Automatic Blood Pressure Monitor

[Millennium]

Hi everyone

This will get a little personal but I'm not too concerned about security and I've been here a LONG time so here goes.

I have Type 2 Diabetes due to a previous medication. It's been and gone once, but is back and is well controlled with Metformin. Now being technically diabetic (ok I guess more than technically), the doc has to keep a close look at my blood work, my cholesterol and my blood pressure. Hence I take statins daily.

Now I went for an annual check last week and my bp was something like 140/90+ . The nurse was concerned and discussed this with the doctor, who suggested I use an Automatic Blood Pressure Monitor for a day and check back for the results.

It's basically a battery powered blood pressure measurement tool, that has an arm attachment and you wear on your belt for a day. It takes a reading every 20-30 mins and every hour at night time, then they download the results and get a good idea of your BP.

My first result this morning was 144/89, again on the high side of acceptable.

Anyone have any tips on reducing BP and perhaps what medication I can expect if it's decided anything is necessary? Any side effects? I am planning to get back on the bike soonish and also hoping to cut down on alcohol consumption which undoubtedly is not helping. My BP has never been perfect but it's never been 140 / 90 bad until the last couple of weeks as far as I can tell. I'm trying to think if anything has changed, best I can come up with is I've been in a cast for the last 7 weeks due to a fractured ankle therefore doing even less exercise than the meagre amount of walking I normally do regularly.

Thanks for reading. Just wanted to vent - I'm only ~~35 it's a bit early for a BP problem surely.

[scaryjim]

... I'm only ~~35 it's a bit early for a BP problem surely.

'Fraid not. My hypertension was initially recognised and investigated when I was 26. Back then the trigger mark was 150/100 - it came down to 140/90 about ten years ago. I still hover around that borderline hypertensive mark, but so far it's under control at that point.

... Anyone have any tips on reducing BP ...

I'm afraid it's already too late for my first piece of advice, which would've been to tell your GP where to stick his statins. I've refused medication throughout, because once you start taking it you're basically stuck on it for life.

I hate to be indelicate, but how heavy are you/how active are you? The one thing that hammered my BP (I dropped right back to mid-120s/mid-80s) in the last few years was loosing about a stone and a half and starting to exercise regularly. I managed the weight loss by going on the 5:2 fast, which I'd still swear by today (even though I no longer fast regularly). The only downside was that it made me feel really guilty about rolling my eyes at every GP who told me that one of my problems was being overweight

One thing I would say, though, is that 140/90 isn't really a medical problem as long as it's continuous and stable at that level. You're not about to drop dead from a stroke. It's more an indication that you need to keep an eye on it and take action if it goes up any more. The big push on it in the NHS/Public Health is somewhat political, as it's easy to measure and can be controlled with drugs. It became a performance target for GP surgeries (I'm serious, they're actually performance measured on the proportion of their patients who are below 140/90), so no surprise it's the thing many GPs really push people on...

[Millennium]

I hate to be indelicate, but how heavy are you/how active are you? The one thing that hammered my BP (I dropped right back to mid-120s/mid-80s) in the last few years was loosing about a stone and a half and starting to exercise regularly. I managed the weight loss by going on the 5:2 fast

I have been 108 kg recently, but am currently ~115. I am quite tall, 6ft2 or so. But it's certainly overweight. I am planning on increasing my exercise and have been quite sedentary the last couple of months due to injury.

I'm happy with taking statins for a while.

It's interesting what you say about the NHS targets. However, I'm not sure if I'm super stressed or the ABPM is faulty, I have checked the last two times it read something and it's in the 175/110 range, which I'm pretty sure is bad lol.

**** what can I do.

[scaryjim]

I have been 108 kg recently, but am currently ~115. I am quite tall, 6ft2 or so. But it's certainly overweight. I am planning on increasing my exercise and have been quite sedentary the last couple of months due to injury.

Yeah, I'm also 6' 2" (well, I used to be, I reckon age has taken a bit off that now ) - I started at almost bang on 100kg, and spent months thinking the diet was doing nothing for my BP; but when I got down to around 95kg my BP suddenly dropped. Like I said, I swear by 5:2 - it's slow, but it's pretty sustainable.

I'm happy with taking statins for a while.

I have other friends who've said that, but my understanding of statins is that any BP drops they cause aren't sustainable, and as soon as you stop taking them the BP starts heading up again. They're also MASSIVELY over-prescribed (and that's a direct quote from my last GP!), but that's a rant for a different day

... I'm not sure if I'm super stressed or the ABPM is faulty, I have checked the last two times it read something and it's in the 175/110 range, which I'm pretty sure is bad lol.

Depends what you were doing at the time! Your BP will fluctuate over the course of the day, and if you're particularly aware of the monitor it's likely to be putting you on edge, which will cause higher readings (i.e. you've potentially got a case of portable white coat syndrome). I'd spend the evening trying to relax and getting used to the monitor being there - hopefully you'll find the readings drop.

EDIT: incidentally, it's the second number that's of real interest, and 110 isn't ridiculous for that, although it's pretty high. But if you start with a base of 100 and you're a bit stressed, those readings are ridiculous. If you get those readings after a relaxing evening, prod your GP a bit more!

[Millennium]

I have other friends who've said that, but my understanding of statins is that any BP drops they cause aren't sustainable, and as soon as you stop taking them the BP starts heading up again.

Thanks for the help!

I may be wrong but I think the statins are mainly for cholesterol.

[scaryjim]

... I may be wrong but I think the statins are mainly for cholesterol.

I think they get prescribed for all sorts of things, and iirc there are several different types that do slightly different jobs. My last GP was really very scathing in his assessment of statin prescription, and was the first I'd had who fully supported my preference to not go on medication.

Hope it all goes well for you

[Saracen]

First, I agree with scary on pretty much everything.

Second, you DO need to be a bit careful with readings. Be sure you're doing it properly if you're unsupervised, which is "at rest" and with your arm properly elevated.

Third, those odd high readings aren't a probkem unless it's consistently high, and by high, I mean the 170-ish sys reading.

Fourth, 140/90 is vety much borderline for where medication is necesaary and, PERSONALLY, I wouldn't take medication at that level. But I probably would if it goes much higher and if diet and weight loss don't suffice.

What can you do? Lose weight, and reduce salt intake. I suggest a switch to a low-sodium salt, like potassium chloride rather than sodium chloride (normal table salt). Also, start reading food labels and especially salt levels. Cook fresh produce and avoid processed meals because then tend to be stuffed with salt.

Reduce, SLOWLY, the amount if salt you cook with, or add on. Do it too fast and it affects taste too much. Do it over a period and you'll barely notice.

Medication? This is getting into a tricky area, forum-wise. As always, LISTEN TO YOUR DOCTOR, and the best place for a second opinion is a second doctor.

Types of medication? A lot. Beta blockers, diuretics, all sorts, and what works for one person might not for another. It's typically a case of suck it and see.

Side-effects? Oh, hell yeah. There's a VERY long list for each medication, most of which you won't get,

But does it matter?

High BP is a silent killer, and a major risk factor for, oh, heart attack and/or stroke. As side-effects go, none of them are as bad as the side effects you risk if you don't take medication if you need it, and can't manage via weight loss and/or dietary amendments.

[Taz]

Disclaimer: I am in no way medically qualified so please don't use my experiences as medical advice!

I've been looking into this subject for the last three years. I bought an Omron cuff monitor a few years and was startled at the results - I won't mention the numbers but I'm surprised I'm still alive. This coincided with me suffering from social anxiety - it makes my BP go through the roof. The more I worried about it, the higher my BP go and my social anxiety worsened. I then bought a wrist monitor that was more comfortable to use. One of the things I found with the upper arm blood pressure monitors was that they made me tense up as I am very squeamish and don't like the thought of blood being stopped in my arm! My heart rate would jump to around 170bpm when I was having my blood pressure checked.

Rather than try and fix it through medication, I started an exercise programme with daily activity. Anything from a long walk through to weight training, through to cycling and running. I've lapsed a bit in recent months but it did make a difference over the last two years. I set myself very realistic targets over 2 years so never had to exercise to exhaustion. This made moderate exercise fun.

I also made small changes to my diet that also helped me lose weight and feel better.

In addition I have an app on my phone for self-hypnosis that makes me feel relaxed and good about myself. This has made a huge difference too.

These days I just don't worry about it. I feel calmer and relaxed. I think worrying about medical issues too much can worsen them and also create other medical issues.

When it's my time to end the journey of life on this Earth then that's the end of the matter as far as I'm concerned. Until then, I'm determined to enjoy myself and just do enough to be reasonably fit and healthy.

[Millennium]

Thanks everyone for the fantastic replies.

Small update : My ABMP showed 158/something daytime average. My GP said I will probably have to go on some medication for this, ACE inhibitor of some kind he said, low side effects and effective. However, since I'm under 40 I'm having a consultation with a cardiologist first to rule out rare other possible causes that would have to be looked at. I'm going to have that soon and another ABPM session, and no medication until after that so as not to interfere with any possible investigations.

Overall I'm happy and very happy with the NHS. I've also got back on my bike, and planning about 200 mins exercise a week on that weather notwithstanding. So that should help.

I'm glad I caught this early, in any case. Statins, scaryjim, are not so bad and there have been articles (probably not in journals - not sure) mentioning they may be like Metformin (which I also take...) in improving general lifetime etc etc. Can't claim to be an expert.