Need advice regarding blood pressure

[Leongsam]

Went to the doctor a couple of weeks ago and my blood pressure was 150/100. Doc told me that I had to get it down or he'd have to prescribe medication.

Monitored by blood pressure at home for the last 10 days. It has never gone above 120/75. The Omron bp monitor I'm using has been calibrated and is accurate.

What should I do? Any doctors in the house?

 

[gingerlyn]

no doctor in the house, but you may try to drink celery juice / tomato juice which is proven to bring down blood pressure (if yours is not the severe type)

 

[Leongsam]

no doctor in the house, but you may try to drink celery juice / tomato juice which is proven to bring down blood pressure (if yours is not the severe type)

But the point I am making is that it isn't high in the first place.

If I bring it down below diastolic of 65. I end up with dizzy spells.

Besides 120/80 is supposed to be the acceptable upper limit and I'm below that.

 

[gingerlyn]

The problem with bp measure is that you only measure it at that point of time.
in order to be accurate, it is better if you can measure your blood pressure 24 hours and for few days consecutively.

Then you can access if you are really belong to highblood pressure group.

so if you can get this watch which measures 24 hours
http://www.singhealth.com.sg/Patien...bulatory-Blood-Pressure-Watch-Monitoring.aspx

and you can generate the data from this watch and send to doctor for assessment.

 

[halsey02]

Went to the doctor a couple of weeks ago and my blood pressure was 150/100. Doc told me that I had to get it down or he'd have to prescribe medication.

Monitored by blood pressure at home for the last 10 days. It has never gone above 120/75. The Omron bp monitor I'm using has been calibrated and is accurate.

What should I do? Any doctors in the house?

Two Bananas a day, or take garlic in your food, that may help...when we age, our BP goes up, there are exceptional people who at that age, BP is "normal"...what did the doctor tell you? start on, with medicine? basic one, like Atenol 50mg, a day?

Exercise more often will help, my BP had gone up like you, in the past, & whatever I do to decrease it back to normal range, it hover around the 150/100, 160/90 range & as time goes on, whenever I am stressed...it rises like the stock market, that rang alarm bells...like 190/120...in which I checked in emergency...but it came down to normal range 150/90..within an hr...

What the doc will give you will be the usual medicine for BP..like Amlodipine if they BP is above the range...& still not that good, throw in Lorsatn...this is to prevent stroke...but I have slowly weaned off those..& to basic of Atenol... age is the factor in BP getting high..

Like I had mentioned Bananas does help, include that in your diet, & watch that sodium, in any form. Next would be excercise, find time for it, even you can't go out, pacing up & down in wherever you are, for 15-30 mins helps...

Try not to allow the BP to go out of control, where long term medicine is needed...

 

[bakkuttay]

My wrist monitor differs from doctor arm monitor.
After change to arm monitor, readings comparable.

 

[Froggy]

Boss, come into SBF every other day, you'll feel better.

 

[kopiuncle]

A panel of experts has published new treatment guidelines for the management of high blood pressure that could significantly change the way doctors think about hypertension and determine whether or not to prescribe medications. Here’s what you need to know about the new recommendations, published last Wednesday in the Journal of the American Medical Association.

1. The threshold for treating high blood pressure has been raised for older Americans.  If you’re over 60, you may not need treatment for hypertension unless your systolic blood pressure (the top number of the measurement) is 150 or above, according to the new guidelines. That’s instead of the previous recommendation to treat at levels of 140 or higher. The diastolic pressure (bottom number) is considered high enough to treat if it’s 90 or higher, which is the same as in the previous recommendations.

“We did not find evidence for additional health benefits in achieving a level of 140 instead of 150 in those over age 60,” said Dr. Paul James, co-chair of the guideline committee and chair of family medicine at the University of Iowa Carver College of Medicine. “We were particularly concerned about medication side effects in the elderly population like lightheadedness and dizziness, which increases the risk of falling and broken bones.”

What’s more, older people tend to be on multiple medications for various conditions such as diabetes, arthritis, and high cholesterol; some of these, James pointed out, could interact with blood pressure drugs to increase side effects.




2. Drugs should no longer be used in older Americans to drive down their systolic pressure to below 150.  That recommendation was made after the committee reviewed a number of recent large clinical trials and found that driving levels down closer to a healthy blood pressure reading — 120/80 — did not prevent additional strokes or heart attacks and led to more side effects from the medications. Older patients who are currently achieving those lower levels on their medications without side effects, however, can stay on the treatment regimen that’s working for them, the guidelines state.

3. Adults under age 60 should aim to have their blood pressure below 140/90.

This recommendation remains unchanged, with one exception. Those with diabetes or kidney disease, regardless of their age, should also now aim for systolic blood pressure levels of below 140 instead of the previous recommendation of below 130. “Again, we didn’t find evidence to support the need to get to this lower blood pressure for those with special health conditions,” James said.

4. Lifestyle changes to lower blood pressure should be emphasized along with medications. These include following a low-sodium diet, losing excess weight, daily exercise, and a diet focusing on fruits, vegetables, and whole grains. The guideline committee referred doctors to a new heart disease prevention guideline issued by the American Heart Association outlining specific advice doctors should provide to patients.

Dr. Randall Zusman, director of the division of hypertension at Massachusetts General Hospital Heart Center, who was not involved with writing the new guidelines, wondered why the authors did not include lifestyle recommendations specific to lowering high blood pressure such as relaxation techniques. His center offers a stress management program for hypertensive patients to teach them ways to elicit the “relaxation response,” which lowers blood pressure and heart rate.

5. Expanded array of drugs recommended as a first line of treatment. Doctors should prescribe any of four classes of drugs: thiazide-type diuretics, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin receptor blockers to treat high blood pressure in those experiencing it for the first time. The previous guideline emphasized using only diuretics as a first-line therapy, James said. African-Americans, however, should be prescribed calcium channel blockers or ACE inhibitors first because those medications are more effective at lowering their blood pressure. Beta blockers should not be considered as a first treatment of choice, the guidelines state, because a recent study found that patients who took them had a higher risk of having a stroke or heart attack or of dying from heart disease than those who took other blood pressure drugs.

Deborah Kotz can be reached at [email protected]. Follow her on Twitter @debkotz2.

 

[gingerlyn]

halsey u try banana, have you tried celery and tomato juice?

 

[Agoraphobic]

All the people at my office who are 50 and above are on some kind of high blood medication and do some kind of walking, swimming, cycling or jogging and watch what they eat. Suggest you do the same.

Cheers!

 

[Runifyouhaveto]

Went to the doctor a couple of weeks ago and my blood pressure was 150/100. Doc told me that I had to get it down or he'd have to prescribe medication.

Monitored by blood pressure at home for the last 10 days. It has never gone above 120/75. The Omron bp monitor I'm using has been calibrated and is accurate.

What should I do? Any doctors in the house?

If it is white-coat hypertension, then you don't need to worry so much.

 

[Leongsam]

The problem with bp measure is that you only measure it at that point of time.
in order to be accurate, it is better if you can measure your blood pressure 24 hours and for few days consecutively.

Then you can access if you are really belong to highblood pressure group.

so if you can get this watch which measures 24 hours
http://www.singhealth.com.sg/Patien...bulatory-Blood-Pressure-Watch-Monitoring.aspx

and you can generate the data from this watch and send to doctor for assessment.

Yeah I did that years ago because I was suffering from LOW blood pressure. It wasn't a compact watch in the good old days. It was a huge contraption that had to be strapped on with a belt around the waist.

I think I'll just continue monitoring my own BP and tell the doctor to bugger off.

 

[Leongsam]

All the people at my office who are 50 and above are on some kind of high blood medication and do some kind of walking, swimming, cycling or jogging and watch what they eat. Suggest you do the same.

Cheers!

I cycle 350 km per week. I'm 60kg and you can count my ribs. I can't possibly do anymore exercise. I'd die of exhaustion.:p Food in NZ isn't salty either.. no MSG and very little sodium as there is no unhealthy hawker stuff here. Hardly eat red meat... mainly fish.

Probably need to join the tonychat vegan club. There I've said it myself before he butts in.

 

[kopiuncle]

Numerous studies have documented that BP, when measured carefully under standardized conditions in physicians’ offices, is a powerful and reliable predictor of morbidity and mortality. Recent studies have documented that 24-hour ambulatory BP monitoring is even a closer surrogate endpoint for heart attack and stroke than is office BP. Because the correlation between 24-hour ambulatory BP measurement and office BP measurement is moderate at best, it’s not unexpected that there will be a significant number of people who are truly hypertensive but in whom the diagnosis is missed by BP measurement in the office setting (masked hypertension). Conversely, BP may be elevated in the office but not on ambulatory BP monitoring — an entity known to most clinicians as white-coat hypertension.

Distinct differences

White-coat hypertension is a well-known clinical entity familiar to most physicians. A variety of studies have shown that the risk in patients with white-coat hypertension is somewhat elevated but distinctly lower than in patients who have sustained hypertension. Despite its commonness, little is known how to best manage white-coat hypertension. Out of fear of over-treatment, some physicians are taking a “wait and see approach” in patients with white-coat hypertension. Conversely, out of fear of litigation, some physicians may take an over-aggressive therapeutic approach, which may lead to hypotension and orthostatic symptoms.


Franz H. Messerli



In stark contrast, masked hypertension is a much less well-known (but not necessarily a less common) entity, which seems to carry a distinctly more serious prognosis. This was documented by Pickering and colleagues, who were the group that proposed the term “masked hypertension.” The same entity has been described occasionally as “reversed white-coat hypertension.” It was initially regarded as rare but was recently found to be present (to some extent) in about one-third of the hypertensive population. Risk factors for masked hypertension include alcohol, tobacco, caffeine and physical inactivity.

In the PAMELA population, patients with masked hypertension have a prevalence of echocardiographic left ventricular hypertrophy that was much greater than that of normotensive patients. Inappropriate target organ disease (ie, inappropriate for office BP) should, therefore, trigger suspicion of masked hypertension and motivate physicians to expose a susceptible patient to 24-hour ambulatory BP monitoring.

Difficulties detecting masked hypertension

The clinician should remember that it’s much easier to suspect the diagnosis of white-coat hypertension, as patients will usually tell that the BP is normal at home. In contrast, masked hypertension needs to be looked for, and there are few clinical hints as to its presence. Normal BP in the clinical setting does not mean that a patient is not at risk for an elevated BP, which can occur at other times of the day.

This is particularly true in patients who are treated with antihypertensive drugs that are not covering a full 24-hour period such as atenolol (Tenormin, AstraZeneca), losartan (Cozaar, Merck) and hydrochlorothiazide. Because the patient takes the medication in the morning, BP values in the physician’s office most often are normal but may be substantially elevated at the end of the dosing interval (ie, during the night and early morning hours). Thus, in many hypertensive patients, clinic BP is seemingly well-controlled, but morning BP, before taking the medication, may be elevated, thereby exposing the patient to a high risk of CV events. Unfortunately, masked hypertension has become a blind spot in the current management of this disease.

Although we certainly cannot make a sweeping recommendation that all patients with high BP (or normal BP) should undergo 24-hour ambulatory BP monitoring, we think that the presence of inappropriate target organ disease such as LV hypertrophy or microalburminuria should raise suspicion of masked hypertension and motivate physicians to initiate a further work-up.

As to the therapeutic approach, we should remember that white-coat hypertension has a benign prognosis and can only be over-treated; therefore, a conservative approach is probably justified. Quite in contrast, masked hypertension has a much more serious prognosis and can only be undertreated; it deserves, therefore, a much more aggressive therapeutic approach.

For more information:

Clement D. N Engl J Med. 2003;348:2407-2415.

Hansen T. Hypertension. 2005;45:499-504.

Messerli F. J Am Coll Cardiol. 2002;40:2201-2203.

 

[Leongsam]

I've taken my BP at home in the morning, in the evening, at lunch time... always below 120/75 as long as I sit down for 10 minutes and watch TV.

If I've been rushing around, it does go higher about 140/90 but it it always comes down to 120/75 or lower after a relaxing for a while.

As far as I can see, BP is never a fixed value. It responds to the needs of the body just like pulse rate and breathing intensity. The question that nobody seems to be answer is how high can it go under stressful conditions before it is considered to be dangerous.

 

[Runifyouhaveto]

I've taken my BP at home in the morning, in the evening, at lunch time... always below 120/75 as long as I sit down for 10 minutes and watch TV.

If I've been rushing around, it does go higher about 140/90 but it it always comes down to 120/75 or lower after a relaxing for a while.

As far as I can see, BP is never a fixed value. It responds to the needs of the body just like pulse rate and breathing intensity. The question that nobody seems to be answer is how high can it go under stressful conditions before it is considered to be dangerous.

Your BP appears to be very very very normal. if it doesn't shoot up when you rush around then you need to worry.

White-coat hypertension appears when you are diagnosed with higher BP specially only during medical examinations, probably due to anxiety, prolonged-waiting, excitement upon entering doctor's room, sexy nurses, etc..... White-coat hypertension is not really a medical condition.

If you don't mind investigating more, see another GP doctor or change a blood pressure machine to double-check.

 

[eatshitndie]

Monitored by blood pressure at home for the last 10 days. It has never gone above 120/75. The Omron bp monitor I'm using has been calibrated and is accurate.

you're normal as your systolic bpl is equal to or less than 120 and diastolic bpl is less than 80. nothing to worry about in terms of blood pressure. your doctor's measurement might be performed when you were excited with the sexy nurse bending down to wrap your arm, or his instrument was lacking calibration and maintenance. :p

 

[Leongsam]

http://bleacherreport.com/articles/30864-formula-1-are-f1-drivers-considered-athletes

As our driver sits on the grid waiting for the lights to go out, his heart rate has increased to 185 bpm even though he is not moving a single muscle. During the race adrenaline will push the heart rate up even higher, sometimes over 200 bpm. This will give an average reading of approximately 170 bpm. That heart rate of 170 bpm is equivalent to almost three beats every second. Count it and then imagine your heart going through that for the full two hours.

Did you know? - A driver’s blood pressure will increase by approximately 50 percent during a two-hour race.

 

[Runifyouhaveto]

http://bleacherreport.com/articles/30864-formula-1-are-f1-drivers-considered-athletes

As our driver sits on the grid waiting for the lights to go out, his heart rate has increased to 185 bpm even though he is not moving a single muscle. During the race adrenaline will push the heart rate up even higher, sometimes over 200 bpm. This will give an average reading of approximately 170 bpm. That heart rate of 170 bpm is equivalent to almost three beats every second. Count it and then imagine your heart going through that for the full two hours.

Did you know? - A driver’s blood pressure will increase by approximately 50 percent during a two-hour race.

Correct, taxi drivers are at super-high risk of getting heart-attack.

If BP is sustained at high-level. It can be as serious as increasing risk of heat failure, stroke, kidney failure, etc or even chronic problems like fainting or eyeballs start retain blood/water and affects vision.

 

[Leongsam]

you're normal as your systolic bpl is equal to or less than 120 and diastolic bpl is less than 80. nothing to worry about in terms of blood pressure. your doctor's measurement might be performed when you were excited with the sexy nurse bending down to wrap your arm, or his instrument was lacking calibration and maintenance. :p

The nurse is butt ugly.... one of those fat matronly figures that the West is so full of.... very nice lady though.