How To Take an Accurate Blood Pressure Reading

Did you know that approximately 4.6 million Canadians aged 20 years and older (19% of the population) have high blood pressure? That is why it is so important that we get our blood pressure checked and do our best to make it accurate.

The first part of accuracy is to choose the appropriate blood pressure cuff size. Cuffs that are too short or too narrow may give a falsely high reading. Using a regular sized cuff on a large arm may lead to a false diagnoses of hypertension. This means that heavy or very muscular people with thick arms need a larger bladder, while children need a smaller bladder.

* Ask your doctor to make sure they are using the appropriate cuff for your arm.

– The width of the inflatable bladder should be about 40% of the upper arm circumference (about 12-24 cm in the average adult).
– The length of the inflatable bladder should be about 80% of upper arm circumference (almost long enough to encircle the arm).

Here are some things that you should do before taking your blood pressure:

-You should not smoke, drink caffeinated beverages, or exercise 30 minutes before your blood pressure is measured.

-The room should be quite and comfortably warm

-Your arm when taking the blood pressure should be at mid chest level, or your elbow at the level of your heart

-Remove excess clothing that might interfere with the BP cuff or constrict blood flow in the arm.

-Your legs should not be dangling or crossed over. It’s better if you rest for 5 minutes in that position before the measurement.

-Try not to talk during the measurement.

– When the doctor is deflating the cuff. It is recommended that the pressure should fall at 2 – 3 mmHg per second, anything faster may likely result in an inaccurate measurement. This means when the doctor is letting the pressure come out of the cuff that it should take at least 10 seconds.

-If you need to check the pressure again for accuracy wait about five minutes between readings. Typically, blood pressure is higher in the mornings and lower in the evenings.

-If the blood pressure reading is a concern, masked or white coat hypertension is suspected, a 24- hour blood pressure study may be required to assess your overall blood pressure profile.

Below is a table for blood pressure measurements (Canadian Guidelines):

Category (Systolic / Diastolic)
Normal            (120-129 / 80-84)
High – Normal (130-139 / 85-89)
High blood pressure (measured in a doctor’s office) (140 / 90)
High blood pressure (measured at home with home monitoring device) (135 / 85)
High blood pressure for people with diabetes (140 / 90)

* One high reading does not necessarily mean you have high blood pressure. If you have one high reading, you should have it measured at least two more times on separate days to check whether it is consistently high.

To summarize the table above:

Normal blood pressure is between 120/80 mm Hg and 129/84 mm Hg.

Blood pressure that is consistently more than 140/90 mm Hg when measured in the doctor’s office or 135/85 mmHg when measured at home is considered high. If you have diabetes, 140/90 mm Hg is high.

* If your blood pressure is between 130/85 mm Hg and 139/89 mm Hg, you have “high-normal” blood pressure, which is more likely to develop into high blood pressure.

Because hypertension is a “silent disease” many people are not worried about it. However hypertension can cause much harm to the body if untreated, some of the harms it can cause include the following: stroke, vascular dementia, hypertensive retinopathy, left ventricular dysfunction, angina, heart attack, heart failure, chronic kidney disease and intermittent claudication.

The good news is that you can try lifestyle changes to make it better. One of the best treatments is to loose weight, you can also try a DASH diet (dietary strategies against hypertension – talk to your doctor about this). It is also important to have low sodium intake, increase your physical activity (discuss with your doctor), use alcohol in moderation, stress management and please (pretty please) stop smoking.

If the lifestyle management is not working to control your blood pressure (follow up should be in about 3 – 6 months) you may have to talk with you doctor about trying some medications to get your blood pressure under control.

“Take care of your body. It’s the only place you have to live”.

Love my life and your life,
Peter Eppinga M.D.

Stay Away From the “White Stuff”…..SUGAR

We consume a lot of refined sugar in the form of high fructose corn syrup and table SUGAR. According to the new Statscan report, which used data from the 2004 Canadian Community Health Survey, one in every five calories that Canadians consume comes from SUGAR. Canadians consume an average of about 110 grams of sugar per day (the equivalent of about 26 teaspoons). About a third of that intake is derived from normal sugars that come from vegetables and fruit.

Calculating that out, the report showed us that 35% of the sugar we consume is coming from the “White Stuff” we should stay away from…namely that includes sweets and soft drinks. This means the average Canadian consumes about 38.5 grams (10 teaspoons) from the bad “White Stuff” per day!

We have come from consuming a little bit of SUGAR in our diets to now having a large portion of our daily diet complimented with SUGAR.

SUGAR is one of the causes of the Obesity Pandemic in North America. About 31% of Canadians (and about 30% of Americans) are obese and the number is growing and has been growing for the past 20 years in addition to this we are now dealing with the childhood obesity problem.

Our holidays are associated with SUGAR. Halloween (sweets), Easter (chocolates), and Christmas (candy canes) have the culture of SUGAR built around them. Even at birthday parties the birthday cake is covered in SUGAR and the drinks are full of it as well.

Science tells us if our body has too much SUGAR it will react negatively to it (especially high fructose corn syrup). It can lead to obesity, which we know that obesity leads to certain cancers, cardiovascular disease and type 2 diabetes. The good news is you can eliminate it from your diet.

How to avoid the SUGAR problem:

1. Try not to buy it – the more sugary treats that are close to you….you will eat it. Don’t buy SUGARY soft drinks (pop), the sugar or pop will always win if it is in your house.

2. Take small steps to slowly wean it from your life. Find creative ways to eliminate refined SUGAR from your diet.

3. Have good support from your friends. Share your goals with them and the people in your home. Tell them, “If you see me eating SUGAR….remind me I want to stop it”.

4. Reward yourself with all of your efforts. Enjoy your life and fun!

5. Eat more fruits, vegetables, decrease SUGAR intake and exercise and you will loose weight. Talk with your Doctor or medical health professional about your goals and ask them for their help.

I have many things I tell myself in the morning and one quote that has changed my life is,

“I eat food to fuel my body and NOT to satisfy my appetite, I only have one body and I need to look after it”.

Cheers to eliminating refined SUGAR from your diet. “Love My Life” and my one and only body 🙂

What is the greatest medicine? What makes the biggest difference to your health?

~ People with knee arthritis were on this medicine for one hour, three times/week and this reduced their rates of pain and disability by 47%.

~ This treatment decreased progression to Dementia and Alzheimer’s by 50% in older patients.

~ Patients with high risk of Diabetes had a 58% decrease in the chances of getting frank diabetes on this medicine.

~ Post-menopausal women were treated 4 hours/week and had a 41% reduction in the risk of hip fractures.

~ This treatment decreased anxiety by 48% in a big meta analysis.

~ Patients suffering from depression were on this treatment and 30% were relieved with a low dose of the treatment and this increased to 47% as the treatment was increased.

~ Following 100,000 Harvard Alumni for over 12 years this treatment gave a 23% lower risk of death than those who did not get the treatment.

~ This medicine is the number one treatment of fatigue and most importantly this therapy increases ones quality of life.


THE TREATMENT WAS SIMPLE EXERCISE. Yup you heard me right….Exercise….and with exercise there is no side effects but health benefits.

Dr. Steven Blair conducted a study called the Aerobic Centre longitudinal Study. Where he followed 50,000 men and women. A part of the study was looking for the strongest predictor of death…what do you think he found….did you think smoking was the strongest predictor of death? What about high blood pressure? Both of these were not the answer he found the strongest predictor of death is Low Fitness.


The studies above looked mainly at walking as the form of exercise. By spending ½ hour or 1 hour being active every day will be a positive benefit to your health.

Another study to note is the nurse’s health study which followed women who were not active and then followed them as they increased their activity to one hour/week and found that they reduced heart disease rates by almost a half!

Your style and approach to exercise is what matters:

~ Remember to talk to your doctor before you start any exercise program.

~ You can meet with friends to play sport or go for a walk

~ Your commute to work can be a walk to work…you save money on parking and your body receives the health benefits from it.

~ Walking the dog is great…one study found dog walkers meet the exercise requirements more often.

~ You can play in a Basketball tournament! By the way the Haida’s won the All Native Tournament this year. Way to Masset Masters and Skidegate Saints! 2013 Champs!

There is no “pill” better than exercise. Hippocrates said, “Walking is man’s best medicine” and I couldn’t agree anymore.

(It is also good for your Brain…..but that will be a later post) 🙂

Peter Eppinga M.D. “Love my Life” especially when exercising!



Aboriginal Teen Suicide Prevention

Love my Life t-shirt is to remember all those who have taken their life by suicide. The Haida design is of an eagle and a raven inside of a heart. Allan Weir is the Haida artist who did the magnificent design. Allan and I unfortunately have had our own cousins take their life in Haida Gwaii and this shirt is to remember them.

The purpose of this shirt is to reach out to the youth specifically the Aboriginal youth to prevent suicide. The websites provided on the shirt allow youth to read about mental health issues themselves. allows youth to fill out a questionnaire that will tell them more about how they feel and if it is necessary to contact a mental health professional in their local community or call the number provided on the website. Please check out for more information on filling out the questionnaire.

Remember suicide is 100% preventable and depression is a common complaint that I have seen in the emergency room and family practice setting. There is hope out there and different treatments available. A great elder once told me, Honour your life and Esteem others better then yourself. I wanted to leave the same message with you to Honour your Life and get help if you need it.

You have a purpose for your life and you are not an accident. You are an original. When the Creator made you He threw away the mold so that there would only be one of you in this world. The Creator has great things planned for your life! Never let anyone’s opinion of you determine what you will do with your life. Be proud of who you are. If you’re Aboriginal be even more proud of who you are and know that you are intelligent and capable of doing anything with your life!

“Look up hold your head high……be proud of who you are!” I put this on the bottom of the shirt and made the letters upside down so the person who is wearing the shirt will be able to read it as reminder to be proud of who they are. They will have what is called a positive affirmation about themselves. I have seen many youth looking down and not making eye contact with me when I shake their hand. I just wanted to remind them and you to look up and be proud of where you come from. You are going to do great things for your community.

Stay blessed! Love my Life!

Peter Eppinga M.D.

Young Adult and Teen Mental Health

Something’s not quite right…..

You’ve noticed that you’ve been feeling or acting differently. Maybe you’re feeling a bit more moody, anxious or stressed than usual. Maybe your finding it difficult to accomplish tasks as easily as you used to or your drinking is getting out of hand. Maybe things just don’t feel quite right, and you don’t know why.

It could just be a tough time you’re going through….maybe it’s something more. Checking it out at right away can help make all the difference. offers quizzes to help you better understand what’s going on with you and provides support such as education, self-help tools, website links, a chat link, and assistance in connecting to local professional resources. Fraser Health and BC Mental Health and Addiction Services’ website and is focused on early intervention and prevention for teens and young adults.

Acting early will help you feel better faster, and stop the problem from getting worse.

If you do find out that your dealing with depression, anxiety,  or substance misuse, you’re not alone. One in five B.C. youth and young adults experience these types of issues and if you act early, you can stop them from interfering with your life at home, school, work, and with your friends. Help is there.

I just visited   and thought it was a fantastic resource. I highly recommend checking this site out! This goes out to all my Haida Peeps!