Sudden onset of high blood pressure
 

I take a small daily dose of beta blocker to keep my bp at a nice 135/85. Works just fine. However every few years - no more often - it jumps way up for no discernible cause, the past few days were to 175/100 so I drove to the clinic (it being Sunday) and got fixed up (or down, actually).

If it happened more often discerning a cause would be easier.

Anyone else out there get these sudden peaks at long intervals ?

Oh, and is there anything new apart from beta blockers and diuretics ? (and meditation of course).

"...beta blockers and diuretics?"

Yes, a whole pharmacological generation!

ACE inhibitors, long acting nitrates and calcium channel blockers for a start.



:p

Thanks, Mac. Will mention to my MD (an intelligent man).

I'd love to know why the conditions comes - and goes.

Incidently the nurse at the CAP Clinic I went to, located in a town where other than tourism, fishing is the main industry and obviously we all eat a Mediterranian Diet heavy in garlic, olive oil and washed down with red wine, and people live to their nineties, said "180/85 ? That's nothing to worry about."

Not that I agree but I note her comment in relationship to what she measures in people every day in that location.

Your prophecy come home to roost, perhaps? I recall you posting pictures, which I can't find, of your rather tasty cleaning lady .........

Possibly a bi-product of your recent plumbing adventures.

Usual boring advice suggesting weight loss, general fitness, and reduced salt.
Medication wise : anything ending in "-pril" or "-artan" might be worth discussing with your Dr (sorry, you referred to your "MD" ! ). :)

Thanks, everyone. Not boring advice either Ulster, but I don't use salt and do an hour in the gym every morning. Still have a 'tum' though.

BP back to a very healthy 130/80 this morning (and Kerry the cleaner just left...)

High Blood Pressure
 

OFSO for an alternate approach to your BP woes you might like to take a look at a new book by American cardiologist William Davies. The book is called "Wheat Belly" and is both a good and interesting read for all of us who fly and wanting to maintain our medicals.

Thanks all. Acting on the advice of my mother-in-law (aged 91 going on 92, blind but sharp-witted as ever,) I've gone to a diuretic (40mg furosemida) mornings and half a beta blocker (2.5mg bisoprolol fumerato) evenings.

BP is now 135/85 pretty well constant. No side effects, either.

Any future 'spikes' lasting less than 48hrs will be ignored.

Wheat Belly: virtually every supermarket here sells 'fresh' bread. However it's made from premixed dough delivered by trucks each day. The resulting bread lasts about five days before going stale. OTOH, a local French bakery sells it's own bread from it's own dough and it goes stale in 24 hours. If you have to eat bread, the latter is the most healthy.

I am a high anxiety client of the beta blocker pharmaceutical brands. BP is a strange issue, diet of the common prescription did little. The Beta's (bystolic) have done well after ditching an alpha blocker, yrs later added a calcium blocker. I have since changed my mindset a little more to the ":mad: it" frame of mind and it seems to help the most for my ailments. Not that I disregard my health or safety of others, just eliminating stress that is useless. Back to my opening statement I believe that useless stressful influences are the largest factor for my psychological and physical health. Try to eat well, sleep well and live well. Personal relationships, expectations from all your daily duties are not worth your health and I have found to be more successful in all aspects with more of a screw it attitude towards stress.

Excellent advice, grounded.

As an aside, for those many of us who have annual checkups, I wonder how useful this really is. How many complaints can arise or go unchecked in the intervening 12 months ? One might say "better than nothing" but is it ?

grounded

I have read that the Astronauts on takeoff get BP readings of 220/120.
there are arguments that any BP reading with a heart rate over 70 bpm are misleading? So if you are anxious with the old ticker running along at 100 ???

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 :mad:, 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 :)

Don't die of worrying

Thanks gingernut, probably the best advice ever.

So now, several weeks later, back to one half a 5mg fumerato de bisopronol tablet morning and the other half in the evening (beta blocker) and BP remains around 135/85 plus or minus 5%. Don't smoke, don't drink (by mediterranian coastline standards) and go to gym to do aerobics plus weights 3-5 days a week. 70th birthday in six weeks.

Looks like I may make it :)

135/85 plus 5% is 142/89 which some might describe as a tad on the high side for a resting BP. As a BP chaser of some repute, I'd suggest a slug of Perindopril with perhaps a dash of Amlodipine maleate, as recommended by your friendly cardiologist, in your evening Fundador. This will mitigate the effects of increased Manzanilla intake, an indulgence which is in itself highly beneficial for the exaltation of the soul. Smoking, on the other hand, might cause bladder cancer which in turn can mean you have to wear a catheter in between operations. This inhibits one's sex life experiences. Going to the gym does nothing at all for those who are aged, such as I, unless it is to absorb, in varying degrees of vicarious pleasure, the stocking clad backsides of slender young women on running machines.

I'm a lot less worried about you, than those wandering around uncontrolled.

We could debate target's and numbers all day, the readings you report sound like they are going the correct way :-)

From the age of 18 to a few years ago my BP was 145/90 at every annual medical. A very wise surgeon friend said "well, that's you - that's your blood pressure. And your system will have 'grown up' to tolerate that. Just as Mrs OFSO has a normal BP of 120/65 and that is her level and she could not tolerate yours for ten years."

In the same way my uric acid is high but I don't have gout. And I know folk with cholesterol over 200 who have lived in a state of great health to 93, and people with abnormal triglyceride levels who have survived to their late eighties.

I believe in taking precautions (obesity, smoking, drinking, free radicals) but I think sometimes the medical profession forgets we are all different.

Another wise old German (not the same one but just as wise !) said to me once: "we doctors should always remember: treat the patient, not the test results".

Sorry but that is absolute rubbish. It is NEVER too late to start. Aerobics and weights done sensibly have a great effect.

OFSO has a valid point we are all different what is normal and harmless for one isn't for another yet we are all treated the same.

i had high readings in my 20s and have past 20 plus medicals since.

second point Doctors love to measure things and something like BP which is NOT constant, can vary during the day, month year etc, how high your heart rate is, how stressed you are etc maybe not as indicative as some make out!

I also find the scale is conducive to something racy! fast.
" You loose your licence if caught doing over the ton :E

Much better for your BP if the Doc says " your BP is 2.6 over 1.9 :ok: why the 170/100? that itself is a racy sounding scale! itself enough to raise the old BP

Blood pressure units are "Millimetres of Mercury" , Pace. From those old-fashioned days when a real sphygmomanometer contained a column of the fascinating liquid metal !
If you prefer smaller (less racy !) numbers, why not simply scale that reading down to 1.7/1.0 ? The ratio is still the same !