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The science behind on-the-wrist blood pressure tracking

empirical.health

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Re: The science behind on-the-wrist blood pressure tracking

#31

Post by brandonb »

mysterypie wrote: post #26

I'm hoping someone can answer a question that's been bugging me for years: When I take blood pressure medication my blood pressure goes down but my heart rate goes up [1]. That can't be good. Heart rate has a strong inverse correlation with lifespan, and this even holds across species (animals with higher heart rates have shorter lifespans). So does lowering blood pressure reduce the risk of heart disease, stroke, et…

This sounds like reflex tachycardia -- your body wants to ensure blood is flowing to all the right places, so it raises heart rate to partially compensate for blood pressure falling. Reflex tachycardia can be a normal response to certain types of blood pressure medications, like vasodilators or diuretics. Beta blockers are a different common type of blood pressure medication that attempt to lower both blood pressure and heart rate simultaneously.

If the increase in heart rate is large (>30bpm), especially when going from laying to standing, it could be a sign of underlying dysautonomia or POTS. If you experience symptoms (dizziness, fatigue, fainting, etc) it's worth getting evaluated. We (the OP) do offer medical care for POTS here: https://empirical.health/pots

As for the relationship between low heart rate and longer life spans, it's not necessarily causal -- a lower heart rate is often a sign of a stronger cardiac muscle (each beat pumps more blood, so fewer beats per minute are required to pump the same volume of blood). So I'd suspect much of the relationship here is driven by these confounding variables!

Re: The science behind on-the-wrist blood pressure tracking

#32

Post by kbrisso »

wil421 wrote: post #23
kbrisso wrote: post #3

Measuring blood pressure on the wrist is tricky. I usually do three measurements to get an accurate reading. I have two machines I use. The older one is actually better than the new one. Another thing is, pay attention to how you feel. I can feel my blood pressure when it's high and usually know when the device reading is off. I do this because my family has a history of high blood pressure and so far because of life…

Why do you have to do it so often? Why do you even do it if you’re not on meds? Third, what would you even do if it’s high?

I don't check my blood pressure every day. Maybe twice a month or when I feel like crap. I also check my glucose. Why? I believe if I keep myself in check I will keep myself out of the hospital as I age. High blood pressure and diabetes are two things I can manage. I don't want to be on meds unless I absolutely have to. Exercise and these tools allow me to figure out what I can eat and not. I'm not obsessed with my health or a health "nut". The upside is I don't get sick that much and feel good.

Re: The science behind on-the-wrist blood pressure tracking

#33

Post by AStonesThrow »

mysterypie wrote: post #26

I'm hoping someone can answer a question that's been bugging me for years: When I take blood pressure medication my blood pressure goes down but my heart rate goes up [1]. That can't be good. Heart rate has a strong inverse correlation with lifespan, and this even holds across species (animals with higher heart rates have shorter lifespans). So does lowering blood pressure reduce the risk of heart disease, stroke, et…

It's the futility of trying to make two arbitrary numbers go down and covering up a mere symptom.

Hypertension is correlated with a lot of issues, and it's easy to measure.

It's also easy to keep formulating novel chemicals, so keep complaining about side effects, and your physician will be happy to keep spinning the Formulary Roulette Wheel.

Re: The science behind on-the-wrist blood pressure tracking

#34

Post by nisegami »

Two tidbits from me:

Several years ago, I got an omron wrist cuff blood pressure monitor. Some doctors showed heavy skepticism at the time but I've never seen any reason to think it's inaccurate when properly mounted and with healthy batteries.

I had a sleep study done last year using a brand new machine the lab got (literally unboxed while I was there) that uses a combination of the ecg signals and pulse timing to calculate blood pressure continuously once calibrated. Seemed pretty cool to me and I got the impression this technique is fairly new?

Re: The science behind on-the-wrist blood pressure tracking

#35

Post by AStonesThrow »

sph wrote: post #19
corry wrote: post #4

Actually, there is a wrist device called "Aktiia" that's approved for use for continuous BP monitoring with clinical accuracy by the UK and German health authorities (I believe). It's a bit of a pain to get over the pond, but with a shipment-forwarding company + a UK App Store account you can get up and running. I've dabbled a bit with it and it's very close to the cuff measurements. It works by calibrating with thei…

> And goes without saying, your blood pressure SHOULD go up and down based on your activity and time of day. You just aren't used to seeing it other than at true rest. Yeah, people panic reading a single 150 systolic, yet routinely it can reach 220+ during heavy exercise. It's perfectly fine. The health metric is the BP at rest, i.e. how low it goes when you're completely idle. I find it takes up to 20 minutes to rea…

During a recent visit, I mentioned my "White Coat Syndrome" was probably affecting me right there, so they selected their most attractive woman with the best perfume and a manual sphygmomanometer for a hands-on measurement, before releasing me.

Re: The science behind on-the-wrist blood pressure tracking

#37

Post by naveen99 »

mysterypie wrote: post #26

I'm hoping someone can answer a question that's been bugging me for years: When I take blood pressure medication my blood pressure goes down but my heart rate goes up [1]. That can't be good. Heart rate has a strong inverse correlation with lifespan, and this even holds across species (animals with higher heart rates have shorter lifespans). So does lowering blood pressure reduce the risk of heart disease, stroke, et…

It’s complicated. You need blood pressure to live…

Too low heart rate can also be a problem.

talk to your cardiologist about your specifics.

At the population level, the guidelines have backed off over the last 20 years. What’s normal now used to be called high blood pressure.

Re: The science behind on-the-wrist blood pressure tracking

#38

Post by smeeth »

mysterypie wrote: post #26

I'm hoping someone can answer a question that's been bugging me for years: When I take blood pressure medication my blood pressure goes down but my heart rate goes up [1]. That can't be good. Heart rate has a strong inverse correlation with lifespan, and this even holds across species (animals with higher heart rates have shorter lifespans). So does lowering blood pressure reduce the risk of heart disease, stroke, et…

I'm not a doctor, but my understanding is that lower blood pressure can indeed lead to a higher heart rate under certain circumstances. For instance, people taking minoxidil for hair loss can experience lower blood pressure, which leads to higher heart rates and increased left ventricle thickness as a side effect.

My suspicion is that this happens because the heart is trying to maintain a constant oxygen supply to the muscles. However, if blood pressure is lowered by improving factors like arterial flexibility, stroke volume (amount of blood per heartbeat), muscle oxygen efficiency, or oxygen content in the blood, the heart wouldn't need to pump faster.

Re: The science behind on-the-wrist blood pressure tracking

#39

Post by oidar »

candiddevmike wrote: post #9
oidar wrote: post #5

I would love to have continuous BP monitoring. I ready for this tech to mature. I'd wager that blood pressure varies way more during the day than weight (which can vary as much as 5 lbs or more) - and continuous, easy BP monitoring at would cause HT dxs to drop significantly.

Why do you think this would cause HT diagnosis to drop? If anything all of these continuous monitors create more patient visits and probably more diagnosis. I'm interested in what the future holds when these things are capable of FDA-approved diagnosing. Will Apple send a prescription for BP meds to my pharmacy?

I think there is a lot of white coat HT that makes up many cases. I think the ACS recommends a measurement 3 times in a row at different office visits. So, maybe anxiety might be a direct cause of HT dx.

Re: The science behind on-the-wrist blood pressure tracking

#40

Post by oidar »

rootusrootus wrote: post #17
oidar wrote: post #5

I would love to have continuous BP monitoring. I ready for this tech to mature. I'd wager that blood pressure varies way more during the day than weight (which can vary as much as 5 lbs or more) - and continuous, easy BP monitoring at would cause HT dxs to drop significantly.

> HT dxs I'm unfamiliar with this abbreviation but did my best with Google. Does it mean 'hypertension diagnoses'?

yes
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