High blood pressure / Hypertension

[Ronstar]

At my last yearly checkup last August, my doc mentioned that my blood pressure was borderline high (147/76). He eluded that blood pressure medication could be in my future.

I don't want to go on any medications. Today I checked BP at 157/79. I need to correct the bp issue before my next dr appt in August. So I've got 4 months to do it.

I suspect that diet is the biggest culprit in my high bp. So I'll start fixing that.

I don't think weight is an issue. BMI between 25 and 26. I don't think lack of exercise is an issue. I exercise at least 5 days a week (run, bike, hike, weights)


For those of you battling high blood pressure, what works for you?

 

[Montecfo]

Mine was lower than yours (say 130+ over 85+) and my doctor insisted I take some meds. But I have known cardiac issues.

High BP is tied to a lot of more serious health issues. It's definitely something to address quickly.

 

[jim584672]

I think some people just have high pressure naturally. Nothing you can really do about it. A good BMI and exercise with some drugs is about it. They have me on a water pill and a calcium channel blocker.

 

[euro]

I think calling 147/76 "borderline high" is highly questionable. 157/79 even worse, of course. I'm neither a doctor, not do I play one on TV, but if I were you, I would call your doctor NOW and ask him for a prescription. I bet he'll do so immediately without another visit. Generally, it is good to try to avoid pharmaceutical interventions where possible, but you'll find it extremely difficult to get a BP THAT high into a better range (120/80 or lower) by just tweaking diet and popping vitamins. Take pharmaceutical action NOW and then see if you can replace the drugs with home remedies over time. 157, if consistent, is serious business.

 

[Car-Guy]

I've been on BP meds for 15+ years now. "Sometimes" it can take a while to get them adjusted for an individual. I was lucky, the first dosage attempt worked but I've known folks that took months to get it right. My BP stays in the 130/140 over 75/80 range and my Dr seems happy with that... I tried diet and exercise and nothing seemed to make my BP change other than meds. YMMV

 

[Ian S]

You should monitor your bp daily with an accurate device to get a good baseline. While your bottom number is ok, your top is on the high side and it's the one that seems to be considered the more important in older folks these days. Also sometimes people have higher bp readings in the doctor's office so it's important to see what it is at home under non stressful conditions.

 

[Silver]

The attached guidelines from the American Heart Association may help. These were published in November of 2021, and are the most current guidelines I am aware of.

https://www.health.harvard.edu/heart-health/reading-the-new-blood-pressure-guidelines

It is the top number they focus on, and anything over 120 is considered elevated. Our vascular system becomes naturally less flexible as we age, so it is very difficult to reverse that without meds.

 

[tulak]

You should monitor your bp daily with an accurate device to get a good baseline. While your bottom number is ok, your top is on the high side and it's the one that seems to be considered the more important in older folks these days. Also sometimes people have higher bp readings in the doctor's office so it's important to see what it is at home under non stressful conditions.

Be careful. I measured regularly and my new PCP classified me as overly paranoid about my BP. I’ve had BP issues for over a decade and the only time I successfully reduced my BP is when I did Whole30. The only exception I made was alcohol (beer/wine), otherwise I was strict with the diet.

I’m regularly in the 130-140 range, sometimes more. My PCP told me not to worry unless I’m consistently over 140 and to only measure once a month.

I tried recently to reduce my BP with a Whole30 diet, without luck. I’m not quite sure why it didn’t work, but it could also be stressed induced for me (work). Back when I did Whole30 was earlier in the pandemic and I had very little stress during that time.

I wish you all the best in finding a non-medication solution. I’m also trying to avoid meds, but unfortunately I think they might be unavoidable.

 

[pacergal]

The above guidelines are good, except now I believe they want adults over 65 at 115/75.

Ronstar--do you have family history of Hypertension? Sometimes you can be normal weight, good diet, good exercise and still have high BP.

Medications are about the only thing that will help if you do "all the right things" and still have elevated readings.
And sometimes it takes trying different meds.
It actually wasn't until I had a consult with PharmD at Kaiser that I got on a good combo that took my BP way lower than it has been.

Good luck to you.
Untreated Hypertension causes stress and damage to the kidneys along with heart and blood vessels. It's not something you want to be blasé about.

 

[skyking1]

I've had borderline BP my whole life and not treating it has cost me.
The cardiologist says I have thickened muscle wall in the heart due to it and that's not good for your electrical system.
I'm on my second go with BP medicine.
Last time I exercised right out of the bottom of it to the point that I would get dizzy, my BP got too low.
I have gained a bunch of weight back and the BP is right back in the bad area so I'm back on medicine.
What I have noticed is not a lot of bad side effects from it if that helps at all.
I'm currently on Lisinopril which in some studies has been shown to lower heart rate.
My resting heart rate has been going down and I'll be talking to the cardiologist about that.

 

[mpeirce]

“They” revised the definition of high blood pressure a few years back (2017).

Previously they recommend intervention at 140/90 while now the threshold is 130/80.

The change moved 14% of the total US adult population into the has high blood pressure category (32% to 46%).

This was done by the American Heart Association, so take that as you may.

 

[PaunchyPirate]

Sometimes it's just the way a person's body is. OP, my doctor would consider your numbers high. My 85 year old mother is a petite, tiny person who follows a very healthy diet and she has been on blood pressure meds for years.

I went for at least 10 years with doctors telling me I had "borderline" high blood pressure. My solution was to not go see a doctor. Then when I needed a doctor, I picked a new one. Several times, that new doctor said I needed to watch my blood pressure. I didn't do this to avoid being told I had high blood pressure, but rather because I was moving between locations through the years and didn't really have any obvious health issues to make me go to the same doctor repeatedly. Finally, at about age 52, I decided to add regularly seeing a doctor to my health regimen. After 2 appointments with him where he measured blood pressure in the range you are seeing, he officially declared me as having hypertension and insisted that I begin medications. I have had no side effects from these meds other than VERY occasionally experiencing some minor dizziness if I go from a bending over to standing up position very quickly. My blood pressure is now almost always in the 120/78 range. I'm now 59 years old.

 

[RE2Boys]

I was borderline at 140 for at least 15 years, but both parents had BP and heart issues. And persistent borderline cholesterol readings. I guess bad genes. After bypass surgery, reluctantly gave in and went the med route for BP and statins at age 70, figure I'm fortunate to still be alive. Other than meds, make sure you get regulars exercise and especially watch out for salt, it is everywhere in the prepared and processed foods we eat.

 

[JoeWras]

Be careful. I measured regularly and my new PCP classified me as overly paranoid about my BP. I’ve had BP issues for over a decade and the only time I successfully reduced my BP is when I did Whole30.

You too? I thought I was the only one. 35 years ago as a young man, my PCP said it was a bit high. I donated blood and Red Cross gave us a little card to record the readings (usually around 130/80). When doc measured 140, I whipped out my card and said it is better when I donate blood.

He then sat down and started writing on the chart that I had "Type A Personality" and it is causing me problems including high blood pressure. My plea to him was I was an engineer and liked numbers. Nope. He was forever going to classify me as Mr. Type A.

My BP stayed that way for 30 years. After I retired, it dropped to 120/75.
Yes, retirement dropped my BP.

 

[googily]

The above guidelines are good, except now I believe they want adults over 65 at 115/75.

Ronstar--do you have family history of Hypertension? Sometimes you can be normal weight, good diet, good exercise and still have high BP.

Medications are about the only thing that will help if you do "all the right things" and still have elevated readings.
And sometimes it takes trying different meds.
It actually wasn't until I had a consult with PharmD at Kaiser that I got on a good combo that took my BP way lower than it has been.

Good luck to you.
Untreated Hypertension causes stress and damage to the kidneys along with heart and blood vessels. It's not something you want to be blasé about.

I don't think the 115/75 for adults over 65 is correct. The entire country would be on BP meds. And BP does tend to increase as you age, even if you are healthy. I think it's 130/80 for older folks.

 

[Gotadimple]

The big change in the BP readings cited in the Harvard article above (new link below), is that there is no difference in ages. Any adult with a BP of <120 and <80 is normal, and when BP changes to 130-139 OR 80-89, you are considered in Stage 1 hypertension.

https://www.health.harvard.edu/heart-health/reading-the-new-blood-pressure-guidelines

 

[jollystomper]

I was diagnosed with borderline high BP in my mid-thirties. Due to family history (both parents and one older brother with high BP), My doctor recommended that I take BP meds, which I have done since then. my BMI put me in the "overweight" category at the time, but as I was very athletic my doctor did not see weight as a concern.

I have never felt or noticed any side effects from them - not saying that there are not, I just have never noticed any. Over time as I became less heavily athletic (transitioning from "contact" type sports to more "endurance" type sports) I have brought my weight down and I moderate my diet.

I am glad that I started taken them when I did, as I was diagnosed with an enlarged hear in my early 40s, and had surgery to correct it. While the root cause was a birth defect, not taking the meds would likely have made things worse.

 

[Montecfo]

I've had borderline BP my whole life and not treating it has cost me.
The cardiologist says I have thickened muscle wall in the heart due to it and that's not good for your electrical system.
I'm on my second go with BP medicine.
Last time I exercised right out of the bottom of it to the point that I would get dizzy, my BP got too low.
I have gained a bunch of weight back and the BP is right back in the bad area so I'm back on medicine.
What I have noticed is not a lot of bad side effects from it if that helps at all.
I'm currently on Lisinopril which in some studies has been shown to lower heart rate.
My resting heart rate has been going down and I'll be talking to the cardiologist about that.

I am taking the lowest dose of Lisinopril and after trying a couple of others, find it is effective and side effects limited. BP 120/80.

 

[MRG]

I was on meds for over 20 years and got off after I retired AND lost weight. Lots of weight and most of my problems disappeared. Seven years later I am on 25mg of metoprolol. Sometimes it is a little more than I need but I'm not breaking them in two yet.

 

[TrvlBug]

I have a family history on DM side of hypertention and have been on meds for years. My doc wants me to keep it to 130-135/80. Lost 20 lbs and it dropped to 125/75. I exercise regularly.

I don't see mentioned if you have 'white coat syndrome' which I do big time. At the doctor's office my BP is much higher than at home. Get a monitor and measure it in the morning before breakfast and after resting for 10 minutes or so. I measure mine about once a week. My yearly is coming up next week and I'll bring my monitor with me to ensure it's still calibrated properly.

 

[jollystomper]

I don't see mentioned if you have 'white coat syndrome' which I do big time. At the doctor's office my BP is much higher than at home.

A good point. This happens to me. I found it correlated with how "rushed" I was getting to the doctor. Sometimes if the initial reading was higher, they would wait 15-20 minutes and take another one, and it would be lower. I address this somewhat by trying to get to the office 15-20 minutes early for my appointments and bringing material to read/work on while waiting. That seems to help settle down that initial reading.

 

[tmitchell]

Does alcohol increase or decrease bp? My Dr said it lowers it but I’m reading the opposite, especially in larger quantities?

 

[Alan]

Timely thread, I have an appointment in a couple of weeks to discuss my BP with my GP. I have been monitoring my BP at home for several years and every year the average number has been creeping up until the top number averaged 140.5 in 2021. This first few months of this year have been higher at 142.8/78.5 with a series of days with readings over 150 so I discussed this with my GP a week ago. She told me to take it morning, midday and evening every day for a week and drop the results off to her at the office for review before seeing me again.

The only contributing factors I have that I can see is my age.

The average this past week has been 150/80 so I expect to be put on medication when I see her. She also ordered blood work and an ekg which I did last week and they were both normal.

 

[Mark1]

I don't think weight is an issue. BMI between 25 and 26. I don't think lack of exercise is an issue. I exercise at least 5 days a week (run, bike, hike, weights)

For those of you battling high blood pressure, what works for you?

I was on BP medication for ~4 year when around 40 years old (BMI was ~26.5 at the time). I decided I wasn't taking medication for the rest of my life so I lost weight and got off the medication when my BMI hit ~25. I'm still not on any BP medication 20 years later (current BMI ~23).



Enclosed is a short passage from Guyton and Hall Textbook of Medical Physiology (John Hall. 13th Ed).

In most patients, excess weight gain and a sedentary lifestyle appear to play a major role in causing hypertension. The majority of patients with hypertension are over weight, and studies of different populations suggest that excess weight and obesity may account for as much as 65 to 75 percent of the risk of developing hypertension. Clinical studies have clearly shown the value of weight loss for reducing blood pressure in most patients with hypertension. In fact, clinical guidelines for treating treating hypertension recommend increased physical activity and weight loss as a first step in treating most patients with hypertension.



It's kind of interesting that the textbook doesn't say even mention medication as the default first option. I guess doctors know we don't want to hear that we are simply fat and need to loss weight.

 

[NW-Bound]

+1 to posters who said BP of 140+ systolic should be taken seriously.

I have always had high BP, although was never overweight (current BMI of 24) and I try to limit salt intake. Many people have this condition, and it's called "essential hypertension" when there's no obvious cause of it.

In my 30s, my BP was 125-130/80-85. Then it crept up to 130-135/85-90. I went on a low dosage of 5 mg/day of Lisinopril for years.

Then, in my 60s, it went up to 140-145/85-90 despite the 5 mg/day of Lisinopril. My doctor kept increasing it, and at 25 mg/day it was still not effective. I started to get the side effect of dry coughing, so the doctor switched me to Losartan. First 50 mg/day, then 100 mg/day. Still no effect.

He added HCTZ (hydrochlorothiazide), which is a diuretic, first at 10 mg/day. My BP dropped to 135-140/80-85. It was still high so it got bumped up to 25 mg/day. That worked. I am now at 125-130/75-80, which is lower than I ever was.

The problem is I now get some itchy eczema spots on my arms, wrist, elbow, and my shoulder blade. It came suddenly, and I did not make the connection to the HCTZ until I researched on the Web. I now take only 1/2 of the HCTZ for a while to see the results, before I emailed my doctor for advice.

I have been measuring my BP religiously and keeping records, and computing the weekly average. When I shared it with my doctor, he was glad that I did. It's hard to adjust the dosage if you don't have good data.