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When did doc make you go on blood press meds?
Old 09-18-2022, 06:45 PM   #1
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When did doc make you go on blood press meds?

Dentist said my blood pressure was high but as they were using a wrist thing I didn't think much about it. But as it does run in the family I thought I'd get something to check and while high it doesn't seem all that bad (though hardly good). I have a doctors appointment in October I was just wondering what to expect. The standards seem a bit low to me but what do I know?
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Hypertension treatment
Old 09-18-2022, 07:20 PM   #2
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Hypertension treatment

Usual is start a diuretic and/or an angiotensin II receptor blocker (ARB). Example: Losartan. I suggest you measure and record your B/P and heart rate at least daily until your appointment. This will show a trend, not "white-coat" anxiety. My PCP use diastolic above 85 or systolic above 140. This will very with PCP. In a month, five or so reading out of limits is nothing to worry about.
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Old 09-18-2022, 07:27 PM   #3
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Thanks, I guess it is kind of obvious that I don't really want medicine but of course I will do what I have to.
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Old 09-18-2022, 08:03 PM   #4
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I suffer from white coat syndrome. And the assistant in many doctors offices does not have you sit for 5 minutes before they take your BP. So to see for myself, I purchased an Omron BP monitor. For awhile, I would take a reading once or twice a day. Average of many readings was 120/80. When any doctor mentions "Oh, your BP is high." I tell him about my long term measurement process. End of subject.
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Old 09-18-2022, 08:04 PM   #5
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Read up on the recommendations for your age. The standard is to let BP go a little higher as we age. I was running just under 150/80 and my doctor did not put me on medication.

This is an article from 2014 when the guidelines changed.

https://www.aarp.org/health/conditio...ntroversy.html

From the article:
Quote:
The new guidelines change nothing if you're younger than 60. But if you're 60 or older, the target has moved up: Your goal is to keep your blood pressure at 150/90 or lower.
Again, talk to your Doctor but make sure to discuss adjusting for age/gender as part of the discussion.
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Old 09-18-2022, 08:27 PM   #6
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Thanks. I Have only taken it 2 days running but it was 136/93 abd 145/96. Bottom seemed awfully high but maybe I did it wrong.
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Old 09-18-2022, 08:28 PM   #7
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My blood pressure dropped when I reduced my carbohydrate intake. I already avoided fast/junk food. It’s very effective.
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Old 09-18-2022, 10:15 PM   #8
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I suffer from white coat syndrome. And the assistant in many doctors offices does not have you sit for 5 minutes before they take your BP. So to see for myself, I purchased an Omron BP monitor. For awhile, I would take a reading once or twice a day. Average of many readings was 120/80. When any doctor mentions "Oh, your BP is high." I tell him about my long term measurement process. End of subject.
This seems like a good approach. Be sure to get a quality automatic cuff and perhaps take it in to a pharmacy with a machine to check its accuracy. The pharmacy machines tend to be calibrated fairly frequently. Other option is to take it to MD office to check (hopefully MD office has a mercury sphygmomanometer). The issue taking BP in pharmacy is that it is quite noisy. I found it ridiculous that the new machines installed at the local pharmacy now 'talk' to you about BP issues all the way through the measurement. As a side note, I think the last place in the world that you would find me having a 'normal' BP would be at the dentist's office!!
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Old 09-18-2022, 10:24 PM   #9
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Other option is to take it to MD office to check (hopefully MD office has a mercury sphygmomanometer).
The only thing I would trust is a person taking a manual BP and comparing that to the machine. I took my BP monitor to the Dr office and it was definitely reading high. So I mentally take some off from the reading I get from my machine. I also look at my machine as a trend reader rather than a single data point. If it started reading significantly higher than what it normally reads, I’d be concerned. I take my reading every morning and it’s in a pretty consistent narrow range.
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Old 09-18-2022, 10:30 PM   #10
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The only thing I would trust is a person taking a manual BP and comparing that to the machine. I took my BP monitor to the Dr office and it was definitely reading high. So I mentally take some off from the reading I get from my machine. I also look at my machine as a trend reader rather than a single data point. If it started reading significantly higher than what it normally reads, I’d be concerned. I take my reading every morning and it’s in a pretty consistent narrow range.
Yes manual with a mercury sphygmomanometer is the gold standard in an outpatient setting. Issue is that many MD offices and clinics are now using automatic digital cuffs too. I don't know of a study but I wouldn't be surprised if they were less well calibrated than pharmacy machines for several reasons. Bottom line is that it's a good idea to check against a mercury sphygmomanometer at least once a year.
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Old 09-18-2022, 11:00 PM   #11
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Yes manual with a mercury sphygmomanometer is the gold standard in an outpatient setting. Issue is that many MD offices and clinics are now using automatic digital cuffs too. I don't know of a study but I wouldn't be surprised if they were less well calibrated than pharmacy machines for several reasons. Bottom line is that it's a good idea to check against a mercury sphygmomanometer at least once a year.
I agree that most offices and hospital/outpatient settings use the machines, but my Dr still uses a manual cuff and I’d suspect that most offices would still have the ability to do a manual read. My mother in law was sent from her assisted living facility to the ER only to find out that her BP wasn’t sky high. ER sent her back to the facility and the facility did check her BP manually and found out their equipment was way off. Ugh.

Not sure why you think a pharmacy machine gets calibrated more often (regularly), but my belief is that most equipment does not get calibrated no matter where I’ve gone. My experience leads me to believe they’re all reading high. But, I’m just a sample of one, even with my current health issue and new found engagement with the healthcare industry. Double Ugh!
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Old 09-18-2022, 11:11 PM   #12
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I didn't even know pharmacies had blood pressure machines anymore. I knew it used to be a thing but as I'm not looking for one and seldom at the pharmacy I probably would not pay attention. I live in my own little world a bit too much!
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Old 09-18-2022, 11:20 PM   #13
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Let up on the use of salt too.
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Old 09-18-2022, 11:45 PM   #14
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Yes manual with a mercury sphygmomanometer is the gold standard in an outpatient setting. Issue is that many MD offices and clinics are now using automatic digital cuffs too. I don't know of a study but I wouldn't be surprised if they were less well calibrated than pharmacy machines for several reasons. Bottom line is that it's a good idea to check against a mercury sphygmomanometer at least once a year.
While this is not a bad idea, the manual sphygomanometers are only the gold standard because the medical field is slow to accept change and have defined BP based on that ancient technology. Digital devices are apparently MUCH more consistant. I learned this when training to be an emergency medical responder a few years ago. There have been studies but the problem is that blood pressure is defined by a measurement made the old way so it is impossible for a new technology to do better since any discrepancy means the new device is in error by definition.

My BP was a little high about 10 years ago (~130/90). It was checked before participating in a "New Year New You" program at my gym. About 12 weeks later after exercising a lot more and dropping 17 lbs without changing my diet I was back below 120/80.

I also went to the dentist a few weeks ago and it was measured high. I have gotten out of shape the last few years, pre-covid but covid made it much worse so I don't doubt the measurement. My diet is also not as good as it was previously. I was also getting a root planing so I was pretty worked up and nervous. Apparently dentists are concerned because if they give you anesthesia to numb you it raises BP and people can stroke out in the chair so they are playing CYA.

I'm not ignoring my situation nor am I panicking. I'll spend some time exercising and getting back in shape and self monitor. If I don't see improvement I will see a doctor.

I am certainly not suggesting what anyone else should do. High blood pressure is a serious condition and easily treatable. My decision on a course of action is based on my previous experience with what quickly lowered BP in ME and the fact that I know I am back in the out-of-shape situation I was previously.
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Old 09-19-2022, 05:16 AM   #15
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Make it simple for OP. Get you a $40 to $50 Omrom or Konquest (looks like a new brand they are pushing at Amazon). Amazon, Walgreens, CVS, wherever.

Take readings twice a day. Mine are real high in the morning, but ridiculously low in the evening. Some folks are low in morning. After you have about 20 readings, then you can determine whether you have a problem.

Salt, exercise, calibrating, higher end devices are absolutely correct, but I would have a whole bunch of readings, first.
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Old 09-19-2022, 05:48 AM   #16
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^this. I take readings and give my doc a graph. He pays more attention to my hundreds of readings than his single reading.
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Old 09-19-2022, 05:54 AM   #17
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Old 09-19-2022, 06:08 AM   #18
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Quote:
Originally Posted by badatmath View Post
Dentist said my blood pressure was high but as they were using a wrist thing I didn't think much about it. But as it does run in the family I thought I'd get something to check and while high it doesn't seem all that bad (though hardly good). I have a doctors appointment in October I was just wondering what to expect. The standards seem a bit low to me but what do I know?
Dentists do not help the situation using these useless machines.

1) You are under stress going to the dentist
2) Wrist measurement machines are sketchy, at best
3) Your body is positioned wrong
4) The assistant is usually making you talk

Useless. They should be banned from doing it this way.

Absolutely go to your doctor to get a proper measurement. BP may be the most important factor for cardiac and arterial health.
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Old 09-19-2022, 06:47 AM   #19
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Here's another tip I never see mentioned. If you or your spouse has a smaller or more petite frame than the average person, make sure the cuff your doctor's staff is using is not too big for you. The standard sized cuff is made for medium to larger people: it may yield inaccurate measurements if a person is petite.

If the pressure seems higher than normal and you don't normally have white coat issues, ask them to retake it with a smaller cuff, just as comparison. Most doctor's staffs won't think to do this unless you ask.
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Old 09-19-2022, 06:57 AM   #20
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Your doctor can't make you go on blood pressure meds. They can suggest you go on meds and offer options. If your blood pressure is high during the visit then they should advise you to get a blood pressure monitor and use it daily to get a more accurate reading of your normal pressure. If it is normally over 140/85 and your doctor offers meds then you should take them. You may even want to take them if you average over 130/80 and your doctor offers but that is up to you.
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