Hypertension investigations, better late than never.

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I have been attending a hypertension referral centre after having had hypertension for fourteen years. This is from the letter of my second consultation in September.

“ His blood pressure at the clinic today was 187/82. He has very labile hypertension but I wonder the reality if it is his blood pressure tends to be low but very reactive rather than predominately high certainly he seems to have had side effects on a number of antihypertensives raising the question as to whether he was in fact being over treated. To avoid complicating things we are leaving his medication as it is although if he gets symptomatic hypertension it would probably be worth reducing his losartan (from 100mg to 50mg) 

We will arrange the MR scan and I look forward to hearing the results of his 24 hour ambulatory BP monitor. 

Going into his past in a little more detail it sounds as if he hasn’t had a lot in the way of investigations for his hypertension and I am going to arrange an MR scan to address his aneurysm but more importantly whether his renal arteries are involved in it (which might not be apparent from the surveillance ultrasounds he gets) and also to clarify a little more about his liver cysts and in particular the extent to which his kidneys may be involved” 

MR scan is on Friday but my next clinic appointment is not until mid January.

Over the past ten days my average BP reading has been higher at 157/78 compared to 147/78 in the previous two months.

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  • Posted

    Derek, wouldnt it have been nice if this had all been done before ! Still, it looks like you have someone who is on the ball and is determined to improve things for you. Are you gong to ask for your clinic appt. to be brought forward ? Next January is quite a wait. All the best, keep in touch.

    Bess

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    • Posted

      Back in 2001 when I had an angiogram that was clear after two stress ECG's had false positives. The consultant said  this time I wlll sort out your BP at my outpatients clinic once and for all. When I didn't hear from him I asked my GP who said there is nothing about it on you discharge notes (written by one of Romanian his students) I phoned his secretary who said its not on your discharge notes.

      I then asked my then GP to refer me to the hypertension clinic. He said if I referred every person with hypertension there the queue would stretch from here to the hospital. End of story.

      Nowadays with more NHS experience I would have written to the consultant. The best advice I had from a GP was" Patient Power". He said we cannot get appointments brought forward, contact them yourself they do not like that. The first time I did that for an appointment 21 weeks away  got me an appointment for the next week.

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  • Posted

    So what about your 24 hr monitor when you getting that good luck
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  • Posted

    Wow!!!!!!!!!  Fascinating stuff.  Bet loads of people are being over treated but rare for a doc to put that on paper.   We are all now suffering from hypertension investigation envy and are further jealous of the fact that your doc has read your medical notes even if a little late in the day.  Good luck with the scan.  Good luck with everything and keep us posted. 

    Alex

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    • Posted

      Check on Hypertension Referral Centres. There are not many around. In theory the NICE regulation is that if your BP is  consistently over 160 systolic you should be referred to one. Most GP's seem not to know that or the existance of the centres.
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    • Posted

      I never realised that if systolic pressure was 160+ for a period of time that you could/should be referred to hypertension clinic. Mine was consistently over that for years before my latest "crusade" to lower it myself.

      Good luck on Friday Derek. Do keep us posted. I sense that we are all going to be there (mentally not physically) with you!!

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    • Posted

      I got the 160+ fact from the representative of of a company who had developed a new technique to control BP (renal denervation now suspended for further invetigation) and confirmed it from the NICE site. Her mother was 160+ and even with her medical background had a job getting her referred to a clinic.

       

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    • Posted

      Given it's such a big issue you'd think they'd try harder or  maybe that's why they don't.  Perhaps we ought to start our own campaign.  Enough expertise on this website to write a book or two on blood pressure:

        Hypertension - the True Story and then the following year we could do the sequel - The Return of Hypertension

      Yes Derek.  As Fisherman says we are with you in spirit on Friday.  Take care and all the very best.

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    • Posted

      Personally I don't hold out great hopes for them finding a reason for my hypertension. One would think that a kidney or elsewhere problem would keep it high not fluctuating wildly,

       

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    • Posted

      I only discovered my high bp when I moved in with my (then) girlfriend (as of April this year, my wife!) and moved surgeries. They did some comprehensive tests and discovered my hypertension. Previously I only went to the docs when I was feeling VERY poorly. Something to do with misplaced macho pride!!
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    • Posted

      If you ever have a 24 hour BP monitor ask for a print out of it. You will likely be very different from me. 

      One I have had hourly readings from 1am as 121/86, 121/78, 157/110, 140/97, 121/84,146/105, 144/89.

      Over the 24 hours the average was 141/74.

      While awake 142/76

      While supposedly asleep 138/68

      Highest over the 24 hours was 176/115 at 9.14 am.

      Lowest over the 24 hours 121/80. 

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    • Posted

      Thank you. It will be January 11th before my next appointment . Unless he sees something dramatic in the scans.

      The consultant is one of us as he too is a patient. He had a massive heart attack last year and is obviously on medications. When I mentioned it to him he said "Who told you that?, It was nothing, it was a long time ago, well last October.

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    • Posted

      My mother was in a care home for about eight years as she had dementia but she was the only person there not on any medications. No hypertension and a very strong heart at 92. 
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    • Posted

      Mum had a slight fall in her cottage last week (she refuses to go into a home but has carers visit her three times a day) and when I reached her I took her to her GP who confirmed that apart from bruising above her eye, her heart was strong, bp excellent and all the signs were that she was pretty much unaffected by her fall. How people of that age keep going is amazing! She puts it down to a diet of herring (called bloaters here in Norfolk). That's all her parents could afford in those pre WW2 days. Very oily fish are herring so could be something in it!!!
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    • Posted

      Your Mum sounds like a fantastic lady. I feel lke rushing out to buy herring ! How often has your Mum been eating this fish ? There is a book by Michael Pollan called In Defence of Food in which he states that when you buy food, look on the label and if there's anything in it which your grandmother wouldnt recognise, dont eat it! I am in awe of these amazing people that get to great ages. I have a neighbour who is 97 year s old and every day I see her go out with her shoppiing bag to get the bus to the shops. She is strong and sturdy and always helping others. Always smiling. Makes me feel like a wreck ! Right, in the morning, I'm off to get some herring, glad your Mum's ok.

      Bess

      Ps. Good luck on Friday Derek.

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    • Posted

      A fall that broke her hip, a hip replacement that didn't work and needed to be redone caused my mothers death. Falls cause many an end. My 91 year old neighbour had heart failure and lived on her own with carers and family help. She had a fall the other week that gave her a bad cut on her head and hastened her end.
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    • Posted

      I like herring but even fillited ones have too many bones in them for me. Mackeral are better as the bones are a bit bigger and we had them tonight.

      My great grandfather was a cooper who made barrels for herring in a small Highland fishing village.

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    • Posted

      Mum was born in Great Yarmouth in 1920. She was the youngest of 3 girls. My aunts died aged 88 and 92. Mum is still going strong. As a young girl she would be sent down to the quayside to pick up herring that may have fallen out of the baskets when being unloaded from the drifters (drift net trawlers) I pull her leg about it saying it was stealing!! There would be a small army of Scottish ladies who used to gut the herring at the various ports where the drifters tied up. Yarmouth was the most southerly one, although a fee would go pntp Lowestoft. Mum could write a book about those early days and her time in the WAFS in WW2. I can't stand herring but love smoked mackeral.
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    • Posted

      He was a Crofter as well as a Cooper. I expect his barrels were all used locally in Helmsdale. Not many fishing boats left there now as the herring have moved on.
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    • Posted

      Sadly Derek you are right, no herring of any quantity anymore off the East Coast. At one time there were so many drifters that when they moored up you could walk across them from one side of the harbour to the other. Fact. No one thought that fish stocks could ever be over fished. 
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