Borderline Hypertendion

Many of us will disagree about your no real side effects. I've been on about eight different meds and only two did not give me bad side effects. 

If there are no side affects surely you are better lowering bp with meds if its going to stop you having a heart attack

Is she reads the information leaflet with any BP medication it will list the possible side effects. The one that amused me was that it may turn your toes blue.

I have had my throat swell up , erectile dysfunction, constipation and an all over rash to mention but four, 

Oh, i suppose we are all different

And not for the better when we get side effects:-)

We need drugs to cure not to to take forever and how many do?

Well, I'm 73 now, I haven't had a heart attack 18 years on from being told I needed to take BP meds, and it's by no means true that BP medications never have side-effects for anyone. You only have to read up on some of these boards (especially amlodipine) to see that that's not true. I'm glad you don't have any side-effects, and many people don't of course. However, you can't just assume that no one will.

Yes, of course you can have a heart attack or a stroke if you have sustained, untreated high BP after a long period. I clearly stated in my post that I wasn't saying no one should take BP meds.

However, I'm being monitored by my doctor every six months and I trust him. Having a borderline-high BP isn't going to suddenly produce a stroke or heart attack overnight unless you have a strong family tendency to these conditions, in which case medication won't make a huge difference anyway.

I was simply stating the case for patients to have more input to their condition rather than being panicked into taking medication by threats from their medical advisors - who aren't always totally independent.

Thank you for your reply lily it has made me feel much better.  I have a bit of time as I am not allowed to take the blood pressure tablets until I have had some blood tests.  She issued a prescription and told me not to take them until then so she obviously doesn't think I am going to drop down dead immediately.  I have another appointment to get the results back on the 10th January so I have some time to adopt a health lifestyle before then and hopefully I can lower it by a healthier lifestyle  I started immediately with the alcohol, salt and exercise and diet changes.  I suppose I will have to put Christmas on hold this year and make drastic cut backs to my plans.  Well done on controlling your blood pressure and your weight loss and maintenance.

SAGE ADVICE and sharing!  HAPPY CHRISTMAS!

No no NO, Daisi! Putting Christmas on hold is just about the worst thing you could do. It will just put your focus on what you (mistakenly in my opinion) see as a serious problem, and make things worse. There's no way you're going to make any serious difference to your BP or your weight between now and 10 January anyway, even if you go on a near-fast.

On the assumption you're not going to get blind drunk every night for a week, eat an entire family pudding on the day and see in the New Year with a magnum of champagne just for you, I'd say go for it! A bit of normal festive fare on a few days of the year won't do you any harm. I've already started in on the mini-mince pies and am planning to do myself proud on Monday. In the New Year I'll step up my exercise levels a bit, and I know I'll rapidly lose the few extra pounds I'll have gained. It works every year.

It takes many years of high blood pressure to do any serious damage, and yours isn't even really high. That diastolic of 86 is only high-side of normal for age 59. The systolic of 156 is quite high, but it's the diastolic that's more important. A one-off high systolic in the presence of a more-or-less normal diastolic means nothing at all, as systolic pressure can be influenced by stress or anxiety - hence the expression "white coat syndrome".

My mother was found to have a BP of 195/140 at age 75, when she went to hospital after breaking her arm. As a former nu rse, I was furious that her GP had never picked up on this, especially as she was a lifelong two-packs-a-day smoker, and had suffered from frequent bouts of bronchitis for 20 years. (He subsequently admitted, when confronted, that he'd never once taken her BP in all that time!)

She immediately went on medication, which fortunately didn't give her any side-effects, and lived till the age of 89. It's true that she developed vascular dementia in her later years, but that can happen to anyone over the age of 80, and I suspect her 40-a-day habit, starting at age 14, didn't help a lot either.

Forget all about your BP over Christmas. Then dig out that BP monitor and start checking it from time to time. But no need to obsess over it - everyone's BP goes up and down throughout the day. Start your exercise programme now and the sensible eating after the holidays, and if you're still worried about your BP ask your doctor to put you on a 24-hour monitoring test. That's the gold standard for working out whether your BP is really a problem.

And above all, happy Whatever!

Aww thanks lily, you are right, I do seem to have got myself into a bit of a state about it all but this forum has given me some very good advice and for that I am grateful.  I did have a nip of rum in my tea last night it was so cold here I don't went on here as some of the posts are greyed out.  So i will join you in saying happy Whatever and hope you have a happy healthy new year.

Thank you for your reply Derek.  I do have a blood pressure monitor at home but I lost interest in it after I first bought it when my BP was normal and left it in a cupboard, I could kick myself now as I could have spotted it going up earlier.  There are different opinions on borderline BP. Here in the UK they say anything over 140/80 but in the USA they say borderline is 150/90 and below 160/100.

I'm surprised at the American figure.

I go to a NHS hypertension centre and there they say to take four readings over a ten minute period three times a day.

what?????

Your BP varies a lot during the day. It is also looking for consistency. If they are very mixed they are not to be believed but if three out of four are close you can accept them. Some tell you discard the highest and lowest out of three others to use an average. My BP monitor gives an average of any series of readings I do.

4 times within 10 minutes is rubbish.

 

Perhaps to you but not to this expert on hypertension 

You know derek76 if you want to pick a fight or start bullying others this is not the place.  You have your opinion and experience as do the rest of us.  

Whether 156/86 is seen as borderline or not depends on your doctor, Derek, and whether or not they're prepared to look at the more recent research on acceptable BP after middle age. I don't think it's really a country thing either, though I have the impression British doctors are less tolerant of slight increases after the age of 50 than some of their Continental colleagues.

My former GP, who wanted to prescribe medication for 150/90 at age 55, and the current one, who's not unduly concerned about an occasional spike of 160/95 at age 73, are both Belgian. The second one is male and about 15 years older than the first one, who was female, so there doesn't seem to be an age or gender bias either. I think it's mainly a question of which research they've read the most of.

I never pick fights on here but you seem to put in aggressive one liners without any facts.

I can't post links on here but the UK guideline to doctors for non diabetic patients is:

Stage 1 hypertension Clinic blood pressure is 140/90 mmHg or higher and subsequent ambulatory blood pressure monitoring (ABPM) daytime average or home blood pressure monitoring (HBPM) average blood pressure is 135/85 mmHg or higher.

Stage 2 hypertension Clinic blood pressure is 160/100 mmHg or higher and subsequent ABPM daytime average or HBPM average blood pressure is 150/95 mmHg or higher.

Severe hypertension Clinic systolic blood pressure is 180 mmHg or higher or clinic diastolic blood pressure is 110 mmHg or higher.

 

Hey, knock it off you two or you'll get us all taken down! There's some stuff on here that a lot of people would find very useful and reassuring - especially Bob37393's valuable contribution, which I've bookmarked btw, just in case. (Thanks Bob.) Let's all play nicely - it's Christmas. Or Winterval, or Whatever... Saturnalia, anyone?

Have a good one anyway!

Disagree as I too experience issues with blood pressure due to WCS; and a new young doctor (in a new state) who thinks she knows more than my doctors in NC. Thankfully, I have had two major surgeries in 2017 which completely discredit the new young doctor as my blood pressure is 91/61; 111/59 pre-anesthetic and 118/69; 111/70 post-anesthetic.  My physical therapist has also recorded my blood pressure well below 120/80 during my lengthy rehabilitation.  My blood pressure is completely normal EXCEPT when I go to the new young doctor at which time I sit in a puddle of sweat (dripping out of every orifice, hair matted to my scalp) and anxiety as I think what nonsense she will throw at me today?  I am here to see her due to an upper respiratory infection or toe nail fungus, and she is going to force Lisinopril at me without hearing one word I say or think.  In fact, the new young doctor does not even have my medical records from NC because NC is my home and I will not under any circumstance give this particular doctor "new provider" status, no way...  Thankfully, my orthopaedic surgeon, PT both in WI and my doctors back home in NC support me and my decision NOT to take any blood pressure medication that the new young doctor insists on prescribing.  I have WCS.  The new young doctor is a quack.  So you see derek76, as a 55-year-old professional with degrees including Health and Health Education along with my own personal experience and opinion I too can comment with some degree of authenticity. 

Can you not just change your doctor over there, henpen, or is there some kind of insurance issue? Surely it's not like the Stalinist Nanny system they have in the UK? (Sorry Brits, but I worked in it for 10 years and navigated it during the final illnesses of both my parents, so I do know what I'm talking about.) We can change at will under the Belgian health system, though it's true that the State insurance contribution is slightly higher if we formally register with the same GP (PCP). Even then we can change as long as we don't do it too often or without a valid reason like a house move.

No doctor has ever forced any medication on me. Either I smile sweetly and tear up the scrip outside (as per the BP meds from my unsuspecting previous GP) or I just walk. The latter case refers to my last-but-one GP, nearly 30 years ago, when she told me that if I refused to take HRT after the menopause I'd have to find another doctor. Doable!

I fell on my feet with the current treasure after a house move four years ago. He's opposed to automatic medication for any but the most serious conditions, and very open to dialogue with his patients. We made a pact last year. I'll continue to see him at least twice a year, and if/when my diastolic pressure goes up to 95 on a sustained basis or 100 as a one-off spike, he'll prescribe medication and I'll take it. If push comes to shove, I know he'll select the best medication for me, at the lowest possible starter dose, and listen to me if I report side-effects.

I really think you should dump this jumped-up young girl if she's bullying you.

Merry Christmas and a Healthy New Year.

Lily, The UK problem now is too many people and not enough doctors. Many GP's are leaving the NHS. Many local practices including the one I go to are not accepting new patients apart from children born to existing ones. When we joined it about ten years ago our doctor said that he had recently moved here and was now semi retired and only working three days a week, With ones leaving he was again full time but now seems to be doing four days a week.

I was surprised by a full page advert in the national press saying that some surgeries would be open from 8am to 8pm over Christmas apart from Christmas Day. I checked  and none were in our area apart from a Walk In one at the Railway Station. On normal days it has a three hour wait to be seen. My wife had to go there once and the doctor had very poor English and gave her a prescription that was for twice the stated dosage on the leaflet in the packet. It got past the pharmacist. When we phoned the Walk In one a different one with poor English agreed that the wrong dosage had been on the prescription.

I'm now wondering how the Walk In one will be open over Christmas as with no trains for two days the station will be shut.

Dear Henpen.  I can't help but wonder if you now reside in Va.  One of my DIL's is a Physician.  She was in a Practice in N.C. and moved to Va. several years ago.  She has a High IQ but the Common Sense of a Rock!  She told me a Few years back, when she sees a Patient, diagnoses their condition, prescribes the appropriate Med(s), if they question her, they have Psychological Problems and she refers them to a Psychiatrist!  She was Serious!  In my Humble Opinion, SHE is the Certified Nut Case!

?(And my having told her is probably the reason she doesn't like me!  Boo Hoo!!)  If She is your GP - Run Far, Far away!  

Same to you Derek, all the best to you and your family.

Wishing you a healthier New Year and a solution to your hypertension. 

Well there is a bit of good news, I have really been trying and I did notice an overall drop yesterday following the guideline to take 3 readings and average them four times a day and today I have done two lots of 3 one this morning and one just now and they both averaged around 146/84.  Trying not to get too excited but cant wait for 6pm to do the next one just to be sure. LOL.  The doc told me to do 4 per day morning, lunchtime, early evening and before bed, so I hoping they stay consistent.  Maybe all the reassuring comments on here have helped.  Thank you all.

Daisi, You're FINE!  I forgot to take mine BEFORE I drank my morning coffee.  Wife makes Very Strong!  Just took mine with my OMRON Digital Arm Cuff.  It was 167/82.  Yes that's High BUT by the time I start moving, have some Breakfast, get out and about to get my mind off some temporary Stressful Issues, I guarantee you it will be close to Normal!  After the Holiday Season, Wife and I will be back on our Exercise Regimens and I won't even check it EVERY DAY!  Plus I have my last 18 lbs to eliminate to get below 170.  Normal BMI for 70 Year Old, 5' 10" Cranky Male!  LOL!

Glad to hear that Daisi. However...

Like henpen, I don't want to be a party pooper, but I seriously doubt whether this small drop has anything at all to do with your efforts. Not because I don't believe you're making an effort, but because things just don't happen that quickly. It generally takes six months to a year of lifestyle changes to bring about a significant drop in BP. Given that the biggest reduction is in the stress-sensitive systolic pressure, it's far more likely that 146/84 is more like your normal reading and the systolic of 156 recorded by the nurse was an abnormal high down to "white-coat syndrome".

I'm slightly queasy about the idea of you looking forward to BP readings too, as a) even the most minor excitement can pump up your systolic and b) I'm concerned that you're going to feel you've "failed" if it's gone up slightly the next time you take it, and then try to compensate by worrying about what you're eating/drinking all over Christmas. Best to stay as calm as possible, and just note each reading for your doctor without getting involved in it. Everyone's BP - both readings, but especially the systolic - varies widely throughout the day. It's the general trend that counts.

Oh, and if you're going to do the whole Christmas thing - which I sincerely hope you are - I'd strongly advise against taking your BP at all on the day. It will always go up after any excitement or dietary indiscretions, so readings taken at such a time would be meaningless. I wouldn't dream of taking mine on Christmas Day - the monitor would probably blow up! Ditto if you're doing the big British family thing on Boxing Day. Your doctor will understand that.

Go ahead and have a good time over the festive season. In the words of those somewhat dire skin care ads: "You're worth it!"

Hi Lilly I am laughing here, you are so funny.  You are probably right as it was still 146/84 the next time I did it in fact two of them were below 140 out of the three.  The first one for me is always high for some reason even though I sit down for 5 minutes. The high readings at the docs was probably because she kept telling me I was a candidate for a stroke! Not very reassuring. Yes I am going to do the whole Christmas thing starting tomorrow, I think I just panicked but it has been both great fun and very reassuring on here and you have all managed to convince me I am not going to drop down dead if I scoff the mince pies and quaff the champagne!  I am also going to do the big British family thing on Boxing day   And no I decided I will take my blood pressure tomorrow morning and that will be it until Wednesday.  I am going to do New Year as well and then I will do dry January for charity.  I have to have an incentive to do that as we socialise a lot on the weekends but if I know I am signed up for it I wont let them down.  Thanks for all the help. You sure have cheered me up.  I only hope nobody buys me one of those dire products from the skincare ads I have tried them all and whatever you spend you cant turn back time.  A bit of Nivea and some supermarket make-up and I am all set to go Have a lovely Christmas and I will raise a glass to you over dinner!

Good for you, Daisi! I'll raise my champagne glass to you too (and to everyone else in here).

If you don't mind my asking, there's just one small thing that puzzles me. You say the nurse kept telling you you were "a candidate for a stroke". Do you know why that was? Was it because you BP was high (by her yardstick anyway), on the basis blood results, family history or something else? It seems a strange thing to say to a patient - unless they're a full-blown alcoholic, a chain-smoker, or you're just trying to scare the living sheet out of them. If she was aiming for the latter, she certainly seems to have succeeded!

I can say from similar experiences that many nurses in GP surgeries have some stage ideas.

She was strange and grossly overweight which always annoys me if they try to be critical of somebody else.  She has no blood results back I only went to have them done the same day after the appointment and they wont be back for a couple of weeks because of the holidays, they take 10 days without the holidays in my area.  She didn't ask any family history but she did know I smoke, but I am not a chain smoker I smoke probably 15 roll ups a day.  I think that she said that because I was reticent to take it further at that point and wanted the opportunity to see if I could healthy live my BP down.  I am not a big drinker although I do indulge now and again but she didn't ask about that either.  To cut a long story short she made me see the doctor who was not my usual doctor who knows all my history but a doctor that was taking the stray appointments off the nurse.  The doc did another  thing I considered strange she gave me a script for the pills and sent me off for the blood tests but told me I could not take them until she had the results back.  My usual doctor would never have done that.  Usually I have a big mouth and would have questioned the whole thing but I was somewhat stunned and just wanted to get out of there. The appointment I had with her I managed to change yesterday to see my usual doctor  after New Year, he is very approachable and willing to discuss options and I want to discuss the different tablets if it comes to it.  For over twenty years I have had palpitations and took propranolol for them for a long time, when I started on them my blood pressure was up for my age and they stopped the palpitations and brought the blood pressure down as well.  They caused me no side effects whatsoever. Anyway to cut a long story short my doc decided he was going to wean me off them because I was older by then and sent me to the cardiologist who did extensive tests and said they were purely ectopic and nothing to worry about.  They never cured I still have them now.  If I do have to take tablets I want to ask him if I can try propranolol again which would kill two birds with one stone and I know I didn't get a bad reaction rather than start with new one's where the leaflet says can cause all sorts of side effects.  I tend not to be two concerned about leaflets though I once found myself in a position where I had to take the morning after pill and it said "can cause a brain haemorrhage"! I don't know which I was more scared of ending up pregnant or having a haemorrhage" lol. Both the nurse and the doctor are not English so maybe they have a different training and I have never seen either of them before.  So I will feel much more comfortable about all this when I see my regular doctor. I think nowadays the medics will say anything to scare the living sheet out of a person to stop them smoking even a ear infection could have been down to smoking a doctor once told me!!

Oh Daisi - prescribing BP meds (including propranolol) for someone on 15 a day is a bit like rearranging the deckchairs on the Titanic!

Since your BP is only borderline high anyway, the benefits to your arteries from the small reduction medication will bring about will be insignificant in comparison to the huge risk you're running by smoking. It's the cigarettes that are furring up your arteries and slowly raising your BP. Medication will relax the walls of your arteries, making them a bit wider, but will do nothing whatever to slow down the progressive deposit of plaque in them.

I hate to nag, but 15 a day is still too much. I get that they're roll-ups, which are marginally less dangerous than commercial brands, but you're still running a huge risk, as I'm sure you know.

Would you consider replacing some of your cigarettes by vaping? That way, you'd still get your nicotine fix but without all the harmful tars. I'm not going to suggest patches, as I know smokers find these very unsatisfactory. They cope with the nicotine addiction, but don't address the psychosocial dependence on the business of smoking. I'm not suggesting you try making changes during the holiday season, and not during your "dry January" either, but maybe you could start thinking about it in February?

And yes - I'm afraid the doctor who said the ear infection could have been down to smoking was right. On the other hand, if I was smoking 15 a day, getting an ear infection would be well down my list of health worries!

To put this into perspective, not everyone who smokes - even very heavily - gets cancer or cardiovascular disease. And the converse is true as well. I once worked with a life-long non-smoker who died of lung cancer when she was only 46. However, the fact remains that smoking does take its toll on the body, albeit in different ways.

My father, who smoked 50 a day, died of lung cancer at age 67. My mother, a 40-a-day gal, avoided cancer, heart disease and major strokes, but cigarettes would certainly have contributed to the vascular dementia that made the last nine years of her life a misery. The brain is particularly susceptible to the effects of arterial plaque, as much of it is supplied by surprisingly small arteries, which easily become blocked. When I finally managed to persuade my mother's doctor to order a CT scan, only six months before her death, it showed multiple areas of ischaemic damage (i.e. due to reduced blood supply) as a result of repeated TIAs. These transient ischaemic attacks are often known as silent or mini-strokes, as they pass unnoticed by the patient. My mother's aunt, who always claimed to smoke a heroic 60 a day made it to 91, but also suffered from vascular dementia for more than 15 years at the end. Incidentally, my mum always used to say she couldn't make out how the old lady could fit 60 cigarettes into her day, though Auntie Edie did admit that she woke two or three times a night for a drag!

Anyway - that's enough nagging. Have a great Christmas and New Year!

I smoked twenty a day for over forty years. I stopped in 1993. I had stopped salt and sugar in1983 and don't eat ready meals. After stopping smoking I said to a consultant that I did not really feel all that much better for having stopped smoking. He said that in seven years’ time my chances of lung cancer and  heart disease would be almost as good as if I had never smoked. I doubt if I would ever have smoked but my first two jobs were with tobacco companies and I got 100 a week free.

Almost seven years to the day I had worse than usual chest discomfort (indigestion and Gerd) and went to my GP and she took my BP and it was 210/110 and sent me to the chest pain clinic. It had been checked about four months before when I had a prostate biopsy and it was normal as it had been at other random checks previously. Another eleven years on and I was told that I was glucose intolerant. Now that phrase is not allowed so I am T2 diabetic.  

So stopping ones bad habits does not always do any good.

Re daisi’s fat nurse. So many of them are like that and opinionated with it.I asked to see a dietician after being diagnosed asT2. She was a fat young lady and spent the time I was with her tucking into a bag of Wotsits and telling me my diet was really good.

Well Derek, you'll never really know whether stopping smoking in 1993 did you any good, will you? If you hadn't stopped you might be dead by now or - worse still - gaga! It's the latter prospect that always scares me the most.

Loved the story of the fat dietitian stuffing her face with junk food. It is funny, but sadly we see too much of this. The reason given for all the morbidly-obese NHS hospital nurses and home-care assistants is that they work so much overtime they don't get time to eat properly, which I suppose could be true. But it doesn't really explain all the massive GP practice nurses, who work much shorter hours. In any case, when I first started in the NHS in the early 60s we all worked a 48-hour week as our normal hours, staffing levels weren't much better then than they are now (in spite of what the papers say) and very few of us were even mildly overweight.

When I was in hospital for two nights when I had laser surgery on my prostate in 2004 the three nurses in their 30’s who attended me all said they had high blood pressure.

I look with surprise at the unhealthy food and snacks sold in hospital eating places. Sadly where WRVS used to mainly do the catering it has now often  been contracted out to Costa Coffee. 

Now the standard full-time working week for NHS staff is 37.5 hours and seems from what I see is  done over three days. I once commented to my GP on people eating junk food and he nodded towards reception and said like the ones out there. At least I don’t see them standing outside smoking as the  previous practice we went to.