Hypertension- what to expect from GP?

[JuanTabo]

I was told to monitor my BP at home 10x a day after a high reading at the GP surgery last week, it’s fairly consistently elevated but near normal at the beginning and end of each day. I realise it will depend on various other factors such as underlying conditions but in general is the GP likely to insist on medication or are lifestyle modifications alone ever given a trial first?

I don’t drink or smoke but I’m fairly sedentary, fifty plus and with plenty of scope for dietary changes.

Who told you 10x a day? Guidelines say 2x a day (3 readings at each attempt, documenting the lowest one) and 2 weeks of readings, then give readings to gp

https://images.app.goo.gl/W3jMgps1dc5mSAL18

That's nice guidelines..average of over 135/85 is treated

Monitor BP ten times a day? I've never heard of that.

Morning and evening, for a week, is standard and then take those results to the GP

Non medication methods of reducing BP are a good starting point unless your BP is incredibly high and then it needs to be brought down quickly

I had high BP at routine check at GP for medication I take. I had to wear a monitor for 24 hours. It was high but borderline for medication.

I exercise a lot, don't smoke am not overweight and eat well. We agreed to maintain healthy lifestyle and che k intermittently. I have my own monitor now and it is generally ok.

Op I would start some exercise maybe just walking for 30 mins a day and make dietary changes. Anything helps.

Lose weight and walking is great for BP control.

I would imagine the next step is to discuss with a cardiologist- when my hypertension was discovered I monitored at home for 10 days, was then referred for a 72 hour blood pressure trace and then had a ecg to rule things out. Once all that had been completed I was then put on medication.
They also recommended a whole load of lifestyle changes however I was early 20s with a fit and healthy lifestyle so they knew it was something more.

🤣 as if you go straight to a cardiologist!

If you submitted those readings to me we would ask you to repeat them properly (am and pm readings for at least 5 days) or to be booked for our ABPM/24 hour monitor.

If your readings were returned in hypertensive range, depending on the exact reading, we would consider starting you on medication. We would also bring having a discussion about lifestyle measures which should be adopted.

They shouldn’t insist on anything unless it’s super high. It’s probably going to be a conversation about options- medication or lifestyle and then review progress.

You ve answered your own question.

Why not make some changes? eg dietary and exercise if your BP still hasn't fallen then see your GP.

Hypertension is your warning sign to change your lifestyle, ignore it and you are on the road to a stroke or heart attack.

10x ? were you given a specific reason for that number? 4x max would be normal.

It’s not ten times a day for the rest of my life, I hope, only for the long weekend. I didn’t even question it, I was just glad to get out of there. The HCP said if I can’t manage all ten each day then to aim for a minimum of six. Interesting to hear that might be overkill.

Thanks for all the replies anyway, I’ve had a good look at dietary guidelines and cleared out any UPF. Hopefully that and increasing mileage will do the trick.

I’m fairly sedentary in comparison to a few years ago, but I still run three times a week and walk three times a day - just not as far or as fast as I used to.

Sorry if the question was confusing - I wondered what to expect from the GP, not whether to make changes. They’ve got to be made with or without any medication I imagine.

I am not a doctor or medic but I’d guess with those they’d go for lifestyle changes - they are not too bad and the second day was really good. But that’s just a guess.

Thank you, I appreciate the reassurance.

Not a doctor but I had hypertension in pregnancy and with me I was only put on medication when readings hit 150/100. They were aiming for medication to bring it down to 135/85 or less. Unless your average is higher than 140/90 I think you would just be advised to try dietary changes and exercise

Thanks, that’s also reassuring.

🙄🙄🙄🙄No you don’t but if the gp was concerned then yes they would contact a cardiologist and go through the rest of the checks as what happened to me.

Looking at those figures it would be starting an anti-hypertensive medication, couldn't say what specifically as I don't know your medical details and it does vary obviously.

Have you worked out the averages OP?

😧 but thanks, it’s good to be mentally prepared for this if it’s a probability.

Actually I stand corrected OP, my quick maths (and not strictly NICE guidelines) puts you around 122/84 which I would say would be lifestyle improvements would be good to keep things at bay. The systolic at 122 should be fine but the diastolic is very marginally raised so keep an eye.

Happy to be corrected by anyone more knowledgable though.

That’s a good idea, I’ll do it now.

Phew! Thanks for doing some quick maths, I hate numbers so I really appreciate that!

It's worth asking your Dr whether 136/112 is likely to be accurate. Hopefully someone more knowledgeable will come on, but when I had some readings like that on a 24 hour machine the cardiologist said likely inaccurate due to small gap between the numbers.