Blood pressure question

[TravelingChris]

My dh has been prescribed a bp medication and I don't even think he needs it. His bp seems normal to me. At what point do they medicate for high bp? I told him not to start the medication now anyway since he is about to travel to Australia where it is summer and the medication says to keep away from the sun.

 

The reason I don't understand why the doctor would prescribe anything is since his blood pressure is like mine and none of my many doctors want to do anything for me at all with regards to it. In fact, no one has said I have high blood pressure and they have in fact said my bp is fine.

[Chrystal]

What is his blood pressure?

The very highest that anyone wants is 120/80. ANYTHING over that is considered hypertension.

The summer situation just means that he needs to wear sunscreen when he is there, but everyone should do that no matter what season it is.

If you don't believe that he should be taking the medicine maybe it would be a good idea to get a second opinion before starting it.

[Debbi in Texas]

My doctor started trying to get me to take bp medication when my bottom number was 80. I put it off for some time, you know, I was going to lose weight. I finally did go on medication. Dh has had the same experieince except he wasn't overweight.

 

I think they have started treating it at lower levels.

 

Debbi

[Chrystal]

My doctor started trying to get me to take bp medication when my bottom number was 80. I put it off for some time, you know, I was going to lose weight. I finally did go on medication. Dh has had the same experieince except he wasn't overweight.

 

I think they have started treating it at lower levels.

 

Debbi

 

Remember that the numbers are just that, numbers. What they stand for is what is important. The top number is the pressure in your arteries while your heart is beating. The bottom number is the pressure while your heart is at rest. Of course aerobic exercise helps lower both these numbers because it helps exercise the heart muscle itself and make it more effecient at it's job, pumping blood. Just like when you do bicep curls you don't have to exert as much energy when you lift something heavy.

 

Both numbers are important. When your heart is having to work hard to either pump the blood or keep it from coming back and pooling it exerts more energy. When the pressure in your veins is high it also causes the veins to stretch out. Sorta like filling a balloon. Once it stretches out that far it doesn't snap back as easily.

Both of these situations can cause strokes (from the arteries in your neck and brain stretching) and heart attacks (from the heart working so hard). Not to mention problems in every other system in your body.

 

It just isn't something to mess around with.

Get a second opinion from a cardiologist.

[TravelingChris]

I went to the Mayo site and to the American Heart Association site and they both said the High BP is 140/90 or higher. He doesn't have that and neither do I. I am on heavy medications on my own and am very uninterested in having DH go on dangerous drugs. That said, I am now going to go gungho on what he will need to do- take aspirin daily, dark chocolate, nuts, celery, oats, and no salt adding to foods.But he doesn't need to start a diuretic right before he goes on a 23hour plane trip. Nor do I want him taking the drug without me able to observe and help him.

[Chrystal]

I went to the Mayo site and to the American Heart Association site and they both said the High BP is 140/90 or higher. He doesn't have that and neither do I. I am on heavy medications on my own and am very uninterested in having DH go on dangerous drugs. That said, I am now going to go gungho on what he will need to do- take aspirin daily, dark chocolate, nuts, celery, oats, and no salt adding to foods.But he doesn't need to start a diuretic right before he goes on a 23hour plane trip. Nor do I want him taking the drug without me able to observe and help him.

 

What medicine was prescribed? You mention diuretics. There are different types of medicine used to treat hypertension. If he is prescribed diuretics it may be that there is a fluid balance problem that is causing his blood pressure to be high. That could lead to fluid in his lungs and that definitely is not something you want.

 

The information you are pulling up sounds old.

As a nurse and nursing instructor, I can assure you that 120/80 is considered very high normal. 140/90 is definitely hypertension, but that doesn't mean that 130/80 isn't also hypertension.

You never did say what his pressure was.

 

I can't push for the visit with a cardiologist harder. I know that you want what is best for hubby and this just isn't something to play around with. I say this as someone who lost her mother at 52 to a pulmonary embolism. I miss her everyday and if she had listened to her doctors (and me) she would still be here. But as a nurse she thought it was nothing and didn't.

[whitestavern]

I am not a medical professional, but I have to disagree with Chrystal. I do read a lot about health issues and have always heard that 120/80 is considered "optimal" and "normal". I had a bad bout w/acid reflux last year and my bp was elevated. I spoke to several doctors about it as I was concerned (at that point I didn't know why it was elevated). They all acted nonchalantly about it. Conspiracy theorist that I am sometimes, I think it's the drug companies pushing these lower numbers. Just like they want to give statins to anyone w/cholesterol over 200.

 

I have read what the OP has re: 140/90 being considered high. I have heard that as far as treatment is concerned they wait until it's even higher. Do lots of research. It's probably a good idea to see a cardiologist to hear what he has to say. If you can find out why, hopefully you can treat it without medication.

[Chrystal]

Once again it comes down to how current your information is.

 

I keep up-to-date with all of this type of information. It is my job.

Medicine is constantly changing and updating as new information becomes available. You have to remember that not too long ago, in the spectrum of history, we still bled people to cure them.

 

The doctors that I know would much rather treat you with lifestyle changes than prescribe a long-term medication, but most people are really not willing to do what it takes to make a huge lifestyle change.

 

Be careful where you get your information. There is a lot of outdated stuff out there.

[Chrystal]

my bp was elevated. I spoke to several doctors about it as I was concerned (at that point I didn't know why it was elevated). They all acted nonchalantly about it. .

 

 

They probably acted this way because it is normal for your bp to be elevated when you are in pain, anxious, or under any other type of stress.

That's why hypertension is normally diagnosed only after several different high readings under normal conditions.

[ThatCyndiGirl]

In Physiology class two years ago we were told that the new normal is 110/70. No, I do NOT believe that these newer, lower numbers are a cospiracy by the drug companies to push more drugs. I believe it is a result of newer research and more knowledge.

 

I take BP meds. My brother took them, then stopped taking them for a whole year. TWELVE STROKES LATER he is back on them and it took three years of rehab before he could go back to work.

 

 

Please, please, please I cannot stress this enough: he should take the meds and wear sunscreen. This is nothing to play around with.

[Perry]

The guidelines most in use currently are from JNC-7 , published in 2003. New ones are supposed to come out this year.

 

See Table 1. at the link.

 

The “Seventh Report of the Joint National Committee on Prevention,

Detection, Evaluation, and Treatment of High Blood Pressure” provides a

new guideline for hypertension prevention and management. The following

are the report’s key messages:

• In persons older than 50 years, systolic blood pressure greater than

140 mmHg is a much more important cardiovascular disease (CVD) risk

factor than diastolic blood pressure.

• The risk of CVD beginning at 115/75 mmHg doubles with each

increment of 20/10 mmHg; individuals who are normotensive at age

55 have a 90 percent lifetime risk for developing hypertension.

• Individuals with a systolic blood pressure of 120–139 mmHg or a

diastolic blood pressure of 80–89 mmHg should be considered as

prehypertensive and require health-promoting lifestyle modifications

to prevent CVD.

• Thiazide-type diuretics should be used in drug treatment for most

patients with uncomplicated hypertension, either alone or combined with

drugs from other classes. Certain high-risk conditions are compelling

indications for the initial use of other antihypertensive drug classes

(angiotensin converting enzyme inhibitors, angiotensin receptor blockers,

beta-blockers, calcium channel blockers).

• Most patients with hypertension will require two or more antihypertensive

medications to achieve goal blood pressure (<140/90 mmHg, or

<130/80 mmHg for patients with diabetes or chronic kidney disease).

• If blood pressure is >20/10 mmHg above goal blood pressure, consideration

should be given to initiating therapy with two agents, one of which usually

should be a thiazide-type diuretic.

• The most effective therapy prescribed by the most careful clinician will

control hypertension only if patients are motivated. Motivation improves

when patients have positive experiences with, and trust in, the clinician.

Empathy builds trust and is a potent motivator.

• In presenting these guidelines, the committee recognizes that the responsible

physician’s judgment remains paramount.

Here is a concise table with the major recommendations. I can't copy it here but here is a copy of the algorithm

 

 

 

 

 

Basically, treatment is usually started at 140/ 90, or 130/80 in patients with kidney disease or diabetes.

Of course, it's up to the physician and the patient to make the decision for each individual.

Edited January 27, 2010 by Perry

[Perry]

What is his blood pressure?

The very highest that anyone wants is 120/80. ANYTHING over that is considered hypertension.

The summer situation just means that he needs to wear sunscreen when he is there, but everyone should do that no matter what season it is.

If you don't believe that he should be taking the medicine maybe it would be a good idea to get a second opinion before starting it.

 

Here is the current classification, from JAMA.

 

 

[TravelingChris]

Thanks Perry. Yes, he would probably be considered pre-hypertensive and that is why I want to do lifestyle changes first. He does not have either diabetes or kidney disease and he is exercising both aerobically and with weights for 23 years consistently. He is also under 50.

 

WIth me, my blood pressure is all over the place but I don't think it is unusual with someone with chronic pain. It frequently in the 130 over 89 range but just as frequently in the 120 or high 110 over 70 range. Only one doctor ever got excited about it and he was quickly overruled by my regular internist who retested me and found me in the normal range.

 

When he comes back from overseas, I will have him recheck with the doctor and find out why exactly he wants him to go on drugs. He will bring the JAMA recommendations with him. If the doctor is seeing some other risk that I don't know about, I would like to know. Living with my own chronic illnesses for 15 1/2 years and coping with medical problems of my kids has made me very aware of many medical issues. I am not convinced this is a pharmaceutical conspiracy but on the other hand, I am not one to put someone on medication without being convinced there is a need, either.