High blood pressure / Hypertension

[Alan]

While talking with my wife’s sister a few days ago she said her heart surgeon wanted her to go on BP medication even though her BP is 130. He told her that it is because she now has a replacement heart valve and in his experience non mechanical replacement valves last longer when the BP is kept lower. He said it would be a minimal dosage. She has always been super slender and fit but had surgery in January 2020 to replace the aortic valve and the whole arch of the aorta coming out of the heart to repair an ascending aortic dissection.

 

[NW-Bound]

Here's a scary thing. It's called "resistant hypertension".

It's the condition of a patient who is on 3 different drugs, and they are at the maximum dosage. I am already on 2, but only the Losartan is at the maximum dosage.

My doctor said that his mother was on 4 different drugs. Aye, aye, aye...

 

[tulak]

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.

I’m the same. I like data (engineer) and I’ve been experimenting over the last couple months to see if I could find something to lower my BP without meds.

Unfortunately, once they have that perception set, there’s little you can do and now it’s in my records. What makes it worse is that the nurse measured me at 120 and then something ridiculous like 113 after I said (nicely) that I didn’t think her measurement was accurate and why. We then measured with the BP monitor I brought - wanting to make sure it was accurate - and it measured me over 140.

The doc later measured me at 138 and then 136, but those measurements didn’t make it into my records. Only what the nurse measured, which was 120/80, a completely fictional measurement. And he said, see, your BP monitor is measuring high, probably a bad device/cuff, and you should get the model he recommends. Even though it wasn’t that far off from his measurements.

So what to do?

I’ll drop the BP conversation and monitor it myself. If I feel that it’s worrisome, then I’ll bring it up with my PCP, otherwise I won’t mention BP to him again.

Sorry to distract from OP’s original question…

 

[JoeWras]

I’ll drop the BP conversation and monitor it myself. If I feel that it’s worrisome, then I’ll bring it up with my PCP, otherwise I won’t mention BP to him again.

Sorry to distract from OP’s original question…

It isn't a complete distraction. There is the issue of white coat hypertension and also measurement device deviations.

My mom had HBP and in those early days of going to the hospital, I got fear of being measured because I worried I'd be like mom.

I eventually lost my white coat hypertension by having it measured so many times through my blood donations that it became natural.

 

[Dash man]

My father had his first of a series of strokes at 55. So I’ve always watched my blood pressure.
I’ve been on meds for probably 15 years. I started out with one, then two. It lasted for ten years until I had a physical scheduled and I did bloodwork prior. My kidney numbers were all over the place. I went in for my physical and my blood pressure was ~170/105. I hadn’t been watching it as closely because the medications I had been on were stabilizing my BP for a number of years. They had stop working and my elevated BP was stressing my kidneys. My PCP switched my meds to something different, and got me an appointment with a nephrologist. It took her about nine months to find the right combination of four medications that brought my BP back down, which is now about 115/67 on average.
The medications don’t have any side effects after my body adjusted to them. I had to adjust other medications to make these work.
Whatever you do, don’t ignore your blood pressure. It can kill or debilitate you in many ways if not treated.

 

[H2ODude]

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

In my forties I noticed increases with consumption, got up to 160 when giving blood. I allow large volumes of beer on special occasions, like the canoe camping trip with 5 guys a few weeks ago. Checked BP when got back and yep, elevated up to 160 over 85 or something a bit more than 85 IIRC. I’ve been on .25 metoprolol and losartan for 3-4 years. I don’t care to increase meds and frankly would like to eliminate them. But they keep me ~115/70 and give me no side effects whatsoever.

We’re all different in how we react to drugs, be they alcohol or from the pharmacy. I’m 71, Mtn bike, walk tons, and go to gym. I suspect if I were to drop 10-15# from my 185 (BMI 25) the BP would improve. I suppose things like camping trips with large loads of beer might risk a burst artery but that sounds a lot better than letting Alzheimer’s or cancer catch me as I move towards 80.

So back to your post, I would disagree with your doc. Maybe one relaxing glass of wine occasionally, but not “especially in larger quantities.”

Forgot humorous note on camping trip with 6 old guys waking up in 6 tents; first thing you’d hear is someone yelling “take your pills!” Followed by the rattling of plastic prescription bottles!

 

[NW-Bound]

Regarding BP measurements, new machines now have the mode where they automatically make 3 consecutive measurements, then show the average. It's because each measurement can vary +- 5mm Hg easily.

I do not use the "averaging" mode, and take 3 single measurements, which I then enter into my spreadsheet. I like to see the variations to see how consistent the measurements are. Yes, I am an engineer.

 

[NW-Bound]

Regarding alcohol, I normally drink a glass of wine at dinner. Well, quite often 2.

I stopped all alcohol consumption for a week to see if it made a difference. Nope.

So, I am back to drinking, but now try to keep it at one glass.

 

[tulak]

I eventually lost my white coat hypertension by having it measured so many times through my blood donations that it became natural.

I didn’t mention the part where I talked about continuous BP monitoring devices. My doctor wasn’t having any of it.

I get lazy with BP monitoring and go through phases. I’m always paying some attention and I think for the most part I’m borderline, so that’s ok.

White coat syndrome is real. I was around 158/90 when they measured me pre-colonoscopy. Since they monitor BP during the procedure, I asked the nurse afterwards for my BP measurements and they were in the upper-120s. I’m happy with that.

As for continuous BP monitors, there is a Swiss company that sells one that is reasonably priced. But it’s another gadget around the wrist and currently only available in a few EU/UK countries. I’ll be happy when it’s added to the Apple Watch.

 

[Turbo29]

I had a doctor mention to me that the thinking on "White coat hypertension" has changed. It may not be as innocuous as once thought.

The thinking is that if a person's blood pressure spikes due to the stress of the doctor in the office it may also be spiking during normal life whenever the person encounters a stress, which could be a problem.

 

[tulak]

Alcohol doesn’t change my BP. I drink, it’s low, I don’t drink, it’s high, and vice-versa.

I’ve eliminated most salt from my diet. It’s a lot easier when I make my own meals. I never add salt and don’t eat processed foods.

My BMI is currently 23 and hasn’t been higher than 24 in years. I usually exercise regularly, even though I’ve been slacking lately. Based on past experience, exercise doesn’t seem to make a difference either.

I believe everyone is different and you need to find what works for you. Definitely try the recommended approaches, diet, exercise, etc., but don’t be surprised if it doesn’t work.

Btw, there’s an interesting Attia podcast that discussed hypertension (fructose) that was mentioned in another thread. One thing to keep in mind is when you measure your BP, since consumption of salt/sugars can result in a spike. And that’s a simple observation based on a long technical conversation between two doctors.

 

[plsprius]

I think it’s really important to measure BP correctly. Here are some guidelines that you or your doctor’s nurse may be ignoring, particularly the 5 min quiet period :

Don't drink a caffeinated beverage or smoke during the 30 minutes before the test.

Sit quietly for five minutes before the test begins.

During the measurement, sit in a chair with your feet on the floor and your arm supported so your elbow is at about heart level.

The inflatable part of the cuff should completely cover at least 80% of your upper arm, and the cuff should be placed on bare skin, not over a shirt.

Don't talk during the measurement.​

From: https://www.health.harvard.edu/heart-health/tips-to-measure-your-blood-pressure-correctly

I think the take home message is that you need a home BP monitor to know your true BP. And, take it in to your doctor to see what it reads at the doctor’s office.

 

[Jenna]

You might enjoy a book called The Salt Fix. I know it sounds counterintuitive but the author's message is presented with well documented information. I found it fascinating.

 

[tmm99]

Here's a scary thing. It's called "resistant hypertension".

It's the condition of a patient who is on 3 different drugs, and they are at the maximum dosage. I am already on 2, but only the Losartan is at the maximum dosage.

My doctor said that his mother was on 4 different drugs. Aye, aye, aye...

I am not a doctor and I'm not particularly recommending you or anybody to take this. I'm just stating that some people who are having problems lowering their BP seem to be having success using this aged garlic supplement. It works kind of like a blood thinner? Not sure.

https://www.amazon.com/Kyolic-Formu...pY2tSZWRpcmVjdCZkb05vdExvZ0NsaWNrPXRydWU&th=1

My cousin in Japan used to take the liquid form of this supplement in the 70s, to ward off colds. I guess it works for different things...

Here are the first two reviews of the product.

Reviewed in the United States on February 3, 2019
Style: CapsulesSize: 300 Count (Pack of 1)Verified Purchase
After reading about this product on Consumer Labs website I decided to give it a try. I have been fighting high BP for 2 years since I had bypass surgery. My BP has been constantly in the 150/88 range, sometimes much higher, with many different dosages and different meds from the doctor. They just couldn't get it down. After taking this garlic a little over a week, this morning at the doctors office my BP was 114/78. Let me repeat.114/78. They took it twice just to be sure. I will be using this product from now on. I feel so much better.

Update-After using this for 6 months my BP averages 115/65. Another benefit I have noticed is that mosquito's no longer bite me. Living in the south I have always been a target of these and other biting pest and would have to wear long pants or "Off" while outside but no more. I don't smell garlicky to people but the biting pest are sure turned off from it.

I buy this once/year and get a year's supply. I take it mainly because of studies done by Mathew Budoff at UCLA which showed via cardio scans that it can reverse soft plaque. As I had a small amount of soft plaque when I had a cardio scan, I thought this was worth trying.

I took 4 caps a day and I experienced easy bruising much the same way I do when I take a gel capsule of fish oil every single day. I'm OK with just 2 a day, but I take it not for my BP.

 

[audreyh1]

1. Monitor your blood pressure at home. It’s common to read high at the doctor’s office.

2. Essential (no known cause) hypertension is which is usually treated by lifelong drugs, is often a first sign of insulin resistance/metabolic dysfunction, and can be lowered again by diet: cutting out junk food and sugars, restricting carbs somewhat. If you are sure you are metabolically healthy: don’t have blood sugars creeping up, have low fasting insulin, and healthy liver numbers, low triglycerides, then there is more likely a different cause.

But insulin resistance is very common, even for people with normal weight, and hypertension a very common symptom. It’s better to address the root cause rather than just take drugs to treat the symptom.

 

[street]

Some great advice for you Ronstar. It sounds like you are doing everything right. I ditto the salt responses that is something that will throw me for a loop.

I have been lucky with pretty good BP so far in life. I wish you the best and find what works for you.

 

[googily]

About 15 years ago I was put on BP meds. After I lost 40 lbs, we switched it to a diuretic combo, and I've been on that for 12 years, having lost an additional 30 lbs.

Last summer, when I may or may not have had a TIA, my BP was fine, measured in the hospital after an overnight stay at 120/70.

I stopped measuring it until I got the nudge that it was time to see my PCP to renew my BP meds, and it was suddenly 145/85. I watched it for a couple of weeks, knowing that I had been slacking off on good nutrition and exercise, but still only got it back to about 135/80. I was resigning myself to having to go on stronger meds, which bummed me out.

Then I remembered that I hadn't been taking my Theracurmin, the ritzy version of curcumin. Within four days, I was averaging 122/72. So, yeah.

(I have read that there's now discussion of 140/90 being an acceptable target if you have a CAC score of zero, but thankfully I don't feel like I need that in my holster anymore when I see my doctor tomorrow!)

 

[audreyh1]

I think it’s really important to measure BP correctly. Here are some guidelines that you or your doctor’s nurse may be ignoring, particularly the 5 min quiet period :

Don't drink a caffeinated beverage or smoke during the 30 minutes before the test.

Sit quietly for five minutes before the test begins.

During the measurement, sit in a chair with your feet on the floor and your arm supported so your elbow is at about heart level.

The inflatable part of the cuff should completely cover at least 80% of your upper arm, and the cuff should be placed on bare skin, not over a shirt.

Don't talk during the measurement.​

From: https://www.health.harvard.edu/heart-health/tips-to-measure-your-blood-pressure-correctly

I think the take home message is that you need a home BP monitor to know your true BP. And, take it in to your doctor to see what it reads at the doctor’s office.

This is true. The measuring at my doctor’s office is terrible including rushed.

She tells me measurements at home are better.

Last checkup - “120/80 - that’s perfect”. My answer: “That’s high for me. it’s usually under 110 at home.”

 

[DD4L]

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?

Agree - strict Vegan diet - not for the self-righteous bragging on social media nor saving the earth reasons.

Our backgrounds are very similar, exercise choices are pretty much the same and my high Stage 1 Hypertension wasn't budging no matter what I did, it was just getting slowly worse with age. I get angry and anxious in local traffic (people look down at their phones and don't move as the light changes to green - Michael Douglas Falling Down)

Job - just as stressful before and after so a consistent stress baseline. Local traffic same, high stress before and after.

After just over a month I went back and the nurse took a bp reading of 108/62.

Yeah I was pretty shocked too

Happy surprise, diet was the only change. I also feel more relaxed generally, couldn't care less about traffic now. Mostly.

Basically if it's green I eat it:-

Frozen Brocolli, Brussel Sprouts (WalMart and Aldi)
Spinach with olive oil and black pepper, green beans (All Aldi)
Tofu ($2 from Walmart - green label) dried out and baked in the oven
Tempeh (About $3 also Walmart) chopped up and fried in the pan.

Breakfast is old fashioned Oatmeal with Flax Seed and Stevia (Aldi)

Almonds, green-ish banana and an apple every day for snacking times (Aldi)

Walmart $1.88 multi-grain bread for toast...toast is my weakness.

Chocolate or plain animal biscuits (Dollar store or WalMart) also a weakness.

WalMart Plain/Strawberry Kefir for the gut and Camomile instead of coffee. Coffee is gone.

No guarantees your body will react the same as mine but has to be worth a go? Also lost notable weight off my gut heading towards age 50 so happy with that too.

Hope this helps.

DD4L

 

[Jerry1]

Look up blood pressure by age. 140/80 is normal for over 60 male. I’m right at that level and while it’s a little uncomfortable for me, as in I’d like it to be lower, my dr doesn’t seem to be concerned. One supplement I’m aware of is Carditone. You might want to investigate that.

Second, make sure you and your doctor take your blood pressure properly as was mentioned above. Also, take your home monitor with you to the doctor and make sure you’re getting similar readings.

More controversial is salt. I go to a holistic dr, an MD, and he actually wrote a book on how you need salt and that there’s no connection to blood pressure. I’m no doctor so all this is something to consider and discuss with your doctor or evaluate on your own. One thing to keep in mind is that he’s talking about sea salt with all it’s accompanying minerals, not table salt.

Good luck. I’m hoping to never go on meds, but if I was in the 150’s I’d be a bit worried.

 

[Ronstar]

Thanks everyone for your advice and stories!

All 4 of my grandparents had blood pressure issues, but not my parents. So maybe my high blood pressure is hereditary.

Until my next dr visit a few months from now, I’m going to attack it with diet / supplements and see how it goes. I have an OMRON home bp monitor that I’ll be using daily and put together a spreadsheet to give the dr.

I’ve been reading online, but I like to hear stories from real people like the folks here.

 

[savory]

I am in pretty good shape and my weight is the best it has been in years. BP was high at my physical. Wanted to make sure it was not white coat syndrome. I purchased an at home BP machine. It was a bit all over, sometimes going down close or below the old 120/80. But most of the time at the same level as OP.

My doctor shared a life projection with me provided by Kaiser, I guess. It suggested a statin and BP med would improve quality of life, perhaps extend it. Who knows for sure? In the meantime, BP has been greatly improved and I expect that must be good.

 

[audreyh1]

Thanks everyone for your advice and stories!

All 4 of my grandparents had blood pressure issues, but not my parents. So maybe my high blood pressure is hereditary.

Until my next dr visit a few months from now, I’m going to attack it with diet / supplements and see how it goes. I have an OMRON home bp monitor that I’ll be using daily and put together a spreadsheet to give the dr.

I’ve been reading online, but I like to hear stories from real people like the folks here.

My blood pressure dropped ~20 points when I switched to a low carb diet. I lost some weight, but not a huge amount as I was barely overweight. When your insulin is routinely low, your kidneys retain less water and this lowers BP. Also there are links between fructose metabolism (juices, sugary drinks sweets/desserts) and uric acid causing hypertension. So diet is indeed key.

I monitor BP at home. Sometimes I get readings as low as 99/65!

 

[Turbo29]

I think it’s really important to measure BP correctly. Here are some guidelines that you or your doctor’s nurse may be ignoring, particularly the 5 min quiet period :

Don't drink a caffeinated beverage or smoke during the 30 minutes before the test.

Sit quietly for five minutes before the test begins.

During the measurement, sit in a chair with your feet on the floor and your arm supported so your elbow is at about heart level.

The inflatable part of the cuff should completely cover at least 80% of your upper arm, and the cuff should be placed on bare skin, not over a shirt.

Don't talk during the measurement.​

From: https://www.health.harvard.edu/heart-health/tips-to-measure-your-blood-pressure-correctly

Please send these instructions to the staff in my PCP's office.

 

[RetiredAt55.5]

Look up blood pressure by age. 140/80 is normal for over 60 male. I’m right at that level and while it’s a little uncomfortable for me, as in I’d like it to be lower, my dr doesn’t seem to be concerned. One supplement I’m aware of is Carditone. You might want to investigate that.

Second, make sure you and your doctor take your blood pressure properly as was mentioned above. Also, take your home monitor with you to the doctor and make sure you’re getting similar reading.

I'm a 61 year old male, good BMI, and take my own readings plus about 20 readings I get per year when I donate platelets at the Red Cross. My top number ranges from 130 to 140 almost all the time, with a very occasional 150 at the Red Cross (probably because I was hurrying to get there).

I shared my readings with my nurse practioner and she isn't concerned. She considers anything <= 140 to be 'ok' and she doesn't recommend any prescriptions to lower it.

There seems to be 2 schools of thought in the medical community on whether everyone should be in the 120's.