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Blood pressure fluctuations

Not being medically knowledgable, could you give me some direction with regard to my wild blood pressure ride.  I am 59, active, and never really had any illness.  A week or so ago I had an occasion to visit the doctor with regard to my blood pressure being rather high.  I am 5.11 and 180 lbs.  Blood work was done and returned with an elevated LDL/HDL which was stated to control by diet (I was told to lose 60 points off the bad guy).  I take no medicines other than herbs (E, A, Zinc, Potassium and a daily regime of aspirin).  At that time my reading was 170/100 and just to let you know I get really nervous when situations arise which are out of my control.  There was concern for the rise but later during the day it dropped back to 122/74, which according to the doctor was what he would expect.  The following day my highest recorded reding was 128/88 and the lowest of 101/72 recorded after a bike ride.  The next day the high was 138/90 and a low of 120/78.  The next was 150/103 and a low of 116/80.  Today, during the last three hours (waking hours) I awoke at 139/93, bnike rode to 125/95 and am now sitting at 122/72.  I really have a light headed feeling and am not sure just how to react.  Although my diet of late hasn't been the best, it is being corrected.  Are there any thoughts as to why the rise and fall (I can expect some fluctuations regarding my lifestyle, but the Diastolic rise and fall has me worried)?
Thanx
7 Responses
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238668 tn?1232732330
MEDICAL PROFESSIONAL
Dear Jeff,
Blood pressures do fluxuate over the course of the day depending on your activity and stress levels but in general any reading done at rest over 150 systolic or 95 diastolic indicates a high blood pressure problem.  Sometimes an ambulatory 24-hour BP monitor is used to help establish the pattern of BP throughout the course of the day.  The treatment of only occasionally elevated pressures may only be diet, exercise and weight loss but it may also require medications.  This is something that you will have to watch closely and follow-up regularly with your doctor.  I have attached some additional information about high blood pressure and other web sites that can give you more information.

High blood pressure, or hypertension (HTN) , 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.  

High blood pressure may be primary (essential) or secondary.   If the  hypertension is secondary there may be a treatable cause.  Most of these causes are relatively rare (i.e. renal artery stenosis, pheochromocytoma).  If no secondary cause is found then the high blood pressure is said to be primary.  The vast majority of cases of HTN are  primary.  The main cause of primary HTN is genetic.


Q: I am hoping to get pregnant in the future and I am wondering if this will effect things?
A: Blood pressure may be elevate during pregnancy and if you have a predisposition to high blood pressure it should be closely monitored during pregnancy.

Q: I believe the higher blood pressure is directly related to anxiety which may be OK for the "normal"
person, however with me having this disorder I deal with anxiety A LOT and I often endure it without my medication.
A: It is important to take the medication you need for anxiety.  In addition you may need blood pressure medication if your high blood pressure continues.


Q: How do salt and sodium affect high blood pressure?

A: 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.

Q: How does being overweight affect high blood pressure?

A: 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.

Q: How does medicine help control high blood pressure?
A: 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.


Q: Will I have to take medications for my hypertension the rest of my life?
A: Generally, someone with high blood pressure will be on lifelong medication.

Q: At what point do I need to see a heart specialist for this condition?
A: Usually hypertension can be managed by an Internal Medicine doctor.

Q: Will there ever be a right combination (of medication) to treat this condition?
A: It may take several trials to find the right combination of drugs.   There are many different medications and new ones are coming out each year.

Q: My parents both had heart attacks and strokes and father had a bypass in Sept. 97 (age 74), mom had her stroke at age 49. They still take meds for hypertension. With this history is there a possibility I might have a heart attack in my later years?
A: Heart disease tends to run in families.  Those who have a family history of heart problems shoud take extra care of themselves (i.e. weight loss, high blood pressure control, exercise, etc.).


http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/hbp.html
http://www.ihr.com/medreprt/articles/bloodpr.html
http://www.musc.edu/iash/
http://www.am-osteo-assn.org/ccoop/hibldprs.htm
http://www.mco.edu/whl/know.html
http://www.bloodpressure.com/
http://www.mediconsult.com/hypertension/
http://www-med.stanford.edu/school/DGIM/Teaching/Modules/HTN.html
http://www.merck.com/!!uYfKE0uiyuYfKE0uiy/pubs/mmanual/html/khgnjgcd.htm
http://www.aafp.org/afp/091596/special.html
http://pharminfo.com/disease/cardio_db.html
http://www.pslgroup.com/HYPERTENSION.HTM

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.


Helpful - 1
Avatar universal
A related discussion, Fluctuations in blood pressure was started.
Helpful - 0
Avatar universal
A related discussion, gout medicine and high blood pressure was started.
Helpful - 0
Avatar universal
I am wearing a heart monitor for irregular heart beat. I am now 59 and have had them since I was
40. I always notice they come about two weeks out of the month. Is there a chance they are harmonal
or is it only a sign of heart problems.
Helpful - 0
238668 tn?1232732330
MEDICAL PROFESSIONAL
Dear Jeff,
Blood pressures do fluxuate over the course of the day depending on your activity and stress levels but in general any reading done at rest over 150 systolic or 95 diastolic indicates a high blood pressure problem.  Sometimes an ambulatory 24-hour BP monitor is used to help establish the pattern of BP throughout the course of the day.  The treatment of only occasionally elevated pressures may only be diet, exercise and weight loss but it may also require medications.  This is something that you will have to watch closely and follow-up regularly with your doctor.  I have attached some additional information about high blood pressure and other web sites that can give you more information.

High blood pressure, or hypertension (HTN) , 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.  

High blood pressure may be primary (essential) or secondary.   If the  hypertension is secondary there may be a treatable cause.  Most of these causes are relatively rare (i.e. renal artery stenosis, pheochromocytoma).  If no secondary cause is found then the high blood pressure is said to be primary.  The vast majority of cases of HTN are  primary.  The main cause of primary HTN is genetic.


Q: I am hoping to get pregnant in the future and I am wondering if this will effect things?
A: Blood pressure may be elevate during pregnancy and if you have a predisposition to high blood pressure it should be closely monitored during pregnancy.

Q: I believe the higher blood pressure is directly related to anxiety which may be OK for the "normal"
person, however with me having this disorder I deal with anxiety A LOT and I often endure it without my medication.
A: It is important to take the medication you need for anxiety.  In addition you may need blood pressure medication if your high blood pressure continues.


Q: How do salt and sodium affect high blood pressure?

A: 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.

Q: How does being overweight affect high blood pressure?

A: 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.

Q: How does medicine help control high blood pressure?
A: 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.


Q: Will I have to take medications for my hypertension the rest of my life?
A: Generally, someone with high blood pressure will be on lifelong medication.

Q: At what point do I need to see a heart specialist for this condition?
A: Usually hypertension can be managed by an Internal Medicine doctor.

Q: Will there ever be a right combination (of medication) to treat this condition?
A: It may take several trials to find the right combination of drugs.   There are many different medications and new ones are coming out each year.

Q: My parents both had heart attacks and strokes and father had a bypass in Sept. 97 (age 74), mom had her stroke at age 49. They still take meds for hypertension. With this history is there a possibility I might have a heart attack in my later years?
A: Heart disease tends to run in families.  Those who have a family history of heart problems shoud take extra care of themselves (i.e. weight loss, high blood pressure control, exercise, etc.).


http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/hbp.html
http://www.ihr.com/medreprt/articles/bloodpr.html
http://www.musc.edu/iash/
http://www.am-osteo-assn.org/ccoop/hibldprs.htm
http://www.mco.edu/whl/know.html
http://www.bloodpressure.com/
http://www.mediconsult.com/hypertension/
http://www-med.stanford.edu/school/DGIM/Teaching/Modules/HTN.html
http://www.merck.com/!!uYfKE0uiyuYfKE0uiy/pubs/mmanual/html/khgnjgcd.htm
http://www.aafp.org/afp/091596/special.html
http://pharminfo.com/disease/cardio_db.html
http://www.pslgroup.com/HYPERTENSION.HTM

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.


Helpful - 0
Avatar universal
JR
jeff,
you dont have any kidney problems do you? sounds to me maybe like a problem with sodium regulation to me. slight elevations/declinations are normal. your range dosent seem to be too bad, so it may be absolutely nothing to worry about. i go up and down like that due to mood, salt intake, dehydration etc.
Helpful - 0
Avatar universal
wondering...........
  You question whether or not Jeff has kidney problems in regards t his bp..........I know that as a result of surgery I have mild kidney failure and at this time am having trouble regulating my bp....some days perfectly normal....other days wild fluctuating from 120/60 to 180/60....no one has ever told me that dehydration could be a cause of bp problems.....could you explain?? I know some days I'm good with drinking water but then other days when extremely busy or not at home will find I drink very little...am taking monopril...hctz....norvasc...toprolxl...and so far not at all consistant with bp...can go weeks with perfectly great readings and then go weeks with lots of fluctuating.......frustrating!!!!!!
Helpful - 0

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