Is there anything I can do about my blood pressure?
October 6, 2009 5:34 PM   Subscribe

What's causing my rather sudden high blood pressure? How much of it is my anxiety? Most importantly, is there anything I can do lower it quickly? Yes I know I should see a doctor (I've sort of just come from there). There's lots of additional information inside.

Today I went to Planned Parenthood today to get my birth control pills refilled, and my blood pressure was crazy. I've been on birth control pills since I was 16 to control my very painful periods. At 19, I was diagnosed with endometriosis. The most successful symptom treatment for me has been cycling my pills and only having a period every 9-12 weeks. They're still debilitatingly painful, but they don't control my life because I don't have them so often.

I also have an anxiety disorder with both generalized anxiety and occasional panic attacks. Many of my anxiety triggers are physical. I'm generally a twitchy, tense, fretting sort of person. I'm very claustrophobic. It's always made me unreasonably nervous to have my blood pressure taken; the cuff tightening always made my heart rate pick up made me feel a touch panicky.

In the last six months or so, every time I've had my blood pressure taken, it's been higher and higher. While I've always been anxious when I got it taken, now my heart rate explodes as soon as the cuff starts tightening. Today, when the cuff went on, my pulse exploded, and my blood pressure was insane (like 150/100). She (the nurse/doctor/PA/whatever) took it three times, but at that point I was upset and twitchy, so it didn't get any better. She's not allowed to refill my birth control pills until I get a lower blood pressure reading.

I drink a bit too much and exercise a too little; my diet is rather good, with piles of vegetables and whole grains, and very little processed food. I'm 28 and I don't smoke. My mother has high blood pressure in the last couple of years, but she's 52 and a heavy smoker. I'm overweight (5' 3 1/2" 180 lbs) but she said by my records showed it had been basically consistent for the last three years. She also said she wouldn't expect my blood pressure to be like that at my age if I weighed 300 lbs. She seemed to think it was largely due to how anxious I was (as opposed to, as is my concern, a major medical issue), but then, she was trying to be as calming as possible and wasn't likely to say "Well, you're at terrible risk of a stroke."

In addition to worrying about getting pregnant, I'm very worried about dealing with my endometriosis pain without birth control. Before I started skipping periods, I was even more anxious, very depressed, and at times suicidal because of the chronic cycle of pain. I'm also officially terrified of the blood pressure issue just for its own sake as well.

My husband and I were laid off last year and are barely scraping along as freelancers now. I don't have insurance, but have an appointment this month get the Healthy San Francisco plan, so I will have access to some health services in the not terribly distant future. Obviously, I'll see a doctor then and hopefully deal with the whole thing in a more complete way. Long term, I know I should focus on less salt and more exercise.

I go back on Saturday to have a reading taken again. Other than meditate, deep breathe, and pray, is there anything I can do to help get a lower reading?
posted by anonymous to Health & Fitness (22 answers total) 4 users marked this as a favorite
 
Maybe you can ask an admin. to post if you have tried cutting back on sodium and if you drink caffeine. I would start there, but those are high readings.
posted by 6:1 at 5:44 PM on October 6, 2009


You probably know this, but blood pressure readings can vary hugely within in a few minutes. I have the same kind of issues- I get nervous and that makes the thing read high.

I found just closing my eyes and concentrating on taking deep breaths while having it taken brought me down 10 or 20 points.
posted by drjimmy11 at 5:50 PM on October 6, 2009


(Sorry, I just saw you already posted "deep breathing." One thing I tried was "practicing" using the machine at the local supermarket. For me, the feeling of the thing tightening on my arm is a little scary, so I was trying to condition myself to it. Next time I went back to the doctor my reading was much lower.)
posted by drjimmy11 at 5:51 PM on October 6, 2009


If your stres reaction is that severe, then medicate the anxiety for the exam. Take a Valium, Ativan or Xanax one hour before. You should get a reading very slightly below your normal (ie, unanxious) base reading within a three hour window.
posted by DarlingBri at 6:04 PM on October 6, 2009


It might be worth buying your own cuff. Take a reading when you're relaxed in your own home and see if you really have "white coat" hypertension.
posted by keener_sounds at 6:14 PM on October 6, 2009


During a difficult part of my life, I kept testing with high blood pressure when I went to see my doctor and they did switch me to a lower hormone pill. But every time I went, my blood pressure would skyrocket anyway because I was so nervous about having it taken. It sounds like there might be a little of that going on for you as well.

Get a decent home blood pressure monitor from the drug store, learn how to use it, and track it yourself at home every day. Make sure you are calm and relaxed and try to take it at the same time. Write down your results. They might still be high sometimes, but doing this helped me understand what calmed me down and what was average for me.

When you go to the doctor again, bring the machine and the data you've collected. If you end up testing higher there, then talk about the discrepancy with your doc.

Also, it always helps me to tell the person taking my BP that I tend to test high and that I have some anxiety about it.
posted by juliplease at 6:15 PM on October 6, 2009


You don't mention any other regular medications, but if you're taking any you should discuss them with your doctor and your pharmacist to see if a combination could be driving your blood pressure up. I had terrible trouble with my blood pressure when I was taking the pill and a particular NSAID; it turned out I couldn't use both at the same time.
posted by immlass at 6:33 PM on October 6, 2009


Every time my blood pressure was high (before we knew what was causing it, anyway), my doc asked if I'd had any caffeine lately. Definitely cut that out before your appointment.
posted by cgg at 6:38 PM on October 6, 2009


I don't know about lowering it, but for your information, I was in the hospital several months ago for what turned out to be nothing - but while I was there I was terrified of what might be happening to me. I have always had blood pressure hovering around 100/65. So, they check me into the room and take my pressure: It's frickin' 150/120! They freak out and suggest that I get on some blood pressure meds. I refused them because I knew it was just the result of stress.

My point is this: Stress can raise your blood pressure a lot in a very short period of time... as in instantaneously. So, stress reduction seems to be one avenue to seriously consider.
posted by crapples at 7:03 PM on October 6, 2009


Seconding several above, particularly juliplaease, regarding a long term plan- this happens to me, and I had exactly the same issue re: birth control pills. What helped my case was getting my own electronic monitor and monitoring at home for a few weeks before the appointment, and then bringing the data with me. In my case, I am averageish or a little below at home, but it shoots up when I get anxious. My doctor noted what I had done in my chart to cover her own butt, and was happy to prescribe after that.

For the Saturday appt: avoid caffeine, make sure your doc knows about any other prescriptions, drink make sure you're well-hydrated.
posted by charmedimsure at 7:12 PM on October 6, 2009


Same thing happened to me last year during the months leading up to moving house. "Er...I can't refill your rx because your bp is 143/100." "WTF?!"

I insisted to them that it was temporary because it was the damned stress from the move, so they put me on low estrogen pills in the meantime. My bp went back to normal after the move. What helped during the high-stress months was getting my own bp cuff from the drugstore so I could monitor the ups and downs. There were noticeable results after meditating and after starting to exercise regularly. I cut all added salt out of my diet too, which was difficult but not as difficult as wondering if I was going to have a stroke at any moment.

2nding that it's helpful to bring records re the ups and downs of bp at home, so you can explain to the MD "OK, you're getting a high reading here but that's because doctors stress me out. At home my readings are much better, see?"
posted by cybercoitus interruptus at 7:50 PM on October 6, 2009


White coat hypertension...
posted by Maias at 7:52 PM on October 6, 2009


I have exactly the same problem. I hate going to the doctor and get myself all amped up and stressed out when I have to go for an exam. High blood pressure runs in my family, so it is something I need to keep in check. Get a little digital blood pressure monitor and start tracking your blood pressure at home, writing down your numbers. Cut way down on alcohol, salt and caffeine. Reducing alcohol can make a HUGE immediate difference. For exercise, even just walking briskly for a half hour a day will help. You don't mention if you are on any anti-anxiety medications. This might help. When you have to go to the doctor, get there early (like 15 minutes) and sit quietly in the waiting room and breath deeply and try and make yourself relax. I will even close my eyes and completely zone out while waiting.

Even if you don't have high blood pressure due to heart disease, smoking or poor diet, the stress and anxiety will take its toll on your heart if it doesn't get under control. It's hard, I know, especially when it feels like drinking a bunch of beer or wine is the only thing that helps me unwind. Good luck, you are not alone!
posted by pluckysparrow at 8:00 PM on October 6, 2009


I would also bet that it's caused by stress, as a similar thing happens to me. I've got a history of anxiety, particularly when dealing with health related issues, and every single time I go to my primary care doctor, my BP is way up. Like, I can literally feel it rising as the nurse goes to take it. Doesn't make sense, because my BP is usually not higher than 120/80 when I get it taken at any other doctor or monitor it at home. There is such a thing as White Coat Syndrome, and even if you don't *feel* anxious, your subconscious could be working overtime and affect your vitals anyway. Talk to your doctor about this, and possibly see about getting an at-home monitor (pretty inexpensive at your local big box store) to keep track of it. As someone else mentioned, maybe you could get a small dose of Ativan or other anti-anxiety med and take it before your scheduled visit.
posted by jenny76 at 8:03 PM on October 6, 2009


Yeah, get an at home monitor. I found that Ibuprofin jacks mine up sky high. 20 points, no problem, especially if I'm feeling stressy already.

Also look at your intake of tyramine. Since I started paying attention to my intake, I found a direct correlation between a few days of high intake and high blood pressure. I also found a correlation between high blood pressure and migraine.

If I keep those things in check, my bp stays steady, right where it should be: 265/180.
posted by gjc at 8:25 PM on October 6, 2009


Nth-ing get a home blood pressure monitor. My gynecologist first suggested white coat syndrome, but, ironically, when I went into the hospital for fairly major surgery, my bp upon arrival was pretty much normal, and in the days following surgery, it dropped even a bit more; every time I have it checked at the gynecologist's office, though, it's astronomical--quite frighteningly so: 158/110 last time. When I check it on my home monitor, it generally runs about 110/68. WTF?

I'm thinking there may be some element of white coat syndrome (I always feel my blood pressure crash as I'm driving home from an appointment; have to pull over sometimes, even), but it may have something to do with the damned tight cuff. Every time my doctor's assistant takes the bp, the cuff gets so tight, it puts bruises on my arm--yeah, I have some pretty beefy upper arms, and not just fat, either. My mother's doctor once told her that a too-tight cuff will distort the reading, usually skewing high (great big farm-girl arms run in my family). This also rings true to me since the cuff they used in the hospital was one of those automated ones that they just leave on, completely comfortable. I"ve asked my doctors to use a larger cuff, but they've told me that's the largest they have, which seems bizarre, since I KNOW they have to have patients with bigger arms than mine.

At home I use the largest cuff provided with the machine; it fits exactly as the markings say it should and never crushes my arm at all. I've tried this with "public" bp machines at various stores--I sit down at just about any one I see and check it out: Invariably, if the cuff is so tight when inflated that it leaves welts, my bp will be scary high; if not, it will be normal. Just fyi--my arm at bp cuff level measures 13.5".

Obviously, this may not apply to you--your arms may be lean and lithe--but you did mention you're a bit overweight. Good luck (and calm thoughts) (and comfy cuffs) to you as you work to figure this out.
posted by miss patrish at 9:01 PM on October 6, 2009


Seconding miss patrish's comment about cuff size. The last time I had my blood pressure taken at the doctors, they tried to tell me that the 170/130 reading was accurate. In hospital recently (during a gallstone attack, no less) my BP was 132/72. The difference was almost certainly the cuff and white coat syndrome (aka being treated like a complete moron by dipshit medical staff).

You might also consider if you're taking anything that may raise blood pressure. Things like sinus medications will raise it, so double-check any over-the-counter stuff, just in case.

Best of luck!
posted by ninazer0 at 9:59 PM on October 6, 2009


I would recommend cutting back on the drinking. I was in the same position as you, same height, about the same weight, and I typically had very steady to low blood pressure. A couple years ago I noticed my blood pressure steadily increasing, a few months later I decided to stop drinking and my blood pressure started dropping right away.

I spoke with a Dr. about it and she said that alcohol is actually one of the leading causes of high blood pressure in women.
posted by Beautiful Downtown Burbank at 10:09 PM on October 6, 2009


Sounds like "white coat hypertension", at least in large part. (See above.) You don't have to buy blood pressure equipment; most supermarket pharmacies have a free machine for their customers that is fairly accurate.
Make sure that you have been inactive for at least five minutes before taking your blood pressure. Since you are anxious about it, I'd suggest that you take several readings. It may be that each reading will be lower if you relax and expect it to be. That's been my experience.
For sure, stress can raise it, but in some cases it's just an autonomic nervous system reaction, especially if the cuff is tight. I have "white coat syndrome" although I am a calm person; I also have "floating veins" when it comes to intravenous tubes.
posted by ragtimepiano at 11:19 PM on October 6, 2009


I do have "white coat hypertension." A previous doctor of mine set up an appointment for me where all she was going to do was measure my blood pressure, and it was normal. (Perhaps even a bit low.) But any other doctor's appointment? Not as high as your blood pressure, but still too high for a prescription. That particular doctor was willing to write me a prescription for the pill anyway, since she had a normal reading on file for me.

My new doctor (at Planned Parenthood, actually) won't hear anything of it. She points out, quite rightly, that if I react with high blood pressure to a routine doctor's visit, I'm probably reacting the same way to innumerable stressful situations every single day. She gives me two chances. If it's too high the first time, I get to sit for a minute, take a few deep breaths and think peaceful thoughts and try it again. (It's always fine the second time, actually.)

So people above have given you a lot of good advice about trying to actually lower your blood pressure in a more complete way, and making sure it's being measured accurately and all of that. I just wanted to add my doctor's opinion that white coat hypertension is maybe a useful thing to note in your file for more emergent situations and such, but in the case of getting under the wire to qualify for a pill prescription, it's not such a great excuse.
posted by adiabat at 11:53 PM on October 6, 2009 [1 favorite]


Motrin and many other over the counter drugs that people forget to mention when they're asked about "medications" can cause hypertension as well. I'm not sure why PP has that policy, newer OCPs aren't really that big of a cause of hypertension.

Exercise and lose some weight. Sounds like white coat hypertension, which caries moderate risk between sustained hypertension and normotension.
posted by gramcracker at 4:50 AM on October 7, 2009


As others have suggested, cut out ibuprofen, cut down on alcohol, cut down on caffeine, cut down on salt intake, and make sure you are drinking enough water. Anecdotal: my aunt has noticed that her bp stays lower if she takes fish oil supplements daily - they're fairly inexpensive, so you could always try that, and one a day certainly won't be harmful unless you are allergic to fish.

Since you are under a lot of stress, try exercising a bit more - it will help your whole body feel better.

I'd also recommend going to the drugstore and using one of their machines. Get used to it, make sure you're sitting still when you do it, and take several readings. My hunch is that you will get lower readings while you are not in the doctor's office.

Also mentioned was the size of the cuff. I have big arms, and my doctor always has to use the larger cuff on me. If my blood pressure is taken with the smaller standard-size cuff, it always reads high, and is so tight that my arm hurts for at least an hour or two. Explain to the doctor that you are anxious about your blood pressure being taken, mainly because the cuff is always very tight, and ask if they can use a larger cuff. If you have been getting regular normal readings at the drugstore, mention that too.
posted by bedhead at 5:28 AM on October 7, 2009


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