B.P.. and Drugs....To Use or Not to Use.....

[Mare__0]

  Hello, Cardiolologist..You have helped my family before and now I am posting.  Since, there is heart disease in my family with early deaths, I thought I had better have a check-up.  . I am 55 yrs. old and female.  I saw the cardio man and the girl took the B.P...She was having trouble getting it and finally registered 150/94...I was a bit upset over that reading. The doc walked in and I asked him to retake it..He threw down his pen on his desk as if I annoyed him and retook it..It was still 150/90.but the diatolic was going down a lil bit. .He never mentioned high BP...I told him of my concerns of heart disease and asked him for an EKG...He told me that he would order a Stress Thalium (something like this but it is called something 99, but the same concept with the dye) It was a five hour long ordeal but not painful. I also told the doc that my feet were swelling and bottom of the legs as I sit at the computer for hours.  He RX'd a drug called diazide and some Jobe elastic knee high stockings. I had the Thallium type stress test and they took my B.P. just before they started and an  EKG.  My BP there was 130/80...Then the test began...I had no pain during the threadmill (except my head was hurting)  and the tech kept telling me to keep going and keep going as he wanted 85% Max...I reached this and he said my BP went to 250 at max but quickly came down onceI I was off and ended up in the 130/60 range when I got through..  The cardio's LVN called me a few days later and told me all is normal. I did ask her about the 250 range and if i would stroke out if I exercised to this degree (g)!!  She said that she would ask the doc..but all is normal..Two weeks later (today).this gal  called me and told me that the doctor wants me on B.P. medication for the rest of my life becuz of the 250 reading at 85% on the threadmill and also the reading in his office prior at 150/94....I told her no. She said Yes...the doctor is a cardiologist and he knows best. I told her that some times my BP goes up in a doctors office and sometimes it registers 130/80 or 125/78 and sometimes it is 130/90 and sometimes it is 155/92.  I told her that mostly it is in a normal range...I told her that I do not know why it goes high in some doc;s offices and not in others. Anyway, my question is: Is 250 BP reading Max (85%)  on this threadmill a bad reading warranting the patient on BP meds the rest of one's life?  Does readings like I indicated above warrant BP medication...Did the 130/80 at the start of this Thallium Test mean that this number is "not Normal" either..Man, I do not know what is normal anymore...This LVN wants my BP down to 120/.70 forever...Right now, I am a Wreck....This drug begins with a D and is 5mg...I have not picked it up yet..I took the diazide for the feet swelling last month and did not notice amy different..I am off of it as of two weeks ago,,  my feet go down once I am laying down and  stay off the computer from sitting and wrapping my legs and feet around the wooden runners a long time..The socks do nothing.. I need your help, doctor.  Sorry this is long.  Can you help clear up this matter and educate me.... I told them that I would buy an automatic BP machine and she said they were no good and not accurate. Only the cuff is accurate.  I told her that I would most likely have trouble taking it with the cuff...She also said that many of her patients are a lot younger and they are on BP medication...Am, I worrying needlessly and just go ahead and get on this drug whether I need it or not?.  Thanks very much, Doctor........Maree
-------------------------------------------------------------------------------
Dear Maree,
Q: Is 250 BP reading Max (85%) on this treadmill a bad reading warranting the patient on BP meds the rest of one's life?  
A: Not necessarily.  But this is an abnormal result and is weighed into the decision to recommend starting medication.
Q: Does readings like I indicated above warrant BP medication...Did the 130/80 at the start of this Thallium Test mean that this number is "not Normal" either ?  
A: Normal BP is 120/80 or less.  Blood pressures above 140/90 generally warrant starting medications.  If the BP is controlled with life style changes and weight loss it may be possible to stop medications.

Below is some additional information on high blood pressure.
High blood pressure, or hypertension , is defined in an adult as a blood pressure
greater than or equal to 140 mm Hg systolic pressure or greater than or equal to
90 mm Hg diastolic pressure. Blood pressure is measured in millimeters of
mercury (mm Hg). High blood pressure directly increases the risk of
coronary heart disease (which leads to heart attack) and stroke (or brain
attack), especially along with other risk factors.
High blood pressure can occur in children or adults, but is particularly prevalent in
blacks, middle-aged and elderly people, obese people, heavy drinkers and women who are taking oral
contraceptives. Individuals with diabetes mellitus gout or kidney disease have a higher frequency of
hypertension.
How do salt and sodium affect high blood pressure?
Most Americans consume far more salt (sodium) than their bodies need. Heavy sodium consumption increases blood pressure in some people, leading to high blood pressure. People who are diagnosed with high blood pressure are often placed on restricted-sodium diets.
Reducing sodium (or salt) consumption may help lower blood pressure in some people. Your doctor may
recommend a sodium (salt) restricted diet. This will mean you'll have to avoid salty foods and cut down on the amount of salt you use in cooking and at the table.
How does being overweight affect high blood pressure?
Studies have shown that body weight, changes in body weight over time, and skinfold thickness are related to changes in blood pressure levels. These factors have been linked to the subsequent rise and development of high blood pressure. People who are overweight are more likely to have high-normal to mild high blood
pressure.
Physical inactivity is a risk factor for heart disease. In addition, a sedentary or inactive lifestyle tends to
contribute to obesity, a risk factor for both high blood pressure and heart disease. Regular exercise helps
control weight and lower blood pressure. Don't be afraid to be active — exercise should definitely be part of your daily program. Besides helping to reduce your risk of heart attack, it can also help you lose weight or maintain a healthy weight.
Statistics show that many people who have high blood pressure are also overweight. If you are overweight or have gained weight over time, you'll be advised to cut down on calories and lose weight. Your doctor can prescribe a diet that's right for you.
If you're given a diet, follow it closely, including any recommendations about reducing your consumption of alcohol. Alcoholic drinks are high in non-nutritious calories, so if you're trying to lose weight, avoid alcoholic beverages. Often when people lose weight, their blood pressure drops as well.
How does medicine help control high blood pressure?
For some people, weight loss, sodium reduction and other lifestyle changes won't lower high blood pressure as much as it needs to be lowered. If that's your situation, you will probably need to take medication. Many medications are available to reduce high blood pressure. Some get rid of excess fluid and sodium (salt). Others relax constricted blood vessels. Others prevent blood vessels from constricting and narrowing. Because there is usually no cure for high blood pressure, treatment generally must be carried out for life. If treatment is stopped, the pressure may rise again.
Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist