Feb 2008 Update Since the last post in sept 2007, my blood pressure profile has deteriorated - my impression has been that I have been too active, thus causing inflammation. In December 2007 I went on a Transatlantic voyage and, instead of an improvement, it actually got worse - to the point that I checked in with the ship's doctor - he pronounced me OK but came up with a new wrinkle. This was that travel is disruptive, new food, new surroundings, more emotional stress - and I am a very experienced traveller! Was there a mechanical explanation for this variability, I wondered, plaques breasking down, aggravation of existing inflammatory patches, etc? He said it was his common experience to listen to tales like mine and his prime culprits were:-

• Eating too much
• Hidden salt loads in meals cooked by others

The upshot was that I ended up in January in California undertaking another course of EECP. This has gradually settled things down but it happened that I went for 2 sessions a day with a break in between that used to spend in places like coffee bars, etc., drinking decaffeinated coffee and tea. The blood pressure did not properly settle down until the end of the 35 sessions and until I had an insight that the decaffeinated regime might be part of the problem. I have so far avoided both salt and decaffeinated products for a total of just over 2 weeks. The result is quite significant, the systolic BP is down by about 12-15 mm and stable. Long may it continue! And so the regime that works for me appears to be:-

• Not eating too much
  
• Avoiding high salt loads
• Avoiding both caffeinated and decaffeinated drinks
• Fairly regular EECP maintenance

There is no guarantee that exactly the same will work for others because their physiology will be different, but the basic approach may help. On the eating problem, after 10 weeks away from the UK I ended up 200 grammes lighter than when I left - so eating was not the real problem, it was probably salt and caffeine or caffeine solvents left in the drinks.

I will publish the BP data soon, together with a commentary on how various clinics conduct EECP. To be most effective, the patient should take part in the treatment regime and be ready to signal shortfalls in the clinic's procedures  ¶ 7:15 pm