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Get a 24-Hour Blood Pressure Reading to really know your heart health
- High blood pressure (hypertension) is a warning sign of multiple health issues.
- A new study finds that the best way to determine a person’s heart health is to look at their blood pressure over 24 hours.
- This method could offset “white coat hypertension,” where the stress of going to the doctor’s office can increase a person’s blood pressure.
Heart disease is the leading cause of death in the United States, accounting for nearly 1 in every 4 deaths — or about 610,000 deathsTrusted Source — each year.
It’s also the most expensive disease, costing the country nearly $1 billion each day.
The vast majority of cardiovascular disease cases are preventable, had people received earlier diagnoses and treatments.
One way to detect signs of cardiovascular disease is a simple blood pressure reading.
High blood pressure (hypertension) has long been known to be the biggest — and most treatable — risk factor associated with diseases of the heart and vascular system. But many people don’t know they have it until it’s too late, according to the Centers for Disease Control and Prevention (CDC)Trusted Source.
Now, researchers have discovered a new way to get more accurate measurements of blood pressure, which can hopefully get people on the right medications sooner and help prevent cardiovascular disease.
By recording people’s blood pressure over 24 hours rather than just once in a clinic or hospital setting, doctors can more accurately diagnose high blood pressure and effectively predict someone’s risk for heart and vascular disease, according to a new international study recently published in JAMATrusted Source.
To determine the most reliable way to measure blood pressure, researchers followed 11,135 people from Europe, East Asia, and Latin America for 14 years.
They compared the accuracy of blood pressure readings that were taken in a medical setting to blood pressure recordings that were taken during both night and day over 24-hour periods.
The researchers found that the 24-hour and nighttime blood pressure measurements provided a more accurate estimate of one’s risk for heart and vascular disease compared to the in-office readings.
“Although heart and vascular disease are strongly associated with blood pressure, irrespective of how it is measured, until now we did not know which type of blood pressure measurement captured risk in the most accurate way,” study co-author Dr. Gladys Maestre, a researcher from the University of Texas, Rio Grande Valley School of Medicine, said in a statement.
The findings suggest that blood pressure should be monitored repeatedly for 24 hours to help diagnose people’s heart issues and, ultimately, prevent cardiovascular disease, according to the researchers.
“Ever since devices to measure blood pressure were invented more than 100 years ago, it’s been known that elevation of such readings predicted the eventual development of blood vessel disease, heart attack, stroke, heart failure, and kidney dysfunction,” says Dr. Richard Wright, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California.
In general, the further a person’s blood pressure readings deviate from the ideal, the more likely they are to eventually develop any of these health issues, Wright added.
However, a huge issue comes into play when blood pressure is measured in a healthcare setting.
Many people have elevated blood pressure readings due to anxiety of being in a medical environment — known as the white coat effect — and those high readings don’t accurately reflect a person’s overall blood pressure levels.
“Unfortunately, blood pressure isn’t a fixed number for any individual and varies widely over each day, being much higher during stress or physical exercise, and typically lowest at night during asleep,” he explained.
Even the stress of having a blood pressure cuff put on the arm or seeing a doctor walk into the room can cause some people’s blood pressure to spike, he added.
Twenty-four hour monitoring can look at a person’s blood pressure fluctuations throughout an entire day rather than at a given moment.
There’s also a huge advantage of measuring blood pressure during sleep because the results aren’t affected by daytime meals or activities.
“Ambulatory monitors give us a great sense of what the patient’s blood pressure is doing in real life as well as when they are sleeping, when it should decrease,” Dr. Nicole Harkin, a board-certified cardiologist and lipidologist with Manhattan Cardiovascular Associates in New York City, said.
“They also give us a large data set of blood pressures to look at, as opposed to a one-time snapshot in the doctor’s office, which is subject to many variables, including errors in measurement as well the patient’s recent activity level, medication timing, and inadequate rest prior to measurement,” she said.
According to Harkin, the current American College of Cardiology and American Heart Association blood pressure guidelines support the use of ambulatory blood pressure monitoring to better predict cardiovascular outcomes.
Coverage for ambulatory blood pressure monitoring varies across different insurance providers. Much of the time, it’s only covered for people who experience white coat hypertension, in which an individual’s blood pressure is higher in a doctor’s office than it would normally be, she explained.
Seeing as ambulatory blood pressure monitoring can better predict long-term heart disease outcomes, healthcare providers should place a greater emphasis on 24-hour readings than those taken in a doctor’s office.
If people know their blood pressure is higher than it should be, the better they can manage it to minimize the odds they’ll develop heart disease down the road.
High blood pressure can be the biggest predictor of heart disease, so the sooner people can start managing their blood pressure, the lower their risk of heart and vascular disease may be.
Short-Term Stress and Anxiety Can Actually Be Good for You
- Researchers say short-term stress can be beneficial by boosting performance as well as bolstering our immune system.
- They add that anxiety can be useful when it jolts us into finishing a task or warns us of danger.
- Stress and anxiety can add adrenaline to the circulatory system, increase respiration, slow digestion, and improve vision.
- However, chronic stress and unwarranted anxiety can be unhealthy in a number of ways.
It’s impossible to go through life without dealing with some stress and anxiety.
Nor would you necessarily want to, mental health experts say.
Chronic stress is usually cast in an unhealthy light. And with good reason.
Heart disease, diabetes, decreased libido, gastrointestinal problems, and disruptions in sleep and appetite are just on the short list of health problems linked to elevated stress over long periods of time.
In 2018, Harvard researchers reported that people with high levels of the stress hormone cortisol performed worse on memory tests.
“The main reason we view stress so negatively is the dominant narrative put forth by stress research. [It] focuses on the negative impacts of stress, such as chronic and debilitating diseases like hypertension, obesity, and type 2 diabetes,” said Jennifer Wegmann, who teaches stress management at Binghamton University’s Decker School of Nursing.
Wegmann notes that 2017 research from the American Psychological Association (APA) found that 20 percent of Americans said they were experiencing extremely high levels of stress.
“If Americans can learn to utilize stress in a positive way, it could not only help mitigate the negative outcomes people are experiencing, but lead to improved well-being, more productivity, and personal growth,” she told Healthline.
“Stress causes harm when it exceeds any level that a person can reasonably absorb or use to build psychological strength,” Lisa Damour, PhD, author of the book “Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls,” said in a presentation this week at the APA’s annual convention in Chicago.
Short-term stress, however, can be beneficial.
“It’s important for psychologists to share our knowledge about stress with broad audiences: that stress is a given in daily life, that working at the edge of our abilities often builds those capacities, and that moderate levels of stress can have an inoculating function, which leads to higher than average resilience when we are faced with new difficulties,” she told the APA conference audience.
Anxiety, too, has its purpose.
Damour likened it to “an internal alarm system, likely handed down by evolution, that alerts us to threats both external — such as a driver swerving in a nearby lane — and internal — such as when we’ve procrastinated too long and it’s time to get started on our work.”
“Likewise,” she added, “anxiety becomes unhealthy when its alarm makes no sense. Sometimes, people feel routinely anxious for no reason at all. At other times, the alarm is totally out of proportion to the threat, such as when a student has a panic attack over a minor quiz.”
Charley Melson, executive director of the addiction treatment program Praxis by Landmark Recovery in Louisville, Kentucky, and a licensed professional clinical counselor, tells Healthline the body adds adrenaline to the bloodstream when under stress. That causes physiological reactions, which include increased respiration and blood flow, slower digestion, and improved vision.
Kevon Owen, a clinical psychotherapist, likens anxiety to caffeine, which increases energy and improves alertness and reaction time.
“Caffeine is the external imitation of anxiety,” the Oklahoma City counselor told Healthline.
He notes that caffeine use can also exacerbate anxiety.
“Stress is your mind’s way of prioritizing and organizing tasks that need to be done,” he said. “These things do not become negative until they interrupt or disrupt motivators or begin causing negative mental or physical anguish.”
Melson says moderate, normal psychological stress “can be used by students and professionals as a form of motivation to accomplish goals and meet deadlines.”
“Similarly, stress can help keep you alert and focused, working almost like an adrenaline rush. It can even improve your recall in some situations,” she said.
As the Harvard researchers noted, however, the opposite may be true with chronic stress.
Experiencing “stage fright” and “testing anxiety” may also be mislabeled as universally negative, says Mary Joye, a licensed mental health counselor at Winter Haven Counseling in Florida.
“Anxiety is a wonderful propeller for accomplishment. It’s also good for an edge in sports and entertainment if you’re a performer. It keeps you on your toes as long as it’s not out of control. It is also what will help you rehearse, study, and in general, motivate you to become your personal best,” she told Healthline.
Inna Leiter, a licensed clinical psychologist at the Center for Cognitive Behavioral Therapy in Media, Pennsylvania, agrees.
She notes that the Yerkes–Dodson law of psychology “dictates that performance will improve with physiological or mental arousal, but only up to a point.”
“When levels of arousal become too high, performance starts to decrease,” she told Healthline.
She adds that research shows that different tasks require different levels of arousal for optimal performance.
“For example, intellectually intensive tasks often require a lower level of stress for optimal performance due to a competing need for focus and good judgment, while tasks that require a great deal of persistence (like running a marathon) may be best performed under higher levels of stimulation,” she said.
There’s even a clinical term for positive stress: eustress.
“When people are able to see the difference between positive eustress and negative stress, they can start using their stress and anxiety to their advantage,” Kristen Fescoe, clinical program manager at the stress-management firm Resility Health in Jacksonville, Florida, told Healthline.
“Just knowing this is helpful, because many people experience some anxiety, assume it will hurt their performance, and then get anxious about being anxious, and now they are too anxious,” agreed Dr. Gail Saltz, an associate professor of psychiatry at the New York Presbyterian Hospital Weill–Cornell School of Medicine, who advises viewing anxiety as a form of excitement rather than a source of worry.
Sheila Tucker, a licensed associate marriage and family therapist and owner of Heart Mind & Soul Counseling in Hilton Head Island, South Carolina, tells Healthline that experiencing stress can have positive psychological benefits, too.
“Symptoms of stress and anxiety can show up when something is missing from your life, like free time, or when something is important to you,” Tucker said.
“This is a great opportunity to take a step back and look at the situation. By reframing or shifting your perspective of your experience, the grip of stress and anxiety lessen. Not to mention, you gain valuable insight on what’s really going on in your life,” she added.
“Anyone feeling overwhelmed by stress should, if possible, take measures to reduce his or her stress and/or seek help from a trained professional to learn stress-management strategies,” Damour said at the APA conference.
“For the management of anxiety, some people find relief through workbooks that help them to evaluate and challenge their own irrational thoughts. If that approach isn’t successful, or preferred, a trained professional should be consulted. In recent years, mindfulness techniques have also emerged as an effective approach to addressing both stress and anxiety,” she continued.
Damour also urged psychologists to counter the notion that people should feel calm and relaxed most of the time.
“We want to support well-being, but don’t set the bar at being happy nearly all of the time. That is a dangerous idea, because it is unnecessary and unachievable,” she said.
“If you are under the impression that you should always be joyful, your day-to-day experience may ultimately turn out to be pretty miserable.”