Doctors lack of care with HBP.

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Dp 46 male, has over the last 12 months had a 24 hour bp monitor from the GP which showed high blood pressure. I believe the average was around 150/95. we have a home monitor and does fluctuate but the issue seems to be with the diastolic levels. He’s had some contact with the Gp who shrug him off

for context he’s slim, non smoker, non drinker, fairly active, diet could be a bit better but not terrible eating habits. Doctors have told him as he has no particular risk factors just lifestyle changes but there’s not much he can change. Stress might be a factor with work and kids etc - specifically we have an autistic teenager who’s being very difficult atm. His bp does seem to fluctuate.

yesterday he had a trip to our local MIU for a work injury and his bp was 170/118. Yes it might have been white coat syndrome and pain - turns out it was a small fracture but she was really concerned and said to speak to gp asap.

did it at home later in the day it was 143/104.

surely this level needs medication?!

Yes this isn't good. he needs to go back to the GP (perhaps see a different one) and talk about it again.

He should just make an appointment and say his BP is high he'd like to start on blood pressure lowering medication (antihypertesive).

Reference this guide:

www.nice.org.uk/guidance/ng136/resources/how-do-i-control-my-blood-pressure-lifestyle-options-and-choice-of-medicines-patient-decision-aid-pdf-6899918221

Thanks both. Doctors have always been dismissive on previous visits. I’ve sent off an online request as you can never get through on the phone… he’s not heard anything back yet!

Has he not been offered medication? What health authority do you live in they will have protocols usually along the NICE guidelines. He needs to get his BP under control and well managed to protect his kidneys asap.

Loads of male patients refuse to go on medication and come back years later with damaged kidneys. Is your DH willing to take medication?

They were a bit like that with me, I did an e-consult and asked for help managing it, a pharmacist got in touch and they prescribed a low dose, 4mg of Candesartan which really helped.

I started BP medication after getting high readings.
Just looked at info I was given at doctors.
BP is raised if 135/85 aged <80 years.
If consecutive readings 170/115 contact GP.
My readings always go higher when at GP's, I keep testing at home.
Have check ups regularly so I always give readings.
It caught up with me early 50's, my parents & sibling all had it.
What about DP immediate family?

What have the lower readings been? You say he fluctuates. It may not be appropriate to medicate. Do a week of readings, 3-4 times a day, some sitting, some standing and some laying down and take that back to the GP.

Yes he would be willing!

I’m glad to hear it’s helped!

Sometimes he gets around 130/90. Occasionally his diastolic is in the high 80s.

His mum has high blood pressure. She’d late 60s and diagnosed maybe 5 years ago but likely she had it years before that without realising. Unsure on his father - funnily enough he’s just found out the man who he thought was his father, isn’t so we have no idea on the health history on paternal side!

Why the variation of position may I ask? As the instructions for blood pressure reading on NHS say to do it sitting down.

They did ask me to email in readings taken twice a day (mornings and evenings) at home for a week first. they will probably ask for this.

@StiffAsAVicar I am not a doctor (allied HCP though) but I was wondering if he had postural hypotension, ie, his BP dropped too low on standing, it would be a reason that antihypertensives would not be appropriate. OP said his readings varied so was just checking that BP wasn’t going too low. It doesn’t sound like this is the case here though. But I’ve seen it happen with patients where their BP does go too high but attempts to reduce it have caused falls/collapses etc….