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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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When Should I Get Concerned About My BP Reading ?

My blood pressure has been taken several times over the past few years - over five years ago it was 160 systolic and the doc then muttered 'that's stroke level'. In the past couple of years it's been up and down and they even put me on a 24 hour monitor last year (which didn't work properly). I've been again today and the reading was 180/100. The nurse said to come back in 4 weeks and she will take it again and if it is still as high, she'll refer me back to the doc. I stopped smoking 12 months ago and weigh 13.5 stone (about 190 lbs). Should I be concerned about the readings - and about the fact that the medics are shilly-shallying around. Should I insist on them doing something more - even if it is only medication - or just wait until the next test in four weeks time? I want to say a very big thank you to every one who has responded in such a kind way. I wish I could give everyone 10 points, but that just isn't possible, but the thought is there. In view of what has been said I have arranged an appointment to see my doctor tomorrow. My age is 64, incidentally.
Fri, 18 Dec 2009
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You don't mention your age and it is relevant in terms of your risk for having an untoward event - like a stroke. Regardless, 180/100 is at a level that should be addressed...stroke level? probably not, but long term damage to the heart, kidney, penis, and eyes are of your concern. Additionally you have at least two major risk factors for coronary disease (smoking history - [congrats on quitting] and hypertension). So loweing your systolic pressure to between 120 and 130 will further reduce your risk for having heart disease. I think primary doctors get overwhelmed by the number of health issues that they need to address every day with every patient. Working in a specialty clinic, I see the results of poorly controlled blood pressure every day. It can be as big a deal as having a heart attack in terms of reducing heart function over time. People always seem so surprised to find that this blood pressure that they have been ignoring for decades destroyed their heart function and now they have congestive failure. It is time to start a medication. Typical starting agents would include ACE inhibitors, diuretics, and calcium channel blockers with Beta blockers next on the list. It is not uncommon that more than a single agent is necessary to achieve goal. Lastly, you may also want to be evaluated for secondary reasons for hypertension such as renal artery stenosis and sleep apnea, which both can dramatically raise blood pressure. I hope this helps. Good luck.
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When Should I Get Concerned About My BP Reading ?

You don t mention your age and it is relevant in terms of your risk for having an untoward event - like a stroke. Regardless, 180/100 is at a level that should be addressed...stroke level? probably not, but long term damage to the heart, kidney, penis, and eyes are of your concern. Additionally you have at least two major risk factors for coronary disease (smoking history - [congrats on quitting] and hypertension). So loweing your systolic pressure to between 120 and 130 will further reduce your risk for having heart disease. I think primary doctors get overwhelmed by the number of health issues that they need to address every day with every patient. Working in a specialty clinic, I see the results of poorly controlled blood pressure every day. It can be as big a deal as having a heart attack in terms of reducing heart function over time. People always seem so surprised to find that this blood pressure that they have been ignoring for decades destroyed their heart function and now they have congestive failure. It is time to start a medication. Typical starting agents would include ACE inhibitors, diuretics, and calcium channel blockers with Beta blockers next on the list. It is not uncommon that more than a single agent is necessary to achieve goal. Lastly, you may also want to be evaluated for secondary reasons for hypertension such as renal artery stenosis and sleep apnea, which both can dramatically raise blood pressure. I hope this helps. Good luck.