Life At Slow-Mo

For the past three months, I have built a habit of doing three things right after I wake up. First, I step on the scale to get my weight reading. Second, I plug in my blood pressure monitor and take the reading that day. Third, I go downstairs and water the plant. Depending on whether I have fasted at least 14 hours or not, sometimes I defer weighing until my fasting has run its course.

When taking my blood pressure reading, I do it two or three times to make sure I get the right measurement. What I mean by ‘the right measurement’ is the lower reading. Yes, I can be that meticulous when it comes to getting the best result for me.

I do have reasons to be concerned. Most of the time, the first reading of the morning would always be above 120/80 mm Hg. By medical definition, I was at the onset of hypertension, or hypertension stage 1 as my blood pressure recording app calls it. Since the reading seemed to be consistent, I am starting to believe that I have hypertension, indeed.

In the past few days, I am adding new habits to my morning routines. We just adopted a vacuuming robot. It has to work very early before everyone is up to keep it from getting in the way when there are people running around the house. So nowadays, right after weighing, I go downstairs and activate the robot before I water the plants. As soon as I was done with the watering and the robot has gone back to its charging cradle, I do some exercise in the living room. Then I take a shower and take my blood pressure reading.

Interestingly, the readings are now within the normal range. Just this morning, I got 115/178, which is very normal. Is there a difference between taking blood pressure right after waking up and at other times of the day?

Apparently yes. Blood pressure follows a daily pattern. It starts to rise a few hours before waking up, and peaks during midday. In late afternoon and evening, it begins to drop until it reaches its lowest level during sleep. During exercise, blood pressure will rise along in response to the heart pumping faster to get oxygen to the muscles. This will cause the systolic pressure to rise between 160 to 220 mm Hg. Post-workout, the blood pressure will return to normal.

Because of pressure differences throughout the day, it is not enough to take blood-pressure readings once a day to detect hypertension. Some abnormal patterns must be present to come to that conclusion. For example:

• High blood pressure during the night
• High blood pressure early in the morning
• Less than 10% drop in blood pressure overnight
• Systolic pressure over 220 mm Hg during exercise
• Slow return to normal blood pressure after exercise

Even if they are present, abnormal patterns may indicate other diseases. For example: obstructive sleep apnea, kidney disease, diabetes, thyroid disease, and nervous system disorder. Poor lifestyle also has similar effects, such as being obese, smoking, stress, etc.

So the best course of action is to consult an internist. To help in the diagnosis, I need to log my blood pressure at least twice a day: once in the morning and once at night before sleep.