High blood pressure (in athletes)

[Susan]

DH had a health check at our doctor recently. They measured his blood pressure and it was quite high. They said this could have been related to being nervous because of the examination and told him they would measure it again in some weeks and would have to medicate him if it stays as high.

We borrowed a blood pressure monitor to measure his bp at home to see if his high numbers are related to being nervous at the doctor, but he measures at about 150 over 80 quite frequently even at home.

What bothers me is that he is at a normal weight, doesn't smoke, doesn't drink and does about one hour of sports daily, more on weekends. He's really an athlete. He should be healthy when I look at his lifestyle. We eat basically the same (my bp measurements are at about 100 over 60), a lot of vegetables, no sugar, mostly organic, real whole food cooked by myself.

The doctors seem not to be used to treating people that really live a healthy lifestyle and most of the tips we got regarding high bp seem to be targeted at unhealthy, not very active people.
I looked at the "DASH" eating plan that is designed to lower your blood pressure (http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf), but the plan really doesn't offer any improvements over our diet - we already do what this plan suggests and more. I will try to use even less salt (but it's not very appealing to eat food that tastes empty without salt to be honest).

I worry what will happen if DH can't lower his blood pressure. I'm not sure if the medication he will be put on will allow him to ride his bike and do sports as he did before. I'm not sure if there are risks when doing a lot of endurance sports while on bp medication? (And I'm not sure if the doctors will be aware of those risks when I think of the advice DH has gotten so far?)

Until now, I was sure that we do the right things regarding our lifestyle, but now I'm not so sure anymore. The thought that DH may be putting himself at risk while doing sports makes me feel really bad. I'm even asking myself if he puts himself under even more stress by trying to be active.
And I am at a loss what he could do to avoid bp medication. He said he will stop drinking coffee which he did until now and I will cook without salt as much as possible - but that doesn't seem a lot (especially when I think about the many things that obviously couldn't keep his bp at a normal level).

There are so many women here that lead a healthy active lifestyle and may have a different point of view than doctors that don't seem to be used to treating athletes. Do you have any advice?

[OakLeaf]

I'm in the same boat so I'm interested to hear what others have to say.

I actually think a lot of it has to do with your day-to-day life, not your workout routine. There have been a number of studies lately that show that it's not your "exercise" volume, it's your sitting volume that makes the difference in your health. If he works at a desk job, try a standing desk. For me, I just have to get away from the stupid computer...

Beware of not getting enough salt. That's a chronic issue for me. I hadn't even been trying to cut down and kept bouncing off mild hyponatremia until I started making sure to drink electrolyte drinks instead of plain water. (Once I even wound up in the ER on IV saline.)


ETA - Look at some of the more recent literature about overdiagnosis, too, and make your own decision whether his numbers are something to be concerned about at all. My diastolic is a whole lot higher than his, unfortunately. My acupuncture doctor was most concerned about the tight gap between my numbers, which makes mine much more difficult to treat.

[Crankin]

My DH has high bp, same situation as your DH. It's genetic (he also had 2 stents put in 6 years ago). He takes a very low dose (5-10mg) of a BP medication that is not a beta blocker. It does not affect his riding at all. There are lots of medications for high blood pressure and many have been around for years, so are well tested. You may be thinking of beta blockers, which lower your heart rate and suck for athletic people to take. My DH's cardiologist wanted him on one after his angioplasty, but that lasted about 2 days, since DH's resting HR is already super low. It's more for people like our friend, who had the same surgery as my DH, is still 50+ lbs. overweight and never does any exercise.
Unfortunately, being athletic does not always protect you from these things.

[OakLeaf]

I've been told/read that ACE inhibitors are no good for active people, either, because as soon as you start to sweat, your BP drops to the point of dizziness. And the idea of having to pee any more than I already do, makes diuretics very unattractive...

[Susan]

Thank you for your input.

He really works at a desk job, and as far as I know a sometimes quite stressful job too, but there's not so much he can do about this. Of course he can make an effort to stand up and walk around more often.



Beware of not getting enough salt. That's a chronic issue for me. I hadn't even been trying to cut down and kept bouncing off mild hyponatremia until I started making sure to drink electrolyte drinks instead of plain water. (Once I even wound up in the ER on IV saline.)


Thank you for pointing this out. From what I've read so far, it seemed to me that less salt is always better. The mentioned DASH plan recommends about 2/3 teaspoon of salt per day, which seems not much if you want to prepare 4 meals and take into account that some foods like bread already contain salt (but maybe I'm overestimating the amount of salt I normally use, I will have to watch it more closely).
We also drink plain water only.

Nice to hear that taking medication doesn't affect your DHs ability to ride, Crankin. I will tell DH that he may have to make it clear how much exercise he does, so that the doctor can prescribe the right medication for him.
My mum is on beta blockers and does not do very well on them, it's one of the reasons that I am concerned about DH taking bp-meds.

[westtexas]

One thing you might consider is switching the kind of salt you use. I would ask a human doctor before doing this, but sometimes in heart patients they have them use a potassium chloride instead of sodium salt. I don't know what the taste difference is, but especially if you are on a thiazide diuretic (which tends to help you retain sodium and lose potassium) it might be a viable alternative. I have no evidence or proof to back that statement up, but it might be worth looking in to. Another thing I have read is that sea salt may not have the negative side effects on cardiovascular health that regular salt does.

It's tough when you are doing everything right and still your health isn't perfect. I have a good friend who is fit and lean and his bad cholesterol is off the chart, despite a vegetarian diet and cholesterol losing drugs. But just think about how much worse it might be if you weren't doing everything you could already, right?

[Crankin]

Yes, it is very important to make it clear how much exercise and what intensity level you do, because as we have both found out, many physicians have no concept of what we do, even though it is nowhere near competitive level. It's a lot more than what they envision, i.e. taking a walk a few days a week, or a few classes at the gym. And this becomes even more important as you age. Anyway, DH is about to ditch his cardiologist for the one he went to for a second opinion. It's a bit of a pain to go into the city, but this guy is used to working with athletes and is on the cutting edge of treatment, being at a hospital that is known around the world.
I think i need to start standing more, too, although I don't think I can do therapy standing up... I've noticed changes in my body, since I stopped teaching, which is a much more active job.

[ultraviolet]

I second taking into consideration genetic factors. Is there a history of high blood pressure in his family?

My mother has always been low-normal weight, eaten a fairly healthy balanced diet, and always active...her blood pressure is through the roof without medication. In fact, almost every woman in her family has had blood pressure issues.

And now, I have it, too. Though I didn't realize it until I started getting chronic migraines and we started digging into what was causing them. I take a daily 10mg dose of Lisinopril, and that is enough to keep my numbers low enough to a) prevent migraines and b) keep my doctor happy, without impacting my ability to swim, bike, or run.

I'm not thrilled with the idea of a daily medication, but since I've done all of the other things the doctor has suggested (mainly changes in diet, since I was already actively exercising 4-5 times a week) I was willing to do it to get rid of the migraines I was experiencing regularly. Especially because those migraines caused me to DNS four races/events in the past two years.

For the record, my doctor wouldn't treat 150/80 with medication. He would start by saying no caffeine. Then: limited sugar, taking a look at overall added salt intake and possibly adjusting that downward (though he's not entirely convinced that salt is the blood pressure demon that it's made out to be), adding more fish to the diet, and reducing refined carb intake. Caffeine is really the big one for him, though. (Of course, I go to a doctor that thinks changes in lifestyle are better for you than taking pills. So, he saves the pills until he's seen the other changes don't/won't work for someone.)

[OakLeaf]

Since I already know that my food allergies cause palpitations and increased heart rate, I started poking around to see if they could cause hypertension too.

A while back Dianyla posted a chart (http://forums.teamestrogen.com/showpost.php?p=524798&postcount=58) of histamine pathways in the body. Yup, hypertension is on there.

Up until now it hasn't really been worth it to me to adhere strictly to my allergy diet. It was like a 30% improvement in quality of life for a 200% increase in hassle. But if it'll keep me off BP meds I'll work at it. Maybe your DH should try a challenge diet, especially if he has known allergies of any type.

[zoom-zoom]

My hubby is on a couple of low-dose BP meds. I'm not sure which ones, but the ones he was originally on caused horrible edema. What he's on now doesn't.

He's very active...high BP runs in his family...this is a family of slim cyclists and marathon runners. He's 20-30#s overweight, but this isn't the cause of his HBP--it would be there even at ideal weight.

He has started to stand at work. Fortunately he works for a major office furniture manufacturer, so he was able to change to a standing height desk and has a taller office chair when he needs to sit.

Can your hubby sit on a yoga ball if a taller desk is not an option? I know a few people who do this, since it helps to work the core and requires more work to stay upright.

Another thought is to look for a physician who understands the specific needs of athletes. We really lucked-out...our doc is an avid cyclist who often commutes to the office on his bike. We're really fortunate to have a PCP who treats us as athletes and not the same way he would treat the general couch potato public. Years ago I was having knee issues and my doc and his PA both helped me find a solution that didn't = stop running...many docs would have told me to quit being active, which is backwards.

[tulip]

As I understand it (but I'm no doctor), stress can really affect BP. If your husband's job is very stressful--to the point of affecting his health--it might be an opportunity to figure out how to lower that stress. I left a job that was so stressful that I had multiple health problems from the stress. I did not have high BP, but I serious bruxism, nearly chronic back and hip pain, and extra weight. I left that job and those issues resolved themselves.

Just something to think about as you and your husband figure out how best to be healthy and happy.

[emily_in_nc]

Regarding cutting back on salt to decrease BP, make sure to read this article from last week's Dr. Gabe Mirkin e-zine. I found it quite interesting. In a nutshell, he does not think the research supports cutting salt intake except in non-exercisers, and in fact, that it can be dangerous to do so in athletes:

http://www.drmirkin.com/public/ezine050811.html

Good luck!

[Susan]

Thank you for all your answers.:)

Crankin, that's what I meant, when they hear someone is being active or "doing sports" they think about a small biketour on the weekend. And it's ok, I guess they are right most of the time. Most people consider themselves "active" and think that they "eat well" even if they don't - and probably doctors are used to this.
Finding a physician that is more used to treating active people or even an athlete herself so that she can relate to what we do - I guess this would be great.

As far as I know, high bp is not common in DHs family, but he told me that he had high bp as teenager, so genetics could be a factor.

Regarding his job, DH cut back one work hour the last few days and slept a little longer than usual. He cut back on coffee. I don't know how long this will last, but I guess it won't do any harm ;)
I tried to de-stress him a bit, took him for a small biketour in the evening and made some good-night tea.

Emily, this article is really interesting. Strange how different studies sometimes come to contradicting results. I think I will just continue to use enough salt to taste while not overdoing it - this seems to make the most sense to me.

[tulip]

Sounds like a good start, coming home one hour early, sleeping a little more, and having less coffee. How much coffee and other caffeine drinks does he drink?

[Crankin]

I know that we are about to change our primary care doctor and this is one of the big reasons. Our doctor stopped doing primary care and only does sleep studies now. The guy who worked with her brought his wife into the practice; he's just goofy and she's (no offense to anyone) a slightly overweight woman in her forties who questioned me if I had "chest pain when climbing stairs," when I told her I was concerned about my chest hurting/getting bronchitis or pneumonia when I had a sinus infection. It gets worse when you get over 55; I have noticed a distinct difference in the way I am spoken to by some medical people. They speak like i am a child and try to "explain" things like I'm a moron.
It is true that it helps to have a doctor that rides or runs or swims or something! My gynecologist is a tri-athlete; while she has gone a bit overboard (to the point of wearing very inappropriate attire at the health club, causing creepy guys to hit on her) after losing 125 lbs., when I talk to her about my concerns, she listens and totally understands. She doesn't tell me to slow down, even though I have various medical and sports injury things.

[channlluv]

Blood pressure problems run in my family, too, and I take Lisinopril, as well. I have to be careful, though, when I do longer workout rides because my bp will drop too much. My doctor told me to not take a pill on a day I'm doing a long workout. I also have to monitor my blood pressure at home. I have a digital cuff and a journal and I take my blood pressure at least once a week.

Roxy

[soprano]

Thank you for all your answers.:)
Most people consider themselves "active" and think that they "eat well" even if they don't - and probably doctors are used to this.


I find that rather than saying that I'm active or that I get plenty of exercise, it helps to tell the doctor something solid like "I'm currently riding 80 miles a week." After that, they take my concerns about maintaining my lifestyle more seriously.

I ride for most of my transportation, and everyone at my cardiologist's office loves it when I come with helmet in hand :)

[zoom-zoom]

I find that rather than saying that I'm active or that I get plenty of exercise, it helps to tell the doctor something solid like "I'm currently riding 80 miles a week." After that, they take my concerns about maintaining my lifestyle more seriously.

Yes. #s put things into perspective. My doc knew I was a serious runner and not just a fitness "jogger" when I was training for marathons and putting in 45-55 miles/week on a regular basis and he approaches my care with this knowledge. How to treat someone doing relatively intense workouts 5-7 days/week is very different than it should be for someone doing the minimum 30 minutes 3x/week. A good physician should get this...if they don't I'd be taking my business elsewhere. But I think we have a responsibility to make them aware of the #s, too. Heck, we should be PROUD to present them with this info. :D

[tulip]

It sounds like alot of people here go to the doctor alot. Curious--how often do you go? I go once a year max; sometimes I extend it to once every two years. Then it's only to my women's health nurse practitioner for my annualish exam.

The last time I went to the doctor for a "check up," she told me that I only need to see her if I get sick. Otherwise, I'm healthy and keep doing what I'm doing. Fine with me; I haven't been to see her for nearly two years. That time was because of bad tendinitis in my arm from typing and mousing too much.

[Crankin]

I agree that numbers should talk. That's why I am changing. When I told her "I rode my bike 3,227 miles in 2010, I got a blank stare and she continued on to ask me if my marriage was OK.
:eek:
Tulip, I go to the doctor when I have to. I used to be there, lots. Usually now, it's twice a year for sinus infections/allergy related stuff. I go for my annual gyno exam, and I see an endocrinologist for my osteoporosis. This year I decided to see my PCP for an overall check up, get all of the blood work, etc. That's when I was asked about the stair climbing/chest pain.

[tulip]

I'm so sorry to hear about your chest pain! If I had anything like that, I'd go right away. I count my blessings that I don't have to go to the doctor much at all so far in my adult life. When I was a kid...that was different. I had all sorts of ailments.

Come to think of it, I do go to a specialty eye doctor once a year, too, so I guess that counts.

Hm, I guess I go more than I figure.

[zoom-zoom]

It sounds like alot of people here go to the doctor alot. Curious--how often do you go? I go once a year max; sometimes I extend it to once every two years. Then it's only to my women's health nurse practitioner for my annualish exam.

1x/year for pap. 2x/year for asthma follow-ups. In 5+ years of running and biking I have only had one injury that sent me to the doctor...well, aside from that sprain that had me in urgent care for an x-ray a week after the fact (I was pretty sure it wasn't a fracture, but everyone else urged me to have it confirmed). For a while I was in the office every couple of months with sinus issues...the neti pot put a stop to that garbage! :D

[ultraviolet]

Until I started having chronic migraines, the only regular doctor visits I made were my once a year gyn exams. Other than that, I really only went if something was wrong (cold longer than a week, injury, etc.). I had a whole slew of visits with various specialists when we were trying to figure out my migraine issues. The last time I went to the doctor to check-in on how things were going on that front, we decided that a once a year check-in was fine unless or until something came up--recurrence of the migraines, a change in nature of the migraines, or some complication/problem related to the bp meds. Mostly he's worried about my pressure dropping too low, so I monitor every day at home. So far, I'm on track to not have to see him again for a while. :rolleyes:

[Crankin]

Tulip, the chest pain was not "chest pain," i.e. cardiac. It was my normal congestion/asthma, which I have had all of my life. If I get a sinus infection, it can go quickly into bronchitis, if it's not caught in time. She just freaked out and did not listen to me when I told her my symptoms... and if she had half a brain, she would have seen "allergies" written all over my chart. It's like as soon as they look at my birthdate, they judge me as an unfit, unhealthy person, despite the fact that I look like I am in great shape.

[emily_in_nc]

1x/year for pap.

I don't know your situation, but my PCP advised me that since I've never had an abnormal pap and am in a long-term monogamous relationship, I only have to have a pap every 3 years. This after years and years after having them yearly. I guess they've changed the recommendations. Works for me!

I do go to my PCP (no separate gyn, she does my pelvic exam too) yearly not because I'm sick but b/c preventive care is 100% covered by my insurance. Basically, we talk, she renews my asthma inhaler Rx, does a pelvic and breast exam, and tells me how great my health is. She's a runner and a cyclist so totally gets me. :)

I can't even remember the last time I had to go for a sick visit... :p

[zoom-zoom]

I don't know your situation, but my PCP advised me that since I've never had an abnormal pap and am in a long-term monogamous relationship, I only have to have a pap every 3 years. This after years and years after having them yearly. I guess they've changed the recommendations. Works for me!

I think I could go less often, but insurance covers it and it always seems that I have some female issue or another that I need to address (I have endo, adenomyosis, and 8 years or so after having thermal ablation my periods are getting heavier, again...and my cycles have been stupid short for years, so it always seems that I'm trying to find another way to push back the inevitable hysterectomy until I am at least in my mid-40s).

[soprano]

It sounds like alot of people here go to the doctor alot. Curious--how often do you go?

Chronic migraines here, plus my cardiologist is convinced that I have a connective tissue disorder (I am not convinced myself, but it's fun to see my heart on TV) so they like to see my face pretty often. I do think that there is something else wrong with me that has yet to be identified. I am naturally neither energetic nor strong. If I don't eat extremely well, or get lots of exercise, I feel like crap and get very lethargic very fast. Working full time is a struggle for me. Bike commuting has been a lifesaver in terms of keeping me fit enough to make it through a normal day.

I often get the impression that many people feel that being healthy leads to an active lifestyle, and not the other way around. Drives me nuts.

[Susan]

Good idea to tell them an actual number. If I only knew those numbers myself :o
We both don't train for any events, so officially are no serious athletes. We live without a car, so do everything including commuting on bike, and usually get an extra hour of exercise per day by running, going on a MTB-ride or doing weight training. And we spend our weekends with long bike tours.
So, without being serious about the sports we do, we still do more of it than most people I know (but less than a lot of you on TE).

It's a bit difficult to communicate this sometimes :)

Regarding your question Tulip, I go when I think something is so wrong that it won't heal by itself, and I try to do the annual checkups.

[ny biker]

Well, let's see...doctors...GYN annually for check up and rx for mammogram, pulmonologist annually for check up and to get asthma prescriptions renewed, pulmonary function test every 2 years. I used to go to the neurologist annually for migraine check up and rx renewal, but since the migraines are not as bad as they used to be I go the PCP for that rx now. Also dentist checkup/cleaning 2x per year and eye exam annually because my contact lens rx expires every year. And the annual dermatologist exam.

Then there's the as-needed stuff. Last year I had two trips to an allergist to deal with head to toe hives, plus one emergency Saturday PCP visit when the hives first appeared to get prednisone. Also two visits to an ENT, plus a CT scan of my sinuses, to address bad sinus pain. Then there were the visits to the dentist for the root canal, which wound up also solving the bad sinus pain.

In previous years my as-needed doctor visits have involved long-term neck and shoulder pain, knee pain, frequent periods and breast pain. Plus various upper respiratory infections that turned into breathing problems, injuries from cycling crashes, that insect bite that turned into cellulitis...

Plus the flu shot every autumn.

[Crankin]

Susan, you don't need to be training for an event to be a "serious" athlete. Your lifestyle most certainly qualifies as "serious." The same way I would put myself in this category. I do think medical people have difficulty envisioning this lifestyle, especially if they are more casual exercisers or extremely competitive.
As far as the the doctor visits, what I mentioned before is pretty much my visits to my pcp. I go to the dentist 4X a year, as both of my parents had pretty bad periodontal disease and I was going in that direction. This has helped get it under control greatly. I get a mammogram yearly, and a bone density scan, as osteoporosis is the only real "thing" I have, other than allergies/asthma. I see the endocrinologist a couple of times a year, for tx of the osteoporosis.
I spent most of 2007-2008 going to various specialists to diagnose my mysterious pain, tingling, headaches, stomach issues. Although I ended up under the care of a rheumatologist for fibromyalgia, there really was no definitive diagnosis. I may have a mild presentation of the disease, as I never had the cognitive symptoms. Because of this experience, I know my body a lot better and now know the pattern of what happens if I am over training, stressed, etc. I also don't run to the doctor as much. But, my tipping point is if I think I might have bronchitis or if my asthma is acting up because of a cold or sinus infection. My asthma is 100% better and under control than it was 20 years ago, so I do not ignore that.

[tulip]

Susan, I hope you find a resolution for your husband's high blood pressure. My ex MIL had it (but was/is obese with serious anxiety and hyperchondria) and it was very difficult her and everyone around her.

I figure I am just a normal person in the doctor-visit department, but I am very fortunate that I only go when I need to, which has been very, very rare. I don't have allergies or any other issues that would require a visit. I've never been to a dermatologist, although I would have benefited as a teenager! I have olive skin and no trouble spots as far as I can tell. I have had high cholesterol in the past, but that is under control through diet and exercise, and I was never on the high end that would require meds, just careful habits.

When I was a total stressbag a few years ago, I had back issues and hip issues and sinus issues...but those went away when I changed my situation.

So I go to a nurse practitioner for an annual exam and mammo every 18-months to 2 years, and my eye doctor every year for monitoring (no active issues for 25 years, but since I only have one good eye, I err on the side of caution for that). My glasses prescription haven't changed in about 10 years or more. I suspect that will change as I creep toward 50, though! I have good intentions about going to the dentist twice a year, but it's usually only once a year, if that, for a cleaning.

I'll count my blessings and do all I can to keep it this way!

[emily_in_nc]

I guess I am guilty of under-reporting! In addition to my yearly preventive physical with my PCP, I also go to my dermatologist once a year for a full body scan (I have lots of moles but nothing has been a problem yet), get an eye exam and new glasses yearly (seems like my Rx is forever changing), and go to the dentist twice a year for cleanings. Other than that, I did just go for my first colonoscopy since I turned 50 in April, and I also went to a pain managemant doc recently for my old cycling accident injury (fractured pelvis). He prescribed a TENS unit, which has helped a LOT. So, I don't anticipate any more doctor visits for some time to come!

[lo123]

I have high bp, diagnosed at 28. My mother was diagnosed with it at the same age.
I was having horrible headaches and my vision got worse--at its worst bp was 160/95. I now take bystolic, a beta blocker. The drug choice was right for me because I have a congenital heart defect too, and increased blood pressure is bad for it. I don't care for the beta blocker with exercise, but it helps me to keep the other heart stuff under control so I'm good.


It sounds like alot of people here go to the doctor alot. Curious--how often do you go?
oh lord.. I hate thinking about this...
1. rheumatologist once every 4 weeks = ~13 appointments per year
2. pulmonologist = 2 appointments per year
3. cardiologist = 1 appointment per year (more if needed)
4. PCP = 1 for checkup and usually 5 or so more for sinus infections, etc. = ~6 per year
5. OB/GYN = 1 appointment per year
6. dermatologst = 1 appointment per year (more if needed)

yeesh.. so at least 24 appointments a year. that's a depressing number.:mad:

BUT, I would need more appointments if I weren't cycling. Cycling has allowed me to exercise despite several chronic health issues. It's also kept me from needing to use my cane or wheelchair in the past 4 years. Exercise changed my life.

[OakLeaf]

Well I broke down and made an appointment. It's become a vicious cycle, where I'm anxious about my BP, the increased anxiety leads to more inactivity, and the inactivity increases my BP. Now I get to be anxious about seeing the doctor too. :rolleyes: (but I've promised myself I won't let her talk me into any other screenings that I'm opposed to)

I'm a bit reassured by a little bit of googling though, in particular these two: http://athletesheart.blogspot.com/2010/02/athletes-and-high-blood-pressure.html http://www.drjohnm.org/2011/01/cw-put-your-arm-in-the-machine/

DH has been on an ACE inhibitor for about six months and although he's quite inactive, he hasn't had any side effects other than a slight cough. I'm hoping it will be the same for me. And that once my BP comes down the anxiety will become more manageable.

[Susan]

I wish you the best, OakLeaf.

DH started monitoring his BP at home and has significantly lower readings in this relaxed environment. He also limited his coffee intake. His readings are now normal most of the time and the doc didn't prescribe any medication so far.

[OakLeaf]

Thanks for your good wishes Susan.

I learned something else just now: arm position ENORMOUSLY influences BP readings.

http://www.nature.com/jhh/journal/v17/n6/pdf/1001563a.pdf

My doctor's nurse has measured my BP in a supported horizontal position. I know I'm very white-coatish, always have been. But at stores, etc., and more recently at home, I've been measuring it in more of a dependent position. So did my acupuncture doctor who apparently should have known better. In all of those places I'd been getting readings that were still high enough that I made the appointment. Yesterday and this morning I took it in both positions and both times the diastolic was 20-25 mm lower. :eek:

Too late to cancel my appointment tomorrow, but I'll bring her a copy of this article, and it'll be a good opportunity to bring her my revised and much tightened Living Will.

[Crankin]

OK, maybe I am really dumb, but what exactly is the "dependent" position? Like when your arm is hanging down, not resting on anything?

Just asking.

[OakLeaf]

"Dependent" is hanging down below heart level, "unsupported" means it's not resting on something.

So with your arm on the armrest of a chair (e.g.) it could be supported but still dependent.

In one of those drugstore machines, for someone like me with short humeri, it's both dependent and unsupported (or I guess partially supported, since my forearm is on the rest but my elbow isn't).

[Deborajen]

Well, I just got added to the high BP group. I turned 50 just over a week ago and "celebrated" by being put on Lisinopril. I'm not quite as active as I was a year and a half ago - I used to run 8-10 miles per week, worked out (rowing machine or recumbent bike) once or twice a week and rode my bike a couple times a week. Now I walk or run my dog EVERY day (30-45 min. per day walking or 20-30 min. running; we only run once a week or twice a week max and it's run/walk for 2 miles), play golf once a week (walking the course with a push cart), work out occasionally - so I'm not quite as active, but I'm not sedentary. My mom and my brother have both had BP issues but have managed them with diet/exercise and just some short-term meds, so there really isn't a strong family history.

I'm surprised by this - it's frustrating! I've been trying to pick up running again but yesterday's dose, which was my first, made me dizzy and my BP was 114/64 after a round of golf. It had been in the 140's - 150's systolic with the diastolic number consistently in the 80's for the last three weeks. My doctor requested I take my BP at least three times per week, different times per day, for three weeks and give him the readings. I bought a cuff to measure at home to make this easier. I want to keep this under control, though, and I don't think taking a reading three times per week is enough information since I'm not sedentary. It seems like I should check after vigorous exercise, after work (which has been VERY stressful), first thing in the morning, etc. Does this sound sensible, or is it too much information?

[Pip]

I'm 39 and have had borderline high blood pressure for years. The irony is that I have an autoimmune disorder which in theory leads to low pressure. My endo theorised that one my meds might be bumping the blood pressure up a little too high, but I need it at this dose to ensure my renin levels are good, so what can you do? On the other hand, high blood pressure also seems to be genetic on my mother's side of the family. I'm lucky that my GP understands my levels of physical activity, and that she and her practice nurse monitor my health regularly. I also see my endocrinologist once or twice a year. With any luck I'll be able to stay off the blood pressure meds for a few more years yet!

[lovelygamer]

One thing you might consider is switching the kind of salt you use. I would ask a human doctor before doing this, but sometimes in heart patients they have them use a potassium chloride instead of sodium salt. I don't know what the taste difference is, but especially if you are on a thiazide diuretic (which tends to help you retain sodium and lose potassium) it might be a viable alternative. I have no evidence or proof to back that statement up, but it might be worth looking in to. Another thing I have read is that sea salt may not have the negative side effects on cardiovascular health that regular salt does.

It's tough when you are doing everything right and still your health isn't perfect. I have a good friend who is fit and lean and his bad cholesterol is off the chart, despite a vegetarian diet and cholesterol losing drugs. But just think about how much worse it might be if you weren't doing everything you could already, right?

I have done this before and the potassium does taste different, although it has the bitterness that we identify with salt. You get used to it in a few weeks. I only switched at the advice of a doctor and I didn't have to keep using it long term.

Good luck. I don't know much about BP problems. I do know a 12 year old with them right now though, and it baffles me. She is struggling with it because of the "no activity" rules her doctor gave her. She can't play outside the rest of the summer. Mine has always been fine and I'm not even at a healthy weight.

[Fredwina]

I have broderline HT and have been taking Lisinopril for about 6 years with no problems. So trhe meds and reactions may vary from person to person.
Another thing I did not see is the time of day has an influnce on Bp(it starts out low in the morning and climbs thru the day)