How can I lower my blood pressure on the day of my medical exam??

By David Thorpe

How can I lower my blood pressure on the day of my medical exam?

Blood pressure has long been a source of stress for the truck driver.  It is frequently referred to as the silent killer by many of us who work in health care.  If you suffer high blood pressure it is important that it is controlled and managed.  This can be done through natural means such as with exercises, diet and weight loss.  It may also be accomplished through medical management such as with the prescription of blood pressure medications.  Whatever way you choose, the blood pressure on the day of your exam must still be below 140/90 in order to certify without delay.  Let’s first take a look at some basic information about blood pressure before getting into managing it on the day of your exam.

What are the signs and symptoms?

As mentioned, those who have high blood pressure often do not feel signs and symptoms.  If you ignore your blood pressure because you feel that you will have signs and symptoms that will alert you to the fact that it requires treatment, you are taking a dangerous chance with your life.

A number of symptoms have been indirectly related to very high blood pressure.  These include headaches and nose bleeds, dizziness for example.  Although these may relate to severe and chronic blood pressure issues, these symptoms can be caused by other medical problems.  If you suffer some or any of these symptoms you should be evaluated by your family doctor.

What happens if I do not treat high blood pressure?

Things will most likely go from bad to worse.  Even Stage 1 hypertension (140 – 159/90 – 99), if suffered for prolonged periods of time can have an adverse effect on your health.  Uncontrolled high blood pressure can lead to stroke by damaging and weakening your brain’s blood vessels, causing them to narrow, rupture or leak.  It can also cause blood blots to form in the arteries leading to your brain, blocking blood flow leading to a stroke.

In addition to stroke, uncontrolled high blood pressure puts more pressure on your heart and kidneys, leading to problems in these areas.  Sexual dysfunction in men has often been linked to uncontrolled high blood pressure.

How about white coat syndrome?

The term “white coat syndrome” or “white coat hypertension” have been used for years to indicate if you have high blood pressure readings only when you are In a medical setting.  This is something that may be more prevalent with truck drivers and others who must qualify to work, and there exists stress relating to having to meet the minimum requirements to drive and work.

From a medical standpoint, it typically means that there is evidence that your blood pressure has tested normal at home, or maybe at the pharmacy, but is typically higher when tested at the doctor’s office or during your DOT medical exam.

Your blood pressure is not fixed – it rises and falls throughout the day in response to what you are doing and what is happening around you.  White coat syndrome is a response to being nervous about having your blood pressure tested, although a person does not always notice they are nervous.  A driver may actually have their blood pressure rise as high as much as 30 points (systolic or the first number in your blood pressure) if very anxious.  It is therefore important for a driver who is anxious about their medical exam to know what to do to help manage this before going in to their exam.

What can I do the day of the exam to ensure that my blood pressure is at its lowest point?

If you suffer from high blood pressure the first thing you should always do is have it medically managed.  See your doctor and follow their advice.  Also, don’t forget to take your medications if you are medically managed.  Taking your meds is important to having a good blood pressure during your DOT physical.  So, don’t forget to take your meds as directed by your treating provider.

The day of the exam, and maybe a few days before there are some other things that you may do to help ensure that your BP will be as low as is possible.

1. Get a good night’s sleep. If you are tired, you are more likely to have higher blood pressure when examined.
2. Let the examiner know you suffer white coat syndrome if this is true.
3. Avoid foods that will elevate blood pressure the day of and day before is possible. These include of course foods that contain salt as well as other things that can elevate your BP.  And of course, do not add additional salt to your foods.  Foods to avoid include, spicy foods (including Chinese foods), deli meats, pickles, canned soups, and alcohol all of which can cause a quick spike in your BP.  Having a big meal right before being tested is also not a good idea.  Caffeinated products (coffee and soda) are discussed later, but should also be avoided.
4. Have a banana an hour or two before being tested. Bananas contain potassium, an electrolyte that plays an important role in some of the mechanisms that control blood flow and heartbeat.
5. Avoid caffeine/nicotine at least 1 hour before being tested. It is best to not have coffee or other products containing caffeine a day before, and not to smoke at least an hour before being tested.
6. Beet juice has been shown to temporarily lower your blood pressure. A study done at St. Bartholomew’s hospital in London showed a decrease in blood pressure in less than an hour after drinking 20 oz. of beet juice.  It was significantly lower in 2 and a half hours after.
7. Drink a glass of water right before your exam. Water has a calming effect on the nervous system, and flushes out sodium (the mineral in salt that increases your blood pressure).
8. Empty your bladder. Having a full bladder will actually elevate your blood pressure.  So if you have to go, do it before your blood pressure is tested.
9. If possible, take a walk for 15 minutes before your exam. This will create rhythmic breathing and oxygenation in blood, reduces anxiety and can lower your blood pressure.
10. Deeper breathing 15 minutes before being testing can have a significant but temporary effect by reducing anxiety and increasing oxygen, and lower your blood pressure. Also during your exam, close your eyes, take three deep breaths.  Inhale slowly and deeply through your nose, and exhale out through your mouth 3 times directly before or while being tested.  You may actually lower your BP 10 to 20 points by doing this.

If your blood pressure still tests high, ask the medical examiner if you may lie down in the exam room for 15 minutes and turn the lights out.  Then retest.  If it continues to be high you may actually have high blood pressure, or what you are doing to manage your blood pressure may not be working.   You should consult with your treating provider or see your family doctor to treat or better manage your high blood pressure.