Can you fake a low blood pressure reading?

Factual Questions
1

I don’t think this question is actually as weird as it first seems.

I’m dealing with getting my blood pressure in check and noticed that I can raise my reading by flexing, clenching, crossing my legs, etc etc etc. I use a typical compressing cuff on my upper left arm.

Sometimes, I’ve noticed my reading while sitting upright on the couch is higher than what it should be.

I’ve discovered that if I wait a bit and re-run it, but lay my arm on the couch armrest, meaning my arm is more aligned with my heart and NOT BELOW IT, my reading will come down.

Last doc visit I explained that I’ve been reporting the lower reading I get out of multiple readings.

I explained that I find repositioning myself can cause the reading to go lower, and that “I don’t know how to fake a low reading. Know what I mean? I can think about stressful stuff or angry stuff and get it to spike upwards, but I can’t fake it down low.”

I’ve read with some devices you are required to hold your arm above your heart.

So my posture is usually like this: I lay my cuff arm up on the arm rest and lean my head back so that I’m in a relaxed position, and lay my other arm out to my side with my palm up. This results in the best, low readings.

The instructions are antiquated because it’s an older cuff, however, we calibrated it in the doc office and cleared it as accurate. The old instructions are to lay your arm out in front of you on a table with your palms up.

Are my low readings accurate or am I fooling myself?

2

I take my BP. I was told that I should sit up and rest my arm on something to keep it at the height of my heart. Your blood pressure will read higher if you let your forearm dangle.

3

As a firefirghter there are times where a rehab area is set up. Here we get a ‘time out’ after strenuous activity and a Doc or EMT will check our vitals before clearing us to return to the fire scene. BP being one of those vitals.

I have noticed certain patterns. What I have noticed that if you get a little tired after activity, and sort of zone out/nap (go with the tiredness), BP is lower. Also if I eat a larger amount of food, again producing a sense of tiredness and try to go with it instead of returning to activity after words BP is lower. I also confirmed that pattern at home. It’s not an instant cheat, but if you have time to plan yes you can cheat.

4

Height of the spot where you’re taking the reading is indeed crucial. If you were to hold your arm straight up, so it’s as much above your heart as possible, that would significantly lower the reading.

It would probably also help to put as much as you can of the rest of your body as far below the heart as possible (so, for instance, standing up instead of sitting down, so your legs go down all the way), but the heart is probably an efficient enough pump that that effect would be small.

That’s the physics answer, based on pressures of fluids. But there will also be physiological answers based on causing the heart to pump less hard, which will probably mostly fall under the general umbrella of relaxation techniques. Then again, those physiological relaxation techniques might not even be “faking” it: Relaxing, reducing stress, etc., is exactly what your doctors would say you should be doing.

5

As to physiology, your blood pressure changes from moment to moment over some small range. And as you’ve seen posture, mental state, feeding state, caffeine, booze, hangovers, recent illness, time of day, asleep / drowsy / awake, and all the rest have an effect in the moment as well.

Let’s back up to what we / you are trying to accomplish. Medically, your long term average BP (like measured every 10 seconds 24/7 over a period of weeks) is diagnostic for circulatory problems, heart problems, etc.

All you’re doing with your daily reading using a cuff is taking a tiny sample of all those continuous values.

You “faking it” by holding your arm funny is no more useful than is taking a reading of e.g. 130/75 but writing it down as 120/80.

Another key factor for diagnostic purposes is the long term trend in your numbers. e.g. How do the most recent month’s numbers compare to 6 months, 1 year, or 2 years ago?

For that purpose, what matters for data gathering is that:

  1. The numbers be gathered in a consistent manner every time so any changes are signal, not noise.

  2. Your posture and the calibration of your machine not be crazy out of normal so the readings have some comparability to what the rest of humanity experiences as low, normal, or high readings.

If your goal is to fool your doc, fiddling with these items is a way to do it. If the goal is to get quality advice and quality treatment, then your goal should be to not fool with these numbers.

Lastly, if you’re just asking as a matter of physiological curiosity how you might influence these numbers try this. After some practice with relaxation / meditation techniques you can probably learn to drop your numbers by maybe 10/5 on command for a few minutes. Whether that brief change has any health benefits is up to you.

6

One of these is deep breathing, which is what I try to do at the doctor’s office during my physical, along with making sure that whatever physical or emotional stress I may have gone through to get there has had time to disperse. I try to do deep breathing, but sometimes the doctor persists in engaging me in conversation.

7

Correct way to measure BP (from CDC):

  • Don’t eat or drink anything 30 minutes before you take your blood pressure.
  • Empty your bladder before your reading.
  • Sit in a comfortable chair with your back supported for at least 5 minutes before your reading.
  • Put both feet flat on the ground and keep your legs uncrossed.
  • Rest your arm with the cuff on a table at chest height.
  • Make sure the blood pressure cuff is snug but not too tight. The cuff should be against your bare skin, not over clothing.
  • Do not talk while your blood pressure is being measured.

This is the way I measure BP at home and I consistently have normal to low pressures.

Cardiologist’s way to measure BP:
Hustle from waiting room to exam room.
Up on exam table - feet swinging, no arm or back support, no rest time.
Cuff over sleeve of shirt.
Nurse’s attempt to chat/gather info during reading.
Cardiologist: “Hmm…BP is a bit high. Gonna need to increase your dosage of your Lisinopril/Metoprolol/Losartan.”

Pisses me off every time.

I now keep a log of my home measurements to show to any cardiologist that suggests a dosage increase and I usually make disparaging comments about his office procedures.

8

I actually get nervous when my blood pressure is low.

I do have high blood pressure and am on medication for it.

After my 2 small strokes back in 2019 they felt that it was because my blood pressure was too low. So they cut down on the medication. They said that they want me in the 130 range.

Well, good luck with that. Even with the lower amount of blood pressure meds, I’m usually around 110 or 115.

But this past week I had readings of 89/54 and 95/49. I wasn’t lightheaded or anything, but it did make me nervous.

9

Great info, guys, thanks.

To clarify a few points, I thought I’d explain things a bit more.

I had/have VERY HIGH blood pressure and have for pretty much my whole adult life. Recently, I’ve started to notice that I’ve been getting sick or feeling ill and finally put two and two together that when I have really high BP, I feel weak and sick and have sensations in my chest.

My father has heart issues and is in fact in late stage heart failure. We discovered this in the first 4 months of this year through a series of emergencies. In March, I decided I needed to at least get myself a GP and start working towards fixing things. I’m also getting married in October, and with all my Dad’s issues, and my untreatable genetics, my bonny bride to be insisted I get my BP under control.

My first visit was in march, and my BP was 179/111 which was fairly normal for me (very high). Sometimes it would be in the 190/120 range on days I felt particularly yuck.

She put me on Telmisartan and I’m on a pretty serious weight loss campaign for the wedding. I’ve also taken other measures as suggested by my doctor, such as dietary and recreational changes. I’m also getting a lot more exercise. To that end since April 8th I’m down from 246 to 229 today.

She was having me report my blood pressure daily via an online flowchart. A few days after starting the medication, my BP fell to the 135/95ish range.

After a month, she upped my dose from 20mg to 40 and said that was pretty standard.

At this point she backed my daily BP log to 3 times a week. I told them when I was in last that I could reposition for a lower reading and felt like THAT was more accurate than any initial HIGHER readings, and both the PA and Doctor agreed it was ok to log the lower of all readings. They both agreed if I am able to relax and bring it down, that’s a good thing (sort of the over-riding goal).

So to be clear, if I do it the way others have described here like I’m in the doctors office, in a chair feet dangling arm down or in my lap, I get something in the 125/90ish range, OR if I put my arms up on the armrests it’ll go down about 5-10 per each. My lowest reading was 107/74 but typically I’m right at 120/80 if not below. Last few days I have not been feeling very great but I believe I understand the circumstances at cause, and my readings have been a little higher (183/93 today).

I also got that fancy new Samsung Watch that does BP readings, and it seems to be within a few points of my cuff, not that I ever use it to report, just to monitor for my own novelty.

10

I take my own blood pressure quite often. I know that I can lower mine substantially if I just take a few moments to “get my mind right.”

11

Basically, much like an analog clock face, or a mercury thermometer, getting useful results depends on everyone using the same zero point. If a patient is laying on their side, the B/P will read either low or high depending on which arm the cuff is on and thus the effect that gravity has on flow of the blood. In the ICU, pts sometimes have a line into an artery or vein that gives a continuous pressure reading, once a shift you have to calibrate these, which includes confirming that the sensor is level with the heart.

12

I went through a BP crisis a while back and was checking it hourly. It became obvious that my BP went down 20 points whenever I watched “The Great British Baking Show.”

American TV in general would always raise it. It turns out this is on purpose. American production companies play new shows for test audiences. Among the many factors measured is BP, and if the show doesn’t raise it, it’s considered a loser,

13

Husband recently got to go through a 24 hour BP monitoring, which was fun. Also because the day and night setting got switched, so it was reading more often during the night.

We noticed that if he sits on the sofa, with his legs on the sofa, and his arm on the sofa arm, the numbers are a bit lower.

The doctor also mentioned that if we would take a second reading within 5-10 minutes of the first reading, the second reading would be lower than the first.

After the 24 hour monitoring, she decide that most of the time his numbers are good enough to forego medical intervention. We are still doing daily fast walks of 30 minutes or more, and he lost 3 kgs (6.5 lbs) since his first appointment, which was approximately 3 months earlier. His BMI is in the normal range.

Main point is as others have said. Always do the readings in the same position. Time of day may be important as well, especially if work is causing you stress.

14

I am of Indian origin, and heard about Yogis who could get their metabolism / blood pressure to slow down to the levels of hibernation.

I know of one scientific publication that validated a Yogi’s self “hibernation “ - https://doi.org/10.1016/0306-4565(87)90060-X

But I am not a medical or Yoga expert.

15

Glad to hear you’re doing everything you can to get this problem under control before it kills you early. It isn’t easy, but as your stamina improves you’ll feel like you’re getting younger by the month. It’s a great feeling.

16

I’ll respond although it’s mostly been answered. I think a key thing to remember is that the numbers we use to define high blood pressure come from studies that utilized a very standardized way of measuring it. The CDC guidelines essentially reflect that way. As another poster noted, doctor’s offices in general are pretty bad at following this protocol because we’re already trying to cram an hours worth of information into 15-20 minutes as it is. Studies have also shown that home BP logs are better than 24 hour ambulatory BP logs are much better than clinic BP measurements, so I almost always go with my patient’s reports. So, in general, no, there is no way to “fake” a low blood pressure unless you just flat out lie. The general trend and average blood pressures, including expected changes like the expected nocturnal dip, are what we are really looking at.

17

Thank you. I just had my first full gym work out in about 6 years or longer. Watching my father deteriorate has really motivated me to start on track to get my health better.

I go back for my next blood work-out and cholesterol check on June 8th. I’m excited that I’m already down enough in weight that I could check in 20lbs less than my last visit. But I fully intend to go back over my arm positions. The reason I posted this was because I felt like the way I am taking it (arm elevated on the armrest) is closer to the “right” way to take it, but will give a different reading than I am going to get in the office visit, and hope I’m not shooing myself in the foot. But I will go over all this w my doc again then.

Do you (or anyone else who reads this) have any opinions RE: Smartwatches that measure BP? I have a Galaxy Watch 3. Technically they have the BP monitor locked, but there’s a secondary app that unlocks it in an unofficial capacity. So far it’s usually within a few points of my cuff, but it measures via some method I’m unfamiliar with—measures a wavelength of some sort–not from a compressed pressure reading.

18

Keeping the cuff at your heart level is important, as being off from there will falsely raise or lower the BP. I should probably walk back what I said about faking low blood pressure because that will give you incorrect readings. A good physician will put more stock in your home BP log than the clinic one but there is white coat hypertension and masked hypertension which further complicates things. Sounds like you’re on track to some significant health improvements though!
Edited to add: I don’t know how accurate or even how those types of machines monitor BP. If you find they correlate pretty well with your true upper arm cuff measurements I suppose it doesn’t hurt, but I wouldn’t make any diagnoses off of it. Just as I wouldn’t say somebody has atrial fibrillation just because their Apple Watch or FitBit or something says they do, but I would investigate further.

19

I find I can take two readings consecutively and get different results - like 149/77 the first time, 142/72 the second time. Not spectacularly different, but the numbers are obviously not exact. They’ve been fiddling with medications to fix my BP, I used to read in the 170’s. I started on medication when I had a private pilot medical back in my 40’s and the doctor said over 90 for the low number was not acceptable.

My home readings lately are in the 130’s-140’s range, but at the doctor’s office last, it was about 158. My next appointment I will be taking my home unit in to do a direct comparison/calibration.

I knew someone back in the 1980’s who said meditation and biofeedback, with practice, could control your BP readings. I’m going to guess you can’t turn a 150 into a 110, but possibly make a 10 point difference or so with relaxation techniques. (Apparently eating pretzels while watching TV might help too.)

20

If one was to relax, stand up for a long time before the reading, etc. I am sure one could lower their pressure by 10 points or so, but I doubt most people could lower it by more than 20 mmHg.