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1124887 tn?1313754891

Variable blood pressure, what to do?

Hello.

I'm a 30 y/o male, doing what I can to prevent cardiovascular disease. From being somewhat overweight and in poor shape, with slightly elevated cholesterol (6,0 mmol/l total, 1,0 HDL, 3,8 LDL, sorry for using SI units, but I don't remember the formula to convert) and a resting BP of 125/65, my BMI is now 22, my cholesterol is 4,4/1,1/3,2, I exercise 3-4 times/week, hiking/jogging and some lifting. My morning BP is 90/55, evening BP is 100/60. I don't take medications except 10 mg propranolol occationally to prevent PACs (and sinus tachycardia) when I'm stressed.

My BP is often higher at the doctors office, but rarely very high. Last time 120/75. Earlier, with overweight and less healthy lifestyle, it could occationally be in the 150s.

I'm fully aware that my BP most of the time is normal, but I occationally get symptoms that I somehow relate to a high blood pressure, when I'm stressed. It can be a pressure sensation in my head (rare), short (seconds) bilateral pulsatile tinnitus when standing up, difficulty to focus, feeling of "wool" in my head. I'm aware that my shoulder/neck muscles at times are tense.

I've checked my BP right after a stressful 10 hour day at work. 110/65.

In my country, the average BP counts, and doctors are not very concerned about white coat HTN or BP spikes. I can't get any medications because I occationally have symptoms of hypotension (rare though as my BP seem to regulate well when standing), and my doctor said it would be dangerous for me. Also symptoms when eating to little salt.

What can I do? Another question, if I'm feeling stressed and my BP is slightly high, it's usually the diast. that's higher, like, say 120/85. Earlier, the sys. would be most elevated, like 150/80. Does that mean anything?

It should be mentioned that I'm tested for cardiovascular disease, perfect results. Excellent c-IMT and f-IMT, lower percentile, excellent stress test and echo, blood tests and EKG. Non-smoker.

Thank you.
3 Responses
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Avatar universal
Yeah that seems reasonable. Once a month would be max, but as long as you are doing well otherwise, once every 3 months would be still plenty at your age and in your health.
Helpful - 0
1124887 tn?1313754891
Thank you doctor, for an excellent and very reassuring answer.

I will keep on eating healthy and exercise. If you read this, I'm just curious, how often should I check the blood pressure? I know I was fairly obsessed on checking vital signs like pulse, blood pressure, temperature, etc. earlier, when I suffered from a fair amount of benign PACs and an occational short SVT, but reassurance and propranolol pretty much took care of that, so I'm learning to trust my heart, and trying to help people at the communities here instead. Is every couple of months enough?

Again, thanks

:)

Helpful - 0
Avatar universal
You have done absolutely everything you can to keep yourself in ideal health, and you should congratulate yourself on hard work which has paid off.

None of your blood pressure results (when resting, active, or stressed) that you have provided are in any way concerning. Even an occasional diastolic blood pressure of 85 is acceptable, and even more reassuring when you note that it is routinely lower than that.

Everyone's blood pressure fluctuates, throughout the day, with activity or stress, illness, resting, etc. None of the blood pressure results that you experience currently warrant any therapy.

To be honest, at your age, with your current good state of health, you do not need to be checking your blood pressure frequently like this, as the anxiety of having to check frequently can contribute more to blood pressure lability than anything else.

The symptoms you experience with headache and tinnitus and difficulty focusing can be consistent with tension headaches in the setting of stress, and not related to heart or blood pressure issues, especially since you had a normal blood pressure in the setting of this.
Helpful - 0

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