Good morning! Hope this letter finds you well. What a great time of year this is. March is less than 42 hours away!

This happens almost every time a patient comes in for a stress test. Our patient says, “I’m not sure if I can do this – it’s been a while”. After 10-15 minutes of walking, they’ve given a great effort, and they’re sweaty, not stinky, sweaty…and they’re smiling.   

“Wow, that was fun. I feel great! I should do that more often.” They say that 95% of the time. 

What’s happening is their body is full of serotonin, endorphins, and adrenaline. Happy stuff. Happy stuff, saying, “Nice work, Carol. You just reduced the odds of getting 40+ diseases. So I’m going to reward you by making you feel like a million bucks – for the next 3-12 hours.” Doesn’t it make you feel like we were genetically designed to feel this good after exercise?

We get so many great questions about blood pressure. I thought we could address a few of them in front of the group. Let me please say that these are my opinions only. They do not necessarily represent the viewpoints of the thousands of other physicians we are proud to team with for Walk with a Doc.  

Q: Is blood pressure really important?

A: Yes.Very.

Q: What does caffeine do to my blood pressure?

A: Caffeine does acutely raise BP by approximately 8 mm Hg systolic and 6 mm Hg diastolic within 1 hour, lasting ≥3 hours. However, good news, tolerance develops within 1-2 weeks in regular coffee drinkers, and long-term coffee consumption (up to 6 cups/day) is not associated with increased hypertension risk or cardiovascular events. Stated another way, that acute rise of 8 mm Hg is more likely to be seen in coffee-naive individuals.

Q: What blood pressure is too high?

A: The 2025 ACC/AHA guidelines recommend an office BP goal of <130/80 mm Hg for adults with hypertension, with encouragement to achieve <120 mm Hg systolic when feasible. For patients with diabetes, CAD, cerebrovascular disease, or PAD, the current recommendation is <130/80 mm Hg, with consideration of <120 mm Hg systolic for those at high cardiovascular or kidney risk.

Q: Should I have a cuff at home?

A: If you have high blood pressure, I recommend it. This is the site that we recommend to our patients to find a validated BP cuff. There are plenty of options here.

Q: What blood pressure numbers are too low?

A: There’s no real too low if you are not having symptoms. If you do experience dizziness, lightheadedness, or fatigue, you should seek evaluation. There have been a lot of patients seeing profound weight loss recently. With this drop in weight, I would recommend staying in tune with any symptoms, as weight and BP often travel together. You very well may need to come off a BP med or two.

Q: Does walking help my blood pressure:

A: Oh, my goodness, yes!

Q: How often should I check my blood pressure?

A: We have patients who check it once a year in the doctor’s office (not enough)

We have patients who check it everyday, 4 times a day, and I personally think that is a little much.

*I recommend my patients check it twice in the am (1 hour after medications) 5 mins apart and again in the evening 5 minutes apart, for one week. We take those 28 readings and have a great idea of what their average is. Once we know the average, we recommend maybe 1-3 times a week – max. 

Q: My blood pressure is “all over the place”. Is something wrong with me?

A: Probably not. You need to check with your own physician, but blood pressure can range by 15 mm Hg regularly. 

Q: White coat hypertension?

A: White coat hypertension is high blood pressure only while in the doctor’s office. We used to blow this off, but not anymore. Studies have proven that patients with White Coat Hypertension are more likely to develop hypertension down the road. If you have White Coat Hypertension, you should check your blood pressure on a more regular basis than the next person.

We hope this may answer a question or two you may have regarding hypertension. If you have other questions, please join your local Walk with a Doc program this weekend and ask me or any of the other Walk with a Doc physicians/nurses.

Have a fantastic weekend, and thank you for letting us be a part of your day.

“When I’m no longer rapping, I want to open up an ice cream parlor and call myself Scoop Dogg.” -Snoop Dogg