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Discussion

Interpreting BP..

Can anyone tell me what may possibly be going on with a patient of mine who's normal BP is around 110/70 110/78 but occasionally will have pain and readings go to 100/90.

MD has no concern. No tests ordered. No current medications in use.

Featured Replies

What tests did you request from the physician?

  • Experts

If the systolic is not changing, and only the diastolic is, try taking the BP again a few minutes later. With increased pain, you would expect to see an increase in the systolic pressure only. And since the numbers are so close together with only a difference of 10, I would recheck the BP..............

They also could have just tightened up their arm right when you were taking the BP, that would cause the same thing to happen.

I personally would not be concerned with that BP either.............you would have to have multiple BPS with elevated diastolic for there to be a reason to treat. One time only, no way.

You should see some of the pts in ICU will SBP of 70 and MD says is acceptable in that pt case and will do nothing about it.

QUOTE=JamiRN]Can anyone tell me what may possibly be going on with a patient of mine who's normal BP is around 110/70 110/78 but occasionally will have pain and readings go to 100/90.

MD has no concern. No tests ordered. No current medications in use.

  • Author

Thanks for the input.I saw this patient yesterday and without any c/o pain, at rest 106/78. I guess it just seems odd to see such a little gap (10) between systolic and diastolic with pain. He is a fairly big man too. :)

  • Experts

If the patient's muscles tense up while you are taking the BP, you can get a BP like that. What do you do? Take it again in a few minutes. Simple as that. :)

".......we have found that in subjects with an uncommonly narrow pulse pressure, the auscultated BP measurement frequently overestimates DBP by 5 mm Hg or more. This overestimation, particularly in view of the lower cardiovascular risk of isolated diastolic hypertension, suggests the need for reconsideration of the widespread and automatic practice of treating patients with isolated diastolic hypertension. Intra-arterial measurement could be helpful in assessing such patients but is not clinically practical. Wideband external pulse recording would be useful in assessing the accuracy of the diastolic reading, but an instrument based on K2 analysis is not at present commercially available. Nevertheless, our findings suggest that when an auscultated BP is characterized by a narrow pulse pressure, the possibility of an overestimation of DBP should be considered"

http://hyper.ahajournals.org/cgi/content/full/26/3/383

You might find this link useful for your question.

Mike

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