what is "true" hbp?

Silly question but I've been trying to figure out if I have true htn or just it's just a side effect of pain, inflammation & meds.

I'm afraid with my bp going from a steady 70/40 - 90/60 daily from age 9 - 44; then the past few months it being 150/110 - 165/115 that my cardiologist does not care (my primary wants me on bp meds) - it's worrying me that I may develop heart disease or a stroke etc when it stays this high w/o midodrine for my neurocardiogenic syncope/orthostatic intolerance.

I've been having worsening headaches and severe tachycardia with shortness of breath even w/o exertion but I do have pretty severe ANS problems so maybe this is par for the course.

At first I wasn't worried because with meds and inflammation my dr said it could be higher but now months later no w/no midodrine it staying higher worries me.  

Any idea how long I should wait it out to see if it goes back down?

[erijon]

Hey Lisa,

Your diastolic number is too high, I can't image any kind of doctor being comfortable with that number. Your number would classify you as stage 2 hypertension (160/110) which is normally treated very aggressively. I don't know what the normal side effects are of the drug you are on, but a BP that high can and will damage organs and arteries as well. I would do as my family doctor suggests.

Hope this helps,

Jon

[vienna13]

Hi Lisa ,

If you dont mind I tell you what I think.:)
I think you should be on BP medication. It is high, especially the diastolic. It is more dangerous then the first number in my understanding. It must be under 100 at least. For me also my headache is the first sign if my BP went up. You also might have headache because of that.
I don’t know if it is for you because of your other problems, but even if ,it shouldn’t be that long high, if it wasn’t high by itself. I would listen to the doctor who said you need blood p. medication. You always can stop it if your BP would go down.  
My husband and kids have normal BP I used to check for them when they were ill and never went up for them.

My Best
V.    

[vienna13]

And one more thing, you might not get pills for a few days, week-end, I can recommend you to eat something very high in magnesium, that can lower diastolic …spinach 1 cup 157 mg,,white beans 1 cup 137 mg., Kellogg's All-Bran  cereal  1 cup 218 mg…fish haddock or halibut is the best….

[is_something_wrong]

If I remember correctly, you sometimes have a very low blood pressure. If you take meds with a BP of 70/40 you will get seriously unwell. A really low diastolic BP can cause v-fib because coronary blood flow is inhibited (heart don't get blood supply during the systolic phase opposite to other organs). That's why heart attacks can occur with really high diastolic pressure, and why people on nitro can die when using Viagra (last one due to seriously low diastolic)

I guess this is why you aren't treated with meds? I agree, 160/115 is too high. True hypertension is diagnosed with 24h monitoring. From your high diastolic and your history I would guess lots of compensatory mechanisms are active, or you have an as you mentioned. I would guess this is what needs treatment. If I remember correctly you didn't handle beta blockers because your BP got too low?

[is_something_wrong]

Stupid ipad. Was supposed to write "you have an ANS disorder as you mentioned"

[is_something_wrong]

Why don't you take a 24 hour BP monitoring? That way you can find out if you still have seriously low BP at some times and too high at others. If it's constantly elevated, get it treated?

[Mom2four85]

Thanks for all the replies; I didn't worry at first because my cardiologist wanted my bp higher so I don't get lightheaded dizzy or faint this is the normal treatment for ANS issues.

With NCS and OI (autonomic dysfunction) my BP has always stayed very low 70/40 - 90/60 until I started taking a higher dose of  Midodrine in Jan 2011.  My primary had me ask my cardio about it and he said he wanted it higher so I don't faint.  I started getting headaches worse and told my primary she suggested I talk to the cardio about it and the midodrine.  I stopped taking it and since Feb I've gone in and gotten my BP checked a couple of times a week at different doctors.

It has read 150/110 - 165/115 since then at every visit and the ICD tech asked me about it being so high when I had my interrogation Thursday.

It's so worrisome because I know in August 2009 i had no ischemic problems; I don't want to add to my already long list of issues.

Thanks Vienna on the tip for high mag foods, I'll try and see if that works also.

Any idea how long it takes for organ damage to start or what to look for? I'm going to talk to my primary and at least see if the meds will help since it's still so high.

[Mom2four85]

I forgot...I've been taking Inderal daily for headaches & arrhythmia's since I couldn't tolerate other bb's (thanks for the reminder). I just read it's for hbp also, so it's even more bothersome to me that my bp is staying this high.

I'll ask the dr again about my AI (auto immune) and inflammation issues and see if she thinks that's the reason.  Maybe she needs to switch me to a higher dose of Inderal or switch meds.

[is_something_wrong]

Inderal doesn't lower BP so much because it's two effects works opposite on BP. The beta1 effect slows HR and lowers contractility, but the beta2 effect constricts blood vessels, making it excellent towards NCS, the net effect lowers BP but selective beta1 blockers (without the beta2 effect) is far better (and far less tolerable for you earlier...)

That's why you tolerate Inderal :)

How long does your BP need to be elevated to cause organ damage? I guess this is the million dollar question, it depends in different people. Some never get organ damage, some does rapidly. Organ damage is LVH and diastolic failure, kidney diseases and changes in blood vessels, I think.

Again, it may be a good idea to get a 24h monitoring before you decide what to do. That way you can rule out BP drops and you can be sure your BP is actually elevated, not just anxiety while measuring..

[Mom2four85]

going to see a new cardiologist in June so I'm going to make sure I go over this with him and see what he says...maybe this one will understand something about the heart and ANS issues as my first EP did...can't go back to him though because of billing issues with my insurance company.

simple solution is to hook my  ICD wireless unit up to a bp monitor and watch it =)

[Mom2four85]

could the high readings be due to machine errors since my primary and cardio use the automatic bp machines?

I was anxious as heck at my pain dr yesterday knowing he was going to tell me they were going to sedate me to do injections on my back; so by the time I walked in the exam room, I had worked myself up and my head pounding, heart was beating out of my chest...nurse took my bp the "old" fashioned way and said your bp/hr is the same as last week - 120/80 and hr was 82...

maybe I'm just weird and when I get anxious my bp/hr lower? lol

[vienna13]

I am your numbers were fine Lisa !

  Well I don’t know if it is machine errors, but I used to think the same. My BP is changing often 5 minutes to the other 5 minutes; sometimes drastically so I thought also, can it be just the machine?
One thing I always try to remember: The machine should be sitting on the same level as my heart, also always wait 5 minutes calmly.  

Keep the good numbers!
  V.

[vienna13]

I am glad.....

[Mom2four85]

yeah that's why I don't want to take meds to lower my bp if it's not really high...I;ve taken meds to raise my bp for almost 2 years - dr's just frustrate me though...1 med for something and something else to counteract the med they first gave you.

My bp has to stay higher or it's too easy with Autonomic Dysfunction for it to bottom out = faint and heart stops for me.

seems there are no easy answers and not alot of doctors in my area who even understand ANS issues.