Please help me help my mother with her wild blood pressure fluctuations.
June 10, 2012 12:40 AM Subscribe
Please help me decipher my mother's blood pressure issues, especially now that she just had to call 911 and go to the ER.
Background facts: My parents immigrated to the US from India in 1967/1973 (father/mother, respectively), so while they're pretty solidly accustomed to life in the USA, certain artifacts of growing up in India remain. Among them are the inability to candidly discuss medical conditions with their children.
I (as you may have guessed) was born here, and see things a bit differently. My mother has told me she's been given medication for low blood pressure, but on occasion, it spikes (I guess)? Specifically, for the last 7-10 days, she's said that almost like clockwork, there will be one point during the day where she feels her heart racing really fast, and she feels really weak, as if she might faint at any moment. That hasn't happened yet, but earlier tonight, it was bad enough that she finally called 911, an ambulance came, and I get a call from the hospital that she's just been admitted. (I live in the next state, but it's 80 miles away, so in dire circumstances, I can drive over if I have to.) She says that when she was admitted, they measured her BP at 205/185. (From my Googling, the latter number is statistically impossible, but she could've been remembering it wrong.)
What I'm not understanding is . . . if she's been diagnosed with low blood pressure, and has been given medication for it, why would it suddenly shoot up to "GET HELP NOW!" levels? What's up with the once-daily extreme weakness/near-fainting episodes?
Sorry if this is a bit disjointed and/or not par for the course for Ask MeFi. I'm more than a bit distressed and might not be very attuned to the finer details of Ask MeFi etiquette.
(Disclaimers: If it seems strange that I'm going online and asking a bunch of strangers for input . . . I see your point, but I don't know what to do. She's told me not to worry (she's just been discharged and is awaiting her cab home), and being of that old-school mindset, doesn't tell me much for fear of worrying me. And (full disclosure), I've had 3-4 drinks tonight (prior to getting the calls), so I'm not necessarily in the best position to hop into a car and drive 80 miles at high speed down I-95, so I'm basically stuck here.)
Thanks in advance.
Background facts: My parents immigrated to the US from India in 1967/1973 (father/mother, respectively), so while they're pretty solidly accustomed to life in the USA, certain artifacts of growing up in India remain. Among them are the inability to candidly discuss medical conditions with their children.
I (as you may have guessed) was born here, and see things a bit differently. My mother has told me she's been given medication for low blood pressure, but on occasion, it spikes (I guess)? Specifically, for the last 7-10 days, she's said that almost like clockwork, there will be one point during the day where she feels her heart racing really fast, and she feels really weak, as if she might faint at any moment. That hasn't happened yet, but earlier tonight, it was bad enough that she finally called 911, an ambulance came, and I get a call from the hospital that she's just been admitted. (I live in the next state, but it's 80 miles away, so in dire circumstances, I can drive over if I have to.) She says that when she was admitted, they measured her BP at 205/185. (From my Googling, the latter number is statistically impossible, but she could've been remembering it wrong.)
What I'm not understanding is . . . if she's been diagnosed with low blood pressure, and has been given medication for it, why would it suddenly shoot up to "GET HELP NOW!" levels? What's up with the once-daily extreme weakness/near-fainting episodes?
Sorry if this is a bit disjointed and/or not par for the course for Ask MeFi. I'm more than a bit distressed and might not be very attuned to the finer details of Ask MeFi etiquette.
(Disclaimers: If it seems strange that I'm going online and asking a bunch of strangers for input . . . I see your point, but I don't know what to do. She's told me not to worry (she's just been discharged and is awaiting her cab home), and being of that old-school mindset, doesn't tell me much for fear of worrying me. And (full disclosure), I've had 3-4 drinks tonight (prior to getting the calls), so I'm not necessarily in the best position to hop into a car and drive 80 miles at high speed down I-95, so I'm basically stuck here.)
Thanks in advance.
Are you sure that the ongoing blood pressure problem is the root cause of these symptoms in the last week?
For example, for a while I've been using this fruit-flavored drink concentrate that I didn't realize was an "energy drink" which turns out to contain taurine and guarana and who-knows-what-else. So I would get dehydrated, drink several glasses of it, and then have to lie down due to symptoms I would describe the same way as what you said above. I am a pretty big guy with a high body mass so I would expect that, since every Indian woman I've seen is much smaller than me, your mother would be more severely affected if she did the same thing.
(That's just an example of something that might cause the same symptoms at the same time every day, I'm sure there are others. I am not a medical professional.)
posted by XMLicious at 1:30 AM on June 10, 2012 [1 favorite]
For example, for a while I've been using this fruit-flavored drink concentrate that I didn't realize was an "energy drink" which turns out to contain taurine and guarana and who-knows-what-else. So I would get dehydrated, drink several glasses of it, and then have to lie down due to symptoms I would describe the same way as what you said above. I am a pretty big guy with a high body mass so I would expect that, since every Indian woman I've seen is much smaller than me, your mother would be more severely affected if she did the same thing.
(That's just an example of something that might cause the same symptoms at the same time every day, I'm sure there are others. I am not a medical professional.)
posted by XMLicious at 1:30 AM on June 10, 2012 [1 favorite]
Also see if she can have a conversation with her doctor about ANY AND ALL medications she may be taking, as well as the daily sequence for these.
Her medication may be off or she may need to take it at a different time of day.
A relative of mine was taking medication for high blood pressure and began fainting in the morning. One of her peripheral doctors asked her these questions and figured out that she really needs to take certain medications in the morning, others in the evening.
For her, it wasn't even the dosage that needed to be changed, but the sequence of medicines she took during the day.
And keep trying to talk to her about it by telling her that it is the lack of information that is making you worry so much.
posted by calgirl at 1:59 AM on June 10, 2012
Her medication may be off or she may need to take it at a different time of day.
A relative of mine was taking medication for high blood pressure and began fainting in the morning. One of her peripheral doctors asked her these questions and figured out that she really needs to take certain medications in the morning, others in the evening.
For her, it wasn't even the dosage that needed to be changed, but the sequence of medicines she took during the day.
And keep trying to talk to her about it by telling her that it is the lack of information that is making you worry so much.
posted by calgirl at 1:59 AM on June 10, 2012
Good she is coming home now. If you still want to investigate this further here are some thoughts:
1. It is very important for you to find out what drug she is on to raise her blood pressure. Hyptension as such is rarely ever treated with medications. Many South Asian women have normal blood pressures below the lower end of the reference interval for blood pressure (these reference intervals are generally derived from healthy white populations).
2. Did she have any symptoms or was this just a clinical finding when she visited a doctor? If this is the case she may not need treatment at all. So in addition to this drug causing side effects it may actually be unnecessary.
3. She may have postural hypotension which is different from generalised hypotension ie it only takes place when she changes her posture for example standing up from a sitting position .
She may have been given vasoconstrictors (drugs that narrow your blood vessels), this may be something that need re evaluating.
posted by london302 at 3:34 AM on June 10, 2012
1. It is very important for you to find out what drug she is on to raise her blood pressure. Hyptension as such is rarely ever treated with medications. Many South Asian women have normal blood pressures below the lower end of the reference interval for blood pressure (these reference intervals are generally derived from healthy white populations).
2. Did she have any symptoms or was this just a clinical finding when she visited a doctor? If this is the case she may not need treatment at all. So in addition to this drug causing side effects it may actually be unnecessary.
3. She may have postural hypotension which is different from generalised hypotension ie it only takes place when she changes her posture for example standing up from a sitting position .
She may have been given vasoconstrictors (drugs that narrow your blood vessels), this may be something that need re evaluating.
posted by london302 at 3:34 AM on June 10, 2012
My step dad has issues with tachycardia where his blood pressure drops really low and his heart races uncontrollably. Usually, it is for relatively brief periods, but a few times he has had to go to the ER. Things that exacerbate this are cold and allergy medicines with pseudoeffedrine and dehydration (and sometimes his blood pressure medication!). His doctor had him do a stress test and a full battery of cardiac tests, but other than the tachycardia his heart is fine so we just keep an eye on it.
posted by Kimberly at 4:27 AM on June 10, 2012
posted by Kimberly at 4:27 AM on June 10, 2012
Is she diabetic? My first guess is that she has poorly controlled hypertension as well as an autonomic neuropathy, which is causing the presyncope. Two processes is more likely than one here. Alternatively, she's taking medication for hypertension (and may be confused about the purpose), but it's periodically bottoming her out. There are a few other possibilities, but those would be my first avenues of exploration.
I would be interested to know what she's on for her low blood pressure. She is certainly not on a vasoconstrictor, as london suggests, but she may be on a mineralocorticoid, which should not cause sudden spikes in blood pressure.
Bottom line, though, is that we can guess all day, but none of us can tell you the right answer. Would she be open to having you go with her to appointments?
posted by LittleMissCranky at 5:27 AM on June 10, 2012
I would be interested to know what she's on for her low blood pressure. She is certainly not on a vasoconstrictor, as london suggests, but she may be on a mineralocorticoid, which should not cause sudden spikes in blood pressure.
Bottom line, though, is that we can guess all day, but none of us can tell you the right answer. Would she be open to having you go with her to appointments?
posted by LittleMissCranky at 5:27 AM on June 10, 2012
How old is she? If she is 50 you have to consider menopause. A symptom could be heart racing. Women can start having menopause symptoms when they are 40. It would be useful to know how and when her female relatives handled menopause. I know, good luck getting that information. Do you know if she has had a hysterectomy? Because that would rule out this having anything to do with menopause.
If she is 60 then you need to take more responsibility because she could be having early symptoms of Alzheimer's or dementia. And by that I mean that she may not be able to understand or remember what she is supposed to do and you may need to take a more active role in taking care of her.
Who gave her the medications in the first place? Does she have a primary physician? I think you need to step in and get involved by at least going to a doctor visit with her. And if she were my mother I would insist that I have access to her medical records and have access to calling her doctor. I think this is serious and she obviously does not understand what's going on.
You should read up on blood pressure.
Is she salt sensitive? What is the history of women in her line? Is their stroke in her family? Or heart problems? Is she overweight?
If she absolutely can't handle a male relative going to the doctor with her is there a female relative who would go? Or how about a female friend of yours? And take your friend out for a nice dinner in exchange for the help.
posted by cda at 6:13 AM on June 10, 2012
If she is 60 then you need to take more responsibility because she could be having early symptoms of Alzheimer's or dementia. And by that I mean that she may not be able to understand or remember what she is supposed to do and you may need to take a more active role in taking care of her.
Who gave her the medications in the first place? Does she have a primary physician? I think you need to step in and get involved by at least going to a doctor visit with her. And if she were my mother I would insist that I have access to her medical records and have access to calling her doctor. I think this is serious and she obviously does not understand what's going on.
You should read up on blood pressure.
Is she salt sensitive? What is the history of women in her line? Is their stroke in her family? Or heart problems? Is she overweight?
If she absolutely can't handle a male relative going to the doctor with her is there a female relative who would go? Or how about a female friend of yours? And take your friend out for a nice dinner in exchange for the help.
posted by cda at 6:13 AM on June 10, 2012
Find out what medications she is taking and talk to a doctor about what they are for, if your mother will not tell you. I am not a doctor, I take medication to control high blood pressure, but from what I understand low blood pressure usually does not call for medication, unless some other underlying pathology is causing it, What happened to her sounds more like a high or erratic blood pressure problem than low blood pressure. She may have misunderstood what the doctor told her the medication was for. It does sound like you need to get involved in her health care at this point, as much as you can given privacy laws. Good luck with this.
posted by mermayd at 6:57 AM on June 10, 2012
posted by mermayd at 6:57 AM on June 10, 2012
she's said that almost like clockwork, there will be one point during the day where she feels her heart racing really fast, and she feels really weak, as if she might faint at any moment.
Has she told you (or her doctors) what time of the day this occurs? That knowledge might be helpful to figure out what is going on and what possible interaction with her meds, food, actions, etc. might be going on, for instance.
posted by Ms. Next at 7:05 AM on June 10, 2012
Has she told you (or her doctors) what time of the day this occurs? That knowledge might be helpful to figure out what is going on and what possible interaction with her meds, food, actions, etc. might be going on, for instance.
posted by Ms. Next at 7:05 AM on June 10, 2012
For whatever it's worth, I have a heart problem that sounds very similar (though I think a lot of things can manifest in a similar way, things that are not really at all related...) Sudden, extreme tachycardia, tunnel vision, feeling weak and fainty. I have been to many doctors, worn holter monitors, had numerous EKGs, had echocardiograms, and they still don't know what causes it in my case. There are all kinds of things that can lead to those sorts of symptoms; there isn't always a clear explanation.
Are you sure the medicine is for low blood pressure? I am also on blood pressure meds, but in my case it is a beta-blocker to control the tachycardia and heart palpitations, and not to deal with low or high blood pressure.
posted by Arethusa at 7:08 AM on June 10, 2012
Are you sure the medicine is for low blood pressure? I am also on blood pressure meds, but in my case it is a beta-blocker to control the tachycardia and heart palpitations, and not to deal with low or high blood pressure.
posted by Arethusa at 7:08 AM on June 10, 2012
I hate to say it, but now is the time to get more involved.
My sister goes to doctors appointments with my parents, mostly to be the one between the hysteric (mom) and the one in denial (dad), this is the only way we can get the true story. Also, as people age, they tend not to hear what the doctor is saying, focusing instead on what they want to hear, or what they think they hear.
It's important to understand our health as we age, and sometimes, especially if there are cultural differences, lots of older folks tend to just do whatever doctors tell them with no questions asked, and this can be dangerous if there's a chance of misunderstandings.
My blood pressure got up to 210/180 when I taught high school, so it's possible for it to spike like that. It's not healthy, but it's possible.
Offer to go with your mom to a full physical, take a note pad, and advocate for her with the doctor. Find a doctor who shares your cultural background, this should make things easier for you mother.
posted by Ruthless Bunny at 7:57 AM on June 10, 2012
My sister goes to doctors appointments with my parents, mostly to be the one between the hysteric (mom) and the one in denial (dad), this is the only way we can get the true story. Also, as people age, they tend not to hear what the doctor is saying, focusing instead on what they want to hear, or what they think they hear.
It's important to understand our health as we age, and sometimes, especially if there are cultural differences, lots of older folks tend to just do whatever doctors tell them with no questions asked, and this can be dangerous if there's a chance of misunderstandings.
My blood pressure got up to 210/180 when I taught high school, so it's possible for it to spike like that. It's not healthy, but it's possible.
Offer to go with your mom to a full physical, take a note pad, and advocate for her with the doctor. Find a doctor who shares your cultural background, this should make things easier for you mother.
posted by Ruthless Bunny at 7:57 AM on June 10, 2012
if the medication she's on to control the high blood pressure isn't the right dose for her, or simply isn't the right one for her.. it might not be controlling it and it could spike.
Beloved family member of mine has high blood pressure and for years she was on medication that only mildly treated it. She would sometimes have numbers as high as your mother's while faithfully taking her doses. It wasn't until the past couple of years and a being prescribed a second medication for hypertension that it's consistantly sitting at normal.
posted by royalsong at 8:02 AM on June 10, 2012
Beloved family member of mine has high blood pressure and for years she was on medication that only mildly treated it. She would sometimes have numbers as high as your mother's while faithfully taking her doses. It wasn't until the past couple of years and a being prescribed a second medication for hypertension that it's consistantly sitting at normal.
posted by royalsong at 8:02 AM on June 10, 2012
Response by poster: Thanks for all the input. Upon further thought, I'm pretty sure her medication is for high blood pressure, not low. So that may help make more sense of things. She's also on several medications, not just this. (More on that in a second.)
She has had ulcerative colitis for several years, and I know that in the past, I heard medicine names like Remicade and Prednisone, though she's not currently on either of those. She has to go in to the doctor's office for her "injection" periodically -- I think it's every couple of weeks or so, but I'm not positive (it was normally my father taking her, but he's out of the country for another couple of weeks). She's been an insomniac for all of my adult life (I'm 37), and is almost always tired. I'm 95% sure she has chronic depression as well.
On top of that:
Is she diabetic? My first guess is that she has poorly controlled hypertension as well as an autonomic neuropathy, which is causing the presyncope.
She was recently diagnosed as diabetic, yes. So her diet has been impacted -- she's down to very little sugar intake (or sometimes sugar substitutes), keeping the dairy to a minimum, etc. There's other curious things; she couldn't have raw spinach with me recently, so we sautéed it instead and she was fine. I brought over some fresh watermelon and we both enjoyed it, but she was sick overnight (diarrhea, from what I was able to gather). Raw fruits/vegetables have recently become a new no-no.
Is she salt sensitive? What is the history of women in her line? Is their stroke in her family? Or heart problems? Is she overweight?
I've never heard anything about her having issues with salt, and she has what I would consider a lower-than-average threshold for salt; i.e., she's never salted her food much nor felt a desire to. Although her sister (in India) died about a year ago due to a freak aneurysm or stroke (I never got the information quite clearly), generally her family has always been quite healthy. (Might be worthy of noting that all family prior to her live/grew up in rural India, where diet will obviously be a LOT more traditional, simple, and different from the West -- or even urban India, and live on a farm where there's lots of opportunity for physical activity.) Her mother (my grandmother) is still alive and is around 80. (Even my mother isn't exactly sure of her mother's age; this was apparently not uncommon in small villages decades ago.) But she's still entirely clear, lucid, and not at all overweight. She walks slowly and hunched over, and she isn't terribly active anymore, but she still comes off as very much alive, and has no health issues that any of us know of.
My mother is overweight, but not insanely so; she's at about 150-155 when she should (I'm guesstimating) be in the 130ish range. We don't know of any heart issues in her family.
She's 62 years old and so far, there's been zero evidence of loss of mental acuity or focus. She's grumpy one day and cheerful the next, but it's pretty much always been that way, and I would chalk that up to the insomnia combined with the chronic depression.
So . . . I think I've listed every diagnosis we know of; in addition, I remember seeing "high blood fats" (I forget the actual term; started with lipi-) on one of her diagnosis sheets. She recently had a mammogram that came out OK, and a CT scan as a safety measure because she was experiencing a pain toward the back of her head for about a week straight, but that ended up coming out clear also. She's on a variety of medicines -- I would say 3-5 different prescriptions, if I had to guess -- so drug interactions and/or timing of the medications could certainly be an issue.
She's on Medicare with Kaiser Permanente, the latter of which I've heard wildly mixed assessments of. I don't believe she has a primary care physician to juggle all this, but rather, 2-3 different specialists for each of the various issues.
I think she's OK now; she's back to making my wife feel like crap when she calls her, so hey -- life is back to normal. :-\
Thanks again. I'm hoping the above details help.
posted by CommonSense at 11:15 AM on June 10, 2012
She has had ulcerative colitis for several years, and I know that in the past, I heard medicine names like Remicade and Prednisone, though she's not currently on either of those. She has to go in to the doctor's office for her "injection" periodically -- I think it's every couple of weeks or so, but I'm not positive (it was normally my father taking her, but he's out of the country for another couple of weeks). She's been an insomniac for all of my adult life (I'm 37), and is almost always tired. I'm 95% sure she has chronic depression as well.
On top of that:
Is she diabetic? My first guess is that she has poorly controlled hypertension as well as an autonomic neuropathy, which is causing the presyncope.
She was recently diagnosed as diabetic, yes. So her diet has been impacted -- she's down to very little sugar intake (or sometimes sugar substitutes), keeping the dairy to a minimum, etc. There's other curious things; she couldn't have raw spinach with me recently, so we sautéed it instead and she was fine. I brought over some fresh watermelon and we both enjoyed it, but she was sick overnight (diarrhea, from what I was able to gather). Raw fruits/vegetables have recently become a new no-no.
Is she salt sensitive? What is the history of women in her line? Is their stroke in her family? Or heart problems? Is she overweight?
I've never heard anything about her having issues with salt, and she has what I would consider a lower-than-average threshold for salt; i.e., she's never salted her food much nor felt a desire to. Although her sister (in India) died about a year ago due to a freak aneurysm or stroke (I never got the information quite clearly), generally her family has always been quite healthy. (Might be worthy of noting that all family prior to her live/grew up in rural India, where diet will obviously be a LOT more traditional, simple, and different from the West -- or even urban India, and live on a farm where there's lots of opportunity for physical activity.) Her mother (my grandmother) is still alive and is around 80. (Even my mother isn't exactly sure of her mother's age; this was apparently not uncommon in small villages decades ago.) But she's still entirely clear, lucid, and not at all overweight. She walks slowly and hunched over, and she isn't terribly active anymore, but she still comes off as very much alive, and has no health issues that any of us know of.
My mother is overweight, but not insanely so; she's at about 150-155 when she should (I'm guesstimating) be in the 130ish range. We don't know of any heart issues in her family.
She's 62 years old and so far, there's been zero evidence of loss of mental acuity or focus. She's grumpy one day and cheerful the next, but it's pretty much always been that way, and I would chalk that up to the insomnia combined with the chronic depression.
So . . . I think I've listed every diagnosis we know of; in addition, I remember seeing "high blood fats" (I forget the actual term; started with lipi-) on one of her diagnosis sheets. She recently had a mammogram that came out OK, and a CT scan as a safety measure because she was experiencing a pain toward the back of her head for about a week straight, but that ended up coming out clear also. She's on a variety of medicines -- I would say 3-5 different prescriptions, if I had to guess -- so drug interactions and/or timing of the medications could certainly be an issue.
She's on Medicare with Kaiser Permanente, the latter of which I've heard wildly mixed assessments of. I don't believe she has a primary care physician to juggle all this, but rather, 2-3 different specialists for each of the various issues.
I think she's OK now; she's back to making my wife feel like crap when she calls her, so hey -- life is back to normal. :-\
Thanks again. I'm hoping the above details help.
posted by CommonSense at 11:15 AM on June 10, 2012
Response by poster: . . . oh, and yes, I'm well aware I need to start getting more involved/informed. Normally, my mother and father live together (and overall, he's the healthier of the two), but he's taken a contract consulting position in India (never can seem to retire!) that puts him there two months, then back here for a month, then rinse and repeat. I have one sister, but she moved out several years ago after being home in the all-too-common post-college return to the nest. She's not a viable option, as she and her husband moved to London (though they'll be here with their 7-month-old for a couple of weeks next month). My wife is out of town but returns on Friday. So for the moment, it's just me. I own my own business, so that gives me SOME flexibility.
posted by CommonSense at 11:17 AM on June 10, 2012
posted by CommonSense at 11:17 AM on June 10, 2012
I know someone who had a lot of weird fluctuations in BP as a result of taking BP medication. I gather the dosing and timing is delicate, so my first move would be to go back to the doc who prescribes the blood pressure med and talk about all the symptoms she's having.
posted by LobsterMitten at 4:43 PM on June 10, 2012
posted by LobsterMitten at 4:43 PM on June 10, 2012
Can you find out what your mother's medication is? Agree that it's pretty unusual for someone to be medicated solely for low blood pressure.
I had low blood pressure all of my life (which was never medicated), and my blood pressure suddenly went high because of a chronic autoimmune inflammatory illness. Which is what diabetes is, so maybe your mother--if she had low blood pressure previously--is experiencing something similar, even though we have different inflammatory issues.
posted by Sidhedevil at 6:53 PM on June 10, 2012
I had low blood pressure all of my life (which was never medicated), and my blood pressure suddenly went high because of a chronic autoimmune inflammatory illness. Which is what diabetes is, so maybe your mother--if she had low blood pressure previously--is experiencing something similar, even though we have different inflammatory issues.
posted by Sidhedevil at 6:53 PM on June 10, 2012
Anyway, your mother's endocrinologist needs to talk to whoever prescribed the blood-pressure-raising meds. If she previously had orthostatic hypotension or even fainting spells because of low blood pressure or low blood volume, things may have changed because of her insulin response, and the medication might be counterproductive.
posted by Sidhedevil at 6:55 PM on June 10, 2012
posted by Sidhedevil at 6:55 PM on June 10, 2012
Anecdata alert: a relative of mine recently had lots of issues keeping his blood pressure in check - too low at first, then too high after starting various meds for different conditions. Like your mother, he was seeing several different specialists, all of whom prescribed meds for the condition they were treating.
However, what they didn't pay attention to was drug interactions which were causing the mysterious fluctuations and other side effects. In his case, the doctors in the family advised him to get to a geriatrician, because it's a common situation for the elderly to be in, what with all the meds many of them need.
posted by undue influence at 9:27 PM on June 10, 2012
However, what they didn't pay attention to was drug interactions which were causing the mysterious fluctuations and other side effects. In his case, the doctors in the family advised him to get to a geriatrician, because it's a common situation for the elderly to be in, what with all the meds many of them need.
posted by undue influence at 9:27 PM on June 10, 2012
Hi CommonSense, yes, taking meds for high blood pressure is much more common. I'm an ER doctor and I can't tell you anything about why your mother's having episodes of palpitations and feeling faint, but I suspect her doctors will be looking into an arrhythmia.
I did want to tell you though that it is a common misperception that having a high blood pressure means you have to "get to the ER now!" Sadly, this causes many people a lot of anxiety when they take the blood pressure and it's high, and then they keep repeating the blood pressure and each time it gets higher and higher (because they are more anxious!!). They end up coming to the ER and we often just send them home without doing much for them, or at least not more than their primary care doctor could have done. Most of the time people have an elevated blood pressure when they come to the ER because they are either anxious and scared, in pain, or both. When the anxiety or pain goes away, the number comes down.
Yes, it's important in the long run to have a blood pressure that is 120/80 or less. But at any given moment in time, you can have a high blood pressure number, and it's not an emergent problem, as long as you don't have any other symptoms with it. The mantra with blood pressure is "treat the patient, don't treat the number." The number isn't as important as people think. What makes a high blood pressure situation into a high blood pressure emergency is whether the patient is having other symptoms with the high blood pressure, such as stroke-like symptoms (weakness, difficulty with speaking) or chest pain. Check out this page from the American Heart Association for more information.
By the way, I agree with your assessment that 205/185 is an unlikely real BP, because the pulse pressure is so narrow (the top and bottom numbers are very close to one another). I wonder if they were using a cuff that was too small. Or she might have had a very fast heart rate at the time they were taking the BP. One other thing - I suggest you ask if she is avoiding certain foods because of a medication she is on. If she is on a blood thinner called Coumadin then leafy green vegetables can screw up the effects. However, cooking the green vegetables doesn't help with this - actually raw green vegetables are safer.
posted by treehorn+bunny at 9:42 AM on June 11, 2012
I did want to tell you though that it is a common misperception that having a high blood pressure means you have to "get to the ER now!" Sadly, this causes many people a lot of anxiety when they take the blood pressure and it's high, and then they keep repeating the blood pressure and each time it gets higher and higher (because they are more anxious!!). They end up coming to the ER and we often just send them home without doing much for them, or at least not more than their primary care doctor could have done. Most of the time people have an elevated blood pressure when they come to the ER because they are either anxious and scared, in pain, or both. When the anxiety or pain goes away, the number comes down.
Yes, it's important in the long run to have a blood pressure that is 120/80 or less. But at any given moment in time, you can have a high blood pressure number, and it's not an emergent problem, as long as you don't have any other symptoms with it. The mantra with blood pressure is "treat the patient, don't treat the number." The number isn't as important as people think. What makes a high blood pressure situation into a high blood pressure emergency is whether the patient is having other symptoms with the high blood pressure, such as stroke-like symptoms (weakness, difficulty with speaking) or chest pain. Check out this page from the American Heart Association for more information.
By the way, I agree with your assessment that 205/185 is an unlikely real BP, because the pulse pressure is so narrow (the top and bottom numbers are very close to one another). I wonder if they were using a cuff that was too small. Or she might have had a very fast heart rate at the time they were taking the BP. One other thing - I suggest you ask if she is avoiding certain foods because of a medication she is on. If she is on a blood thinner called Coumadin then leafy green vegetables can screw up the effects. However, cooking the green vegetables doesn't help with this - actually raw green vegetables are safer.
posted by treehorn+bunny at 9:42 AM on June 11, 2012
A few other small items. "High blood fats" generally = high cholesterol ("hyperlipidemia").
Also, if your mom is part of Kaiser, she must have a primary care physician - Kaiser is an HMO, and in HMOs, you have to have a primary provider to coordinate your care and to give you referrals to specialists. The emphasis of HMOs is primary and preventative care, and making your PCP the 'gatekeeper' for any specialty evaluation.
posted by treehorn+bunny at 9:47 AM on June 11, 2012
Also, if your mom is part of Kaiser, she must have a primary care physician - Kaiser is an HMO, and in HMOs, you have to have a primary provider to coordinate your care and to give you referrals to specialists. The emphasis of HMOs is primary and preventative care, and making your PCP the 'gatekeeper' for any specialty evaluation.
posted by treehorn+bunny at 9:47 AM on June 11, 2012
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posted by CommonSense at 1:18 AM on June 10, 2012