high blood pressure

[vfr on top]

hi,

i'm 28 and my bp has been around 135/90. I know this is high. I smoke and drink. (which obviously i know i have to quit). But is this bp very high and something to worry about? I am now panicing because my next medical is around the corner and this is obviously going to make it worse.
Is there anything i can do to reduce it quickly. Obviously i know what i have to do long term but is there any short term solutions?

Thanks for the help

[BelfastChild]

Not particularly high but stopping smoking will fix it. And do some exercise

[Oh that's super!]

See your doctor for advice. You'll need to do something about it for the future, even though it's not at a crisis level yet.

[CherokeeDriver]

Mine is higher (140/90) and I had no pbms getting my initial ClassII. Was told if it remains high AME will refer me back to my GP. Don't drink for a couple of days before medical and that will lower it *slightly*. Giving up the fags will only make a difference over a longer period of time. As long as the ECG is OK and you are under 40 I don't think the docs get to worried.

[Loose rivets]

I don't know a lot about BP cos mine is so low I'm deemed an anomaly. ( 80/40 when I came out of surgery. [Checked by three different machines].) However, Mrs R has high BP but will not take medication.

Her massive supply of vegetarian and health books have recently come up with the data for eating celery. The claims are astounding, and if true, it is probably working by relaxing the blood vessels, and may therefore allow the body to ‘re-datumize'. i.e. you would have to keep taking more and more.

Since celery is not unpleasant, why not give it a try?

[BelfastChild]

[quote=CherokeeDriver]Giving up the fags will only make a difference over a longer period of time.quote]

Don't agree - it only takes a few days for the cardiovascular benefits of quitting to kick in. And as for celery....:confused:

[samarkand]

There is a machine called Resperate which I have found help
to reduce my pressure.

I also take Strauss Herbs "Heart Drops" - seems to work really well.

Also have a look here for some more tips...

http://www.usgyms.net/bloodpres.htm

Regards - Sam

[driftdown]

Stop smoking, cut down on alcohol and get your cholesterol checked and more exercise.

They all worked for me although I was told to take a 25mg beta blocker a day. Now I am in better shape I have not been able to get a satisafctory answer as to how much effect the small dose tablet makes and whether I can discontinue taking them.

Better to take action now rather than wait for it to become a major hassle later on.
:ok:

[ABO944]

My blood pressure was a tad high ....

I decided to do something about it, and now I cycle to work (only 15 minutes each way) but enough to work up a sweat.

I also do around 100 push-ups a day.

After getting my blood pressure checked a couple of weeks later, my BP had reduced a lot !

As well as feeling healthier, I actually enjoy the exercise ... something I never used to enjoy !

:ok:

[Re-entry]

The main culprit is alcohol. Also any 'recreational' drugs sharply increase BP but only in the short term. Exercise (eg 20 mins on bike to a sweat ) helps a lot. Smoking itself doesn't make much difference except it stops you exercising as you cannot breathe. Cut out alcohol (totally) and exercise regularly, eat normal diet and BP will be that of an athlete within 7-10 days.

[effortless]

Your BP is highish but JAR says that 160 over 95 is the grounding point. I know this from experience. Lose weight, stop smoking (the single best thing that you can do for yourself), get exercise. If it is this bad now it will be very bad in a few years time.

[Oh that's super!]

And as for celery....:confused:

Ah, celery. It reputedly has a diuretic action. That's probably why.

[got caught]

It's a little on the high side, but stop thinking like a pilot, igniore the figures, look at yourself more holistically, and address your lifestyle issues.

It'll make more of a difference to your health and happiness, and it sounds like your ready to change the way you live anyway.

Avoid unprescribed medication.

[slim_slag]

hi,
i'm 28 and my bp has been around 135/90.
..
..
But is this bp very high and something to worry about?

I would say it's high enough to worry about. You appear to live in the UK. In some more proactive countries you would be well into the 'pre-hypertensive' labelling range and that 90 would make you a candidate for medication. The UK is a bit behind right now, but no doubt will have to catch up sometime, when NICE gets it's act together.

So as mentioned lifestyle changes are in order. Stopping smoking actually isn't going to make that much difference to your BP, but it is the most important thing you can do in order to prevent an early death and/or a life of illness from many other causes.

In a rough order of effectiveness.
Lose Weight
Eat Healthy
Exercise
Reduce dietary salt
Moderate Alcohol
Nothing there too difficult eh? If you are 10kg overweight it's possible that just shedding that could get your BP into the 'normal' label range. You want to avoid having to be medicated.

[Re-entry]

metropolol 50mg.

[BelfastChild]

Do NOT take medication! Slim_slag is spot on. Except don't agree with those who say stopping smoking won't make much difference...

[effortless]

Stopping smoking actually isn't going to make that much difference to your BP, but it is the most important thing you can do in order to prevent an early death and/or a life of illness from many other causes.

Nicotine restricts blood vessels and raises blood pressure. Although smokers think smoking relaxes them, it actually makes their hearts work harder to pump blood to all parts of their bodies. Smoking may also cause artery damage, which increases plaque build-up and makes arteries less flexible.
life clinic (http://www.lifeclinic.com/focus/blood/smoking.asp)

[Re-entry]

So VFR on top. how you doing? As the only person who answered your question, I respectfully request a response.

[Re-entry]

oh. btw slim slag get a life it's better that way. lol

[slim_slag]

Hi effortless,

That lifeclinic site you link to is somewhat behind the times as it still refers to JNC VI, but even so, the link you provide doesn't say what you think it does. Sure, when you inhale tobacco smoke your heart rate increases, your arteries stiffen and your blood pressure goes up, but when you put the ciggie out your blood pressure will return to where it was before. No doubt damage was caused by the temporary increase in blood pressure and the temporary effects are cumulative so heavy smokers have more damage. But, if you randomly take 1000 young people like vfr-on-top off the street, tell them to wait in a room and then take their BP's with a cuff around the arm, you will not find the group of smokers has a higher blood pressure than the non smokers. Maybe that means the way BP is currently measured doesn't give the whole picture, but that's another thread :)

So, vfr-on-top reports he is a 28 year old smoker with BP of 135/90. What I am saying is that if he stops smoking and does nothing else (and doesn't put on weight), then goes down to his GP and has his BP measured, his BP will still be 135/90. He will have more money, can be expected to live longer, will not be coughing up gunks of green muck in the morning, and will not smell as bad - but his BP as measured by the GP will essentially be the same. Smoking is most certainly an additional risk factor for hypertensives, but I don't believe there is any proof that it causes hypertension in 28 year olds - or that stopping smoking is an effective way to treat hypertension as currently defined/measured.

Morning re-entry. So you would start a 28 year old with a BP of 135/90 on a beta blocker? Don't think so, beta blockers have side effects and there are far better ways to approach this case (and also if medication was needed you would first consider a thiazide diuretic). Which google search threw that up? Also my life is fine, thank you :)

[got caught]

metropolol 50mg.

Oh dear, another case of the Medical and Health Forum getting idea's above its station.

Somebodies gonna lose an eye.......

[RichT]

1 x 75 mg asprin daily (1/4 of a tablet), light exercise and stopped the fags worked for me but I am not a doctor.

[effortless]

Slim-Slag Sorry but smoking causes every bloody thing in the whole world. Don't even know that?

You are of course right in that you won't find a significant difference between 28 year old groups but there is a correlation in older groups.

[femaleWannabe]

I had my blood pressure checked by a nurse last week (routine unrelated thing) and she said it was high (don't know the numbers) but not too much to worry about. I have since purchased a home wrist monitor mainly out of curiosity and my blood pressure is registering on average 170/105!!!! I'm only 21, I have never smoked, only drink occassionally (like 1 unit every 2 weeks or something!), I'm not overweight... my diet isn't particularly bad and I go to the gym/swim 4 times a week for an hour. Anyone have any suggestions on how to get it down? Should I go and see my gp as clearly I'm not going to pass a class 1 with my bp like this :( Unless I leave it a couple of weeks and see how it goes....

[Caramba]

Simple thing is - are you using a big enough cuff?- it should cover at least 2/3rds of your arm (long axis, before anyone gets smart) - using too small a cuff can give erroneously (high) figures.

If the cuff is the right size, and you are consistently getting such results, get it checked by your friendly nurse a few more times. If still high, best to see your GP for futher evaluation.

Good luck!

[Primary Care]

Female Wannabee- it sounds like its more of a problem with the machine rather than you. I'd see how it goes. And put your wrist monitor on e-bay !

[femaleWannabe]

I'm not sure if the cuff is big enough or not :confused: It's about 3 inches wide.. and my arm is about 8 inches from wrist to elbow...

Heh, I got it off ebay so maybe that's the problem! If it doesn't improve in the next couple of weeks I'll go get it checked properly. Thanks guys.

[femaleWannabe]

I'm really stupid :} Just read the instructions... I was putting it on so the display was on the outside of my arm (like a watch) but apparently you're meant to put it facing inwards.... not sure why, maybe it fits better or something. Anyway, my blood pressure is now 129/72 which I believe is ok?!! It was high last week though with the nurse so I'll keep monitoring and see....

[Caramba]

FB, I didn't spot it was wrist monitor :O - anyway, sounds like you've fixed the problem :ok: -tho like Primary Care I suspect, I always think devices like this are a bit dodgy...

[Irish Steve]

FB, I didn't spot it was wrist monitor :O - anyway, sounds like you've fixed the problem :ok: -tho like Primary Care I suspect, I always think devices like this are a bit dodgy...

Got one off E-bay a while back, and the specialist who was checking what my BP was doing was delighted that I was checking it on a regular basis, and the results I was getting ( and recording) were tying in very closely with the "professional" equipment. OK the wrist cuffs have to be put on with care, and the usual caveats apply, but to dismiss the wrist units as "dodgy" is a bit like some of the other issues going the rounds here at the moment, it's dangerous to generalise about almost anything these days.

[Primary Care]

but to dismiss the wrist units as "dodgy" is a bit like some of the other issues going the rounds here at the moment, it's dangerous to generalise about almost anything these days.

These devices are very useful, but notorious for giving innacurate readings, especially if not calibrated correctly and frequently. (But then again, so are humans.)

As for the dangers of the Medical and Health Forum, couldn't agree more.

Wonder how long it will be before someone suffers genuine harm as a result of poorly moderated advice.

[Caramba]

Several points were raised by the last couple of posts, not all to do with high blood pressure.

" As for the dangers of the Medical and Health Forum, couldn't agree more."

Well, potentially; I agree there are dangers. However, I think one can reasonably assume that the users of this forum are intelligent, highly interested and motivated in maintaining good health, and will have to work with a qualified physician/AME to keep flight medical status. Hence they will be unlikely to self-medicate or otherwise cause themselves harm.:ok: Mostly it's about shared experience tho commiseration and sympathy also appear. I noted metoprolol appearing a couple of posts back but assumed that was ironic, not serious, advice.

A wrist monitor might be useful if as Primary Care says, properly calibrated, used correctly, and, ideally, cross-checked with a "proper" measuring instrument - which for blood pressure is a mercury sphygomanometer or similar with the correct size of cuff. If these conditions are met then terrific, yes, but Female Wannabe's experience shows how easy it can be to get wildly inaccurate results, which - as in this case - could be highly alarming.:eek:

It isn't difficult to get your BP checked by someone (eg a practise nurse) who knows how to do it correctly, is using the proper kit, and understands the significance of the results. If you really want to go on checking it yourself, ask what the numbers were, so you can at least see if you are in the same ball-park. But ask yourself - do you know what is high, low or normal? Do you know what level of blood pressure "matters"? No? Then perhaps leave it to someone who does?

If there really is a problem surely any competent physician would verify the results for him/herself before making a decision about treatment or not - which is what your specialist is presumably doing, Irish Steve, not relying on your measurements.;)

May all your blood pressures remain low(ish).

C

[Jimmy The Big Greek]

can someone tell me what the normal blood pressure is when lying down?

[femaleWannabe]

Don't know about lying down but I think something like 120/80 is about right for sitting and being relaxed.

[Shunter]

Whatever you do, don't go having a smoke right before you go for the medical, it can easily raise your BP by 10 points for 30 minutes or so.

I used to have quite a stressful job and at one point mine reached 180/120 at which point the doc said 'go home, and stay there!'. Since then I've got a better job, cut down on the alcohol & caffeine, and now swim about 300 lengths a week. I still smoke (for now). BP at last medical was 135/90. You don't have to go for a crazy health kick, just make a little effort on all fronts and it soon goes down.

[DX Wombat]

Oh dear, another case of the Medical and Health Forum getting idea's above its station.
Somebodies gonna lose an eye.......
Well hopefully not, but I do agree that suggesting specific medication be taken is ONLY for a qualified doctor in posession of all the details of the person's medical history. Anything else is downright dangerous. The amount of advice, suggesting certain medications, given in this forum by persons with NO currently valid medical or nursing qualifications can be frightening at times.
Why not try relaxation? It does not involve medication of any sort (prescribed or "Herbal") and can be very effective.

[Daede1]

I'd agree with Wombat.
Ive got high b/p (170/110 untreated, 130/84 on olmesartan).
You can end up running around looking for a miracle cure, taking a million different pills and herbs, but your best off getting along to the docs who will give you something that will work.

Also, Shunter is dead right - dont think 'i mustnt drink' or ' i must lose weight' - just cut back on most things that you know are bad for you.
That said, if your a big fat lump with ten bellies, might be an idea to try shifting some weight first...

[Daede1]

Also:

''A wrist monitor might be useful if as Primary Care says, properly calibrated, used correctly, and, ideally, cross-checked with a "proper" measuring instrument - which for blood pressure is a mercury sphygomanometer or similar with the correct size of cuff. If these conditions are met then terrific, yes, but Female Wannabe's experience shows how easy it can be to get wildly inaccurate results, which - as in this case - could be highly alarming.''

Bugger any kind of monitor that isnt the cuff type. Wrist ones can be manipulated very easily. If you tense your wrist, your bp comes out higher. It is also testing the bp at the bottom of an appendage - if you hold your hand in the air, it lowers your bp (less blood in the arm/hand due to gravity).

Dont waste your money on these home testing things, as you get neurotic, and test yourself every five seconds - trust me, i used to walk up the stairs, test it and see it was high, panic and lay down where i was! then wonder back down stairs, check it , cr@p my pants and lay on the living room floor for another 30 mins until it dropped.
Get down to see the nurse, takes 2 minutes, they give you a reading and then you know from a professional.

Also, the whole 'my b/p always rises when i see a doc' is a pointless argument. Thats a bit like saying ' when i get cut up driving, my b/p rises'. The key point is that your BP elevates in day to day situations, and therefore you probably go through the day with raised blood pressure.


And more to the goddamned point, what, really does it matter if you have a high bp? its better to know and get it treated, than to go your whole life and have a stroke at 50. Im saying this from experience as my dad was 50 when he died of an aortic anuerisym, caused by high blood pressure - he never went to the docs, and never got it tested, and therefore never received treatment.

[kluge]

There is a theory (will have to out the paper) stating that higher BP allows for greater g tolerance. Woopee for aeros !

[Bealzebub]

High blood pressure (hypertension) affects a sizeable proportion of the general population in many countries. For many people there are few symptoms and the problem can be insidious as a result. For most people BP readings are only taken as a secondary consequence of a visit to the GP or another medical practioner. Blood pressure varies as the bodies requirement changes throughout the day and one or two readings in isolation are often of little practical value. If a problem is suspected a number of readings are normally taken and where the problem persists an ambulatory measurement ( at home) over a period of 24 hours may be required.

Where hypertension is established, the guidance and treatment of your medical professional is essential. It has already been stated that common factors such as smoking, being overweight, salt intake, etc. may well have a significance, and rectification of some of these underlying common factors might correct or partially correct the problem. However just as any inordinartly high pressure in pipework will lead to medium or long term problems, be it water pipes or hydraulic pipes, so it will cause serious problems to the owner if their blood plumbing and pump is also subject to long term and sustained periods of high pressure.
When other treatment may be insufficient or inadequate by itself to sufficiently reduce sustained hypertension a medical practioner may prescribe medication to assist in the required reduction and stabilization. This medication takes a number of forms ( and sometimes combinations) and comes in many different dosages and it may require a period of trial and error to establish a comfortable and adequate correction.

For many people hypertension medication has no, or few noticeable side effects. As such the results often far outweigh the inconvenience or resistance to such medication.

From the flying point of view any medication that effectively changes the bodies circulatory mechanism is always going to be a concern, and the aviation medical authorites will want to be involved in the monitoring of the individuals treatment. In reality and for most people this simply means that the treatment is working, stable and with no adverse side effects. For pilots starting on medication, that will normally mean liason with the doctor to establish that the medication prescribed is within the allowable ( and there are many) drug groups. They will then want the pilot to stop flying for a few weeks while it is established the individual has no adverse reaction to the medication. Again if and when dosages of medication are altered there will normally be a short grounding period to establish stable tolerance. Beyond this it simply means monitoring. This will of course be done by the AME on the pilots normal renewal medicals. It is often helpful to provide a sensible list of home readings over a given period if this is possible. It is also a good idea to make a visit to your GP on an annual basis ( or whatever is deemed sensible) to ensure that the medication and doseage remain effective and that the blood chemistry ( simple blood test) is acceptable.

All of this might sound difficult or complicated, but it usually is very straightforward. The aviation medical authorites are very used to dealing with this situation. It normally has no licensing effect on the pilot other than the short grounding for the reasons already given. The health benefits should far outweigh the inconvenience. Hypertension is a dangerous and insidious condition left untreated and nobody should be discouraged from seeking out effective treatment. Not all conditions will require prescribed medication, but those that do will normally benefit. All treatment should always be under the guidance and direction of a properly qualified health professional and sensible but regular monitoring is essential.

On the subject of home monitoring there are various brands of equipment that are reasonably accurate when used properly. At the risk of advertising ( I am not !) my own AME believes Omron produce a range of effective and easily used arm cuff monitors. Home readings are often lower than those you will achieve in a doctors office simply because you are naturally more relaxed at home, and it is a case of taking readings at your own convenience. Many of these monitors come with memories and some with attached simple printers to make the recording of your own readings extremely easy. Cuff size can be an issue, but your medical practioner can best advise you on this point. Some of the wrist measuring devices and cheaper monitors can be of very limited use with regards to accurate monitoring.

In summary, sustained high blood pressure can be a killer so get it checked and where necessary get it treated. Where treatment is desirable and recommended do not worry unduly about the implications with regards to flying, it is something the authorities deal with regularly and they well versed in certifying pilots with this underlying condition. The inconveniences are usually minor and on balance the benefits are potentially huge.

[kluge]

Sounds like I'm recruiting for satan !

I'm on Hyzaar forte (and a cholesterol statin) and NO problems. BP is 120/80 on average. Agree also on the AMO requirements. No biggie. All of this is manageable but you cannot let it get out of control. I was terrified of being grounded and I believe that is the biggest fear that most of us have. Once you realise that your career/passion is not threatened then you breath a sigh of relief. But DO NOT IGNORE IT otherwise it will be much more than getting into a cockpit that will be threatened.

I read somewhere (a US article) that some 45% of the population are hypertensive genetically. 40% of that group do NOTHING about it. Unbelievable.

(The article I referred to in last post re increased 'g' tolerance (it was a bad joke BTW) is from October 2003 Aerobatics magazine - Human Factors High Blood by Scott Poehlman IAC 25179)

K

[Re-entry]

My apologies re former accusation of no life. My point was a response to a colleague in distress (if you read the original question of the thread from vfr on top) . He asked for a short term solution. I gave it to him. He knows the long term solution (pilots are not THAT dumb) and did not ask for an online lecture. He will have at least another year to think about that. I never supposed to offer proper medical advice.

[stilton]

No salt, exercise of course, I would not say cut out drinking unless you cannot go down to a moderate level which (can) be beneficial.

And if, despite everything you cannot get it down, do NOT procastinate, get on medication, it's not that big a deal.You can fly with it.

Or you can do what I did and delay too long (because I was afraid someone would find out) causing myself a permanent though minor cardiovascular problem.

All sorted now, and taking daily medication ( there is no shame) Take care of yourself.

[slim_slag]

no problem re-entry. I suppose when you put it like that your solution is quite ingenious, and illegal, but clever all the same. Never thought of it that way :)

The thing about the questions posed here is that none of us really have a clue about the specific circumstances of the individual, and cannot really provide meaningful advice unless one has seen the patient. But with something as relevant and common as hypertension it's tempting to provide general advice to the population as a whole. So although vfr on top might not need long term advice, somebody else might benefit from being lectured to lose weight, and that can only be a good thing.

When you say "pilots are not THAT dumb" that's not really the point. I once had the honour of seeing a Nobel Prize Laureate in a cardiology outpatients clinic. He had no clue about his problem, but that didn't make him dumb - his prize was in physics and not medicine. Likewise I sometimes cannot order five chicken soft tacos and a diet coke in the drive through, but that doesn't make me dumb either.

[VH-GRUMPY]

I have high blood pressure which is controlled by drugs (MAN). It ends up about 135-145/80-90 depending upon circumstances.

I have just been to my doctor who said lose weight (OK working on it - down about 6 kgs); exercise more and reduce alcohol intake - he said buy a $50-$100 bottle of red and you will only drink 1 glass a night not the 4 you are.

What a clown!

:cool:

[Re-entry]

ASl ? I like your posts.

[nuclear weapon]

vfr,
I'll like to say based on my personal experience you're on the borderline. After passing my first class in 2002 march. I took up martial arts (taekwondo to be precise) Intensive classes twice a week. My weight dropped and i bought a stationary bicycle which is in my living room. I currently do 50 mins on it every sunday Another 650 calories burnt. I've dropped roughly 20 pounds since then and my blood pressure even though it was normal has fallen to the low range. The doctor was impressed when he compared my first results to my renewal one. However unlike you I dont smoke or drink and contrary to what some people are telling you here I will advice you to do your best to drop both habits immediately. As far as I am concerned they serve no usefull purpose. I am sorry if that sounds a bit offensive to those that drink or smoke here.
Having worked in the NHS for a very long time I've seen first hand what abuse of alcohol has done to a lot of families and peoples lives. In almost all the cases they started off as average drinkers. As a man I know it cant look too good when you go to pub with friends to be the only one to order for orange drink or coke. But then you eventually get used to it.
In my own opinion if you do quit you will not be missing anything but you will gain a lot you also get a flat belly. 95% of the time when I tell people my age they simply refuse to believe it I've sometimes had to show some friend at school my license for them to believe it.
Best of luck I can tell it wont be easy but in the end it will be worth it.

[AustralianGoose]

Nuclear Weapon,

I completely agree with you - having seen you first hand, I must say you look incredibly good for your age, not only that but your intelligence is of the highest standards....
:\

[woof]

OzGoose,

I concur, he's fab!

I wish I hadn't drunk so much in my previous years! If I had stuck to the true line, perhaps I would have passed my exams first time and would by now have a type rating and a job.

Oh hang on.........

[corsair]

Bealzebub's advice is spot on. I have high blood pressure and am on an ACE inhibitor not the Beta blocker as mentioned on the beeb today. It was found on my Class 1 renewal but there was no drama. They simply asked for a 24 hour monitor which proved it was high even in bed asleep. I was put on medication successfully. The irritating thing about high blood pressure is that you feel exactly the with or without medication. The only difference is that you will probably die of some related complication if you fail to take your medication.

A Doctor told me that high blood pressure is a game of halves. Half the people who have it don't know, half who know don't take medication and half of those who take medication have side effects.

The biggest problem I found with hypertension was that when I applied for a mortgage the racked up the insurance costs even though I am on medication. Rather ironic, on meds the risk is considerably reduced.

[The Real Slim Shady]

I suffer from high blood pressure and take CAA approved medication to control it.

I don't smoke, I drink moderately and I exercise fiendishly: it's my hobby.

Average BP is normal until I go for my medical when it goes up....white coat syndrome.

Fortunately the CAA are pragmatic; if you join them in trying to reduce your BP they will bend over backwards to help.

[allan907]

Herrumph! First posting on this forum - never had the need to before. However, had my annual aviation medical today and all went swimmingly until we got to the blood pressure part of it. Was high and wouldn't come down so the doc put the medical into hibernation until I've got it sorted. Going to see my GP on Friday but in the meantime what is your advice for getting the pressure down?

Allan907 Factsheet: 182cm, 95kg, age 59, moderate exercise (walk 2 golden retrievers 3 times a day and cycle when I'm down in Cottesloe a coupla days a week), diet could be better - like butter and naughty things like the occasional McD, current stress levels probably high due to nasty divorce/separation, like a glass or 2 or red wine each evening and maybe a scotch.

Any advice gratefully received 'cos I don't want to lose my PPL - I worked too hard for it to lose it now.:(

[the dean]

907

may not be much use to say this...not a doctor..but as instructor of many years i have known some who developed this problem and with diet and exercise got to strap the wings on again...

i imagine it will depend on whether you need treatment and whether that controls the pressure...though i do'nt know if the mere fact you might need medication would prevent you flying again...in the case of the others i can think of , i do'nt think they needed medication but i could be wrong..

i will be interested to see what the medics among us say just out of curiosity...

anyway think positive..and good luck with your GP...:ok:

[niknak]

I suspect he will tell you to keep off the naughty stuff, eat properly, maybe see a dietician and exercise more than you already do.

I was in a similar situation recently (without the divorce) and I've got my BP down from 150/90 to and average of 127/70 through lots and lots of exercise and a sensible diet.
I don't suffer from stress, but the gym/exercise are great levellers, although getting thoughts of your divorce out of your head must be very difficult.

I suspect that your GP might recommend medication of which many are compatible with an aviation medical.

Good luck anyway.

[Re-entry]

This subject got dealt with here before. Don't know if you can search the results. From my personal experience, strenuous exercise is the single most effective fix.
Also, refer my post 'trans fats'. You might be blocked up. In which case I don't know what the answer is. Maybe there isn't one.

[airborne_artist]

907 - I'm the same height as you, a dozen years younger and weigh 45 lbs less, and my BP is well within range. Resting pulse of <50 (what's yours?).

I'd suggest a trip to the GP or similar first, and take some advice as to how to lose around 20-30 lbs.

Up the walks length and pace (to say an hour and half in total, at a good brisk 4 mph), up the cycling/add in some swimming. Think about a gym membership perhaps, if you think you'd keep it up.

Then cut 80% of your red meat from the diet and replace with fish and chicken, cut any beer, ensure at least 5 good portions of fresh fruit and veg, cut any biscuits, cakes and convenience foods, and watch the salt intake

Keep the red wine at 2 glasses per day, and keep the Scotches small-ish.

[allan907]

Thanks for all the advice. Had the battery of tests and an ECG - all normal. Tad high on the cholesterol and a tad low on the testosterone (!) but within the normal range. Will up the exercise, eat slightly more sensibly, take the prescribed tablets (Coversyl) and pop back to the AvMed man in a week or so. Keep fingers crossed for me!

[Vino Collapso]

907,

Comparable stats....height 1.8m, weight 100kg, age 50. Like food and wine with the meal. Not much exercise these days I am afraid but used to be quite active. :=

Failed a class 1 on BP a couple of years back, couldn't get the figures below 165/97. Never had a problem before, always cruised through the BP test. Subsequent testing brought up figures as high as 170/110, but varied up and down throughout the day.

GP prescribed Atenolol which helped a bit but not much so Adalat was also prescribed and the figures dropped to 'normal'. After a couple of weekd settling down the class 1 was re-instated. However some side effects were evident particularly heavy limbs and general lack of get up and go.

Atenolol now frowned upon in the UK due to side effects and stoped by my GP so just on Adalat for the moment and keeping a wary eye on the figures that creep outside limits normally during the morning.

Planning a regime of more exercise to see if I can stabilise it in the green arc and perhaps shed a bit of weight, but you can stress yourself up by putting yourself under pressure to get the readings down which is then self defeating.

Sorry to here about the divorce, these things really do bump up the pressure even if you think you are dealing with it :sad:

[JackOffallTrades]

VFR,

Bit of advice I once heard to get the BP down before a medical is to bash :mad: off!

Not sure I should be saying that on here but apparently it works.:}

[airborne_artist]

JOT - according to this paper (http://www.newscientist.com/article.ns?id=mg18925365.500) it's got to be dual, not solo.

[flightychick]

That could create some interesting scenarios in the CAA's medical department!!! :eek:

[Fly-by-Wife]

VP,

I can't give you any information about flying with high BP, but your tale rang so many bells for me!

Like you I exercise regularly, "drink in moderation, don't smoke, eat healthily and don't have any family history of high blood pressure and feel fit and healthy".

I had a heart "scare" in 2000, aged 37, being kept in hospital for 4 days under 24-hr observation while loads of tests were done. This was all down to an unusual ECG when admitted.

Upshot was a stress-test (treadmill + ECG), which was fine, then a discharge and a referral to a cardiologist (fine), and a battle to get my class 2 medical - again down to the unusual ECG (I've got some inherited oddity, that is perfectly healthy but non-standard). Finally sorted after several letters to Gatwick from GP and consultant.

All the above was, apparently, stress-related. No heart problem at all (the cardiologist even told me I had more chance of winning the lottery than having a heart attack in the next 10 years).

Four years later, a very stressful period at work resulted in me seeing my GP, who noted very high BP - I can't remember the figure, but it was sufficient to cause concern.

Like you, I had a 24-hr monitor (a bit weird, and rather hard to sleep), but it showed - happily - perfectly normal resting BP.

The point of all this is to show you just how much of an effect stress can have, and that it is perfectly possible that what you are experiencing is purely down to stress, and - literally - nothing to worry about.

The 24-hr monitor will - hopefully - give you a clear-cut indication, either no problem or genuine high BP.

If it's no problem- as it probably will be - you have to believe it, and concentrate on finding out about de-stressing and relaxation.

FBW

[The Jolly Roger]

Hey man,

I'm a controller and I get exactly the same feeling of dread at every medical. Can't help it. I do try tho. The doc that did it back at home a few years ago (i'm abroad now), made it worse by doin the lecture thingy too. I gave him some lip about it too.!! He put me on a 24hr monitor and all, as expected was fine. Nurses said white coat hypertension is absolutely endemic but they have to be sure. I wouldn't be too stressed. When you put it on first, the thing nearly blows up in your face its so high!!! :eek: Then when you forget about it a little, it starts to behave normally. They want to see that it drops when your sleeping and doesn't lower everytime you exercise. I'm your age by the way so I hear ya.

Best of luck and don't listen to the doc toooo much......I'd like to see them under a little stress...:\

[CharlieJuliet]

OK having got there: they will try various pills. From experience these will not work on the first pass. (or the second) I had one set of pills for one month, then a second set for the next month and finaly a 3rd set for the 3rd month, and these finally reduced my bp to acceptable levels ( still good after about 5 years). I was off for 3 months, but got my class 1 back. I think that the waiting time could be reduced but the docs are running on old pills!!
Anyway keep the faith - it will sort itself out after some time.
There does not seem to be any follow up to see if the dose is correct - if it works under the NHS it stays. I am sure that the doses that I take could be reduced!!

[gingernut]

It's unlikely that the readings you describe are likely to make a difference to the quality ( or quantity ) of your life, that much.

It'd be a cruel AME that would pull your ticket on the basis of the readings posted, but technically a persistent systolic of 164mmHg or above does warrant treatment. Previous postings on here suggest it'll make no difference to your career though.

I made a post about 2 years ago about this, I'll try and post it again.

[gingernut]

at the risk of repeating myself.....:) I'm pretty sure this evidence is still current.

And remember, stopping alcohol 1 week prior to your medical is likely to bring your readings to an acceptable level. (don't shoot the messenger !!)






As this seems to be a recurring worry for pilots, I thought it may be useful to summarise the current medical thinking about hypertension. (Raised blood pressure).

It's not definitive, but I'll try and be scientific by grading recommendations as follows.

(A) Strong Evidence (Clinical trials of a high standard)
(B) Fairly strong evidence (Clinical studies of less higher standard)
(C) "Expert" opinion.

I'd welcome any contribution/corrections, but to try and make the advice more "robust," I wonder if you would mind also grading your evidence ?



What is "blood pressure?"
It's simply the force exerted on the artery walls by circulating blood.

What do the figures mean?
Usually blood pressure is recorded as two figures, eg 120/70 mmHg. The top figure is the force exerted when the heart is contracted (Systolic blood pressure), the bottom figure when the heart is relaxed (diastolic).

What is hypertension?
Hypertension is diagnosed when the reading are persistently raised.

Is it Common?
Yes, about 30% of adults in the UK have hypertension. (B)

What does persistently raised mean?
Patients should usually have their bp measured again, if initially raised. They should then be asked to return on two occassions, 1 month apart.(C)

Can I help with my diagnosis by monitoring my blood pressure at home?
A popular concept, particularly amongst pilots, some of whom tend to err towards the logical (nurdy) sidehttp://static.pprune.org/images/smilies/nerd.gif(me included).

Unfortunately, no matter how attractive the concept, the use home and ambulatory measurements are not recommended at present. Although further research is currently being performed in this area. Callibration of home machines is also an issue. (As it can be in the health service!).(C)

But doesn't this help identify the "white coat" effect.
The million dollar question. "My blood pressure is ok throughout my day to day routine, it's only ever raised when I see the quack."

There is a school of thought that suggests that even these intermittent rises can lead to long term disease- a controversial area (C)



Is hypertension a disease in itself?
Usually not, (about 95% of cases), it is a risk factor for Cardiovascular Disease- Heart attacks and strokes. (C)

How does my quack make a diagnosis of hypertension?
Usually when one or both of the readings are pesistently raised on different occasions-although if very high he may decide to commence treatment immediately.

What are these readings?
Depends on who you ask. Most authorities agree that a reading equal or over 160/100mmHg warrants treatment. If over 140/90 (some say 80), your quack should be taking into account other risk factors, (eg chloesterol, family history), prior to reaching a decision on your management.

Thresholds are lower for certain patients, eg diabetics. (C)

Who decides the targets?
Experts (C)

Is it worth doing anything about?
Yes, generally a small reduction in BP dramatically reduces the risk of illness and death from heart disease and stroke. A 2mm reduction reduces risk by about 10%) (A)

Can I do anything myself?
There are two strands to this argument, firstly can I actually reduce the blood pressure reading itself? Secondly, can I reduce my cardiovascular risk?

This is quite an important concept, often overlooked if you get too fixated on the numbers.(Pilotshttp://static.pprune.org/images/smilies/smile.gif) I'd suggest number 2 is equally, if not more important than number 1.

Diet and exercise can reduce bp&risk (B)
Relaxation can reduce bp(B)
Alcohol consumption-reduce if raised-bp&risk(B)
Reduce excessive caffeine intake bp(C)
Reduce salt reduce bp(B)
Stop smoking -reduces risk (but not bp)(A)

Remember-small changes can make big differences.

Ok, I've made the changes, and my bp is still up, what next?
This will depend on two things, the actual reading itself, and your cardivascular risk. If persistently over 160/100 you will need drug treatment. If in the "grey area" eg treatment will probably depend on overall risk factors. (B)

For example, if your bp is 140/90, you smoke 20/day, you dad died of a heart attack aged 40, and your cholesterol was high, you are probably aiming for drug treatment.

If you a chap who doesn't smoke, thinks a kebab should consist of fish, tomatoes and peppers, doesn't know the pleasures of a "pie dinner", and thinks that "happy hour" is spent in the pool, then a strategy of close monitoring may be the best strategy.

(Remember pilots, don't get fixated on the numbershttp://static.pprune.org/images/smilies/smile.gif)


My quack has decided I need medication, why should I take a tablet when I feel perfectly well?
Good question- once the decision is made for drug treatment, it's likely that you will need it for life, and it could potentially make you feel unwell. Drug treatment is unlikely to make you "feel" better.

However the benefits of treatment, in terms of reducing death and illness, are clear and well established (A)

Is treatment guaranteed to cut down my risk?
(Okay, for the pilots, some figures)

Definately not! If I had a roomful of 100 people who had a 20% risk of having a heart attack in the next 10 years, then 20 will have a heart attack in 10 years, and 80 will not.

If I successfully treated these people, then in 10 years, 80 will still be healthy (whether they had treatment or not), 15 will still have a heart attack, 5 will be saved.

(Ok it's a bit simple, but you never know, a surgeon could be reading this.)

I'm taking 4 tablets a day, is this a bad sign?
No, in the "old days," you would be started on one tablet, if the response was poor, the dose would be doubled, (again and again) unil control was maintained. Modern thinking suggests that patients should be given "lower" doses of drugs which act in different ways, as this reduces side effects. (B)

Is anyone drug better than another?
The differences are probably negligible, the important thing is to get the blood pressure down. Older drugs (Alpha and Beta blockers) are used less and less. Thiazide diuretics, calcium channel blockers and ACE inhibitors appear to work well, with minimal side effects. (A)

Will treatment and a diagnosis of hypertension affect my life/career?
Probably not- it's important to let your quack know if you are suffering any adverse effects- the range of treatments available is vast. Of course, your AME needs to be informed.

Who is the best person to consult about my hypertension?


Your treatment should easilly be managed by a team, but your day to day care may involve a doctor, health care assistant, nurse, or a pharmacist.

The key to successful managment is to be systematic.


Safe flying, remember if you wish to add to this thread, try and grade your evidence, don't know what you lot think, but would it be possible to keep this thread for updating current guidance, perhaps specific enquiries could be tagged on to existing threads?

cheers, ginge

[Murmur]

I'm 30, exercise 3 times a week

what kind of exercise?

[Earl]

There is a way to lower it very quick.
Nitro pills under the tounge, can buy them in Madrid and most middle eastern countries.
But you are only cheating yourself, pass your medical, but the problem will kill you if not treated.
Lifestyle changes are the only way, reduce the alcohol intake, garlic pills even work.
Exercise more, don't have to go to the gym, just take a long walk everyday.
Giving up or reducing smoking is not a immediate fix, but long term it can help.
If the B/P is that high and not reduced you will have a greater chance of stroking out during any high periods of stress or work related tasks.
This from my AME and personal experience, reduce alcohol, exercise and drop some weight, it works.

[Bob the Doc]

I can certainly concur with gingernut's post. He has summarised the current advice very well.

I would definitely say that white coat hypertension is a well documented issue but as GN says, while your BP may be normal, if it goes too high under stressful conditions, this may in itself be cause for concern.

Calibration of these devices is woefully poor in many situations and some of the automatic machines are not very accurate. Doing BPs with an old fashioned mercury sphygnomamometer is the most accurate but most places have banned them due to elfin safety issues!

Getting the cuff size right is also essential. At my last medical the nurse found my BP to be high but when the doc did it with a bigger cuff it was normal. Small cuffs over-read and large ones under-read. The standard adult cuff is probably too small for many larger adults and so they might be inaccurately defined as hypertensive

All in all, quite a crude measure but a useful one taken in combination with other things.

HTH

Bob

[Bob the Doc]

Oh....and on NO account should you EVER even contemplate buying drugs over the counter to treat this sort of problem without first discussing it with your AME. Many are either unsafe, untested or just don't work. The RAF takes a very dim view of its aircrew self-medicating (for example, even Piriton is a no-no) and I would be surprised if the CAA were any different

[C-N]

I've tried munching garlic and it could lower your BP in minutes, its my bandaid solution every time my BP goes up abnormally. for a long term solution you must stop smoking and drinking alcoloholic drinks. i've heard lately coffee can also recude BP. good luck

[piggybank]

For natural treatments. Depends where you are in the world. Starfruit or "belimbing" gives a fast but short term drop in blood pressure. Ripe fruit will do but the best is the one that is as hard as wood, just developing. Don't juice it as it will make you cough. Slower drop but longer lasting is a "tea" from green leaves of the passion fruit, locals here say the leaves of the purple one is more effective than the regular yellow one.

[sharksandwich]

gingernut and Bob the Doc have given excelllent advice.
To save people wasting their money, the small electronic BP measurement devices advertised in magazines for about £70 are so un-reliable, my local NHS Trust has banned them from the wards.
A better option is to make an occassional appt with your local Practise Nurse (GP surgeries should all have one).
I was taught the most important figure is the lower one (diastolic), which is the pressure when your heart is at rest. Consistant readings of 90 or over may need treatment,because that is the lowest pressure your blood vessels achieve, and like a domestic plumbing system, consistently high pressure may cause leaks.
The higher figure (systolic) is often 100 plus your age (in normal,non-athletic, sedentary people), though a lower reading is preferable.
My own BP had reached a figure which worried me, but I managed to lose 10 kgs (cut down on my drinking), and it is now usually 140/80, which is fine by me (in my 50's).

[piggybank]

In my last post I said about using Starfruit. There is a catch with this, that some prescribed medicines have considerably more effect if consumed with this fruit. Its worth a look at Wikipedia and Google about a bit, sorry for taking a while to mention this.