DEAR DR. DONOHUE: My question is about taking blood pressure readings. I am 87 years old, female, about 5 feet, 5 inches tall and weigh about 130 pounds. When I go for a checkup with my general practitioner, the nurse takes my blood pressure before I see the doctor. The cuff feels comfortable, and the reading is always in the normal range. I have had my blood pressure checked at other places (clinics, etc.) and usually the cuff is inflated very tight (so tight that it hurts) and the reading is very high. If the cuff is inflated too tightly, could it cause a high reading? – I.S.
ANSWER: High blood pressure is one of the most common medical conditions, and correct treatment of blood pressure is essential in order to reduce the risk of heart disease and stroke. It is not uncommon for blood pressure to vary from day to day, or even during a single day, but the changes you describe suggest two possibilities.
The first is that the reading at your own doctor’s office is right, and the other places are wrong, which is probably the most likely. Having blood pressure tested in a new place or by someone you don’t know certainly can cause the reading to be elevated. Automated blood pressure cuffs in pharmacies, etc., are sometimes right but often are wrong – occasionally spectacularly. A very high pressure in the cuff, high enough to cause pain, can cause the blood pressure to go up, but not usually high enough to put people into the hypertensive range.
Another possibility is that the nurse in your doctor’s office isn’t inflating the cuff high enough to get the correct reading, or deflating the cuff too quickly. The wrong-size cuff can lead to large errors in blood pressure readings. While all of these are possible, a trained nurse who takes blood pressure readings every day is not likely to make errors consistently. You can ask your doctor to double-check the nurse’s reading.
High blood pressure is one of the most common ailments for the general population. The booklet on it describes what it does and how it’s treated. Readers can order a copy by writing: Dr. Donohue – No. 104W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Have you ever heard of this? Fifteen minutes after taking a shower, I start itching, and the itch lasts about 20 minutes. It doesn’t matter if I use hot or cold water. What is this? – O.J.
ANSWER: I’m not sure. It might be aquagenic pruritus. “Pruritus” is the medical word for itchiness. Pretreatment with an antihistamine before showering can sometimes prevent the itching. Take it about an hour before you shower. Tiny hives also break out on the skin. They may be so tiny you can’t see them, or they may be in places where you can’t see them. I don’t know if I’m correct. Aquagenic pruritus is so rare that I never expected to hear anyone complain of it. Get this confirmed by a dermatologist.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.© 2013 North America Synd., Inc. All Rights Reserved