My GP challenged my cardiologists treatment

Day after hospital discharge BP was 180/94 at 77 bpm.

?BP monitor Beurer BC58 and analysis by Beurer Health Manager.

?WHO rating 'severe hypertension' for systolic (>=180), diastolic (>=110) - recommendation seek medical advice.

ecg status: atrial fibrillation (no sinus rhythm detectable)

?Cardiologist informed of BP results by email.

​Monitor nstructions are that you should repeat the measurement after resting for five minutes.

This more or less rules out a sensible BP reading in a GP's office during a consultation of 10 minutes!

​The BP machine inflated so hard that the inflation tube blew apart and I was asked to hold the connector together whilst he started it again.

​I used my own pulse oximeter in the surgery to check my pulse rate - it was over 90 beats per minute.

​He declined to reveal my result.

Thanks for the record.

?The aim of my thread was to throw some light on the differences of medical opinion on achievable sensible blood pressure readings.

?There are now many very fit people who are monitoring their fitness parameters and wonder how on earth they are going to meet the World Health Organisation BP targets by the use of drugs.

?I was discharged from the cardiac ward with blood pressure deemed to be 'in the wrong ball park' by my GP yet patients who are discharged from hospital are deemed 'medically fit'.

?I've estimated your BP reading to have an effective pulse rate of 83 bpm.

?A measured rate of 136 would be reflected in the reduced ejection fraction at that rate.

Your cardiac equation is shown below:

Often we do not see a cardiologist but someone very junior who often has to go and ask questions of a registrar. One such appointment:

 I got a very young assistant registrar Dr S. with nil knowledge of cardiology.

I listed all my symptoms and problems and said she should tell me those not applicable to her and I’d take them to my doctor. That did not get a response. She said that I could not have another cardioversion as my first one had failed….total rubbish. I explained again why it had failed and that her colleague Dr X had said that I would get one after 8/9 weeks on Warfarin.  She asked how I had previously got on with Amiodarone. I listed all its ill effects. She said you can’t have cardioversion unless you have been on it first. Rubbish, I had asked Dr X that and he said that the beta blocker was quite sufficient.  I said that my systolic BP has been low since taking the beta blocker but that my diastolic had been up as high as 126. That doesn’t matter  she said, that’s not high. More rubbish as over 90 is regarded as high  and mine was previously in the 70’s or low 80’s. She suggests two other meds that I should be on and I tell her that they were the first BP meds I had been prescribed in 2000 and such were the side effects that I had pleaded to be taken off them. She thought another med had caused it. She then said that she would arrange for the cardioversion. I asked when and she said 6/8 weeks. I asked what had happened to Dr x’s 8/9 weeks some time ago. She had no record of him arranging it…..just as he did not arrange for my heart surgery two years ago. I asked when I should see my GP for the med changes she wanted to make. She said it takes about two weeks for a letter to get to him. At other hospitals they dictated letters while you were about to leave.

When I go out I remember that she had not mentioned my 24 hour BP monitor or 24 hour ECG monitor so I go back and ask what they showed. She said that the ECG showed AF. What else I asked. She said that is all it would show……. I said that the BP monitoring had been done four days prior to my AF starting again and had it shown any irregular heartbeats. She did not know….

I went to see my GP about my other symptoms and had to twist his arm to get him to organise some blood tests. He thought that the Beta Blocker is causing some of the problems. He was not happy about the 8 week wait for cardioversion and he said that he would contact them and also complain about the consultation. I later had a letter from her saying she had received my GP’s letter and she would discuss it with me at my next appointment. By then she had moved on to her next training post...

​I guess there may be very many similar experiences including my own.

​Often our poor bodies are trying to resolve the assistance offered by a plethora of drugs and prescribed by doctors with different health targets according to their own field of expertise and prescribing incentives.

​This has led me to take a self informed scientific approach to my health  treatment which is however the basis on which patients accept prescribed drugs/treatment.

​It is not suprising therefore that there may be little concurrence between doctors who are part of a multi-prescriber team.

It is at this rate that a blood pressure measurement should be taken.

​It is important that systolic, diastolic and pulse rate are all recorded as they are involved jointly in the accurate determination of your blood pressure.

Mine was in the low 40's for many years. A nurse once asked me if I had been very fit. I answered that I could never be accused of that.

​I understand that if you sit very still in silence with no interruptions then your parasympathetic system should gradually kick in and your pulse rate should drop to about 60 beats per minute.

​After going to sleep my pulse rate has dropped by about 10-20 beats per minute measured with a recording finger pulse oximeter.