high blood preasure or not?
May 17, 2011 10:02 AM   Subscribe

Do I have high blood preasure?

I had a physical the other day. My blood pressure was measured at about 134/72 and then 125/72. I was a little nervous at the Doctor's office so maybe that didn't help. My doctor said I'm borderline high blood pressure but he said measure it on your own for a few weeks to see if you're just getting a high reading here. I've been taking my own blood pressure through out the last few days. Some of my readings are 122/69, 138/76, 119/72, 128/76, 115/64, 126/69, 121/72. It's higher in the mornings and it seems lower after I work out in the afternoon. Should I be concerned? I think my doctor is being a little "too thorough". I'm 31 years old and I work out 4-5 times a week. So I'm frustrated that maybe I'm not in as good of shape as I should be. Any comments here are appreciated.
posted by ljs30 to Health & Fitness (15 answers total) 4 users marked this as a favorite
You are fine--keep on doing what ever you have been doing. Check it once/twice a month in the AM after resting/sitting for at least 5-10 minutes. Feet on the floor, relaxed, back straight, cuff in proper place.
posted by rmhsinc at 10:11 AM on May 17, 2011

I'm not a doctor.....

You should not be freaking out, or even worrying too much. You don't have high blood pressure - some of those systolic (the left number) readings are high-normal - borderline your doctor said. The rest (120 give or take) are basically optimal. IN any case, all are within "normal" ranges as I understand them.

I'm guessing your doctor is looking for a pattern of continuously high blood pressure pushing into the "high" zone. - if you were consistently at "high normal" or "borderline" then it's something to look at seriously, but from what you've described, that doesn't appear to be the case.

Do keep checking regularly - it's easy (and interesting) and you'll quickly see whether or not you have an issue, and possibly what behaviours/meds/food/exercise/whatever do to your pressure.

So you shouldn't be any more worried than any other normal 31 year old who hits the gym (good for you) regularly - and the fact that you are now on top of it makes puts you in a far, far better position than most people how rarely if ever check.

So chill, keep working out, and don't worry until there's something to worry about.
posted by TravellingDen at 10:14 AM on May 17, 2011 [1 favorite]

Hypertension is blood pressure above 140/90. 160/100 is when you should probably start taking pills for it, not just exercise. 180/110 is when you start needing immediate treatment because you're likely to get serious bad effects in your brain and kidneys and stuff.

This chart shows that visually, if that helps.

Your numbers sound really decent to me, a paramedic student who has spent 6 years on ambulances. Make sure you measure it in the same body position and stress level every time.

If you work out 4-5 times a week, your cardiovascular health is most likely already better than most of your neighbors'. Just saying.
posted by skyl1n3 at 10:15 AM on May 17, 2011 [3 favorites]

I've been through a diagnosis of hypertension and I'm also someone who is fit and young, so I understand it's frustrating.

First, all of your numbers look good except the one reading at 138/76. Even then the large difference between diastolic and systolic makes me think you were moving around just before you took it, were a little anxious, whatever. Your bottom number is always below 80 which is great. When that number creeps up you would have more cause for concern.

However, you need to be sure you're measuring properly and your monitor is well calibrated. Did you just go buy one or did you get one from your MD? Did they instruct you on using it? Is the cuff the right size? Are you always taking your measurements with your arm properly elevated, feet flat and uncrossed on the floor, back straight and supported, breathing quietly? I get bad readings from just one or two of those measurement rules being ignored, even by nurses. Inevitably I ask for a different chair or ask the nurse to leave the room and it gets better. How you measure is important and needs to be held constant at the doctor's office and at home before you can draw any conclusions from your numbers.
posted by slow graffiti at 10:20 AM on May 17, 2011

I agree that your numbers aren't likely cause for concern. However, I also wanted to address the fact that you're worried based on those numbers that you're not "in good shape" even though you exercise regularly. Hypertension is not always caused by lifestyle factors. In fact, there's really no way to know what causes it in any individual person, though risk factors have been identified. You could be a world-class athlete and develop hypertension due to heredity, aging, or other factors totally outside of your control.

Basically, if you do develop hypertension, it can be treated, but you shouldn't blame yourself. If you're eating a wide variety of healthful foods, exercising most days, and seeing your doctor regularly, you're doing all of the right things. Sometimes, our bodies react in ways we can't control, and we have to work with it. Keep doing what you're doing, keep monitoring your vitals, and talk to your doctor if you're concerned, but whatever happens, it's not your fault.
posted by decathecting at 10:28 AM on May 17, 2011

I am not a doctor. I am an EMT.

Here are the levels for hypertension diagnosis:

Normal: blood pressure less than 120/80

Pre-hypertension: 120-139/ 80-89

High blood pressure (stage 1): 140-159/90-99

High blood pressure (stage 2): higher than 160/100

So yes, your doctor is adhering to the standard in advising of "borderline" high blood pressure with the one time systolic reading of 134.

However, your average of your 7 personal readings is ~124 systolic.

Blood pressure is related to several factors, physical fitness being one, genetics another and *stress* is also a huge factor. You may have "clinical" hypertension (aka "white coat syndrome"), meaning you get stressed simply by knowing that you're about to be tested in some way.

As long as your upper number (systolic) is below 150 then its the lower number (diastolic) that usually gets doctors concerned - it represents your pressure in between heart beats and can be indicative of blood vessel problems. If the diastolic gets to 90 then it's considered a health risk.

I'd say you're fine, keep up the exercise and monitor your bp at home occasionally. If you find that your bp starts trending up and consistently averages in the high 130's to 140's then I would recommend at that point that you get more focused on managing your bp.
posted by de void at 10:29 AM on May 17, 2011 [2 favorites]

And regarding what counts as "high" - the younger you are, the more strict they will be with the guidelines. In a 20 or 30 year old, even 135/90 would be high to some doctors, and that was the point where I was put on meds, but I was having consistent readings at that level. Since the damage to your circulatory system starts at even slightly elevated readings and is cumulative over the course of your life, it really does matter to catch it early and not wait for it to get really bad before you start treating, so ongoing monitoring is good.
posted by slow graffiti at 10:29 AM on May 17, 2011

My mom has always had low (not danger low, but below average person) blood pressure. She's always late for everything, and gets particularly anxious about being late for doctor's appointments (since she's holding up lots of people instead of just herself). She also gets a little nervous at doctor's appointments. This is a bad combination of walking into the office in a bundle of stress and agitation and getting seen almost immediately since they've been waiting on her.

Almost every single time she's had her blood pressure taken right when she gets into the doctor's office, it's high. Like, nurse-makes-a-comment-about-it high. But with the exception of that five minutes, she doesn't have high blood pressure.

So what she's learned to do is ask the nurse to come back in and take her blood pressure after about 15 minutes, even if the doctor's already in the room. The test comes out normal and everyone's happy.

Long story short, it sounds like you're fine, and in the future, don't be afraid to ask the nurse to hold off for a little while on taking your blood pressure so that you have a chance to chill out and get acclimated to the room.
posted by phunniemee at 10:30 AM on May 17, 2011

Sounds like you might be on the edge of pre-hypertension, but you haven't even registered a reading which counts as hypertension.

If your doctor isn't worried about this, you shouldn't be either. Blood pressure and its effects are something we've got a pretty good handle on, all things considered.
posted by valkyryn at 10:43 AM on May 17, 2011

I have white coat hypertension and have been tested multiple times for actual high blood pressure. Every time I go to a new doctor I let them know this, and usually, by about the third visit, I'm relaxed enough in their office so that they can get a normal reading.
posted by kdar at 10:49 AM on May 17, 2011

Honestly, they've been lowering the "high" numbers for high blood pressure in the US for years - until recently, we had the same standards as the UK, with high blood pressure defined as sustained blood pressure of 140/90. Right now, the US is describing "normal" blood pressure as lower than 120/70 and has invented this new category of "pre-hypertension".

I'm sure that many doctors are well-intentioned about this and that there is real concern about the aging population and the interrelationship of overweight/bad diet/no exercise but I'm extremely suspicious about the ever-lowering numbers. Five years ago, I had awesome, doctor-approved blood-pressure of 122/70 and a resting pulse below 60...now my blood-pressure is exactly the same but it's considered "pre-hypertension" and my doctor tells me that I should monitor it. (Always lower when I'm not at the doctor's though!)

I really feel that this - like the push to prescribe statins for patients who do not have heart disease or other cardiac symptoms and for whom the benefit is minimal to nonexistent - is substantially about drug company marketing.

So no, I personally wouldn't worry if you're averaging in the mid-120s over mid-70s. Of course it's never a bad idea to reduce your salt intake, etc etc, but I view that as more preventive good sense than medicalization.
posted by Frowner at 11:06 AM on May 17, 2011 [1 favorite]

Seconding Frowner's skeptical comments. The Center for Medical Consumers has some good information on the topic.
posted by Snerd at 11:21 AM on May 17, 2011 [1 favorite]

Try to get your home BP monitor calibrated by taking it in to your dr's office and comparing their reading with yours. Their BP cuff is going to be accurate and should be the benchmark.

I have the exact same thing happen to me - at the dr's office my BP is high, at home it's good. I took mine in to a follow up appointment to calibrate, but I was told that I could also set up a quick nurse's visit for the sole purpose of calibrating it, which means that you could ask about that if you don't have any appointments coming up.
posted by DrGirlfriend at 11:53 AM on May 17, 2011

You're 31. Here's the chart of BP by age groups. By that chart you fall roughly into the "average" block.

That said, in general, it would be better to have a slightly lower BP at your age, and that's been the recent thinking behind the diagnosis of "pre-hypertensive". Watch your salt intake, in case you are a salt responder (not everybody is). Alcohol can also raise BP. You're doing the right thing by exercising. If you are lifting weights, it's important to have proper breathing technique, so your BP doesn't spike unnecessarily.
posted by VikingSword at 4:03 PM on May 17, 2011

I really feel that this - like the push to prescribe statins for patients who do not have heart disease or other cardiac symptoms and for whom the benefit is minimal to nonexistent - is substantially about drug company marketing.

Maybe it is. but it is also the result of a lot of evidence that higher blood pressures for longer amounts of time is damaging to the body.
posted by gjc at 4:34 PM on May 17, 2011

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