> I tried feeding a lot of this into various Als (Kagi gives you access to a few with a nice interface) and I found that they mostly were stupid in ways that made me think
"stupid in ways that made me think" is (IMO) a really good summary of how AI is useful, as well as its pitfalls.
White coast hypertension isn't just about a clinical setting, it's more generally about the worry about the results of having your BP measured. [EDIT] OK, well maybe there's another type of hypertension which is related to anxiety about a high result regardless of the measurement setting.
I have to take daily BP measurements during titration for ADHD medication. (Using an _A&D UA-611 Plus_ machine at home.)
I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. They'll vary quite wildly (anything from, say, 115/75 to 135/90) despite not moving between measurements or having any reason to be more or less agitated. I generally just ignore the low/high outliers and average the others. There's no pattern either, sometimes the outliers are first, sometimes last.
Also it's not just the monitor I have at home, the same is true of a probably more trustworthy machine in a clinical setting. I mentioned this to my doctor when I last visited and we saw the same thing with multiple measurements using a more sophisticated machine at the clinic.
I check my BP a lot for reasons, too, and this matches my experience as well. A few tips to reduce the variance (but it'll never go away):
* the position of both of your arms, and the angle your elbows are bent at matters. make sure the edge of your desk isn't pushing into your forearm.
* same goes for both of your legs. make sure you're sitting with legs uncrossed, relaxed angles, make sure the edge of your chair isn't pushing into the back of your thighs excessively.
* control your posture. slouching seems to have an effect too, but I'm unclear on the mechanism.
Anecdotally, the nurses at the doctor's offices I go to rarely (~never) bother to control for any of this other than telling me not to cross my legs. So while I fully believe white coat hypertension is a thing, I also think there's a lot of poor control of variables here. If you look up the AMA/AHA guidelines for blood pressure, the ranges they offer are predicated on some very prescriptive protocols for measurement.. which I virtually never see adhered to.
I have an intense phobia of dentists; if I were wearing a constant monitor, I bet you could tell when I was at the dentist just by watching the blood pressure and heart rate spikes. (You'd have to find some way of differentiating them from me being in a car accident, or being attacked by a werewolf.)
If you've got one of these machines at home it seems you really want to run it a couple of times. Often I find the first reading I get is quite alarming but then if I sit for a bit longer and run it another 1-2 times I get a very normal reading.
A big reason people's first measurement is often high is the positioning while putting the cuff on, adjusting to the pose, and then settling in place, a process which can spike pressure. Ideally you prepare yourself (cuff on, in place with your arms at rest, etc) and sit there and relax for five minutes before you take the first measurement, making it legitimately reflective of the at-rest state.
This is often isn't possible, but it's a reason doctor visits usually drop you in a room by yourself with a machine that will take multiple measurements with a lengthy delay between. Though that's where the white coat thing comes into play and people are stressed about a doctor coming in, etc.
Taking a BP in person during a medical consultation, while stressed out because I know I have a very limited amount of time to do a verbal data dump of a large amount of information in a good way never fails to give me extreme values.
It also never helps to explain that this has happened many times before and that I have a reasonably high quality BP measurement device at home (most recently the exact same Braun model) that gives me decent measurements when I'm at rest/relaxed. They just look at me like I'm an idiot. How could a civilian concievably master such a complex measurement?
Then I get the predictably insanely high measurement and they look satisfied. Gotcha!
So I did something similar (well less cool, but as old Software devs start finding our bodies don’t work as well after a while we will see more and more of this sort of “taking control”
Would be fun to see the traffic dumps, I would love to try to figure out the protocol offline with them.
Just spent half a day reverse engineering a Windows virtual printer driver (for work) and had to force myself to stop spending the rest of the day doing it.
I have high blood pressure, managed with a low dose of medication. I've had plenty of advice from my PCP and other actual doctors on how to take blood pressure - how to sit, how long to sit still, how to position your arm, etc.
It is remarkable how many medically-adjacent professionals are bad at this. My dentist starts my sessions with a blood pressure reading - theoretically in case they have to numb me or something, probably because it's billable or whatever. What always seems to happen is that I get in for my appointment (driving, which can be stressful even if I'm not running late), they take me to the chair within 2 minutes max, immediately put some sort of wrist cuff on me, hold my arm at an angle that is not what most actual doctors have recommended to me and take a reading that is often high enough to surprise both the hygenist and myself.
The thing is that I have two sufficiently-calibrated Omron units, one at home and one at the office. I take my blood pressure often enough to know what it usually is (and my real doctor takes it at least twice a year). That is to say that no, it's not 200/160 or whatever nonsense the dentist thinks it is and you'd think that with a very small amount of reading they'd know better.
I had my blood pressure tested several times over the course of the month and each time it was high, weirdly high, like 160/100. If I drove in, weirdly high. If I cycled in, weirdly high. If I got another reading after sitting quietly in the waiting room reading my book for half an hour, weirdly high.
They wanted me to start on all sorts of medications immediately.
The second-last time, they got a reading of 220/130, and were going to get an ambulance to take me into hospital immediately.
Er, hang on a minute, folks.
That's beyond "hypertension crisis" and well into "incompatible with life" levels. That's the kind of pressure I see in hydraulic servo feedback channels, not living things.
They grudgingly agreed that someone with high blood pressure probably ought not to be making as much sense as I was, although what would I know about it, they're the professionals, etc etc.
The next time I noticed the automatic blood pressure cuff had a fresh new calibration sticker on it.
130/90. Not bad, for a reading taken at the doctor's surgery.
I wonder how many people are on medication they just plain don't need because of a plainly faulty sphyg though?
> I tried feeding a lot of this into various Als (Kagi gives you access to a few with a nice interface) and I found that they mostly were stupid in ways that made me think
"stupid in ways that made me think" is (IMO) a really good summary of how AI is useful, as well as its pitfalls.
Regarding white coat hypertension, the shot isn’t always necessary. Some people’s blood pressure just goes up from the stress of the clinical setting.
White coast hypertension isn't just about a clinical setting, it's more generally about the worry about the results of having your BP measured. [EDIT] OK, well maybe there's another type of hypertension which is related to anxiety about a high result regardless of the measurement setting.
I have to take daily BP measurements during titration for ADHD medication. (Using an _A&D UA-611 Plus_ machine at home.)
I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. They'll vary quite wildly (anything from, say, 115/75 to 135/90) despite not moving between measurements or having any reason to be more or less agitated. I generally just ignore the low/high outliers and average the others. There's no pattern either, sometimes the outliers are first, sometimes last.
Also it's not just the monitor I have at home, the same is true of a probably more trustworthy machine in a clinical setting. I mentioned this to my doctor when I last visited and we saw the same thing with multiple measurements using a more sophisticated machine at the clinic.
I check my BP a lot for reasons, too, and this matches my experience as well. A few tips to reduce the variance (but it'll never go away):
* the position of both of your arms, and the angle your elbows are bent at matters. make sure the edge of your desk isn't pushing into your forearm.
* same goes for both of your legs. make sure you're sitting with legs uncrossed, relaxed angles, make sure the edge of your chair isn't pushing into the back of your thighs excessively.
* control your posture. slouching seems to have an effect too, but I'm unclear on the mechanism.
Anecdotally, the nurses at the doctor's offices I go to rarely (~never) bother to control for any of this other than telling me not to cross my legs. So while I fully believe white coat hypertension is a thing, I also think there's a lot of poor control of variables here. If you look up the AMA/AHA guidelines for blood pressure, the ranges they offer are predicated on some very prescriptive protocols for measurement.. which I virtually never see adhered to.
I have an intense phobia of dentists; if I were wearing a constant monitor, I bet you could tell when I was at the dentist just by watching the blood pressure and heart rate spikes. (You'd have to find some way of differentiating them from me being in a car accident, or being attacked by a werewolf.)
It's interesting that you have a baseline for 'being attacked by a werewolf'.
If you've got one of these machines at home it seems you really want to run it a couple of times. Often I find the first reading I get is quite alarming but then if I sit for a bit longer and run it another 1-2 times I get a very normal reading.
Also, they can read high if the batteries are low.
A big reason people's first measurement is often high is the positioning while putting the cuff on, adjusting to the pose, and then settling in place, a process which can spike pressure. Ideally you prepare yourself (cuff on, in place with your arms at rest, etc) and sit there and relax for five minutes before you take the first measurement, making it legitimately reflective of the at-rest state.
This is often isn't possible, but it's a reason doctor visits usually drop you in a room by yourself with a machine that will take multiple measurements with a lengthy delay between. Though that's where the white coat thing comes into play and people are stressed about a doctor coming in, etc.
Taking a BP in person during a medical consultation, while stressed out because I know I have a very limited amount of time to do a verbal data dump of a large amount of information in a good way never fails to give me extreme values.
It also never helps to explain that this has happened many times before and that I have a reasonably high quality BP measurement device at home (most recently the exact same Braun model) that gives me decent measurements when I'm at rest/relaxed. They just look at me like I'm an idiot. How could a civilian concievably master such a complex measurement?
Then I get the predictably insanely high measurement and they look satisfied. Gotcha!
Please bring on the AI doctors.
So I did something similar (well less cool, but as old Software devs start finding our bodies don’t work as well after a while we will see more and more of this sort of “taking control”
https://mikado-aktiia.readthedocs.io/en/latest/
That's very cool. I wonder if sniffing the Bluetooth connection directly might be easier than reading the PDF (although not because it's easy).
At least you have more than 24 hours to find out!
you missed a closing parenthesis
Would be fun to see the traffic dumps, I would love to try to figure out the protocol offline with them.
Just spent half a day reverse engineering a Windows virtual printer driver (for work) and had to force myself to stop spending the rest of the day doing it.
Testing blood pressure after a shot seems weird.
I have high blood pressure, managed with a low dose of medication. I've had plenty of advice from my PCP and other actual doctors on how to take blood pressure - how to sit, how long to sit still, how to position your arm, etc.
It is remarkable how many medically-adjacent professionals are bad at this. My dentist starts my sessions with a blood pressure reading - theoretically in case they have to numb me or something, probably because it's billable or whatever. What always seems to happen is that I get in for my appointment (driving, which can be stressful even if I'm not running late), they take me to the chair within 2 minutes max, immediately put some sort of wrist cuff on me, hold my arm at an angle that is not what most actual doctors have recommended to me and take a reading that is often high enough to surprise both the hygenist and myself.
The thing is that I have two sufficiently-calibrated Omron units, one at home and one at the office. I take my blood pressure often enough to know what it usually is (and my real doctor takes it at least twice a year). That is to say that no, it's not 200/160 or whatever nonsense the dentist thinks it is and you'd think that with a very small amount of reading they'd know better.
I have three blood pressure cuffs
They all give me different numbers, by a lot sometimes
btw you think they ever clean those devices?
you think healthy people go to pharmacies?
I won't even touch the signature pen, imagine what's on that
I had my blood pressure tested several times over the course of the month and each time it was high, weirdly high, like 160/100. If I drove in, weirdly high. If I cycled in, weirdly high. If I got another reading after sitting quietly in the waiting room reading my book for half an hour, weirdly high.
They wanted me to start on all sorts of medications immediately.
The second-last time, they got a reading of 220/130, and were going to get an ambulance to take me into hospital immediately.
Er, hang on a minute, folks.
That's beyond "hypertension crisis" and well into "incompatible with life" levels. That's the kind of pressure I see in hydraulic servo feedback channels, not living things.
They grudgingly agreed that someone with high blood pressure probably ought not to be making as much sense as I was, although what would I know about it, they're the professionals, etc etc.
The next time I noticed the automatic blood pressure cuff had a fresh new calibration sticker on it.
130/90. Not bad, for a reading taken at the doctor's surgery.
I wonder how many people are on medication they just plain don't need because of a plainly faulty sphyg though?
If you think that's bad, just think about what's in those finger-holes in bowling balls, between rounds of beer, bowling, and greasy bar food :)