Hypertension

February 23, 2005 12:58 PM

For those with it, what's your experience with hypertension?

I've not seen a doctor yet, but rest assured I will very shortly. So this isn't intended to be any sort of substitute for getting adequate medical care.

Only a few weeks ago did it occur to me to start checking my blood pressure. I had gone to the ER a few times for things like kidney stones and, unsurprisingly, my BP was high then. The medical professionals and I attribtued it to the incredible pain I was experiencing. But, anyway, as I said, it occured to me a few weeks ago to start checking it under normal conditions to see if it is elevated. My dad, for past health reasons of his, has an automated one. And, the thing, it's really high. Over the course of a week, my blood pressure averaged (and didn't deviate much from) about 155 systolic, 115 diastolic. Occasionally both being upwards of those by about 10mmHg.

Doing a lot of web research, the diastolic seems to put me easily in "stage two" hypertension, where stage one and stage two seem to be the "official" designations. Some sources go further with stages three and four, in those my diastolic seems to place me in "stage three". So this seems awfully high. Is it really? Comparatively? I've also been told in the past, or read or something, that it is the diastolic that's the more important measurement. Is this true?

I did see a rheumotoligst last week for pain management and check-up of my skeletal condition (and we've brought out the big guns of opiates); the nurse there who took my BP said that mine was high enough to cause symptoms like headaches (which I do get a lot) and other things, but not high enough to cause the really bad symptoms. Of course, that's skipping over the question of whether I'm likely to drop dead any minute.

So, your experiences and knowledge?

posted by Ethereal Bligh to health & fitness (23 comments total)

My experience is new, but here it is. Mine was around 140/106. I'm a 38 year old non-smoking long-time vegetarian, with a normal BMI. Low, not high blood pressure runs in my family. We don't know the cause at this point why my BP is high. I was started on a very low dosage of diuretics a little over a month ago and increased my exercise to lose some weight and decrease my stress. In a month, I dropped 10 lbs and my BP is currently at 118/78. Side effects from the meds are non-existent, I just have to make sure I get enough natural potassium daily (I have a banana and a glass of OJ and Im set). My advice is get it checked by a doctor and start treating it however you feel is best, but do treat it. I let mine go for too long, I'm fine, but the stress that I allowed myself to suffer instead of dealing with it was really stupid in retrospect. It sounds like you have other health factors and medications happening with this, so those would all be taken into account by your physician. There are a lot of things that can be done to re-set your BP. One thing that really helped me was to believe that I was NOT sick, that I just needed to get my BP clock or whatever you want to call it re-set. Good luck!
posted by Woolcott'sKindredGal at 1:10 PM on February 23, 2005

EB,

I know you may not be looking for this, but be aggressive and expedient in treating BP this high.

I would say, as well, that it is almost certainly making you feel, at a minimun, some degree of constitutional decline - headaches, fatigue, etc.

Aside from that, you likely won't feel much, but the stress it is creating for your vascular system is very real. It's fairly easy to treat, but will require your full cooperation and patience. When you finally have it under control, though, there's no reason to think you will need to use anything that will cause a bothersome side effect.

Hope that helps.

J
posted by docpops at 1:14 PM on February 23, 2005

Mine was in the 140/90 range, and it had been slowly rising over the years. This despite not being overweight and working out three times a week. My doctor was particularly concerned about the diastolic, since this is the time when the heart should be resting. The impression I was given was that a small rise in the diastolic was more dangerous than a similar rise in the systolic.

The trip to the doctor came about because they wouldn't let me give blood anymore. The guidelines have changed in recent years and the systolic/diastolic numbers for "high blood pressure" have been lowered. I went from monitoring to medication, which has gotten me down to "normal" levels.

I take a diuretic and an ACE inhibitor. My body initially responded to the diuretic alone but then got used to it. The combination has been very effective.

Since I was borderline and the rise had taken years, I've experienced no discernible symptoms. It makes it very tempting to not take the medications, but I do so because I want to keep living.
posted by tommasz at 1:14 PM on February 23, 2005

I would also recommend that if possible you take the machine you've been using to check your bp at home to the doctor's with you. They can see how close it is to their own readings, which could be helpful both in knowing how much to rely on the home machine (even good ones can be off) and in seeing about white coat hypertension. (That is, you might find your machine reading higher in their office, too, but at least you'll have something to compare it to.)

Don't delay getting this checked out! In the meantime you might want to check out the DASH diet online.
posted by Pattie at 1:18 PM on February 23, 2005

I'm 26. Last year I was getting CONSTANT headaches, and I was tired all the time. I've suffered migraines in the past, from the time I was 16 until I was around 22, but they had largely gone away. These were different - sort of dull, annoying, but not debilitating headaches.

I went to the doctor, my blood pressure was something awful like 150/120. The doctor blamed in on the headaches and me being afraid of him (which I was certainly not, but, whatever). I thought allergies, so we tried allergy medicine, and he put me through some other tests - X-rays and an MRI to check my kidneys and liver (I think?). Everything checked out.

I never had blood pressure problems before. I hadn't gained any weight, and I hadn't changed my eating habits. I did get a [stressful] job and moved away from home. He made me write down everything I ate for a week. Then he put me on drugs - Ziac, which is betablocker/diuretic. The first dose was too high and I passed out twice. Now I'm on the lowest dosage possible. He ordered me to lose 10 pounds and stop taking the pill. After he discovered I could lower my blood pressure significantly just by forcing myself to relax, he also ordered yoga. I go back next month to have all my levels checked to see if I can go off the medicine. I take my blood pressure every day, and it hovers around 100/80 now; I suspect I'll have to lose a bit more weight or do more yoga to go off it.

The headaches are gone, I've never felt better. I don't know if it's because I have lower blood pressure, because I'm off the pill or because of regular exercise/yoga, but none of those things can be bad for me. I worry quite a bit that the medicine is bad for me in a dozen different ways, though.

Get it checked out. Be aggressive. You'll feel better.
posted by dpx.mfx at 1:21 PM on February 23, 2005 [1 favorite]

155/115 is pretty high. High enough that they'll probably want to put you on some meds for it. You might want to give the DASH diet a try, and get used to keeping careful track of your sodium consumption (not as straightforward as it might seem -- some breakfast cereals have more sodium than potato chips!).

There's a really good Yahoo group, "bloodpressureline," that deals with hypertension. A hypertension specialist helps moderate the group and answers a lot of the questions.
posted by nixxon at 1:24 PM on February 23, 2005 [1 favorite]

I should have noted that I'm in bad shape because of my other problems, but I'm not that overweight. 5'7" and 145lb.

We've been worrying in my family about the cox-2 drugs. My sister's personal experience was elevated BP while taking Vioxx, and a normal BP some time after she quit. Correlation, not necessarily causation. But my mom, who's an RN, has just in the last few months known at least two other nurses that are relatively young (late 30's) who have suffered strokes and were taking one of the cox-2's.

I'd been taking Celebrex. Given my pretty unhealthy lifestyle, I was pretty sure that it was wishful thinking to write the hypertension off to the Celebrex. Even so, and even though my rheumotologist doesn't believe that Celebrex has the risks the Vioxx has (but he was involved in the trials, so I take his enthusiasm with a grain of salt), I insisted on switching to something else. We switched to Indicin, and NSAID that's potent but very hard on the stomach, with an additional dosage of Vicodin. And, man, that's turned the clock back about three years. Walking around the house isn't so painful, which even that had become.

Anyway. That was too much info. But I thought I'd mention the cox-2 thing.

"I know you may not be looking for this, but be aggressive and expedient in treating BP this high."

Oh, I think I am/will. Changing my diet will be very difficult (I had already found the PATH diet online, Pattie), but I do take it pretty seriously.
posted by Ethereal Bligh at 1:29 PM on February 23, 2005

I don't want to hijack, but while we're on the topic.. does anyone have any advice for hypotension? I avoid fairground rides (= almost blackout every time) and the like, but that's about it.
posted by wackybrit at 1:35 PM on February 23, 2005

Not much I can add to the above, EB, especially knowing you have other complications, except to say that the worst damage from hypertension is to your vascular system, as noted already.

What it does is stretch your arteries and veins much like too much pressure in a water hose. Ever seen an old hose that has cracks running along its length? That's what happens, and those cracks 'heal' by scabbing. Eventually, those scabs crack as well, and they heal by more scabbing. Finally, the scabs can either occlude the artery, or break free and block a smaller arterial opening elsewhere, possibly causing a heart attack or a stroke.

Compound this with cholesterol problems and you have me lucky to be alive at 45. Heheh!
So, heard any good 'exploding heart' jokes? ;-P
posted by mischief at 2:17 PM on February 23, 2005

WB- enjoy the low BP. Your brain and heart will benefit.
posted by docpops at 2:17 PM on February 23, 2005

Sort of related, do those machines at CVS produce accurate results?
posted by knave at 3:01 PM on February 23, 2005

knave, the key to any home (or elsewhere) BP monitoring device is to take it to your doctor and calibrate it to his device. Don't just buy one on your own and start using it because they're all inaccurate to some degree. I wouldn't trust any of the cuffs in stores for anything other than gross indications.
posted by tommasz at 3:21 PM on February 23, 2005

I have moderately high blood pressure when unmedicated; I take beta blockers and also try to manage it with diet and exercise.

I was experiencing headaches and fatigue before treatment. Feel 100% better now, no serious side effects from the meds.

The damage from high blood pressure is cumulative and builds up over the years. The sooner you address it, the better.
posted by enrevanche at 3:45 PM on February 23, 2005

I have moderately high blood pressure when unmedicated; I take beta blockers and also try to manage it with diet and exercise.

I was experiencing headaches and fatigue before treatment. Feel 100% better now, no serious side effects from the meds.

Almost an exact ditto here, except I was having a bad case of the jake-legs instead of headaches.

Beta blockers have brought my BP down to 120/80 almost every time.

By the way, don't automatically kick yourself for ending up with high BP. Some of it is accounted for in diet/lifestyle, but a large part of it is hereditary too. (I'm a fit, 100# nonsmoking vegetarian, and I got hbp the year I turned 30. Just runs in the family.)
posted by mudpuppie at 4:23 PM on February 23, 2005

I'm fit and thought I was on a healthy diet, but my doctor recently told me I had high blood-pressure. She asked me to cut down on salt in my diet. I cut it out almost completely and it fixed my blood pressure in a few days. It wasn't until this happened that I noticed how much salt there is in almost anything we eat.
posted by Triplanetary at 4:35 PM on February 23, 2005

Never officially diagnosed, so adjust for that...

I tested on a whim (no symptoms) with an automatic machine at work and got back a truly troubling result of nearly 170 over 120 something. I'd never been too worried about blood pressure and salt since I had read lots of credible info saying that only 10% of the population showed a cause and effect relationship between salt reduction and lowered BP.

Apart from the salt, I usually ate a heart-healthy diet through no particular effort (no meat, low dairy intake, good amounts of fiber, no smoking or drugs, infrequent drinking...), but I'd never felt compelled to watch my salt intake.

I promised my sweetie that I would monitor it and make a special visit to the doctor if, after two weeks, it was still in the scary range.

I started learning about the sources of sodium in my diet and took every opportunity to cut back that didn't mean outright abandonning beloved foods. I switched to new soups with half or less of the sodium that I started with. I switched from American cheese (240 mg per square) to Swiss (60 mg per square) on my sandwiches. I choose new varieties or brands of condiments based on how the compared serving to serving, etc. Salsa was a big one, with variations between ~300 mg to 50 among varieties that are not calling themselves low sodium. (A favorite is this one, which comes at 70 mg instead the 230 of the salsa it replaced on top of my beloved burritos.)

After living with these adjustments for a few weeks, my numbers settled down and now they regularly measure in the 120s (or even lower) over low 70's.

Like I said before, most people don't experience their blood pressure dropping when lowering salt intake, but I sure did. Maybe it shouldn't have been a big surprise since I'd known for years that my weight spiked as much as two , three, four pounds when I ate a ton of salty stuff. I may just have been in denial, motivated by desire to keep thinking of salty foods as my "safe" indulgence after losing a lot of weight.
posted by NortonDC at 4:37 PM on February 23, 2005

And if you're interested, take a peek at my impressions of lots of different lower-sodium soups.
posted by NortonDC at 5:42 PM on February 23, 2005

My experience is weird--I can't find much info about it. 140/75 (high-ish systolic, good diastolic), 110 cholesterol (average of two tests), 6'5", 240 lbs., generally low-stress lifestyle, though I do tend to drink a bit, and I walk at least an hour a day.

SO--how am I doing? When I was 20 pounds lighter, my BP was lower, around 120/70. So, yeah, I know that'd be better, but I haven't been able to find any literature about my particular niche. Any insight, anyone?
posted by MrMoonPie at 7:17 PM on February 23, 2005

a) Lots of these home machines can be inaccurate in some or all cases. You need to have a skilled human operator on the other end of the stethoscope to take blood pressure properly, noting all 5 Korotkoff sounds and when they appear and disappear.

b) The published blood pressure guidelines reflect large studies done where blood pressure is measured seated, in a doctor's office, by a nurse wearing a white coat, in patients who have refrained from caffeine or tobacco use in the past 30 minutes. All the mentioned factors (position, nurse, doctor's office, white coat, caffeine, tobacco) are known to affect the measured pressure. Blood pressures not measured under these conditions are not appropriate for use in diagnosis.

c) 155/115 is not high enough to cause headaches. The nurse is wrong, if that's what she said. Headaches are so common that people often misattribute their cause.

d) There shouldn't be any "experience" of hypertension, other than getting it diagnosed and the side effects of its treatment. It's called the 'silent killer' for a good reason. Its effects occur over years, not days or weeks, and lead to stroke, heart attack, kidney failure, blindness, etc.

e) Malignant hypertension - 240/140 or thereabouts at rest for sustained periods of a couple hours - is a separate entity, does cause headaches, can kill you acutely, and basically nothing I've said above applies to it. It's also very rare.
posted by ikkyu2 at 1:19 AM on February 24, 2005

After reading some of the above posts:

Some antihypertensive medicines, including the very common beta-blockers and calcium channel blockers, prophylax versus migraines. The anti-migraine effects aren't related to changes in blood pressure. Sounds like dpx.mfx got lucky.

Obesity seems to raise blood pressure. According to the guidelines, Mr Moon Pie is borderline hypertensive, and might either be advised to try weight loss and exercise, or might be started on meds immediately. While 110 is a very low (good) cholesterol number, the HDL amount also needs to be taken into consideration.

Studies show that not everyone can reduce BP by reducing salt intake. One study suggested that only 7% of the population can do so, although the percentage was higher in the African-Americans in the study.

For hypotension/fainting, salt tablets are often prescribed. Not being young or female helps.
posted by ikkyu2 at 1:35 AM on February 24, 2005

Obesity seems to raise blood pressure

From what I've read, this is true, for simple reasons -- an obese person has more body mass, thus, a larger total circulatory system, since that mass needs oxygen to stay alive, if you have more, you need more blood vessels to supply it.

If you increase the network, you need to increase the pump pressure to maintain minimum pressure throughout the system. If the city grows, yet still has one well, it needs to increase pump pressure to make sure that the outlying houses get adequate water. Simple physics.

As to me -- minorly hypertensive. I was 125/80, not good but not bad, this winter, it came up to 135/90, and we decided on a course of ACE inhibitors for a while, while I worked on the body and diet some more. So far, so good -- last was 125/75, still a bit high on systolic, but the dystolic is great. Combined with very good blood numbers, I'm feeling more relaxed about the whole thing, but the body is screaming for time for some long hikes and rides. (Need more sunlight, less work....)
posted by eriko at 4:17 AM on February 24, 2005

an obese person has more body mass, thus, a larger total circulatory system, since that mass needs oxygen to stay alive, if you have more, you need more blood vessels to supply it.

Nope. If you increase the total cross sectional area of the resistance vessels, all other things being equal, BP would drop, not increase. Simple physics. If the city grows yet still has one pump, it needs to increase total flow. The heart cannot set pressure; it can increase its rate or increase its stroke volume.

The relationship's more complicated than the Pouseille equation, sadly for those who espouse the simple-physics model. Endocrine factors probably account for it.
posted by ikkyu2 at 5:35 AM on February 25, 2005

For hypotension/fainting, salt tablets are often prescribed.

I guess now I know why I always crave salt and end up dumping half a ton of the stuff on all my food. I'm the only person I know who can drink salt water.
posted by wackybrit at 2:53 PM on February 25, 2005