Blood pressure high out the blue - worried

[Louise123uk]

Hi, I went to the doc this morning for something very routine and the nurse took my blood pressure as a routine thing and it was something mad like 145/118 and she actually got a different monitor out as she thought the first might be broken! I am 40 and don't have the best diet, probs about a stone heavier than my ideal weight and I drink alcohol so I am scared Ive done awful damage! She has given me a monitor and said I have to test 4 times a day for a week and go back and mentioned potentially putting me on meds... She said they would need to do a blood test first though if they are putting me on meds to check organ function and since I drink alcohol I'm scared this could mean I have heart, liver or kidney disease... I do tend to do what you could probs term binge drinking a couple of times a week (so like more than 3 drinks sometimes).

Last night it was a friends birthday so we had pizza and drank quite a bit so I know this may have affected the readings (I was a tad hungover this morn). Could this have had an effect as i dont think my blood pressure has been this bad before at the docs. I also have white coat syndrome quite badly which I told her about but she didn't seem convinced. So so scared that I might have some kind of heart, kidney or liver disease if I do have high blood pressure this young and she seemed surprised and implied there must be some underlying cause if i have it at this age... Since getting home i have tested loads and it has fluctuated loads though never as high as what it was in the surgery or as low as normal - lowest since getting home was 124/84 and highest 138/107... I'm just beside myself...

OK, first thing is to chill out. What is done (and it’s far from clear that anything is done) is done. You may have white coat hypertension. I do, and I can give it to myself if I get really anxious.

Start your health kick, and keep testing as requested, until you’re bored of the whole thing, and that will be your real baseline. If it’s still high there are medications to try. But it’s not the end of the world, really it isn’t. 💐

That's such a good response!

You can do a 24 hour monitor. I had a high reading in hospital on a routine thing and then I had the monitor and the average was WAY lower.

If I can give you one piece of advice, if you want to change your lifestyle, do it now. It only gets harder as you get older. I hate to say it but 40 is not that young and believe me once you get to 50, everything gets so much harder. Factor in menopause and all the other shit we have to deal with, making a lifestyle change at 40 could be the best thing you do for your health and mean your healthy years continue a lot longer! Good luck!

Are you on the pill? That did it for me at 40

Hi, thanks so much for the replies. Yes I am on the mini desogeterol pill currently, only started it a year ago.

I am going to look at my lifestyle as it has all scared me. I started the gym about 6 weeks ago so thats a start and will def think twice about alcohol past one glass. I took about ten readings this morning after I got up and they varied from 110/96 to 114/85, most were around the 120s for systolic and between 85-90 for distolic. So it has come down but I realise these numbers are still high and stage 1 hypertension.... I got one reading of 126/73 which got me all excited but this was more the good outlier (this was probs the middle reading I took)... I know I shouldn't be testing this much but its addictive, grr, I work in the Justice system so at least can't have it with me at work, if I worked in a normal office I know I'd have had it into work... I do think my crazy high one yesterday was more the bottle of wine the night before combined with raging anxiety but then I'd have aexpected to see normal this morn if that was totally the case

You need to monitor a couple of times a day for a week or two. Make sure you sit quietly for a few minutes before you do the reading. And then you'll be able to see an average quite clearly. I did the 24-hour monitor thing with the hospital, what a faff. So uncomfortable and worked about 50% of the time which meant it said my average was 110/65. Err sure.

I have chronic hypertension and was hospitalised at about 190/110 I think it was. Medication made it sit in the late 130s/85 ish so after seeing a cardiologist (I have an aneurysm which has been discovered, probably as a result of high blood pressure) I was given a target of 125/75 maximum and with a second medication, I am there now, quite often a bit lower. (and that's with more than my fair share of wine and a lot of pizza).

No reason why mine suddenly rocketed, but it happened directly after giving birth - all the way through pregnancy it was 110/70!

@CornishGem1975 ooh that's interesting yours was after birth -mine too. This is my second baby and it's gone sky high - I've had to do the 4 readings every day for a week and have been booked in for a blood test and an ECG. I'm in my 30s so they appear super worried considering how high it gets.
My highest reading was 180/101 and it varies between that and 120s/60s. I'm thinking it's the stress of having two under 3 that is causing mine to increase.
May I ask what the medication is like pls?

So weird @DrowningButNooneIsListening I was monitored all the way through pregnancy closely, ie had blood pressure checks at the antenatal assessment unit every 2 weeks because of pre-eclampsia in my first pregnancy. My second pregnancy was fine and then there was my third, also fine. I ended up with an EMCS after a long induction and then 10 days later (after being discharged by community midwives even though I said I had killer migraines and visual disturbances and sore neck) my GP sent me back to the maternity ward. They kept me in for a few days to get the medication sorted and regulate it. I was 40 at the time.

The medication is fine - I've not noticed any side effects at all, apart from needing to pee more as one is a diuretic. My GP also put me on a statin as a preventative measure as heart disease runs very closely in my family, and I've had no effects from them either though I know they get bad press.

FGS STEP AWAY FROM THE MONITOR!

Stress and anxiety will drive your BP up temporarily.

The nurse wants you to do it 4x a day. Find 4 x a day that are convenient to you, set a timer, sit and do calm breathing for a min or two and do it then and no other times at all, and do it like that for a week.

Average of 120/90 is absolutely fine. Improve your diet and get in some exercise and it will be even better. It’s been a good wake up call but that’s all.

@CornishGem1975 yeh me too - monitored every couple of weeks. Apparently it appeared high in labour (funny that) and then it was "fine" postnatal but increased at the 8-12week gp appt. I'm worried I'll be hospitalised if I get high readings with them so have put off getting the other things booked in but have bitten the bullet and finally got an appt.
Ooh ok, that's very reassuring to hear. How did they find your aneurysm(if you don't mind me asking)? Is it treatable or will it always be there?

Average of 120/90 is absolutely fine. Improve your diet and get in some exercise and it will be even better. It’s been a good wake up call but that’s all.

90 diastolic is NOT fine. It should always be less than 80.

Sounds more like you got "white coat syndrome" I get a high reading if a doctor or nurse takes my BP but have completely normal readings when I'm relaxed. I would put it down to that and stop stressing out over it! I'm 48 for ref and have had white coat syndrome with my blood pressure since I actually got pre eclampsia with my first child.

I had some chest pains, GP sent me to A&E - they thought they were non-cardiac, but due to family history, the cardiac nurse referred me for an echocardiogram and a CT scan which is where it showed up. Just had a follow-up this year, and it's grown slightly. It's a wait-and-watch situation. They won't operate on it until it's over 5cm as it's not at risk of rupture before then, mine is just under 4cm. It could take 5 years to get there, could take 20 years to get, or it may never get there so it's about managing risk my keeping blood pressure low. If GP hadn't sent me to A&E I may never have known it existed (until it was too late 😟) so always worth getting checked out if you have any concerns!

Your readings don't sound that high to me - I'm a bit older but was much higher. However I'm v grateful for a health scare as it made me take steps I'd been meaning to to get back on track. So sensible diet and fewer treats, zero salt, v. sensible drinking, regular exercise and it's come right down.

Do test properly. Sit with your legs uncrossed and your arm supported, at waist height. Don't eat or drink for 30 mins before testing and empty your bladder before starting. Breathe gently and relax before testing and gaze at something nice. (I find I can push my BP up if I am planning a meal or shopping list whilst testing, so have to think of nothing!)
. .

You can push it up by taking it over and over and getting into a stressed state.

It doesn't always have to be under 120/80. Lots of things push it up - for example, it's normal for your BP to rise when you exercise, then it comes back down. That's why it's the average that matters.

So yesterday my readings ranged from a couple like 124/92 down to 128/86 and 121/84 as some examples. This morning five readings I got were 111/82, 105/78, 116/84, 112/80, 114/81 which I thought looked ok (though I know the distolic over 80 is still hypertension) but someone pointed out to me something called 'pulse pressure' today and they thought my pulse pressure seemed low (this is the difference between systolic and diastolic) and this might mean heart disease... Do I have bad 'pulse pressure' does anyone know from those readings? I'd never even heard of this.

Also, why do my readings fluctuate so much in one sitting like going from 124/92 to down as far as 105/78 over a 15min period of doing nothing.

I spend my professional life dealing with blood pressures I a clinical setting. I'm also just writing an essay on hypertension and average blood pressure readings so this seems apt.

Firstly, don't panic.

Yes, lifestyle optimisation is key, regardless of whether or not you start medication. Prevention is always better than cure.

Make sure when you do the home readings you are relaxed as much as possible. Don't rush to do them if you forget because they will inevitably be higher.

120/90 as an average isn't horrendous but no one over the internet, medically trained or not, would be able to diagnose or advise without more clinical background. Also, any proper professional wouldn't risk doing so.

In simple terms pulse pressure is the difference between the diastolic and systolic. Ideally should be around 40 between them but again, follow up with your proper clinician.

@hashbrownsandwich will be better placed to advise than I am, but I don't think just being over 80 is exactly "hypertension". I think in the UK it's defined as elevated between 80 and 90, but not too badly and is a sign you need to keep an eye on it and try and bring it down rather than get overly worried.

As @hashbrownsandwich says, you need to follow up with a clinician. I've had some narrow pulse pressure readings but my cardiologist wasn't concerned within the wider picture. That's why you need a specialist to look at your whole profile.

Not necessarily. Depends on your age and other co-morbidities.
We wouldn't treat OP's BP with medication unless it was consistently over 140/90.

Agree with @cptartapp

We allow for a different threshold for home readings as we are aware probably 80% of patients have higher BPs in the surgery than you would at home. I won't go into that much more as it's not helpful.

To be honest based on your info here I wouldn't be rushing for a Dr if you were my patient. We would be focussing on serious lifestyle changes and retesting for a week in 3 months. However, as I say, I can't diagnose specifically and wouldn't want to give you false info. Please do the average home readings and take them to your surgery.

@hashbrownsandwich if you don't mind me asking what kind of major lifestyles changes do you recommend please?
Is there a specific diet to follow as I was advised to follow a keto style diet but this seems to increase my readings somehow. Also I'm struggling with finding the time to get out to exercise with a toddler and a baby - not enough hours in the day and with the daylight fading I don't feel keen going out when it's dark for a run/walk by myself!!

It's basically just about exercise, healthy weight, no smoking and pref no drinking (although obviously 14 units maximum is considered acceptable). Watching cholesterol.

Have a look at the 7 minute workout.

Some of us did all those things for years and still ended up with hypertension and on meds 🤔