Blood Pressure Measurement Error
I’ve been measuring my blood pressure daily for several months now. Being a six sigma black belt I’m concerned with the variation in the measurements. After researching some of the standards for the measurement method it appears that getting consistent measurements is an extremely tricky process. In addition to getting my the proper arm elevation and waiting the recommended ten minutes while sitting quietly, I have found that which arm I’m measuring on, random stressful thoughts that go through my head, and even breathing rate and condition of breath hold can swing the measurement in a statistically significant way. That is leaving out the fact that every organization in my life that measures blood pressure does it using different equipment ( I have standardized) and they take these measurements at different times of the day and after I have entered into different levels of activity and eaten different things that could impact the measurement. All of this seems very concerning due to the fact that diagnosis of hypertension carries significant baggage and can lead to life long prescriptions. I have had a large number (20 maybe) conversations with people who claim to have “white coat syndrome” where their blood pressure goes up when measured by a health professional. I would very much like to hear your opinion on the best way to get a true reading that allows you to take appropriate action on modifying blood pressure. I would also love to hear your opinion on the impact all of this measurement variation has on the literature around health and blood pressure. It would seem that observational studies and data mining attempts would be worthless if the sloppiness of blood pressure measurement is as prevalent as it seems to be in my experience.
Cab a high CAC lead to reduced aerobic output?
I'm a lifelong endurance athlete, including decent levels of success (national rowing championships in my teens/20s, 3X Boston marathon in my 30s/40s, expert-level mountain bike racer, etc) Now in my 50s I have a CAC above 600 and also am seeing significantly reduced aerobic capacity despite steady training (I'm back to rowing now) -- are these things related?
Questions for Inigo in the second session with him
Can you compare different methods for locking into Zone 2 intensity? Specifically, compare: 1. Lactate measurement while exercising 2. Do a gas exchange test on a treadmill and using the HR at fat/Cho crossover 3. Limit of nose-breathing 4. Heart rate drift test (#3 and #4 from Scott Johnston in Training for the Uphill Athlete) 5. Maffetone rules, like HR equal to 180 minus your age +/- 5 depending on condition