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-- back now Sunday house call you know fluctuating blood pressure is a problem for many Americans we have an email this morning.
From -- Brennan who writes us quote I hope you have time to give me some ideas about my recently very erratic blood pressure.
Last -- aren't having huge spike spoke up and down.
I can't make plans to go anywhere when I can't rely on my health.
Anything you could suggested check and improve my blood pressure stability would be much appreciated this is so frustrating perhaps somebody.
What is it what causes this to -- current people.
Well Judy thank you for your email -- that would like to do is without knowing a lot of history about this patient I will give you the list.
Of everything that would cause -- slowly above blood pressure and this is a good time to take out the paper and penned an outpost in the FaceBook.
Really -- a part of ABC these days -- the accuracy of the blood pressure because there's something called white coat syndrome you go to the office you run up.
-- but first results -- you really need three measures of blood pressure.
Off 140 over ninety to really be known as high blood pressure so accuracy is very important.
Apnea a sleep -- we know is one of the causes -- blood pressure you -- sleep well your hormones are out of sync.
You can get high blood pressure and finally -- buster is a hormone that you should check you should ask your doctor to check you out -- -- that's a hole when that comes from the adrenal gland.
-- -- it absorbs -- sodium and can give you these blood pressure these stats -- bad -- you may have some vascular issues in your -- -- -- hypertension.
That could be the reason and finally see that would get to -- -- is.
There are masses and -- all summer called feel and that will give you a lot of fluctuations of your blood pressure you -- -- be careful.
Cortisol level is important to ask your doctor for quarters -- throughout cushions.
Finally diet we've talked on this show a lot of -- the salt intake making sure that you good diet is in order.
And he is and -- -- or your thyroid sometimes too much thyroid hyper thyroid.
Can also give you that fluctuation in summary to that answer and I hope to these and.
Who chipped up to -- on how -- is this problem and and how does it does and suddenly come on.
There -- two huge problem I treat blood pressure in the office every single day did you wind differential diagnosis excellent you've covered all of that I just wanna -- a couple of thank you doctor house.
-- -- -- Did you don't sound like a book.
But -- a commitment of I don't -- -- to -- So there's a couple of things to -- fluctuating blood pressure is something first the -- from circadian rhythms so in other words your blood pressure in the morning parents to be a little lower.
As the day goes on higher.
David's point about white coat syndrome I see that all the time.
People say that we can use those blood pressure devices at home the battery once I find them wildly variant I don't like them.
So what do you do we talked about it once on the show a few weeks ago ambulatory blood pressure monitoring works I need to know what your blood pressure -- throughout the day because a study in 2010.
Giant increase risk of stroke in people whose blood pressure.
Varies throughout the day the number one cause Jamie of it -- blood pressure is people not taking their medications properly.
What are -- prescribed are you going over with your doctor is it working throughout the -- does -- have you if he -- she have you -- a long acting medication on a short acting medication.
It's got to be managed in a way where we get a plateau -- we're gonna have problems and one reading a doctor's office or even three readings is not proof.
What would you also ask -- patients for example they -- -- your office in Germany comes in and has this kind of -- think.
Would you ask them about that their lifestyle something has -- -- various new stress or job change or something that's going on that good for short term causes coming blood pressure.
As opposed to just give them.
Completely right that's a great point and stresses and the number one cause it would be that I forgot it was -- -- -- but that's the number one cause of a short term problem influx from blood pressure.
Ask someone if they're upset David sometimes that cup of coffee you prescribe five minutes before they came running over.
-- -- to see me and I'm running away and they're angry they're blood pressure goes up I have to take -- good -- guys and that white coat that you are can be frightening for some people that aren't used to it.
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