[pilowsky]

Damon Runyon was an extremely famous American writer. Amongst his many pieces is a short story entitled blood pressure. The story starts like this:

"It is maybe eleven-thirty of a Wednesday night, and I am standing at the corner of Forty-eighth Street and Seventh Avenue, thinking about my blood pressure, which is a proposition I never before think much about.

In fact, I never hear of my blood pressure before this Wednesday afternoon when I go around to see Doc Brennan about my stomach, and he puts a gag on my arm and tells me that my blood pressure is higher than a cat's back, and the idea is for me to be careful about what I eat, and to avoid excitement, or I may pop off all of a sudden when I am least expecting it.

'A nervous man such as you with a blood pressure away up in the paint cards must live quietly,' Doc Brennan says. 'Ten bucks, please,' he says."

I particularly like the bit about the "paint cards"

As you can imagine, a few more paragraphs follow in which Runyon becomes embroiled with a series of misadventures involving a bunch of extremely seedy characters before he gets struck on the head and returns to the Doctor.

"'But,' Doc Brennan says, when he takes my blood pressure again, 'your pressure is down below normal now, and as far as it is concerned you are in no danger whatever. It only goes to show what just a little bit of quiet living will do for a guy,' Doc Brennan says. 'Ten bucks, please,' he says."

My interest was immediately piqued. Since my professional life has revolved around the question of how the central nervous system controls the delivery of oxygen to the tissues while maintaining a stable acid-base balance: in other words, the neuroscience of airways breathing and blood pressure, I wondered if playing Bridge has health benefits - for me anyway.

I undertook what is known in the Res. Biz. as an uncontrolled, non-randomised unblinded 'n of 1' trial; in triplicate. I was the only subject.

The study - if you can call it that - was conducted in the morning Australian Eastern Standard Time. I registered in three consecutive ACBL IMP's challenge format tournaments.

I wore an OMRON HEM-FL21 22-42 cm cuff and recorded my blood pressure before I started the tournament and after each hand.

My a priori hypotheses were that in general mental stress associated with Bridge would cause a rise in blood pressure and heart rate overall. In addition, I expected that there might be substantial inter-hand variation where difficult or exciting hands arose.


The results were as follows:

Mean systolic blood pressure fell [mmHg +/- (standard deviation)] from 131+/- 1 (s.d.) to 121 +/- 4. Diastolic pressure fell from 80 +/- 1 to 75 +/- 4. Heart rate also fell from 73 +/-2 to 69 +/- 2.

Clearly, this is simply a bit of fun, but what might it mean. First, a fall in blood pressure of 10/5 mmHg is no small thing. If I could make ACBL tournaments into a pill and stamp 'Pilowsky' on them I'd be a billionaire tomorrow if this effect was real.

What might be going on? I discussed the question with colleagues. We decided that one possibility is that Bridge is a form of 'mindfulness'.

At first, I was surprised, but then I realised that sitting at home quietly playing Bridge against robots without having the associated anxieties of crossing the city to find a park, this may indeed be true. If so then, pending further study in a larger cohort, in a much better-designed study, Bridge may turn out to be one of the few things in life that are not only fun but are also good for you.

How about that?

Conflicts of interest: None, except that I'm hypertensive.

[kenberg]

Pursuing this would be, as you suggest, at least partly for amusement. But let me look a bit at some details.

You say that you took your pressure after each hand. A couple of things come to mind. After hand 1 is a lot like before hand 2, unless you took a rest in between.. Or, to look at this differently, did the pressure drop some after hand 1 and then drop more after hand 2 and further still after hand 3? Or maybe bounce around but on a general downward trend?

I might try some version of this myself.

Blood pressure can hop around. Some 8 or 9 years ago I had a TIA (aka mini-stroke) and spent a lot of time with docs. Like your Runyon character I had never much thought about blood pressure until then but I started taking frequent readings and it was all over the map. The docs had no idea why but a nurse came up with the simple answer: "Don't take your blood pressure so often". Btw, and I mention this because of your professional interests in such matters, I am pretty sure I know what was going on, learning of it almost by accident. I was lying on a table for one of my many exams and I fell asleep. The doc suggested that I be tested for apnea. Yep, I had apnea. And apnea can cause all sorts of problems including strokes, mini-strokes, blood pressure problems and so on. So I wear one of these Darth Vader masks at night and the problems largely cleared up. Ok, I still take modest amounts of medicine for blood pressure but I am 81 and I am overweight, so some blood pressure issues are not surprising. Mostly I am fine.


So I will see how it goes with blood pressure and bridge. Maybe not today, but soon. It's true that in order to play a hand decently you do have to get your emotions under control, and this might have an effect.

[Zelandakh]

Your control value should be sitting quietly for a similar length of time to the playing itself. If I measured my pulse, breathing, heart rate, etc after travelling to a bridge club and compared it with average values while sitting down for a few hours, I would be amazed if the latter values were not considerably lower. Or in other words, GIGO.

[pilowsky]

 Zelandakh, on 2020-September-25, 06:50, said:

Your control value should be sitting quietly for a similar length of time to the playing itself. If I measured my pulse, breathing, heart rate, etc after travelling to a bridge club and compared it with average values while sitting down for a few hours, I would be amazed if the latter values were not considerably lower. Or in other words, GIGO.

Very helpful

[pilowsky]

 kenberg, on 2020-September-25, 06:45, said:

Pursuing this would be, as you suggest, at least partly for amusement. But let me look a bit at some details.

You say that you took your pressure after each hand. A couple of things come to mind. After hand 1 is a lot like before hand 2, unless you took a rest in between.. Or, to look at this differently, did the pressure drop some after hand 1 and then drop more after hand 2 and further still after hand 3? Or maybe bounce around but on a general downward trend?

I might try some version of this myself.

Blood pressure can hop around. Some 8 or 9 years ago I had a TIA (aka mini-stroke) and spent a lot of time with docs. Like your Runyon character I had never much thought about blood pressure until then but I started taking frequent readings and it was all over the map. The docs had no idea why but a nurse came up with the simple answer: "Don't take your blood pressure so often". Btw, and I mention this because of your professional interests in such matters, I am pretty sure I know what was going on, learning of it almost by accident. I was lying on a table for one of my many exams and I fell asleep. The doc suggested that I be tested for apnea. Yep, I had apnea. And apnea can cause all sorts of problems including strokes, mini-strokes, blood pressure problems and so on. So I wear one of these Darth Vader masks at night and the problems largely cleared up. Ok, I still take modest amounts of medicine for blood pressure but I am 81 and I am overweight, so some blood pressure issues are not surprising. Mostly I am fine.


So I will see how it goes with blood pressure and bridge. Maybe not today, but soon. It's true that in order to play a hand decently you do have to get your emotions under control, and this might have an effect.

My average blood pressure was high before the tournament started - I took this to be a 'stress response'. As the tournament progressed my BP fell in a smooth fashion - three times in a row. In me anyway, I suspect this is a meditative effect.
Zelendakh is unaware perhaps that I am a Professor of Physiology, Pharmacology and Neuroscience, who published on this exact topic more than once - amongst other things. It is possible that I know what I am talking about and that he/she doesn't.

Interestingly, as I play I 'felt' calmer and more relaxed. The action of taking my BP in between hands slowed down the pace of play. I have translated this into my actual game. I now make a point of meditatively counting my points three times and assessing my shape and so on before making my bid as a way of relaxing before each hand. This resets my mind from the previous hand, It doesn't have to take long with practice.

[Winstonm]

 pilowsky, on 2020-September-25, 15:05, said:

My average blood pressure was high before the tournament started - I took this to be a 'stress response'. As the tournament progressed my BP fell in a smooth fashion - three times in a row. In me anyway, I suspect this is a meditative effect.
Zelendakh is unaware perhaps that I am a Professor of Physiology, Pharmacology and Neuroscience, who published on this exact topic more than once - amongst other things. It is possible that I know what I am talking about and that he/she doesn't.

Interestingly, as I play I 'felt' calmer and more relaxed. The action of taking my BP in between hands slowed down the pace of play. I have translated this into my actual game. I now make a point of meditatively counting my points three times and assessing my shape and so on before making my bid as a way of relaxing before each hand. This resets my mind from the previous hand, It doesn't have to take long with practice.

I'm wondering if the focus and concentration required by bridge - which tunes out our basic underlying stress - doesn't act like a natural ACE inhibitor.

[pilowsky]

Certainly, it is possible that bridge is relaxing. It would be great if others could come on board and see what they find.
ACE stands for angiotensin converting enzyme. It is found throughout the body but is highly concentrated in the lungs. Focus and concentration would not affect the activity of this enzyme.
A common treatment for hypertension is a class of drugs called ACE-inhibitors the tradename of these drugs usually ends in -pril (eg perindopril) 10% of users get a cough because inhibition of ACE results in greater production of another compound bradykinin which causes receptors in the lungs to be activated and cause cough.
This can sometimes be enough to require a change in medication.
Another major class are the angiotensin receptor blockers these usually end with -artan like 'telmisartan'. These do not cause cough. They arrived on the scene later and are considered to be a better drug.
Stress activates sympathetic nerves and raises blood pressure - supposedly. So does angiotensin.
But, relaxing does not block the enzymes that create angiotensin from its precursor molecules.
I hope that makes sense.

[kenberg]

OK, some scores. First some background and history. I'm 81. Ten years ago when a medical person would ask "What medications are you taking?" I would say none. They would be surprised. Well, I can no longer say "None". I had been taking both HCTZ (hydro-choloro-something-zene I guess) and Lisinopril but I started to cut back on the HCTZ and, when that seemed to be working well, I conferred with the doc and cut out the HCTZ completely. Over the last year I have had some other medical issues. No reason to start planning a funeral but there has been some other stuff with medication, adding and subtracting, and, as a direct result of this thread, I realized this morning that I had inadvertently stopped taking the Lisinopril. That could explain some high numbers, I guess, although I was in to see the doc a few days ago and the pressure was one twenty something over sixty something. So I took a Lisinopril this morning. After which I drank, as I usually do, about half a pot of coffee.

Ok. At 9:00 I had 125/75, at 9:45 it was 133/52, at 10:00 it was 145/87, and it was at 10:00 that I started playing. I played the ten board Forum game with the robots, I took my pressure after every two boards. The scores, starting with "after board 2, then after board 4, etc.

138 / 61
136 / 73
119 / 60
131 / 56
132 / 70

I finished at 10:53 so that's about 5 minutes a board.

as the BP affected by how I thought the board went: Maybe but I doubt it. I though board 1 went badly and board 2 went well (this was correct) and my BP was138 / 61
I thought boards 5 and 6 went reasonable well (this was also correct0 and my BP was 119 / 60. Now, at 11:45, my score is 148 / 89

I'll give this another shot in a week or so, after the Lisinopril has had a chance to do its stuff. But my scores do hop around. I can't tell you about ten years ago, I paid no attention. But it has been true for the past 8 or so years. As I mentioned earlier, a nurse suggested that I not take my BP so often. That's one solution. Perhaps drinking less coffee would be another. All those 130+ scores I report during play are down from the 145 just before play but up from the 125 of 9;00. I think we should hold off conclusions. For the moment.

[nige1]

 pilowsky, on 2020-September-25, 15:05, said:

Interestingly, as I play I 'felt' calmer and more relaxed. The action of taking my BP in between hands slowed down the pace of play. I have translated this into my actual game. I now make a point of meditatively counting my points three times and assessing my shape and so on before making my bid as a way of relaxing before each hand. This resets my mind from the previous hand, It doesn't have to take long with practice.

Samantha Punch, Professor of Sociology at Stirling University, supervises a long-term research project on Bridge, to find out if it's good for you. She would approve of the studies by Paul Pilowsky and Ken Berg. IMO counting points and taking your time should improve Pilowsky's bidding and play, further relaxing him and hence lowering his blood-pressure . Unfortunately, soon, he's likely to become excited from winning more often, raising his blood-pressure again

[pilowsky]

 nige1, on 2020-September-27, 10:41, said:

Samantha Punch, Professor of Sociology at Stirling University, supervises a long-term research project on Bridge, to find out if it's good for you. She would approve of the studies by Paul Pilowsky and Ken Berg. IMO counting points and taking your time should improve Pilowsky's bidding and play, further relaxing him and hence lowering his blood-pressure . Unfortunately, soon, he's likely to become excited from winning more often, raising his blood-pressure again

I think that's important advice. But as you can see from the examples of how I play, I'm probably fairly safe for a while.

[thepossum]

I don't exactly find online bridge very relaxing. Maybe vegetatively playing mindless unimportant robot hands lulls the hyper(evrything) body and brain into some form of relaxation.

But no, the only really relaxing bridge experiences I ever had were truly social ones with fun people or at least people I knew who weren't putting any pressure; or any feeling of being judged, compared, ridiculed, competed with etc

Quick fire competitive online can be fun but not exactly relaxing

I won't bore you on this thread with my best ever experience of Bridge but it involved international casual play on a long distance train journey with good food, company and vodka - oh and they were good players too - just friendly and accommodating and generous Oh and for a youngish naive travller from the West there was a certain excitement and feeling of danger being behind the iron curtain with people who didn't seem too scary at all - and their relaxed demeanour even when our cabin was being searched by border guards managed to keep my tension levels down even then. I shouldn't say anymore really. We live in aterrible world when any ancient information is sometimes used by malicious types to attack and undermine good people

PS I should add for anyone interested it was actually my greatest ever bridge moment - being congratulated for a defensive play by a player of a certain nationality - somewhere where Bridge and other pursuits involving the mind have as much, if not greater, standing than kicking and hitting balls does where I live now

[pilowsky]

 kenberg, on 2020-September-27, 09:53, said:

OK, some scores. First some background and history. I'm 81. Ten years ago when a medical person would ask "What medications are you taking?" I would say none. They would be surprised. Well, I can no longer say "None". I had been taking both HCTZ (hydro-choloro-something-zene I guess) and Lisinopril but I started to cut back on the HCTZ and, when that seemed to be working well, I conferred with the doc and cut out the HCTZ completely. Over the last year I have had some other medical issues. No reason to start planning a funeral but there has been some other stuff with medication, adding and subtracting, and, as a direct result of this thread, I realized this morning that I had inadvertently stopped taking the Lisinopril. That could explain some high numbers, I guess, although I was in to see the doc a few days ago and the pressure was one twenty something over sixty something. So I took a Lisinopril this morning. After which I drank, as I usually do, about half a pot of coffee.

Ok. At 9:00 I had 125/75, at 9:45 it was 133/52, at 10:00 it was 145/87, and it was at 10:00 that I started playing. I played the ten board Forum game with the robots, I took my pressure after every two boards. The scores, starting with "after board 2, then after board 4, etc.

138 / 61
136 / 73
119 / 60
131 / 56
132 / 70

I finished at 10:53 so that's about 5 minutes a board.

as the BP affected by how I thought the board went: Maybe but I doubt it. I though board 1 went badly and board 2 went well (this was correct) and my BP was138 / 61
I thought boards 5 and 6 went reasonable well (this was also correct0 and my BP was 119 / 60. Now, at 11:45, my score is 148 / 89

I'll give this another shot in a week or so, after the Lisinopril has had a chance to do its stuff. But my scores do hop around. I can't tell you about ten years ago, I paid no attention. But it has been true for the past 8 or so years. As I mentioned earlier, a nurse suggested that I not take my BP so often. That's one solution. Perhaps drinking less coffee would be another. All those 130+ scores I report during play are down from the 145 just before play but up from the 125 of 9;00. I think we should hold off conclusions. For the moment.

A few things,
Scores are what you get at Bridge. Blood pressure is not a competitive sport - these are measurements. I didn't provide my 'pre-values' because this was intended as a bit of fun, but in fact, they were quite a bit higher. I think that I get an alerting stress effect prior to the tournament.
I think that you chose well with picking the Forum challenge. For this kind of 'experiment', it's important to have 'skin in the game'. I used ACBL tourneys where I was paying and playing for masterpoints, so there was also an incentive to do well.
The most important of the two numbers is the second one (diastolic). The peak systolic pressurises the arterial tree, the diastolic pressure fills the coronary arteries and the brain circulation while the heart chambers refill. Amongst other things. Obviously there is a lot more to it.

It is important that your BP is kept below 130/80 above that is considered hypertensive. If you are taking any drugs for high blood pressure then you are definitely already hypertensive.
HCTZ 'hydrochlorothiazide' is a member of the thiazide diuretics - it lowers pressure by reducing the amount of fluid in the body. It's a good cheap drug these drugs have been around for a long time, they are very safe, work well and are very well tolerated.
A cornerstone of modern hypertension treatment is combination therapy - just like in Bridge - Doctors combine their chances. Instead of giving massive doses of one drug. Doctors give several different drugs from different classes that affect different systems. Sometimes they are mixed into one pill for convenience.

As I mentioned, a common (up to 10%) side-effect of -pril drugs is cough. Not to be confused with other causes of cough. Hypertension, overweight, bad blood lipids and type 2 diabetes are a syndrome cluster called Syndrome X. It is the modern plague.

[kenberg]

This all got me browsing. The article at https://www.berkeley...sure-top-bottom was interesting and fits my general view of things, with the idea of keep the BO low but don't overdo this good idea. It was 105 over something this morning and 115 / 57 later, after moving around and doing some stuff, so I seem to be back on track. At least reasonably so. I will repeat the experiment later, but probably not today.



I usually do the Form tourney on Sunday and the Prime tourney on Saturday. During the week I often do an ACBL daylong, with the robots, usually an 18 board one. Roughly once a week I play an ACBL tourney with a partner, also 18 boards, no robots involved. I suppose this last is the one that I most feel I should try my best at, since I have a responsibility to a partner. But of course it might not be feasible to take BP during that, although sometimes I am dummy and sometimes there is a decent amount of time left at the end of a round.

For me, I think that about 80% of the time when I get a bad score it is through laziness, or inattention, or some such thing. I look at what I did and i say "Good grief, I know better than that". Whether or not BP correlates with staying focused, I don't know.

[kenberg]

40 minutes into the debate my BP is 121 / 74.

Maybe i should watch more debate. No. No! No!!

Fast paced walking, ok. Lifting weights, ok. Yoga, ok. But more debates? There are limits.

[pilowsky]

40 minutes into the debate mine was 144 /82 HR 74. I'm on two antihypertensives. I had to turn it off before Trump gave me a stroke.

[Zelandakh]

Reaction on CNN: "It was a sh!t show". Anyone have access to Fox to report on the reaction there?

[pilowsky]

 Zelandakh, on 2020-September-29, 20:46, said:

Reaction on CNN: "It was a sh!t show". Anyone have access to Fox to report on the reaction there?

I had to stop after 10 seconds - chest pain radiating down my left arm Eric and Sean

[kenberg]

Both yesterday (Sub, Oct5) and today I checked BP before and after a game, in both cases it went up. But other times it has gone down. Probably I will just leave off checking it.

[pilowsky]

 kenberg, on 2020-October-05, 13:40, said:

Both yesterday (Sub, Oct5) and today I checked BP before and after a game, in both cases it went up. But other times it has gone down. Probably I will just leave off checking it.

So long as it's under control and you're seeing your doctor regularly.