24hr blood pressure monitoring way higher than normal, why? HELP!

[TotallyCoveredInCatHair]

Hi, i'm hoping that someone can help me make sense of this and stop panicking!

I had pre-eclampsia last year with my first DC. My blood pressure went from a usual 130/90-ish to 140/100 at 31 weeks and stayed there. Post DC my blood pressure went back to around what was normal for me but is still a bit iffy with occasional high readings (and panic attacks with chest pains) so i've been seeing the doctor each week since.

I've just had the results for my 24hr blood pressure monitoring and the readings are eye wateringly high, average was 191/132 (lowest 163/121 and higest 220/159). How can this be? I've checked myself with my own monitor a couple of times and got 135/93 and 128/90. How can the readings be 50% higher with the 24hr monitor? I expect some margin of error but this is ridiculous and now its all been escalated with bloods and ECGs and dire warnings. During labour my blood pressure peaked at 181/125, how can it be higher now?

I know my normal blood pressure is higher than the doctor would like, I walk and swim (not as often as prior DC), have a fairly good diet but now they are threatening me with lots of medication, I was on Labetalol for the last month of my pregnancy and hated it, it made me suicidal, I cant go through that again, if these readings are right then i'm frightened about what happens now.

Anyone got any experience with this? Any advice? Please?

Hi TCICH, so sorry you're going through this worry.

My BP history somewhat similar: went high towards end of both my pregnancies, then too high a few days after births - and was on Labetalol post-partum for a few weeks. I didn't have side effects (apart from initial headache the first time) though.

Now a few years later, my BP which I took occaionally at home was spiking up a bit - so they ran a 24 hour monitor. It terrified me (I cheated and looked at readings as they happened on a few occasions ) as the top spikes were really high - though night time readings were mostly ok. Anyway, far higher than anything I ever got at home normally. I think wearing the blinking cuff made me anxious, tbh, and my GP didn't panic at all - she said it was normal for it to be higher during tests, and was reassured by the resting bp, in my case.

I did have an ECG, because I asked for one - no big deal, and was reassuring. Its probably genetic (my Dad is on meds for hypertension, has been since he was in his late 60s - he is now 85 and well) as my diet is fine, moderate exercise, slim build, etc etc.

And as I was considered 'borderline' hypertension, I was given the option of meds - and ended up starting the lowest possible dose of Ramipril, which I have to say has worked, and is working a year later, beautifully. No side effects and 120/75 BP.

If Labetalol was horrible for you (it was at the beginning for me, with the headaches) you can always ask for something else - there are LOADS to choose from. Worst case.

Meantime, do remind yourself that the cuff itself is stressful - it made me jump when it started inflating each time! - and that your 'real' BP is probably not as high as that. Wishing you well, let us know how the tests/decisions pan out xx

Does your GP'S clinic have a home monitoring BP machine that you can use?

If you do have to take BP meds there are different ones and you should be able to find one that suits you. I would be suprised if you were precribed Labetalol
when not pregnant as it is one of the older BP's meds ( that is why it is prescribed in pregnancy) and doctor's now prefer to precribe the newer ones e.g Ramipril.

not an expert, but I agree strongly that you only ended up on Labetalol because you were PG, when not PG there is a far wider choice of other meds such as beta blockers or ace inhibitors that aren't associated with depression, so try not to worry about the side effects.

best wishes for the further testing

Hi
Thanks for the replies, Dr has booked me in for the ECG thursday, i've got my own BP monitor and have been checking regularly throughout the day and have been getting results of ~130/90 .
I guess that I will have all the tests done and see what they say, I dont want to trivialise how serious high BP can be but I dont want to take any meds, i'm BFing, DH and I are trying for DC2 (it took 5 years for DC1) and I really didn't get on with the labetalol, each time the dose was upped the symptoms got worse to the point that I was virtually housebound, tremors, headaches, insomnia, uncontrolled drooling, muscle spasms, sickness, confusion, depression, not very fun, I tend to react to medications.

just a thought - you aren't q large are you - just that my readings are higher when I have an ordinary cuff than with a supersized cuff?

when I had the 24 hour BP it came out overall as borderline, similar or lower than my GP readings, so maybe you could get it redone if you think it was inaccurate?

even on borderline high I was sent off for bloods and ECGs, and the ECG really is no hassle whatsoever, v quick and painless.

oh and sympathies re:the TTC, as obviously you dont want to have to end up on Labetalol again, it does make things less straightforward.

hmm I am a bit big (not lost the baby wt yet), BMI 31 size 16/18, maybe the cuff size was wrong I was just so shocked at the results, hopefully all the other tests will come out ok and they may let me control with lifestyle measures.

I think you need to rein in the TTC till your BP is improved tbh. I know that's hard to hear.
Have you had advice on a low salt diet? It really can make a great difference.

Elibean could you tell me how long (days/weeks) it took for the Ramipril to start to lower your BP?
I started on lowest dose a week ago and as yet have not seen any difference but wonder if I am expecting too much too soon!