hypertension 39 yr old female

I am a 39 yr old female 5 ft 3 in 135 pounds.  I have never had a problem with high blood pressure in the past.  One month ago I went for my OB/GYN check-up and my BP was 128/90.  Three weeks ago, my husband had a heart attack and had a stent placed.  He subsequently purchased a blood pressure cuff, and one night I decided to check my BP.  I was shocked when it was 145/109.  Since then, I've been having consistently high readings, ranging from 135/90 to 174/109.  I went to my doctor to have this checked, and at that time my blood pressure was 128/92.  So, my Dr. thought perhaps there was a problem with the cuff.  I took it back in today, and my BP in the office was 154/98.  The cuff was consistent with that reading, so they concluded that my BP cuff is accurate.  I have spoken to my GP, but I would like a second opinion and have some questions:
1.  Is it possible to have temporary high blood pressure - perhaps from the stress of my husband's heart attack ordeal?
2.  Is it necessary to get on a blood pressure medication, even if just a temporary situation?  If so, can I eventually get off the BP med or is that usually a permanant thing?  I don't want to be on BP meds this young.  
3.  Are the readings stated above considered "dangerous" readings consistent with a stroke or heart attack?
4.  Is it sometimes normal for BP to fluctuate like this?  How do I know when it's a real problem or just a stress-induced problem?

I feel that I am too young for high blood pressure, as I've never had any problem with this before.  However, I do feel that my stress level is sky-high at this point, even when I'm trying to relax.  This most recent high BP issue is making me even more stressed.  Also, I'm already on Wellbutrin for depression.  Could this affect my BP in any way?

[Lee Kirksey, MD]

Hello
There are a number of questions here. Ill try to answer them the best that I can. As you can understand, it is difficult for me to comment about your specific cases because as you know there is a lot of information that is processed from physical examination, labs including cholesterol and others, as well as tests like EKG and echo.

Having said that, yes stress can cause people to have elevated blood pressure. However that doesnt lessen the potential harm from elevated blood pressure. Stress can cause many harmful changes in the body including elevated blood sugars, inflammatory mediators which can lead to many problems.So your blood pressure may be elevated in response to your circumstances, but this is stillharmful

I dont know what age your husband is but a persons age should have nothing to do with how aggressively a medical condition like high blood pressure is treated. In fact, most people would argue that because of the long life ahead of you, a young person should be treated agressively. The ability to get off of a medication after it is started is largely related to the patients interest in improving their diet, wieight, lifestyle including exercise and smoking if present.

There are no precise numbers that correlate withheart attack or stroke. It varies from person to person. That is why most physicians after confirming the diagnosis of blood pressure elevation, treat it aggressively.  There is no way to know if it is a "real"problem aside from eliminating stress and following your BP to see if it improves. Your doctor should look for other reversible causes of high BP like kidney disease

I do suggest that you investigate some means of stress management to improve your coping. This may be quite helpful over time. My book Your Guide to Optimal Health has several chapters on stress management and breathing exercises that might assist with this process. www.yourpersonalwellnesswheel.com. As you know, stress always seems to appear in some way, shape or form. Aggressively address this medical problem if you agree with your doctor that it exists

Best of Health