Medical Q&As

Blood pressure - normal reading?

I am 27 years old and of slim build and of moderate fitness. I recently went to my doctor for a check up and my blood pressure was 150/90. She recommended I have it re-checked the following day and I did. It was 130/85. The nurse said I was borderline and asked me to get it checked again the following week. I got it checked yesterday by my fitness instructor and it was 113/71 which I've been told is low and my pulse was 85, which I've been told is high (this was before I had done any exercise). Why is my blood pressure fluctuating so much all within one week? Is this normal? Why is my pulse high and are they related? Is there something wrong and should I go back to my doctor?

It is normal for blood pressure to fluctuate throughout the day. Blood pressure can be altered by a whole variety of factors. If you are under pressure at work it can rise. If you run to catch a bus it can rise. Even the prospect of having it measured can cause minor apprehension and can cause the level to rise. This effect is referred to as the “white coat” effect and is very common. The first reading that was taken by your doctor was borderline and all subsequent measurements were normal. When we measure blood pressure we record two pressure measurements, which we refer to as the systolic blood pressure and the diastolic blood pressure. The systolic is the higher figure of the two but it is the lower figure that we pay particular attention to when diagnosing blood pressure. A diastolic reading of 90 is in the borderline area and it is reasonable to re-check the blood pressure again on another occasion to see if that figure has changed or not. We never make a diagnosis of high blood pressure on the basis of one isolated reading unless it is catastrophically high. The normal practice is to measure the pressure on three separate occasions and if it is greater than 90 on three separate occasions it is reasonable to infer that the person has mild blood pressure and needs to be assessed further. On the basis of the criteria I have just given you have had three separate blood pressure readings, one of which was borderline and two that were absolutely normal and I would therefore conclude that you do not have high blood pressure. You have been given inconsistent advice from several sources and I would suggest that you return to your doctor and discuss this matter further with her if you have any further concerns on this matter.