Help! Blood pressure seems sky high when anxious

[katamongthepigeons]

I went to GP this week for some minor ailment and because it hadn't been taken for a while, she decided to take my BP, which was 150/95. I know I suffer from "white coat syndrome" and told her so, to which she said she'd take it again next time I went in.

I have a home BP monitor (bought due to pre-eclampsia during pregnancy), so have since been taking my BP regularly. It seems to vary from a normal 125/75 to 160/95 when I know I am very stressed. I sometimes get strange 105/80 readings too, but the average non-stressed readings are probably 130/85 ish.

I am very concerned about my BP "reactivity". I have had a very stressful day today and have consistently got readings about 140-150/90 (one of 165/93).

Is there anyone with similar experience or any experts who can advise whether I should be worried (or on medication)? I would be a bit concerned, if I went on BP medication, that when my BP is lowish, I would suffer symptoms of low BP?

After a few glasses of wine tonight it is still 132/88 . Help!

If you are concerned I would go back to your GP and get them to take it again and tell them about the readings you have got. You need a 24 hour BP check to get an accurate picture of your BP.

Yes you need a 24 hour reading to get a true picture.

Hi, I had a very similar situation to you - BP was high after both pregnancies, and I had to take meds for a few weeks after each birth. Went back to normal, but consultant did say I had a pre-disposition to high BP which would show up as I got older.

A few years later, in v stressful situation (house move, shingles, general chaos!) I took my BP at home and the top figure was high - 160/85ish, though the main thing was it fluctuated wildly. Thats known as 'labile hypertension' and all it means is that you are likely to have high bp later on, and it needs keeping an eye on - the good news is that at least your system is getting a rest on the 'non-high' moments!

Diagnosis of labile bp was confirmed by 24 hour trace, which overall wasn't too bad (ie ok when resting) but had very high peaks - so GP gave me option of low dose meds, or watch and wait. I decided to go with low dose meds, as I knew it would help me not be anxious about it all - and am now on Ramipril, no side effects (for me) and BP a perfect 120/70 most of the time.

I think, given the levels of stress you are experiencing, yours isn't the kind of high a GP would worry about in the short term at all - so if you expect life to get less stressful, I would just have it taken again next time you are at GP's. Or, ask for a 24 hour trace as reassurance if you can't stop worrying

tbh, even with my levels, as I don't have any other risk factors (don't smoke, not overweight, no massive family history) the GP would have been fine with me opting for no meds and just try and relax a bit more - not my forte

Thank you for your replies.

Elibean - that's really helpful. I'll talk to my GP next time I go in.

Like you, I am a non-smoker, no family history and not overweight (and I do do some exercise), but I do drink a couple of diet cokes a day and a couple of glasses of wine most evenings, so I think those will have to be the things which go initially to see if it makes a difference.

As for 24 hour monitoring, if my BP goes up in stressful situations, I can imagine that that particular day my BP would be constantly high! (except when asleep), so I can'y see how it would give a true picture?

Did you consider anti-anxiety meds as an alternative?

It's not unusual for bp to vary throughout the day according to what's going on. It's what it's doing for the majority of the time that's more important. my high bp was discovered after it didn't go down after a pregnancy fraught with bp problems and pre-eclampsia. My bottom figure was in the 120-30 range, so very high indeed and I've never had a choice about taking medication. Any 24 hr test I had done showed that it was high throughout the day and only went down to an acceptable level during the night. You don't say how old you are Kat, but a reading with the bottom figure of 90 would be considered borderline high bp. And a reading of around 85 sounds not too worrying.

Worrying about your bp will certainly affect the readings. I can lower mine by consciously breathing slowly and evenly. Relaxation is very helpful. Just listening to some calming music or sounds (try soundsleeping.com ) and breathing gently in and out really helps me.

I would recommend taking your bp at home once a week and no more for now. If you take it frequently chances are that you will start to get anxious about it which will raise your bp. If you have it taken at your GP a few more times and it is still high, she/he may decide to refer you to a cardiologist who will investigate possible reasons for your bp if they are concerned. As it's not generally over 90 I think they will just advise regular checks and keep an eye on things. I'm 50 now and have been on meds for half my life. I have 6 monthly blood tests for kidney/liver function etc and there has been no damage to either over the years. Definitely keep your alcohol intake to the lower end of the recommended daily allowance, eat sensibly and exercise regularly. And most importantly, try not to worry about it.

Thanks Tunaday. It's helpful to hear other people's experiences. I know I should take my BP less, but I'm struggling with what is the "true" BP to note down. If I take it quite quickly after sitting down it will be near 140/90, but if I wait and relax for 5 minutes it is more likely to be 130/85, and if I relax for 15 mins it could be 125/80. Which of these is the BP to base a medication decision on? I don't spend my whole day relaxing, obviously!
I'm 43 by the way.

I don't think you're supposed to take your BP when you've only just stopped being active - everyone's BP is higher if they've been active recently. The BP reading is supposed to be a resting BP. eg it's a big mistake to run to the doctor's surgery because you're late for an appointment, sit down out of breath and then expect a normal BP reading!!!!

Yes, the reading after 15 mins relaxation is the one which is "resting".

As rabbit and chilli say, its a resting bp. When i take mine i do some slow deep breaths for a bit to make sure i'm not all tense, then take it. 125/80 is pretty good and 140/90 is only borderline high. So def take a resting reading and count that as the one to give your GP. When I have mine taken at the GP he always takes it a few times to allow for having rushed about before the first one. By the third one it's usually decreased.

ps you would want your bp to go up when active, as your heart is pushing blood through your vessels more quickly when you are moving about, as there is a greater demand for oxygen from your muscles. If it didn't go up, it would be most odd!!! The body really ought to be able to cope with spikes of high blood pressure, just not permanent highs when the heart shouldn't be having to work so hard to get the blood effectively around your body (ie when resting and relaxed).

I have this too. Am non smoker, slim (well usually have 3 month old , exercise etc).

The main factor in high bp is salt in the diet, even if you eat healthily it is surprising how much you can end up with via olives, smoked fish, anchovies, tortillas (1g each ). I was amazed because never adding salt to stuff, mainly cooking from scratch I thought my intake would be low!

OK, this is an update for anyone else with the same problem who comes across this thread.

I had my last diet coke on Saturday (I normally drink 2-3 cans per day). Within 2 days, my blood pressure has normalised to a fairly steady 115/75 ish with none of the really high spikes I was having before. I don't think this is a coincidence. My theory is that the caffeine was exaggerating the normal BP response to anxiety and that this response was lasting all day!

The only other thing I have done differently is try to eat a bit more healthily and eat more bananas, but I doubt that this is what has brought about such a dramatic change so quickly.

I'll post again when the GP takes my BP next time - the true test!