I Need to Know

I am a 59 year old female who had an endarterectomy on left carotid (75% blocked) on February 8, 2011.  The right carotid was 35% blocked (watching this with an increase in statin to 80 mg/day).   This was established by CT scan.  I also had a head scan which showed no strokes  The operation was a success...out of the hospital in one day and back to work in three weeks.  My blood pressure has been doing great -- runs about 110-120 over 60-65.  OIn the last couple of days it jumped to 143/79...pulse rate has remained pretty much the same as always .. around 60-65.  I am on 50 mg metoprolol 2x per day and .25 mg of hctz once a day.  I am a terribly anxious person and when my blood pressure goes up it scares me to death. My horrific anxiety has been an issue for years (dating back to childhood). I have a home monitor and if I was by myself I would misuse it.  My daughter lives with me and only takes it once a day in the evening.  Naturally, when I find that it is high it only goes higher because of the anxiety. My GP has me on .05 mg Klonipin (klonopin) 2 times a day...it helps some but not much . It may be well to note here that a chest x-ray was perfomed prior to surgery as well as an EKG which they said "looked great."  The chest x-ray showed mild calcification of the aorta (which was attributed to my age) and that my heart is of normal size.  My GP does not deem it necessary for me to see a cardiologist at this time.   Due to the atherosclerosis in the left carotid would it be wise to see one?

[ed34]

There can be a large number of reasons why blood pressure elevates and it doesn't have to be heart related. It is also worth remembering that if you have plaque in your carotid arteries, it doesn't mean you have to have the disease elsewhere. I had a huge amount of plaque in my coronary arteries but scans revealed nothing in any of my major vessels. Mild calcification of the aorta is not a problem and is not uncommon when you reach a certain age. I think perhaps it would be wiser to start with blood tests before considering seeing a cardiologist. Are your cholesterol levels at normal levels? 143/79 is not dangerous or life threatening. I must also say that I don't trust those electronic blood pressure machines one bit. Yesterday I went to rehabilitation assessment, and they took my BP. The machine said 143/101. Now, I know this is wrong because the day before, my GP took my BP using a stethascope and it was 130/70, exactly what it was the week before. They tried a different cuff and it then stated 180/85. Still way off the true mark. I think those devices cause more stress than they are worth.

[curmudgen]

To add....  blood pressure should be taken after 10 minutes of rest and with a manual manometer for accuracy.  BP can fluctuate widely from hour to hour/day to day and as I discovered one can become obsessed by taking it too frequently....  Monitor yourself once/day for a week or so.  If you are between 110/60 and 140/90 with a pulse between 60 and 100 you are within the "normal" range.  Stress adds considerably to your numbers.

[lucy0206]

Thanks so much for responding.  It was very helpful.  But due to the fact that there was atherosclerosis would seeing a cardiologist  be in order at this point? I also forgot to mention thall all of my blood tests were all normal...including glucose and CRP protein.

[lucy0206]

thanks for responding.... do any doctors ever respond?

[ed34]

"But due to the fact that there was atherosclerosis would seeing a cardiologist  be in order at this point?"
My personal opinion is no. However, if it's going to haunt you and cause stress (and I understand that), then perhaps go for something far less invasive or risky. I think you would be better having a stress echo test. They can induce stress slowly using medication and they monitor the heart on the echo machine to see if your heart behaves any differently to normal. If you have any blockages to be concerned about, then under stress a part of the ventricle muscle will react more slowly than the rest.
"do any doctors ever respond?"   Very rarely here, they are on the expert forum. Click forums at the top, select Doctor forum and then select heart disease.