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by hzay 788 days ago
Is it really secret though? It's the first thing you learn when you google "how to take bp". Like I'm not a medical person but when I was pregnant, I was asked to check BP and I asked the doctor "should I like average 3 readings or something?" and she said "just take one, don't stress it".

This is well known re thyroid medication as well. Also re weight, progesterone, a bunch of things.
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pc86 788 days ago
It's not a secret. Most of my immediate family is or was in healthcare and nobody is getting put on BP meds because of a single errant reading. They're getting put on meds because of persistent, uncontrolled elevated BPs and with non-pharmaceutical interventions not addressing it. Everyone, especially physicians, know there's a list of 20-30 things that can give you temporarily elevated BP that won't respond to BP meds.
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claytongulick 788 days ago
> nobody is getting put on BP meds because of a single errant reading

I'm glad you've had good experiences and relationships with what sound like quality healthcare professionals.

Others have had different experiences.

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importantbrian 788 days ago
Yeah, that's been my experience. Everytime I see my primary my BP is elevated in the office and they send me home with a log and I have to take my BP multiple times a day for 2 weeks and at home it's fine, so I've never been put on meds for it even though it's very high in the office.
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claytongulick 788 days ago
I suppose "well known" is relative, it may surprise you how little agency some people have over their health.

>It's the first thing you learn when you google "how to take bp".

The populations that I frequently deal with are not in a life/financial/cognitive place where this is a thing they would think of doing, or be capable of doing.

Take a look at this [1] about over treatment of mild hypertension. It's not a new problem, and potentially affects millions [2].

There can be enormous pressure on physicians to treat certain conditions from a population-health standpoint with medications if they fit certain clinical criteria.

The recent (2017) change in standards for hypertension [3] have been controversial. It put millions of people into the category of hypertension that weren't previously. Coupled with certain clinical criteria that recommend medication prescription even for mild hypertension, it's concerning that there may be an overprescription issue.

Many busy clinics don't have time to have a patient sit for the recommended 5 minutes of rest before taking BP (though I've seen this improving). Many medical assistants are poorly trained in BP measurement, and are overworked - I've seen many cases where a harried MA will do things like sit a patient down, put a cuff on them over-the-sleeve, as the patient slouches in a chair, with the arm in an incorrect position, a poorly fitted cuff, and just write down the number the machine spits out.

Of course, a good PCP will double check this and look for a trend. Not all PCP's are good and go to this effort.

(I am not a physician, I'm a tech nerd with a clinical background, but I've worked in healthcare for decades)

I've also experienced it personally. I went to the doc once about ten years ago for a wellness check. Based on the in-office BP reading and labs, the NP prescribed me five different medications, including BP meds, statins and others.

I decided to focus on lifestyle changes instead and that's worked well for me, but that's not an option for everyone.

[1] https://www.youtube.com/watch?v=cZCuJheVJA0

[2] https://www.umassmed.edu/news/news-archives/2014/11/umms-fam...

[3] https://www.health.harvard.edu/heart-health/reading-the-new-...

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