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.

Order Your Brain 3 Pounds of Fat Equals Your Life and Destiny

I am so excited to announce the release of my book available in June 2013 it is titled:

YOUR BRAIN – Three Pounds of Fat Equals Your Life and Destiny

All of your thoughts, beliefs, opinions, theories or dogmas are in your mind, which is contained in YOUR BRAIN. In other words whatever you impress in your mind will become expressed in your physical life. Your brain has the ability to change your life and this book will teach you how to look after your brain and maximize its potential.

You can now Pre order your book and we will send you a copy in June when they are available. You can purchase by clicking the buy now button under the book. 

I recently graduated from medical school and during my medical training I became deeply fascinated with the brain. I loved everything about it and how it works. We know little about it and it is responsible for our life. Your mind is housed in your brain, and it is your mind that will determine who you are.

In this book, I give many interesting facts and insights to your brain. There are several ways in which we need to take care of it, including proper sleep and exercise, in order to reap all its benefits and for it to function optimally. This 3 pound piece of fat truly does contain your destiny and you need to learn about it and look after it. Just like maintaining a car, you have to understand how it works and look after the engine, the same is for your brain and mind. As you look after it properly you will get the best results for your life and reap all of its benefits.

I wrote this book with the intention to help you find your destiny in God. There is a reason as to why you are here. God sees your life from the end. From the moment of conception to the end, he knows your life. God never starts anything that is not already complete, including YOU. My desire and hope is to make God’s vision for your life clearer to you. There are many tools in this book to help you see this vision and complete your destiny.

I am sure when you are done reading this book your life will not be the same. A wise doctor once told me, “There are two things that will change your life, the people you meet and the books you read.” This is a book that will change your life and will draw you closer to the Creator of the Universe. The electronic version for kindles and iPads will be available in mid June.

Love My Life and My BRAIN!

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!



How to Have Better Communication With Your Doctor

Have you ever left a doctors appointment feelings your questions were not answered or you were unsure about what to do next?……don’t worry you are not alone.

Today I want to talk about how to speak up for your self when you are at the doctor’s office or the hospital and how to improve communication with your health care team.

When your talking to doctors or nurses tell them how you feel. Don’t be shy to ask questions or correct a doctor or nurse if they misunderstood what you said. The more information you can share with your doctor the better able they will be to help you.

Here are 5 tips for effective communication with your doctor:

  1. Write a list and take a pen. Arrive with your top 2 or 3 questions and take notes.  This will help you track of the conversation and remember what was said.
  2. Bring information, outside test results, and a current list of medications. Do not assume that your doctor has all the medical information at hand.
  3. Bring another set of ears. If you think you may have trouble remembering important information it will be good to have a relative or a trusted friend in the appointment. They can listen, ask questions and take notes for you.
  4. If you do not understand something ask again. Don’t be afraid to ask the doctor to repeat something or explain it in a different way.
  5. Ask for an interpreter if you need one. If English is not your primary language don’t be afraid to ask to have an interpreter present if needed. Call ahead to be sure the interpreter will be available at the time of your visit.

Good communication is a two-way stream. It is your body and it is your life.  It is up to you to speak up for yourself and make sure you get the treatment and information you need to stay healthy. Cheers to living a healthy life.