, at least, the kind that gets medicated.

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Your husband's use of the term "nurse" may refer to a female in scrubs who comes within 5 feet of a patient.

I figured that might be that case as well. I considered putting nurse in quotation marks when originally writing this.

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I wake up every morning and check my bp where I am technically "fasting" and this is when its lowest. Never heard of fasting increasing blood pressure, but I imagine profound fasting (or any states of stress) might.

Regarding numbers and where they lie, JNC 8 gets away from categories like prehypertension and focuses on medication management at various levels with the real focus on keeping blood pressure below (not at) 140/90. If he normally runs lower and never had a blood pressure that high clinically before, I wouldn't consider treating it until I saw a trend. You need two independent visits and readings to justify/diagnose it. I might mention to watch dietary salt in passing or explain that blood pressure can go up or down intermittently throughout the day, but nothing more.

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And this is likely not your husband's fault. At my last PCP visit, I had an individual wearing a "Medical Assistant" badge say to me "I am Sarah [name changed to protect the guilty], I'm going to be your nurse today." I wouldn't be surprised if some of these MAs are giving some sort of "education" on BP, etc.

I work in an ER, and have no idea how offices work.

At least I didn't until EPIC. I can now see logs of calls, etc....

It is shocking the level of medical advice and education given by MAs. Stuff that is well beyond what I would do.

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