Blood pressure

[supercatlady]

I started BP medication last year. I am mid 50s, obese and have sleep apnoea.

Every 3 months they ask me to check BP for 5 days at home.

I check the results on the NHS Blood Pressure check site and they come out high. From memory they are similar to scores pre-medication.

Every time they say no change to medication check in 3 mths. Surely the point of medication is to get scores down to normal range? What am I missing?
scores range from 133-147 and 87-97.

Are you using the correct size cuff for your arm? If you have obesity and use a 'standard adult' sized cuff it will tend to over-read slightly.

No I bought a larger cuff - it fits well

Thoe ranges look absolutely fine to me. I've been in the 130s when I submit my readings (annually) and I have a hospital appointment for another condition every 3 months when BP is also taken and I've never had an issue with being in the 130s and low 140s. Never been as low as 97 either! BP varies all the time.

I'd query if your readings are actually OK, are they saying at the checkup that they're too high or you just think they are in comparison to the NHS info?

Take the reading first thing in the morning because blood pressure tends to rise during the day.

I think the target range for people diagnosed with high bp is higher than the target range for people without high bp.

when you take your readings it should be an average of twice daily readings for a week.
I would wonder whether either your underlying bp is rising, or whether your bp meds aren’t the best match for you?

I was always told to not wear any clothing on my arm when I do it, make sure I have an empty bladder (as much as can be) and don't do it after a meal or activity. This will then give you a true result. Also don't talk while you're doing it.

It’s that according to the nhs checker website, and for measures taken at home, they are high.

thanks for all the top tips - will give them a try

Yes they are higher than they should be for the average person. However whilst up to 120/70 is desirable in general, I think the nhs goal for people with diagnosed high bp is higher than this as it’s difficult to get it this low when medication is needed.

My GP set me a “target” of an average of 135/85. My individual readings are often wildly different in both directions

The target blood pressure for people being treated for hypertension is usually an average of 135/85 from morning and evening measurements over 5 days, as long as you don't have diabetes or any kidney problems: https://www.nice.org.uk/guidance/ng136/chapter/Recommendations#monitoring-treatment-and-blood-pressure-targets. You should do the measurements lying down in a quiet room. I always do mine as soon as I wake up and then last thing before switching off the light at night, when I've been in bed for a while.

Which side of 55 were you when you started medication? If you were under 55 you should be on an ACE inhibitor (e.g. ramipril) or angiotensin receptor blocker (e.g. candesartan). If you were 55 or over you should have been started on a calcium channel blocker (e.g. amlodipine), or possibly a thiazide-like diuretic (indapamide) if you have a history of venous problems (ankle swelling, etc.). GPs/nurses are usually fairly keen to add a second drug if they feel your blood pressure isn't adequately controlled, so I don't think they'd keep on renewing your prescription if they thought you had a significant cardiovascular risk from your blood pressure.

I have chronic hypertension and I am also under cardiology. I disagree with a lot of what is said here!

My target set by cardiology is 125/75 and that is because I also have an aneurysm. (Lots of people have them and don't know about it...) however we are working at the moment to keep it to 120/70 and with a tweak to my meds, we've got there.

Your diastolic at 87-97 is certainly too high. Anything over 80 for diastolic is heading towards high. I wasn't happy with my readings so I asked my GP to look at changing my medication myself, they're happy for me to monitor and request changes as i need.

Do a couple of readings throughout the day, discarding the first one each time. This will give you a more accurate view.

Which side of 55 were you when you started medication? If you were under 55 you should be on an ACE inhibitor (e.g. ramipril) or angiotensin receptor blocker (e.g. candesartan). If you were 55 or over you should have been started on a calcium channel blocker (e.g. amlodipine), or possibly a thiazide-like diuretic (indapamide) if you have a history of venous problems (ankle swelling, etc.).

@FatOaf I have been on both Candesartan and Indapamide for two years now and I am 44!

I have been on both Candesartan and Indapamide for two years now and I am 44!

I presume you were started on candesartan and then had indapamide added when your blood pressure wasn't adequately controlled. OP suggested they were only on one drug.

I was started on amlodipine (at 56), which brought it down quickly but not to within the target range. I then had ramipril added and then indapamide, which finally brought it to an acceptable level.

I’m on ramipril and was under 55 when I started.

im not sure it’s really improved my BP at all, but I’ll check my NHS app.

@FatOaf is it okay to take bp lying/sitting upright in bed? Does it give a more accurate reading if sitting with both feet on the floor? Or it doesn't really make much difference?

I find it more calmer to take my bp sitting upright with my legs on bed.

Sorry, didn't see this previously.

I think it's fine to measure BP sitting up in bed. I usually do it lying in bed, first thing in the morning or last thing at night. The most important thing is to be consistent so you can see whether it's changing.

I'm 55 and about a stone overweight.

I'm on Amlodipine 10 mg... started on 5 mg 2 months ago, and increased last month.

My readings were sky high before and are now still higher than yours.

I'm not sure that helps or not!

I've been referred to cardiology.

You could ask for a second opinion.