To think the GP should have believed this?

[Weddingbells6]

Son (18) had two nosebleeds yesterday. I took his blood pressure 3 times and the average over 3 readings was 152/86 which is obviously high, particularly at that age.

He had been sat still for about an hour before I took the readings and I asked him to sit still, breathe properly, not talk etc.

He had childhood asthma and as part of his annual check ups for asthma the nurse saw his blood pressure was elevated (approx 2 years ago) and sent us home with a blood pressure machine to take 3 readings and average them out and to do it twice per day which we did. This is why I was familiar with the whole taking it three times, making sure you’re not talking etc. His blood pressure was still elevated but if I remember correctly they weren’t concerned as it was slightly lower than what she has gotten in the surgery (I think it was in the pre blood pressure category, think yellow or orange) I trusted them that it was okay as they didn’t feel any further investigation was necessary but in hindsight I should have had this checked more frequently.

The GP today took his BP twice and both times it was 153/87. We had been sat relaxed in the waiting room for 30 minutes, no caffeine etc. I explained that if he looked at my son’s notes he would see that it was elevated last time he had it checked and that I was worried that it may have been high all this time and about the long term affects of that.

The GP advised me / my son to do the same thing we did previously and keep a record over a week which, for the record I agree with and can understand the need for.

But I’m so upset at what the GP kept saying “It’s very unusual for a person this age to have high BP, it could be that you have things on your mind.” “You need to be completely relaxed and take the lowest reading.” And more words to that effecf. It’s like he didn’t believe it could be the case that my son has high blood pressure if that makes sense? It’s not like we showed up today and it was low, it was high both times the GP took it, it was high when the nurse took it, it was high when I took it three times yesterday and it was high when I took it 6 times a day for 7 days 2 years ago. What would it take for him to believe he has high BP? I explained that my Dad died of a heart attack and he asked me how old he was, when I said 70 I felt a bit silly but now I’m cross for not saying ‘but he had hypertension for at least 20 years before that and actually although 70 isn’t considered young it is younger than the average age for a man to die.) I also explained his Grandfather on his Dad’s side had a heart attack (I don’t know how he is now as they’re no contact).

I don’t think it helps that my son looks like the picture of health, he weight lifts and has done since he was 13 so is very muscular.

Surely the GP should have offered some lifestyle advice at least? Or say something along the lines of “If it’s still high then we will look at doing…..” He didn’t ask whether son drinks alcohol / smokes / takes drugs / eats a good diet / caffeine / salt etc. I had just spent an hour talking to my son about how he should probably eat more fruit and veg and up his water intake etc so it would have been nice if the GP seemed to believe his BP was actually high.

I will take the readings and take them back to the GP but WIBU to insist son is checked out more thoroughly if they’re still high? (I kind of already know they will be). AIBU to feel a little like the GP is unreasonable when he couldn’t believe an 18 year old could have high BP?

Just so there’s no drip feeds son doesn’t drink (maybe once every 6 months) smoke or do drugs. He doesn’t have any caffeine at all, no pre workouts, hot drinks or energy drinks etc. However, he does eat more than the recommended amount of red meat so that’s something to look at for us (bodybuilding thing I think). He wanted me to come into the appointment with him by the way because he knew he would need me to remember some of the details.

That's long - sorry.

One of the more concerning posts on this thread..l

Thank you for this.

OP, I don’t see anyone trying to gaslight you or arguing that the readings are wrong or not high. I don’t think the GP was disbelieving either, nor was he being dismissive - he just wanted to gather more information and that’s appropriate for the level the readings are at.

The GP has provided the right next steps. Your DS should learn how to use the cuff and take some readings alone as well, then he can send the week’s worth of data to the GP and they’ll go from there. If it does get brushed off after that then you can tell your DS you think it needs some more attention.

And there’s nothing wrong with accompanying a teen to the doctor when they ask, I’d just make sure to always voluntarily step out at some point so the doctor can ask any additional questions they might not think will be answered openly in your presence because is entirely normal and healthy for there to be things teens are more private about in front of parents.

Thank you.

This is good thanks!

I'm surprised he didn't want blood tests to check his Kidneys & cholesterol. High BP in an 18 year old is worrying, my brother has been on BP medication since he was about 20.

Caffeine doesn't raise blood pressure, it's a diuretic so makes you wee and subsequently diuretics can be used to treat high blood pressure by lowering blood fluid volume. Salt does raise blood pressure however as it increases water in the blood so your body can cope. Teens commonly get 9g a day when the recommended intake is 6g max. Might be worth looking at diet if just to rule out the salt. Some medicines also count towards sodium intake.

Yeah you would think maybe a set of bloods might have been requested but I will do the monitoring and see what happens after that.

No, I think he will if the weeks readings are still high, I’m not angry at our treatment as such more that it seems odd that a GP would be so incredulous at high BP in a teen, it can’t be that rare.

I do definitely think he should be referring for extra testing/ bloods as this isn't the first instance of high BP. Hope DS is ok.

I'm a GP, OP; I think several posters here would be stunned at the number of young men, well into their 20s, who bring their mother to their consultation 😁 It's not at all unusual.

I can understand your frustration at this issue not being addressed 2 years ago when it first came to light, but it sounds like the doctor is taking the right steps now. And it absolutely is an issue - high blood pressure is quite rare in an 18yo, so when it does happen it's much more likely to be due to an underlying cause (what we call secondary hypertension) than it would be in someone who was 58, say. So if it is confirmed, he'll need tests for underlying causes as well as end-organ damage.

If your son was my patient I would be ordering a 24-hour ambulatory monitor at this stage, but we have the machines available in our practice so I appreciate it might be different where you are. But certainly further readings and then tests are warranted.

I think it's fairly normal that they do this. I had a 50+ medical and it seemed obvious to me that they were determined to find nothing wrong with me so there was nothing they'd have to follow up (not that I thought there was anything wrong but she measured my waist as a lot smaller than it was, for instance, it's possible she had the tape measure the wrong way round, but still). The last thing they measured was my blood pressure. It was high. Took it three more times. It was high. Told me to sit down. It was high. Told me to relax. It was high.

Got me to come back in two weeks to have it checked again. It was high.

Got me to.come back in another 2 weeks. It was high.

Got me to wear a 24 hour trace. It was high.

THEN I got some medication.

After a couple of years I noticed that the checks I did at home had started to show as high. I had to start the whole rigmarole again to get the medication increased.

I think you need to show your son how the machine works (he should have picked up on this already) and put him in charge of his own health. You keep mentioning that “we made sure he was relaxed” etc etc etc but at the end of the day you were his mum taking his BP reading and that is not relalt a relaxing thing for most teens!! He’d have your worries to process as well - he’ll be trying to relax and deep breath with you all the whole likely thinking “arrrg mums worried I don’t want to worry her”. He’s not a young child in need of supervision. Give him the machine and explain when and how many readings he needs. By all means check his oth him how it’s going and ask if he’s okay sharing the results with you but actually DOING the test isn’t your role. He’s capable of doing solo and ensuring completely stress free by not having mummy hovering over him.

The GP hasn’t ignored your concerns. He just needs more at home readings. You do seem on the extreme side of anxious over it all. Obvioautl parents will always worry and be concerned to their child’s health no matter the child’s age but you have to teach him to be responsible for his own health. Whilst he is still relatively young yes provide guidance and discussion so he feels prepared for advocating for himself at next appointment but please let him have peace to take his own readings!

I was diagnosed with high blood pressure at 18. I was a young, fit, healthy teenager. The gp obviously didn’t want to seem to concerned incase it worried me. They discussed white coat syndrome and asked me to monitor my blood pressure 3 times a day, always record twice and write down the second reading. I was encouraged to do it at different points of the day and to make sure I was sitting for 5 mins before I took the reading. Reminded me about sitting still, feet flat on the ground, palms up and no talking just to make sure my reading was accurate. The gp wasn’t dismissive, they booked a follow up phone consultation a week later. My blood pressure ranged from 135 - 160 over a week: some days were lower depending on when i was at home relaxing or when I went to the gym (sky high). A week later I was referred to cardiology and had lots of tests done really quickly. It was a cardiologist who found out I had heart disease and I’m on life long medication.

I think your gp was trying to downplay it as it is unusual for teenagers to have high blood pressure. I think it’s a good idea to run through everything he takes and what he does and work out when his blood pressure is the highest.

My mum went with me to every appointment. She checked my readings, Yes I was 18 and an adult but I was also so new to doing all the medical stuff on my own and also a teenager who would have just fobbed it off if she hadn’t pushed me to get it checked.

Also as an extra, if you are looking through his supplements, look for bottles that say "for research purposes".

Stuff like that is known as SARMs. They aren't technically steroids in the traditional sense. They have been designed to mimic and act like steroids was. They are largely untested and a lot of the potential health issues of sustained or long term use have not been fully researched.

Example, like this. Have just had this come up on Facebook as a sponsored advert.

I hope you didn't go in the room with him. How humiliating!

Definitely let him take care of his own health. If he has the NHS app, he can look back on test results etc if he can't remember what he discussed.

Gosh it really really isn’t ‘humiliating’ to be supported by people that love you.

Thank you so much for this. I didn’t mean to sound harsh on the GP at all obviously he’s my child and I want the best for him. We actually have a health centre so this may be an option, I’ll ask when ‘we’ 😂 go back.

I think it's weird that you think this is weird. It's totally normal for a patient to be accompanied to an appointment by a family member.

I agree that they are almost willing it not to be true. I also am willing it’s false but it doesn’t seem likely on a few occasions. Thanks for this.

Thank you for this. My teenager wouldn’t have glasses or teeth if I didn’t look out for him. Glad you got the medication.

@Randomease high blood pressure does cause nose bleeds. Six weeks ago I was in hospital having mine stabilised and was having horrendous nose bleeds, doctor told me it's related. Never got them otherwise.

Wow, that's bad. I'm not in the UK but I recently was referred to my GP as my BP was a bit elevated. Since my initial visit I've been tested for every condition under the sun - I've had more tests since December than I've had in the rest of my life (all okay btw, it seems it's just hereditary). My GP even said he preferred to go with my home readings as he knows I suffer from white coat syndrome, and he prescribed medication on my first visit.

It isn't unusual at all for a GP to take this approach. I was put on medication for high BP a few years ago. Mine was discovered during a general health check (registering at a new surgery after a move). I was mid 60s, so a very common age for this problem, but I was still sent away to do readings at home - 2 weeks in my case - before I was prescribed anything and a dosage decided on. I assumed that it must be some sort of protocol or at least advised practice. So I don't think he doesn't believe you but he does need to check. Over medication for high BP can create real problems too.

He's below the medication threshold. It's "higher" but not concerning. Doctor may be picking up on your anxiety as being a possible trigger for it.