I recently had two episodes of a fast pulse rate following migraine and triptans taken to relieve it. With this came two readings of high blood pressure - - 181/98 and 179/110. I decided to contact the GP just to check on this and he agreed the fast heart rate could have been a reaction to the triptans. However, the BP reading was still high in the surgery (it always is - I suffer badly with white coat syndrome), so he wanted a week's readings taken at home. Of course, I then had white coat syndrome just trying to do my own readings so it took a week for them to subside to a lower level and the average over a week ended up at 142/77 which, at 68, I didn't think was too bad but now he wants a discussion about it which I take to mean he will suggest medication. I would rather tighten up diet etc. but my diet is pretty good now. I know I am no longer pre-diabetic and my readings have been in the normal range for at least a year - also my cholesterol was described as perfect when last taken. I am just wondering what others feel is a high BP reading at my age. I shall take medication if forced to but I shall insist on it being monitored - or I shall monitor myself and make them aware. The practice nurse once insisted on calcium channel blockers after two high readings in surgery. I took these for a week and at the end of that time found I was waiting for the next heart-beat and my digestive system came to a full stop - it took me three months to get it back to normal and we agreed to give up the CCBs. I then controlled BP by diet - mine is usually in the 130-145/70-80 area. It was only when she showed me the excel spreadsheet that predicts your chances of developing heart disease that I realised she had put the wrong figures in - something like 198/98 - I had never had a reading that high before. Anyway, I shall start reading it again at home but, again, it will take a few days for it to adjust to normal as I am now scared of it being high again so inevitably it will rise every time the machine comes out ... 🙃
A question about blood pressure: I recently had two... - PMRGCAuk
A question about blood pressure
Your usual readings would be acceptable to most doctors - nurses can get a bit iffy anything above 120/80! But anyone would think CCBs are the only option!
Age is no longer accepted as a reason for a higher BP - it'll be 130/80-ish whatever.
I think if you get into a routine of checking your BP regularly it becomes second nature and the white coat effect at home will settle down.
Thanks, PMRpro - I'm sure you are right - in fact I shall try and take myself by surprise (ha!) ... or take it first thing in the morning before I'm properly awake and then in the evening. Oh, blast this thing. I shall also adhere strictly to the Michael Mosley/Sarah Myhill Mediterranean type diet, which is what I do anyway although things ease off slightly. I am not overweight but I am close to the top of my range so could easily do with losing another 10lbs. Also intermittent fasting is recommended. I used to do a brisk walk - 3 miles or so every morning but osteo-arthritis in the knee has put paid to that. I can now crawl a slow mile at best.
It's a young doctor - I'm glad to get a response of any kind from our GP as they have been quite neglectful in the past - but sometimes it can seem all or nothing.
As always - I'm grateful for the knowledge and experience all of you share - it means a lot.
PMRpro - is there a BP med that does less harm than others? I will look them all up today but I just want to know what I am talking about before I speak to the GP. I'm certainly not having CCBs again.
I don't think you can say any of them do HARM, if they did they wouldn't be used - it very much depends on which is going to suit you best, The first choice for me 10 years ago was an ACE inhibitor, I developed a very itchy rash which was initially dismissed by the ward staff until I complained to the duty doctor at the weekend who recognised immediately it was an allergic reaction and stopped it on the spot and it now has a large red label on my notes! Then I was switched to low doses of Losartan, an angiotensin receptor blocker, and Bisoprolol, a beta blocker. By using 2 low dosed drugs it usually reduces the risk of side effects. After some time the Losartan was stopped and I stayed on Bisoprolol. It's absolutely fine as far as I can tell.
What did the nurse put you on? Diltiazem or Verapamil? DId she not warn you about slow heart rate and constipation and to report any signs immediately? Not common but known problems.
Thank you! I'm on the research trail but I think I should only need a low dose and will insist on it being monitored and them looking at the results. I suspect stress is the cause of mine - I'm always stressed about something and that's not easy to control - I even meditate but still doesn't help. Again, thanks and I will find my way through.
Did you see my extra comment - I probably andded it after you read it
No, she said it was a low dose and all should be well - nothing about what to expect. She did agree that she had put the wrong figures into the spreadsheet and then agreed that I try to deal with it by diet until it became higher. After that I was usually 130 -140 something/70-80s so she left me alone.
Hi Miserere, I am the same as you with white coat syndrome and BP readings. When I have a yearly review, I too submit a week of readings because I know that my BP reading at the surgery will be sky high!
I was on medication for high BP before PMR. The first type of medication prescribed made me feel so ill that I was sent home from work. I didn't have any side effects from the second one - and still take it. If you are advised that you need to take medication and it doesn't suit you, you can ask to try another.
My BP was controlled by my medication, but did rise again after starting on prednisolone (one of the possible side effects). It has come down again as my pred dose has reduced. At my latest review the doctor accepted my average readings of 130 / 80 as okay for me (age 62).
The surgery nurse gave me advice on taking BP readings and I wanted to share this with you in case you aren't aware (so forgive me if you already know this). She said it was NHS recommended practice for home readings.
Don't eat, drink or smoke for 30 minutes before.
Make sure you don't need the loo!
Sit down at the table with your BP machine 10 minutes before and try to relax (this is when I practice my breathing exercises!)
Take 3 readings 5 minutes apart - the lowest reading is the one to record for your doctor.
I hope all goes well for you and your BP settles down soon.
Hahahaha - if they observed that lot when taking BP in the practice or hospital it would probably eliminate white coat syndrome!!!
And you forgot to say DON'T cross your legs while taking the measurements ...
Thank you, Purpleazalia - useful information. I usuall just take it at my desk and three readings in quick succession. Sometimes I take a few more and watch it coming down. I shall try to be more relaxed about the whole thing. Did you take it first thing in the morning and what time in the evening? I've heard differing things - some say mid morning and mid evening is fine. And thanks, PRO - no crossed legs!!
Being relaxed is the most important thing - don’t regard it as “something I’ve got to do”
Long time ago-a nurse said to me -just imagine you’re in your favourite place -whether that be on a sandy beach, in the garden, or just sitting on a bench enjoying the view..
I'll try it later and make time to do it. Just now I have been fighting with online banking - wouldn't be surprised if it was through the roof!! Thank you, DorsetLady.
More than likely! I hate digital banking too! And it is that time of year for tax returns - times 2 in different languages and Italy has a year end at New Year, the UK in April so most of the info I need can't be gathered until May. Italy is SO civilised, I sign a bit of paper and the tax advisor does it all ...
At least I only have one set of taxes to deal with and that's bad enough! I think I'll leave the next reading until tomorrow. Good luck with your returns!
Ahh yes -technology does that !
I do mine mid morning and mid evening because I've found this has best results for me - you could experiment.
BP can go up when we move around, eat, drink, are temporarily in a stressful (white coat) situation, etc - these variations do not usually indicate the type of high BP that requires medication to bring it down - which is why our best 'at rest' reading is used.
I think I shall try that as well - he mentioned first thing and late evening but by the time I've been up and had a shower, put the kettle on etc. I'm into the day so it becomes a chore to sit and take BP. Later on in the morning would be much easier for me.
Surely you sit down at intervals for a drink or snack during the day? Plan to have a few minutes before starting to drink and check the BP - then drink the tea/coffee/whatever.
Well, only meals as I'm on the LCHF, so I've cut out snacks and drink warm water which I can do when I'm doing anything. I'm also studying English Lit and that can sometimes be stressful - in fact frequently at the moment as I'm just doing the the final assignment. Then there is work, some gardening, cooking and I read on the exercise bike as otherwise I can't stand the boredom. Into Maigret at present - lovely old detective tales. Takes my mind off the idea of peddling hard and going nowhere (I've never learned to ride a real bike and have a dreadful sense of balance on two wheels). I do try and walk each morning - it's a slow and often painful mile that I try to do - I don't always succeed. Then there are physio appointments, osteo appointments, and I'm just starting acupuncture treament as a cousin said she found it helped with her osteo-arthritis. Grasping at straws? Well, sometimes you have to, I find.
Your day seems v busy, Miserere. Know what you mean because I completed an OU degree the other year and was continually up agin it, with assignments. I half wonder if I stressed myself out so much doing them that I brought on PMR by doing so! Btw, I've recently taken to listening to Radio 4 Extra (just to give you something else to do😉). There are some excellent drama series to listen to on that station.
My GP said he preferred readings be taken after one had been up and about a bit. I have taken mine at various times including before and after certain activitiies (eg walking on a treadmill) and the results have been so strange I wonder if my machine is faulty?
I get different readings as well - sometimes in the 120s over 60s and others 150s or even 160s over 80s. I can never tell - all I know is that I don't like the machine. I'll take it later in the morning and see.
My BP seems lower after walking vigorously.
I know PMRpro or DL would have an answer! I came across this today regarding BP:
youtube.com/watch?v=1ESQqSz...
Hope the link works.
So, I sent my week's BP readings to the surgery - they averaged out at 143/77 which I don't think is bad, especially as I hate taking it. Today a dr called and said the readings were a bit high so they wanted to propose medication. I pointed out that the lower reading (77 - systolic?) was fine and the 143 was not very high but she said they preferred the upper reading to be below 135.
Also they want to do another cholesterol test next time as my readings were higher than they'd like at 6.2. I did point out that I was on a keto diet and cholesterol was likely to be higher than average. I also pointed out that at the last reading my triglycerides were 0.82 and HDL was higher than LDL - I can't remember the exact readings now and when I queried the individual results I was told they were absolutely fine - by another doctor. This one said they prefer the total to be nearer to 5. Sarah Myhill prefers them to be anywhere between 5 and 7 and as I have found her to be far more reliable than anyone in my practice I think I shall go with her judgement. I am not taking statins when there is no need.
So, we've agreed to convene again in 3 months when I need to send in another week's worth of readings and have another blood test. Doubtless it will mean a different dr, again, which means that I will have to explain all over again and we shall go through the same process. I just get the feeling that they have a sheet in front of them with tick boxes on and they try to fill as many as they can. They do more to make the patient anxious than anyone else.
I shall apply myself more closely to low carb and try to increase exercise, despite the arthritic knee. I only have a glass of wine occasionally - the last was on coronation day - but I suppose that better go as well, and I shall cut out the daily coffee. What a joy!
The lower is the diastolic reading, the higher the systolic. That systolic is a bit on the high side - it is called isolated systolic hypertension
my.clevelandclinic.org/heal...
Thanks PMRpro - will read this again and see what I can do, although my BMI is in the normal range, my blood sugars are normal, the higher cholesterol comes with a keto diet and higher fat intake, I don't smoke and eat few processed foods. I am gradually trying to increase exercise. I shall research isolated systolic hypertension further!
Hard to find explanations - here is the closest I have come so far: youtube.com/watch?v=0jYjJo0...
Hope the link works.
I wonder if they have considered the higher systolic is due to the fact you are on pred - as he explains the link to cortisol. And you are at quite a high dose still.
However - don't put too much credence on that video - it is Eric Berg and he's been implicated in some very dodgy "fact" sharing.
But getting your pred down is probably the most relevant action you can take.
Thanks pro - I wondered about that and will start another reduction next week using DL's slow taper.
Perhaps a different look at this - I shall take the next three months and do my best. That's all I can do for now as well as reducing steroids. drsanjayguptacardiologist.c...
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