Hi OFSO, I've just had my insurance renewal, and apparently I'm not insured for giving consultations on line, but perhaps a few general principles may be worth discussing.
A "one off" raised bp is unlikely to cause significant harm. There is a point where this is not true, and rarely patients with "malignant hypertension" require immediate admission to hospital (220/120mmHg springs to mind-BUT check the machine and cuff before you dial 999). I've never seen this in a career of taking blood pressures. Younger folk (<age of 40) with persistent raised, or labile, bp's ,deserve rather more robust investigations than old farts like myself. It may be worth asking for a renal (U+E's) blood screen, to eliminate unusual causes for the raised reading. (Rare.) If you are young, it may be worth asking for a referral to the medics. (Proper doctors.)
The damage done to the circulatory system seems to be related to duration of elevation, even if this is modest, rather than the magnitude of elevation itself, so a short term elevation is unlikely to ring too many alarm bells.)
Interesting to see that your blood pressure was "fixed." Are they planning to "unfix" you when your bp levels out ? And how do they monitor that ? It's not a sarcastic comment, but sometimes we are more willing to "step up" , rather than "step down" treatment.
It's reassuring that your "norm" is 135/85mmHg. Depending on who you ask, and what other conditions you may have which may raise your risk (eg diabetes, family history, smoking status etc.), this could be seen as a reasonable level, although remember, your prescriber will be working on different parameters, depending on whether the reading was a "home" reading, or a "surgery" reading. (Home readings tend to be lower, most of the trial data linking bp to disease and are based on surgery readings, which tend to be higher.) I'm a bit of a health facist, but I've been tainted by observing, (and caring for), the victims of uncontrolled hypertension, so my thresholds for upping treatment are perhaps at the lower end.
We also look at things on a "population basis" - that means we put your data into a spreadsheet, age, gender, cholesterol level, bp , smoking status, family history, ethnicity etc (and some other stuff that fails me at this late hout), this then gives us a a figure detailing the risk of an average OFSO having some sort of event over the next 10 years. This steers our treatment choices. Have a look at "CVD risk calculator" for more details - it's important not to take bp alone in isolation, but at the same time, don't get too hooked up on the risk score- everyone's got one. I think the last time I looked, mine was about 9%- in other word, 9 out of a 100 gingernuts will have suffered a catastrophic event in the next 10 years. Which 9 ? Who knows ? Always good fun to mess about with the "smoking" field in the spread sheet- used it many a time to convince patients that quitting really does make a difference. My risk goes up to about 18% if I add a positive for smoking. Of course, these predictions are all a bit "airy fairy" but it's probably the best think we've got to work on at the moment. It's been a while since I've looked at the studies in depth, but in terms of managing risk, in otherwise well patients, it's as good as it gets.
As regards your treatment......it's not wise for me to give specifics, but again some general principles. Beta blockers, and diuretics may be seen as being quite old fashioned, and some time ago, we were "encouraged" to have a discussion with our patients who were prescribed such drugs as atenolol and bendrofluazide. More modern agents, (eg ACE inhibitors), seem to add in some kidney protection, with less side effects. (Probably more important in those under the age of 45yrs)There's quite a good "step-wise" approach detailed in the latest NICE guidelines, I'll try and post a link.
Having said all that, it's probably worth having a chat with your prescriber. There is some mileage in the old adage, "if it's not bust, don't fix it." Reducing risk seems to be related in reducing pressure, rather than the agent used to reduce that risk.
All this Primary Prevention stuff sometimes seems a bit of
, one common criticism I hear is "I only went in for a blood test, and now I have to take tablets," but it's important to remember, you're not actually ill, we're trying our best to stopping you getting ill.
Don't die of worrying