DEAR DR. GOTT: There are many people incorrectly diagnosed with isolated systolic hypertension because the blood pressure cuffs in use are not designed to compensate for the presence of excessive fat or muscle tissue in large people. When discussing this point with a physician, I suggest this experiment: Have the person take his own BP, then wrap a 1/2” thick steak around the arm and take it again. The one physician (a woman) who actually did this was amazed to see her BP go from 115/75 to 165/62.
The medical community needs to develop better ways to measure BP. Heavily muscled and fat people (yes, I’m one) are being misdiagnosed with hypertension every day.
DEAR READER: In all honesty, I find your experiment rather gross, if only because it involves slathering raw beef over one’s arm and medical equipment. However, I can understand your point, as the steak represents excess fat/muscle tissue.
Isolated systolic hypertension refers to a systolic (the first number) great than 140 mm of mercury with a diastolic reading of less than 90.
Views on readings have changed over the years. There was a time when the diastolic (the second number) appeared most important, with the thought that increases in the opposite number (the systolic – first and highest) changed, with the body tolerating those variances. That is not so any longer.
Opposing your beliefs, I feel great strides have been made with regard to today’s equipment. Children and thin-armed people now have access to substantially smaller cuffs while obese and muscle-bound people have ones that are wider and over-all larger. The technical term for a blood pressure cuff is a sphygmomanometer with a cuff size from just under 4” to 20”. That allows for a whole lot of leeway and provides for what should be, accurate readings.
Hypertension often has no symptoms but is easy enough to diagnose. If your physician is indicating you have the disorder based on one reading taken with an ill-fitting cuff, perhaps it is time to get a second opinion. Or, you may have a condition known as white coat hypertension or have been taking a cold remedy, decongestant or pain reliever that can contribute to elevated numbers. You owe it to yourself to get a good reading and to be checked periodically. Because you admit to being overweight, you might find an exercise program and diet will work to your benefit. Cut back on salt, walk around the block and reduce your food consumption. If you are a smoker, discontinue the habit.
Readers who would like related information can order my Health Report “Hypertension” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print out an order form from my website at www.AskDrGottMD.com.
