Fluctuating BP measurements

Patient

Q: 3 months ago I went to urgent care for a bad cold. I was told my blood pressure was a little high, probably from the cold medicine. I wasn't told the numbers. Last week I went for a DOT re-certification. My BP was 155 over something. They had me lay down for about 20 minutes and rechecked, 124/88. The doctor only told me that this was a beautiful number. Should I be concerned? What causes the fluctuation? I am 51, 6ft, 175lbs, good health, lots of activity, no medicines, no smoking, 1 or 2 beers a week.

Doctor

A:   Blood pressure fluctuates normally throughout the day with various activities. Hypertension (high blood pressure) is diagnosed by a consistent elevation of BP readings, usually on three separate occasions greater than one week apart. Blood pressure is ideally measured while at rest, and it is possible that the stress of doctors surgery or rushing to an appointment can transiently raise your blood pressure. It is reassuring to note that when you are resting your blood pressure returns to normal. I would advise getting it rechecked on another occasion or the use of a 24 hour ambulatory blood pressure monitor, to give a more accurate assessment of your average blood pressure readings.

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