Borderline high blood pressure

[Jay Z]

Dear Doc

I am a 40-year old male, and hypertension runs in my family. For the longest time my systolic blood pressure ranges from 135 - 145 over normal diastolic pressure. I do not have any other risk factors for heart disease. I am in shape and excercising, and eat a normal diet. Is medication recommended ? And if so, when to start ?

Jay

[Forum-M.D.-bkj]

Jay,

Thanks for the post.

We have become very aggressive with treatment of hypertension. The latest guidelines even classify a level of 'pre'-hypertension in order to increase awareness of the disease and potential complications.

You are right on the edge between pre-hypertension and stage 1 hypertension. I would first institute aggressive lifestyle modifications and diet control. I would maintain close follow-up and recommend ambulatory blood pressure monitoring.

If those measures did not work I would probably pursue treatment.

good luck

[questioner2]

I read a blog written by Jeff in 2000 wherein he was questioning whether he had high blood pressure since, like mine, the pressure would flucuate from something like 117/72 to 150/94.  Like Jeff, I realize that the numbers in my top range fall into the catagory of high blood pressure, but does a person only go on medication if the pressure is ALWAYS high like that?  If the pressure can fall to normal range, does that mean the person does not really need medication?  This answer was not clear to me from the responses I read that were written to Jeff. Respectfully, Q

[EchoTech]

I am not a doctor, but I believe that your pressure falls outside the guidelines for what is acceptable.  They changed the guidlines a year of two ago, and I think your BP is too high.  I myself would try to get on BP medicine because I see the damage hypertension can wreak on the body after it goes unchecked/not under control for years.  High blood pressure just beats up on the linings of your arteries and can have many bad consequences that you don't feel until the damage is too late to be corrected.  It sounds like you are doing a lot to help yourself, but you may need more in the form of medication.  It is something that in all likehood that you will need to take the rest of your life unless you have other risk factors that you can modify.

Good night and good luck.