High Systolic BP

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HadEnuff

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My systolic BP has been creeping up and has hit a point where my primary doc thinks it warranted a discussion.

I'm fit, 5'10, 175lbs, resting HR in the 50s..

BP readings pretty consistent at around 135/67..

Doc does not think it warrants medication at this time, but wants me to monitor it, and said that if we did opt for meds, the first line would be a low dose of an ACE inhibitor, Enalapril being the most likely one.

The thing that got my attention was her being convinced of a strong correlation between high systolic BP and dementia.

My questions for the group: Got a recommendation for a reliable home BP machine. She specifically recommended one that cuffs the arm, not the wrist.

Any experiences you'd like to share regarding ACE inhibitors?

Thanks
 
You do not need an expensive one. As your doc said a wrist device is not recommended. Walmart has loads to choose from. They average at about $35, I think that is what I paid for the last one.
 
We've used the Relion BP200 monitor for about two years. Seems to work ok, checked out alright at the doctor's office also. Paid $40 for it two years ago from Walmart. It has an arm cuff.
 
I've used a wrist one for years. However, in order to make it viable, I need to take my blood pressure consistently the same way each time. I take mine in my TV chair with my wrist across my heart. If I have my wrist higher or lower, I can see the pressure lower or raise. Above my heart, it drops. Below and it goes up.
Track it daily while waiting for dinner so same time and same empty, or near, stomach. Mine tracks almost to the point with my Dr. visits; around 107/63 plus or minus a few points. I got a little finger thingy that measures O2 saturation too. It tracks 97% or above.
Oh, both machines measure pulse.
 
I've been told not to use the wrist BP monitor by my doc as well.

I know at the beginning of the pandemic, a lot of people here switched from an ACE inhibitor to something else because some studies suggested that people taking an ACE inhibitor could have more severe COVID-19 symptoms. Like I said, this was discussed a lot here at the beginning of the pandemic, but I am not sure of the current status.
 
HadEnuff said:
..
The thing that got my attention was her being convinced of a strong correlation between high systolic BP and dementia.
...
Click to expand...


I'm not saying this isn't true, but in addition to BP increasing with age a slight extra increase in systolic pressure usually occurs beyond 60 years due to "hardening" of the arteries (often a result of atherosclerosis). Source is "Medical Physiology" by Guyton and Hall.

Therefore, I personally wouldn't get too excited just yet.
 
It's intriguing. They now view of think 135 as "high". I would pay attention to it.

I have two stents but no HBP or BP meds
But you need to track it a while. Sometimes of I am not feeling well BP can spike up. Apparently this is normal and clears in a few days.
 
timbervest said:
https://store.getqardio.com/product...9dHDiSNZJauefnQgItKEwFUY3rewiMBhoCttgQAvD_BwE

I've been using Qardio for years. Works with smartphone. Very consistent.
Click to expand...


I’m using a Qardio. I had to replace the first one because it was failing to measure my BP. Qardio replaced it for free and the process was easy. The replacement is better, but it still sometimes fails when taking a measurement.

Somebody mentioned the Welch Allyn BP monitor in another thread. I took a look at it the other day and it looks good. Now I’m pondering if I should replace my Qardio.
 
tulak said:
Now I’m pondering if I should replace my Qardio.
Click to expand...

FWIW, I've occasionally had problems with it working properly. When that happens, I've fixed it with one of two methods.

First, check the batteries in it. When they get weak there is no indication so you just have to remember when you last changed them.

Second, I've restored full functionality by simply deleting the app and reinstalling it. At least on the iPhone, all your past data remains recorded in the Health app, so you don't lose any information.
 
tulak said:
I’m using a Qardio. I had to replace the first one because it was failing to measure my BP. Qardio replaced it for free and the process was easy. The replacement is better, but it still sometimes fails when taking a measurement.

Somebody mentioned the Welch Allyn BP monitor in another thread. I took a look at it the other day and it looks good. Now I’m pondering if I should replace my Qardio.
Click to expand...

I mentioned it. It correlates fairly well with the gold standard, a mercury BP device in the doctor's office. Always sit still for about 5 minutes before taking the measurement. Your arm should be at heart level. Relax your muscles. Your artery does not need to be face up. I put a pillow on a box and play a Sudoku game on my iPad. The Welch Allyn app records the BP. I actually trust my device more than the doctor's office. They use a BP device with a simple dial. It was about $100 on Amazon and took awhile to arrive. But I ordered in April, when everything took awhile to arrive.
 
Blood pressure measuring devices are a perennial topic here. Omron makes most of the them including all the ReliOn ones. They probably all have the same insides and just slightly different outsides. I'm using an Omron purchased for a science fair project more than a dozen years ago. My wife has hypertension and thought this particular device was reading too high and bought another newer one. Same readings on the 2 at home and at the doctor's office. She was pissed and now taking medication.

You might use a deep breathing technique to see if you can lower your number first:
but it might just mask some of your physiology.

I disagree that measuring with a mercury doo-dad in the gold standard. That's because whoever is doing the measurement is using a stethoscope and bleeding off the pressure of the cuff manually. If the go too fast, they mess up or if they miss a heart beat, they will mess up. Full disclosure: One my jobs was measuring the BP of all overnight patients in the hospital I worked at.

Anyways, an inexpensive Omron from Walmart or elsewhere is going to be fine. You can take it into your physician and show them how you use it and see if the way you use it is legit.

Plus if you take your BP measurement often, you will see how variable it actually is.
 
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I had SVT (supraventricular tricardia) two years ago and it was fixed with a successful ablation (Yes!!). When I was going through all this, and my BP was spiking to 200/100 and then dropping rapidly (when the SVT kicked in), I had an Omron BP device at home. A good one with a cuff and on each test it ran three cycles of measurement.

I took that device to my cardiologist and we compared it against his. We ran about 6 tests and the Omron was always within 5% (est) of their unit.

The key with BP testing is as others said above with respect to position, rest time, etc and running enough tests over time to get a good idea as to what a long term average is for you.
 
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Same advice to stay away from the wrist models here as well. A brand name was recommended(can't recall the name). I bought the Walgreen version of the device, sitting on the shelf next to the brand name. We have had it for at least 2 years and it has worked flawlessly, as long as battery replacement occurs. Occasional monitoring at doctor's offices validate the numbers on the home device.
 
braumeister said:
FWIW, I've occasionally had problems with it working properly. When that happens, I've fixed it with one of two methods.



First, check the batteries in it. When they get weak there is no indication so you just have to remember when you last changed them.



Second, I've restored full functionality by simply deleting the app and reinstalling it. At least on the iPhone, all your past data remains recorded in the Health app, so you don't lose any information.
Click to expand...



I didn’t try deleting the app, but did replace batteries on the first unit and it still failed.

I was impressed with Qardio’s customer service. I used their app to contact support and after going through basic, did you try this?, questions, they sent me a refurbished unit for free. Really easy. I’ve also compared it to another BP monitor I have and the results were similar.

I like the Qardio, but it’s frustrating when it fails to take a measurement. Definitely not helpful when trying to get a low BP reading. :)
 
HadEnuff said:
My systolic BP has been creeping up and has hit a point where my primary doc thinks it warranted a discussion.......
.......BP readings pretty consistent at around 135/67..
Click to expand...


Your doc might be looking at the elevated pulse pressure @ 68 (135 - 67), which can be an early symptom of a stiffening aorta. An ACE inhibitor should bring it back in line.


Aging impacts pulse pressure and arterial compliance. With aging, there is a decrease in the compliance of the large elastic arteries. This change is due to structural molecular changes in the arterial wall, including decreased elastin content, increased collagen I deposition, and calcification, which increases the stiffness of the wall. This process is often described as "hardening of the arteries." As the left ventricle contracts against stiffer, less compliant arteries, systolic and diastolic pressures increase and can result in a widened pulse pressure.......There has also been some evidence that supports the notion that ACE inhibitors have beneficial arterial wall effects and may be of use.
Click to expand...


https://www.ncbi.nlm.nih.gov/books/NBK482408/
 
I have used a wrist one for years.
The key is to take your readings consistently and use proper technique per the guidelines with your machine. (usually ,take after resting after 5 minutes, sitting, feet flat on the floor, back straight, and arm resting with wrist and monitor at heart level)
My wrist monitor is very close to what I get at my PCP office.
 
Had an Omron for 3-4 years, sends readings to smartphone. Never had a problem. Think was about $50. Uses an arm cuff, no problems. Seems pretty consistent.
 
Montecfo said:
Sometimes of I am not feeling well BP can spike up.
Click to expand...
Would not be surprised if it was the other way around -> your BP spiking up, so then you don’t feel well. Could be increasing to just a sub-clinical degree, where you don’t sense it, until it is then in red zone.

pacergal said:
I have used a wrist one for years.
My wrist monitor is very close to what I get at my PCP office.
Click to expand...
Wrist readings can be less reliable for a number of reasons: farther from the heart so blood vessel resistance expected to be increased, the hand has its own increased blood vessel resistance, the column of pressure difference if the point of recording (wrist) is lower than the heart... -> arm readings (and machines) better if possible.
 
Ok, just got my OMRON BP Monitor today...

have taken three readings since 3:00 PM..

117/71, 108/64, 114/65
I've heard of "white coat syndrome", which purports to explain high readings at the doctor's office as a result of being anxious about being in a doctor's office. I never feel anxious over a routine yearly physical...
 
HadEnuff said:
Ok, just got my OMRON BP Monitor today...

have taken three readings since 3:00 PM..

117/71, 108/64, 114/65
I've heard of "white coat syndrome", which purports to explain high readings at the doctor's office as a result of being anxious about being in a doctor's office. I never feel anxious over a routine yearly physical...
Click to expand...

I have White Coat Syndrome. Every time I visit the doc or dentist and have my BP taken, it's always much higher than at home. I have years of home readings in a spreadsheet as proof. I am not on any BP med.

It is what it is, I guess.
 
aja8888 said:
it's always much higher than at home. I have years of home readings in a spreadsheet as proof.
Click to expand...

Same here. Last year I decided to try putting a stop to the nagging so I brought in my results from home for the last few years, including a graph showing the average readings. My doc looked at it and said "Well, that looks fine to me, so I won't bug you about it any more."

Success!
 
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