about my GP and blood pressure?(44 Posts)
About 4 months ago I went to see my GP regarding anxiety. It's something I'd seen others in the practice about previously who were quite dismissive -anyway, this one said I'd benefit from meds, and prescribed Citalopram. Ok, so far so good.
My bp was checked, and found to be high. I was asked to come back in a fortnight. It was still high them - appointment another fortnight later. GP said it was still high, but medicating me wasn't a good idea as I'm only in my early 40s and I'd have to be taking meds for the rest of my life if I started now.
I've done some reading myself, taken steps to improve my diet (cut out chocolate, snack foods etc) and limited my caffeine. GP advised me not to add salt to my cooking and meals - I never have!
So I then had a 24hour monitoring in Nov. Results we're ok, I didn't see a detailed breakdown but reading it over my GPs shoulder most of the time my bp was far lower than on any of my GP visits.
Despite this I was told to come back again in 4 weeks. Before my most recent visit (end of Dec) I had another health issue which resulted in me going to A&E. Where they of course took my BP and said it was entirely fine...
Back to my GP just before Xmas. Bp still high, come back in 4 weeks, GP says you really need to stop adding salt to your food (I don't!) and you need to lose weight (this is on going, can't lose it overnight) otherwise your BP won't go down.
Is this typical? For ref, on the BP test, ad at hospital, my bp was around 130/77. Last time at my GP it was 145/95.
I fully accept I'm overweight, I am trying to address that. I'm also starting to do more exercise (I had to stop this in Dec due to work/ home pressures). Going for repeated appts is quite difficult as I have to ask to leave work every time, which is not always convenient. I know my health is important but I just don't feel any progress is being made?
I could have written this post, it's almost identical to me!!!!
I plan on gong to go to my Docs regarding 24 hour bp monitoring but for reassurance more than anything.
Sounds like you are doing everything right, I am doing he same as you, can't think of anything else really. As you rightly say, weight loss takes time. I am convinced my bp will settle as I get into a healthy bmi area.
My bp is high (157/95-156/107 type thing) and palpitations are driving me mad!!
I agree with your gp regarding medication, I really do not want to go down this path, so like you, I have taken responsibility for my own health, I am doing everything I can to be healthy and well.
It's not easy I'm finding, the weight loss is slow. It's taken me a year to get 22 lbs off, still another 22 to go....plod on!!
Double check your gp is using the correct cuff size as you're getting such different readings. I had this in pregnancy. I have fat upper arms but fairly slender lower arms so they were using the standard (medium) cuff on me. Got measured and I needed a large. Correct size cuff = bp no longer high.
Why is he not putting more emphasis on your 24 hour monitoring ? The whole point of this is to see how you BP is in normal conditions, and to see if you have 'white coat BP'.
Using salt in you meals sparingly should not be a problem...its all the hidden salt in processed foods that's the issue these days
Yes 24 hour monitoring sounds like what you need! Also I know you said you're not adding salt to meals but as I have a health condition which requires strictly LOW SALT, check what you're eating! It's in just about everything even diluting juice! Robinsons being the worst offender, something like 4.5g of salt but supermarket is brand was 1.5! Also any cooking sauces or gravy you may use switch to the low salt alternative
He should be going by your 24 hour monitor readings as this is you in your "normal state". A lot of people have higher BP readings when they go to the doctors, this is why they should do the 24 hour monitor before starting medications, as they could be treating a problem that doesn't exist.
Keep doing what you're doing.
That's interesting about the cuff, the ones GP uses never seem to fit properly.
As to the 24hour monitoring, GP said that if my top reading was high on my visits, they'd dismiss it but because it's the bottom reading that's high, I need to keep being checked.
It could also be that you're feeling anxious about having your blood pressure taken. Everytime I have mine taken, it's too high until I chat to the nurse for a while. My best blood pressure was when my lovely doctor read me a poem off his book shelf to relax me.
I don't eat much processed food - in any event, GP didn't mention this, only that I shouldn't add it, which I don't anyway. I will take the point on board though and check salt in anything I do eat going forward.
Apparently anxiety only affects the top part of the reading, not the bottom?
I should have been very anxious when I was in A&E, but my reading then was fine...
I understand it's frustrating that your making changes, which take time, but are being given the same advice.
As said, the salt in processed foods is high, so it could be contributing?
I started working in Adult disabilities in 2006 and was shocked by the numbers of younger people, who had strokes, all with average lifestyles, the numbers have increased since then.
Ask about the 24 hour monitoring when you go again.
Yy to asking about the 24 hour monitoring. And not being on blood pressure pills. If you need them then they should prescribe them. DH had been on them since he was in his 20s. Maybe they want to see if lifestyle changes will help if you're borderline.
Your blood pressure will be higher (temporarily) if you've been active (running round prior to doctor's visit), need the toilet, or have eaten regularly. And it'll usually go up anyway when you have taken at the doctor's - it's known as the white coat syndrome or something. Buy yourself one of the ones you can use yourself at home www.amazon.co.uk/gp/product/B00BEW65YI/ref=oh_aui_search_detailpage?ie=UTF8&psc=1
That way you can check your blood pressure at times when the above factors aren't influencing it.
Have you seen the same GP? Do you feel "comfortable" with him?
White coat hypertension, more commonly known as white coat syndrome, is a phenomenon in which patients exhibit a blood pressure level above the normal range, in a clinical setting, though they don't exhibit it in other settings.
I'm not sure what else I can ask about the 24 hour monitoring? GP said results we're normal during the test, but because it was still very elevated at surgery, wanted me to keep coming in every 4 weeks.
Yes it's been same GP throughout. GP says that white coat syndrome, anxiety etc only affects the top part of the reading, it's the bottom on mine which is consistently too high (when I'm at the surgery that is) and that's what GP is concerned about apparently.
Seems odd that your A&E reading was fine when (I imagine) that was probably more stressful. You definitely need 24 hour monitoring or alternatively buy a home blood pressure monitor yourself and take and record readings at home - for peace of mind if nothing else.
Fluctuations of bp can be a huge problem. GP is doing well to monitor you regularly.
Condidering how many posters complan that their GP is not taking them seriously, I think you should be grateful that yours is so assiduous.
My issue is that initially I was told they would do the 24hour test, and then that would confirm the position one way or the other, but I just seem to be monitored, and the only advice is to stop doing something that I've never done! Or to lose weight which I'm trying to do (I've never been weighed at any appt btw).
It's causing awkwardness at work, because I'm regularly having to ask to come in late or leave early (for the appts, to go and collect the bp monitor then to go and drop it off, to go for blood tests etc) and my employers are asking what my GP is doing, what action is being taken etc, and are surprised that this monitoring has bee going on for 4 months and seems indefinite.
Do you have a BP monitor at home? My BP is usually high at the surgery. I have had 24 hour monitoring which was fine and so now whenever I have a GP appointment I do a few morning and evening readings in the run up to the appointment and he is happy to see those.
I don't have one at home but I don't see what it will add, as my GP has basically ignored the 24hr results. Maybe next appt I will ask if they'd accept those results though, if so I guess it may be worth buying one.
I never have mine taken at the surgery. Just the noise of the monitor starting up is enough to raise mine. I have a monitor at home and take in results taken randomly over a week when required. I only take it when I feel rested, as I really don't want to start obsessing over it, which I do if I get a higher reading.
It sounds as if you have "white coat hypertension". If you can afford it, I would buy your own blood pressure monitor and keep an eye on it yourself.
You can have bp tested at a pharmacy and they will give you the result on a card to give to yr gp. At my doctors they accept pharmacy readings as "real".
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