Any medics here?- feels urgent

[Littlefootduckyspikeetal]

Sorry posting for traffic

im really worried about my MIL, she’s been having scarily high BP readings for weeks, I’m talking 205/110 from no activity. An older relative on my side had a reading 195 over something and was dead in a week. I’m quite concerned for her, but she doesn’t seem to have any other symptoms. Her cholesterol was mildly high but not a lot, and I know that’s not necessarily a big deal as some people have naturally higher than normal cholesterol despite being slim (me for one)

shes got a dr appointment on Tuesday to talk about it but we seem to be treading water here as it’s going on for weeks. She’s not on meds, doesn’t smoke, has a healthy bmi,
doesn’t drink, doesn’t eat much red meat… any clues what could be causing this and any tests I need to tell hubby to ask for? She can’t speak English so she doesn’t really understand what’s happening in appointments

sorry the above was meant for you not OP

If they gave her ramipril, it's known for causing a cough in some people. There are alternatives she can be on.

Not a medic but a professional high blood pressure patient. It can take a while to get the right meds. I need 3 types to get mine down to save levels. Some made me even more depressed than usual.

Not a medic but just to be clear, did you say it's been high and then today has got higher? I'd be seeking advice asap if it's higher today than previous readings.

Who is reading the results? If your MIL is illiterate (as you said above), then is it possible that she is not reading the results correctly? Presumably a responsible family member is attending all medical appointments with her....?

There is nothing to stop your DH calling 111 on his DM’s behalf. If she needs to be seen they can book an appointment for her in A&E or insist on an emergency GP appointment.
There’s no point trying to guess what it might be, just needs to be seen.

I’ve had readings that high in the pat and I’m only 33 but both my parents have high blood pressure and mine has been high since I was a teenager. I got put on 3 tablets to control mine a few years ago I know have normal
blood pressure but only because of the
medication.

‘…to take them because they gave her a cough…’.

Some BP meds such as Ramipril do have the side effect of an irritating cough, tell the GP/consultant so that another medication can be prescribed.

It is not unusual for a combination of several BP medications to be given each at a low dose to bring very high blood pressure down. This is not a lack of care, it is common practice.

Lowering sodium intake is just one aspect of improving BP metrics, as is loosing weight. But there comes a point for some people where medication is required to get the problem under control.

Uncontrolled/high blood pressure is a ‘silent killer’ & stroke is the most frequent cause of disability in the UK.

Consider the Tuesday appointment a fresh start. Whatever MiL is prescribed, she needs to take it. Any problems or issues with side effects, get back to the GP rather than give up.

It seems a shame they stopped her tablets but I suppose working out what's causing it makes sense.

Nothing particularly wrong with marg in small does BTW- some can even be really healthy, and most/all will have a better fat profile than butter. They don't tend to have artificial trans fats in nowadays.

This is kind of a tangential point as obviously she needs some other intervention, but I was starting to be on the brink of needing blood pressure meds over the last year or so. It has gone back to a very healthy range and I think it's due to my happening to change to eat more foods high in healthy fats, probably especially salmon.

*small doses

I think she should see a medical person asap. Since 8am Monday is not that far away now - she should call gp at this time. If she is not able to get a gp appt for Monday, then immediately seek further advice like call 111 or go to a&e. If she has not had recent blood tests, she needs to have them (if they tested her for cholesterol, they likely did others too, but they may need a repeat).

she needs to be counselled about the side effects of the medications - it might be that she is advised to tolerate some side effects (as they prevent worse things from happening). But she should mention her issues to the doctor (who can see if there are alternatives). I think it is sensible for someone else to go to the appt with her - as it might help the family support her and understand what the different meds are for?

In the meantime can you get her to cut out caffeine?

My Dad is in his 80s and when the GP did his BP reading it was 220 (can't remember the other reading) and his GP called an ambulance to get him to A&E.
However, he was taking his existing BP medication as prescribed, which is really important....

It’s not been too bad this morning, high but not crazy, 157/ 97 But it’s in the evening we’re getting these scary numbers

How did she get on with the GP?

So her ecg was abnormal (not sure why this wasn’t mentioned earlier) and she’s being referred to cardiology for further scans. The GP said it’s not too surprising that the ecg was abnormal given the episodes of very high BP.

she’s also diabetic, he wants to enrol her on the study/ healthy living initiative that’s being run. I think she won’t alter how she eats because she doesn’t listen. A lot of her diet is white rice and she swapped to brown sugar as she thinks that’s healthy, and won’t listen other wise.

her cholesterol was 6.7 so she’s going on statins

she’s going on to something like rampril (can’t quite remember the name) the dose was 2.5 GP thought she might need 5 or 10 but probably should build up to it

we took her bp at our house and it was only just in the high category, so she’s having crazy high episodes here and there, which I suppose is ‘better’ than being consistently crazy high, although not sure what’s causing it

her kidneys are fine and nothing to indicate aneurism

thanks for checking in

Prompt optician appointment to look for hypertensive changes back of eyes as well as gp consult

although not sure what’s causing it

Her age, her diet, her lifestyle. The diabetes is a big thing. She needs to get that under control. The lady is working her way up to have a stroke or heart attack.

She'll be referred to the eye clinic and podiatry too. They'll need to check the pulses in her feet. A dietician/nutritionist possibly also.

I am not at all expert but my BP was nothing near that and I was slapped straight onto medication that day. I would personally ring 111 and just double check that things shouldn't be moving faster. It does sound too relaxed for that reading unless there's a reason to think it's a one off.

Oh sorry - I see you are sorted. Glad to hear it.

I had a reading of 200/110 once, my doctor was concerned, put me on medication, and have been on it ever since, for twenty years.
The only other time it was sky high was when I had a blocked kidney, my body was absorbing the urine from that kidney and caused Uremia, Blood poisoning. Causing my bp to rocket.

If she has diabetes and isn’t compliant it is probably her kidney function that is causing episodes of dodgy BP. I’m sorry to say that this is her future if she won’t look after herself.

Ramipril is a good choice for people with diabetes and high BP.

It can cause a cough, but there are alternatives if that happens

Is she type 1 or type 2? Type 1 being insulin dependent, type 2 generally controlled by diet + medication. If she’s type 2 and continuing to eat sugar and refined carbs that will cause all kinds of complications. Diabetes goes hand in hand with high BP and it can itself cause high BP because it can damage the kidneys if it’s uncontrolled.