Death by hypertension. not on bp medication

Although there is no defined level for medication to be given, the usual guide is once it goes above 140/90 it begins to get 'discussed' but varies with a lot of factors, as BP usually rises with age, what is acceptable in an older person, would not be acceptable in a young person.

In my experience (and I could fill the entire page with my regular visits to consultants and stays in hospital), when BP medication is given, there is never any discussion over conditions, just that the BP is too high and medication is required.

I have been to a coroner's before as support/friend, never as a relative and I have found them to be pretty good, honest and helpful. However, it would seem that they are not so au fait with the medical profession who do little to tell their patients about all the things that are wrong with them.

Obviously the smoking did not help his heart, but the description of size and weight of the heart, leads to believe that he consumed more than the average intake of alcohol. Hypertensive heart disease is one particular disease, it is a description of a group of disorders. Not always a fan of Wiki, but in this case, it does give a quite short uncomplicated description. If you Google 'Hypertensive heart disease' you will see a few websites describing it. Avoid the normally good NHS one, as it goes to individual types rather than describing across the board disorders.

james81679...I am not a physician, & not many on these forums are physicians. The worst reading I see in your list is the 164/90. Both the systolic(upper) & diastolic (lower) numbers are a little high.

I'm somewhat confused as to 'why' a coroner would have said that it's because of his bp medication, yet he wasn't on any bp meds. I would think the Coronor would be thinking he was, given the numbers. Given your father's age, the fact that he smoked & drank...plus those numbers...I would have thought the Dr. would have prescribed medication..but the question that comes to mind is...would your Father have taken the meds?..Would he have tossed out the prescriptions.

Some people get it into their heads that they don't need the meds, or they'll lower the numbers on their own..by walking, watching diet etc. 

The 134/90 is a good number. Here in Canada, it's quite acceptable for a person of his age to have a reading of 140/90..but not higher. Even at that reading, they would be monitored, or should be.

I have also noticed the readings are years apart. Yet, with the start of Jan. 11/2016, they are a few months apart. Then they go from Mar/2016 to Aug./2016...

I don't know what you're hoping to find with all of this information..but if you were told your father died from hypertensive disease, perhaps a meeting with his Dr. would be in order, then you can ask if indeed prescriptions for meds were given & was your Father monitored.

Good luck!

Hi James,

First of all, my condolences on the death of your father.

I'm reading the second sentence of your second para to mean that the coroner assumed you would have known he had high BP because he'd been put on medication for it (which was another assumption he was making).

However, none of those readings (including the later ones) are particularly high for a man your father's age according to modern medical thinking. I'm 73 and my BP is normally about 145/85 and has more than once registered 160/90 in my doctor's office, but he hasn't put me on medication. He has, however, told me he wants to keep a close watch on it and will recommend a low dose of medication if it consistently goes any higher. I live in Belgium, which may or may not be significant.

I suspect the coroner may be working on an older assumption - i.e. that the only acceptable level of BP is 120/80. This view is still held by some doctors but it's rapidly falling out of favour these days, particularly for patients over the age of 50 or so, where more flexibility is thought to be desirable.

So the answer to your question is: it depends how modern an outlook his doctor had. I'm afraid there are no absolutes, no one "right" way to do anything, in medicine as in general life. My personal answer, informed by my reading on the subject (I'm a former nurse, albeit from way back) and my own doctor's attitude would be: no, these readings were not high enough for him to have automatically been prescribed medication.

There remains the question of why hypertensive heart disease was given as the cause of death. I'm wondering whether it was the result of an autopsy or just the opinion of the doctor signing the certificate. In my experience, doctors can be quite imprecise about causes of death. Two examples (both from the UK): my grandmother died of a massive stroke, but her cause of death was given simply as hypertension (which almost certainly would have led to the stroke of course); and my father died of a pulmonary embolism with his cause of death given as carcinoma of the lung (though again, cause and effect).

As RHGB (hello again!) has said, there would have been other factors that wouldn't have helped his health. Even light smoking can have a serious effect on cardiovascular health, especially in susceptible individuals, ditto heavy drinking.

I hope the answers here will give you closure, and above all that you're not feeling any guilt about not following up more closely on your father's health. It really doesn't sound to me as if his doctor was at fault in any way.

Hi James,

firstly can I say how sorry I am for your loss.  I know this doesn't help you answer your question but my husband died about 5 years ago aged 60, he also smoked  heavily and had done all his life and drank, alot!! He started on beer and then gradually ended up drinking spirits.  The point I would like to make is that he actually had low blood pressure but died of heart failure, again I am not a dr but the smoking and drinking must have affected his organs (not just heart) I assume.

All the best.