Should I or shouldn't I

I am a 65 year old female who for years has suffered from white coat syndrome. My Dr. is always trying to get me to on B/P meds. My B/P was 160/90 in the office, came home sat right down and took it, it was 124/65. I have a wrist monitor and had taken it along to the DR. it is very accurate.

I saw my DR. two weeks ago and of course walked out with a script for 5 mgs of norvacs. She told me to monitor my B/p and if goes up and stays above 130/70 to start the med. To me that range is not B/P med time.

My B/P is usually good,get a few elevated readings on and off but does not stay up. Yesterday I took my B/P and it was 158/88, got very anxious because I do not want to go on meds. took it many, many times during the day and it was always high except for about three times.Today I took it four times, had one readng of 160/80 and the other 3 were below 130/70, in fact one was 114/60.

So should I start the meds or just continue to monitor it.

There was an article in our paper a few months ago that the AHA as going revise B/P guidelines, it said they think they have them to low and too many people are meds. that do not need to be.

Thanks for any help.

[StephPT]

Here is what my doctor told me.  as you know, white coat syndrome translates into "stress" which is causing your BP to go up.  The same thing is happening as you are taking multiple readings throughout the day, getting more and more worked up about the prospect of taking pills.  What you need to ask yourself is, "how stressed do you get on a day to day basis?", because if this is your body's response to the doctor, it is also your body's responses to ANY stress you encounter.  Your BP is probably higher than you think for a greater percentage of the day then you think, based on this.  You should probably take the meds.  Hypertension is the silent killer, and if it is running high at the times you are seeing it, it is also running high at times you are not.

steph

[Barbarella]

I've been in your shoes, refused meds for many yrs because I was afraid of the side effects.  I too had low readings at home at times.  

I have severe white coat hypertension, and I saw a Hypertension Specialist, he calmed my fears, but at the same time told me when people react with white coat hypertension at the doctor's office, is the anxiety and suspense abou the "what if" , what will my BP be this time.  However, he also said people like us who react hypertensive when in suspense like that how do we know we do not react like that in other situtions that causes suspense i.e. a traffic jam, "how long will I be stuck here", waiting for an important stressful outcome, or anxiety and suspense about something else.  He explained to me that people react different under stress/anxiety/suspense.  Some of them react with diarrhea, shaking, headaches and so on, but their BP stays in the basement.  We on the other hand react with hypertension.

An occasional spike will not kill you he told me, but elevated BP over the years can have an effect on your heart, as in enlargement among other things.

What I had to do was take my BP several times during the day for two weeks.  I was shocked to find out that my average BP was 150/90 without meds.  Now imagine when going to the doctor the anxiety on top of 150/90 and in no time I went over the top as in over 200 syst.

I've been on the clonodine patch (I have to change once a week) for the last 4 yrs with absolutely no side effects.

I agree that the guidelines are getting lower and lower, the same for cholesterol.  

[degrassi]

Absolutely start the meds.........hypertension is dangerous.

[line]

Thanks for the input. I took my b/p this A.M. and it was 130/73, took it again about 1/2 hour ago and it was 116/58. I am afraid it will drop too low with meds. so I will keep monitoring it.

Thanks again, Linda

[Itschuck2c]

See your just stressed again..worried it will go to low..dont take your bp for a week, take the meds.. and dont worry about it!!!