February 2008 Update - Effects of Decaffeinated Drinks

I should note (see previous post)that I have not drunk any significant amount of caffeinated drinks in the last couple of years and stuck to decaffeinated coffee and tea. I began to get a little bit concerned that EECP was producing the results after the course was completed - and so I cut out any decaffeinated drinks as well.

This graphic (up to 25th February) shows what has happened since the end of the EECP course and eliminating any decaffeinated drinks. The course finished on 5th February and the blue line shows that average SBP was still running about 140. A week later I gave up the decaffeinated drinks - and the blue line marched from 140 to near 120 in a week. This effect has persisted right up to date - long may it continue! At the same time I have been able to increase the amount I can walk each day - so hopefully improving the overall level of fitness.

The ship's doctor's strictures about eating and drinking too much have also worked out well - I came back to the UK a couple of weeks ago 300 grammes lighter than when we departed in December. I still drink only a couple of glasses of wine a day and, if anything, I drank less on the ship.

There is a definite relationship between the amount of exercise - too much probably causes some aggravation of inflammatory patches - and blood pressure in my case. I would dearly like some better insight into how these relationships work. Excessive salt and decaffeinated drinks may also play some part but I am sure that other factors have effects that, at present, I do not understand.  ¶ 9:00 pm

  Data update for Nov2007 - Feb 2008 I hope this graphic is not too confusing. It is a time series plot of my systolic (SBP) and diastolic blood pressures (DBP) for the period Nov 2007 to the end of January 2008. These are measured using a Microlife recording unit that takes 3 readings and then averages them. Readings are normally twice a day in the morning and evening and are taken sitting up with legs horizontal after 2 - 3 minutes rest.

The vivid purple line is the daily pedometer reading, an attempt to measure the daily physical effort. The red line is the maximum SBP on any one day and the blue line is a running average of the previous 5 days' figures - to get some idea of the trends.

you can see that all through November there has been a steady increase in SBP even though the physical effort is reducing - that is until we started our holiday at the beginning of december, boarding a cruise liner in Barcelona and then taking 10 days to sail to Boston. I was feeling pretty good at the beginning of the voyage and spent quite lot of time walking on the exercise deck, a 610 metre circuit. This effort is reflected in the pedometer readings, followed a couple of days later with a real jump in maximum SBP, making me feel much worse - to the extent of eventually checking in with the ship's doctor. He did a quick examination and said the basic pump was OK and the variations were due probably to:-

• Change of food and eating too much
  
• Possible increased salt and/or spices load hidden in exotic dishes
• Changed emotional state
  
• Drinking more

Also I was getting older (nearly 68) and not so resilient as before. I was more worried about aggravating plaques, increased inflammatory patches, etc., but of course he could not answer that, not having the right equipment on board.

We landed and then flew to California to stay with some friends, but the increase in average SBP was still a worry - I didn't feel brilliant. I found a local practice in California that had an EECP unit and, having been checked out by their cardiologist, started in on a course of EECP on 10th January, the third in 20 months. This was organised for 2 sessions a day with an interval over lunch of about 2 hours during which I spent some time in coffee bars, etc. You will note that the average SBP did not reduce, even though I felt better and was able to do a lot more walking.  ¶ 7:45 pm

  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