Blood pressure meds, hormones and anxiety

[Unicornshorn]

I was diagnosed with high blood pressure (just at start of stage 2 range), just over 4 weeks ago and put on Lisinopril which worked straight away and brought my readings into a normal range, like 110/78 and no side effects either. I was told to monitor at home once a week. However this week the morning reading was a lot higher and 138/98. . I did get quite stressed about this and also kept getting cuff error symbols on the monitor, then it told me to change the batteries. Having did that I took my readings again the next day and they were 144/88, then 128/89, then 145/92. My heart felt like it was pounding and heart rate in monitor was high but normal when I checked afterwards with pulse oximeter. I did find the process of home measurements and 24 hour monitor really stressful before diagnosis but had been managing quite well since. It seems to be seeing the numbers that freaks me out. I also worry about more meds or an increased dose. I’m not sure what to do now as I don’t know if my readings are due to anxiety or real. They do seem a bit all over the place. I did wake up feeling quite wired the day I got the first higher reading, I seem to get bouts of this which I think are hormonal like butterflies in my tummy. Does anyone know if meds can stop working so soon or there can be blips like this. Do hormones affect levels especially as I’m nearly 50? I need to learn to take readings without getting anxious too, but it feels like a physical reaction now. My heart rate is always higher than normal when I do them but I know some of this is down to the arm getting squeezed. The nurse told me I’ve to let them know if it goes over 140/90 but I’d imagine that’s after a series of readings. I didn’t get much information. I’ve had to put the bloody thing away for now! Any similar experiences would be really helpful, thank you.

No helpful advice but I’m just starting this. I’ve got my 24 hr reading on Monday. My anxiety is on overdrive! I’ve cut out caffeine & am drinking dandelion tea with Hawthorne berry syrup! I’m nearly 48 & was wondering if it was hormone related. I haven’t got an at home monitor because I think it would send me over the edge!

I found the 24 hour monitor ok once I got used to it, it’s better than seeing the readings yourself but a pain at times. My bp was normal less than a year ago so who knows but I do get very anxious bouts and am on HRT. I wish they would invent an easier way to measure. I’m actually not as bothered at the GP as there’s someone to advise but at home I find it harder. I’m actually going to look at hypnosis for this and see if I can download something. I hope you get on ok with the monitor.

When you are stressed about the readings, the readings go up. It's a form of white coat hypertension. I would guess that your BP isn't generally as high as those "stressed readings"

What BP is your doctor happy with? By that I mean......yes, 120/70 is a great reading, but we don't all aspire to that. My doc has told me 135/85 is good for me

Thanks, they haven’t told me in that way, I took two weeks of readings on the meds (5mg) then saw a nurse for blood tests and showed her my readings. I prepared questions for her and asked what reading is too high and she said 140/90 they’d want to know. It’s just frustrating as was doing well and didn’t expect to see a high reading again although yes it doesn’t take much to make me anxious about it.

This sounds like me. I hadn’t had my BP taken since I was pregnant 10 years ago - it was normal then. Fast forward to last summer, I had a minor surgery but I was VERY anxious about it as it involved a biopsy. I was dreading the procedure (I came to realise I suffer from health anxiety) and when I had my BP taken before the surgery it was super high. They still did the surgery thank goodness but I was advised to go straight to my gp with my readings. He seemed surprised as I’m slim, fit, don’t smoke etc etc and said could be anxiety. Anyway, I took readings for a further 7 days and although they weren’t awful they were still high so as a result I’m now on 2.5mg ramipril. They then asked me to do a 24 hour reading but I just couldn’t face it as I knew the readings wouldn’t be accurate as taking my BP causes me such anxiety, I just can’t bring myself to take it anymore. I’m not sure where to go from here, no idea what my BP is as I can’t get a true reading!!

Oh I’m 48 btw and have also wondered if it’s down to hormones. Just wish I could get to the bottom of it!

How do you take your readings?
I find you need to try and repeat same time of day and create some calm.
In the mornings, I go downstairs, drink a glass of water, feed the cat and then sit down with another glass of water and get the monitor out. Then sit and read/scroll for at least 5-10 minutes. Then do first reading. Disregard it. Give it a few more minutes then take another and repeat. By the third reading it's usually dropped significantly.
But no rushing around, no food, no caffeine.

Thanks all. Sorry for not replying I actually did a hypnosis audio last night and had a great sleep! I also try to drink water and wait 20/30 minutes before taking my morning reading but I do have a crazy puppy that will rampage the house and wake everyone else up if I don’t feed him and get him into another room so it is probably more stressful than I realise. But my morning readings had been ok until this week. It was more the diastolic that was high at first. It’s such a smaller range anyway and apparently it’s slower to come down if you’re stressed. Do they change meds if your systolic is good but diastolic higher as in would more meds lower things too much?
I do evening readings too half an hour before my meds to see how they’re holding and they’ve been ok but sometimes a bit higher. Again, it’s not always a perfect situation with a busy household and trying to get peace. One night my neighbour started screaming so that wasn’t a great reading (another story)!! It’s such a delicate thing to get right. I heard about the wrist cuff and watch but not sure they’re accurate or less stressful?! Ironically this happened after losing nearly three stone, I’ve now lost another one but a bit more to go. All my other tests have come back normal like diabetes, cholesterol so that’s good. I really thought I was getting used to it but feel things have gone backwards this week.

I was told that it was only if the average was over 140/90 (135/85) at home, over two weeks, using the best readings from each morning/evening, that they'd want to know. Individual readings they don't seem to care about (mine can be 175/102 individually, and that worries me a bit, but as long as the average is OK, that's all they look at, it seems). So a few readings in the 140s and 150s would definitely not be something they'd care about at my surgery.

Morning readings are normally higher..did they tell you to take random readings throughout the day? They will vary.. take twice, the second one will be lower. Make sure you have your arm supported and in the correct position level with your heart,no distractions,sit still, calmly. Don't waste your money on another monitor. You can always get your local pharmacy to check it..

Thanks both, I was hoping not to go back to daily measurements as it can make me more anxious but maybe doing it only once a week as they’ve told me to do as it seemed the meds are working isn’t enough. My morning readings have usually been lower but maybe because I take my meds at night. I just don’t get how the readings were really good on the meds for 4 weeks then seem to have changed, I reduce my salt, don’t drink or smoke in fact I’m pretty much clean eating. I am a bit overwhelmed at work and get hormonal bursts of anxiety so it’s maybe just what will happen. Maybe I’m also too strict with no treats, not even a glass of wine and need a balance as life seems a bit too focused around this right now.

My doctor told me to take the average of 3 readings, but one of the foundations, think it’s the heart one, says discount the first if it is high and then average the next two.

i also found it very stressful doing the readings, i hated it. I just I guess was anxious about what it would be.

the drugs won’t stop working, but they need to keep reviewing your meds to ensure it’s enough and correct, it may not be. Mine moved several times.

can I ask gently about your weight, mine was as I was overweight, when I lost the weight my bp returned to normal and I was titrated down and taken off the meds by my doctor.

This is much more common that you might think. It’s very stressful. It’s not like a test where the result is the result despite feelings anxious. Anxiety can spike a result hugely. I think therapy for phobias can be really useful in this scenario.

Thank you. I’ve now lost 4 stone since spring 2024, by fasting mostly and a stressful time over Christmas when sertraline disagreed with me and I couldn’t eat I lost one stone very quickly. I’m still just in the obese range so a few more to go.

Do you know if your bp has come down since you started?

My DP has gone through this. He got a bit obsessed with testing (multiple times per day) and got really stressed and panicked if he got high readings - which ends up in a vicious cycle. He was put on a 2nd med and has now stopped testing entirely - which is obviously not ideal either!

I would try to keep testing once per week if you can, keep a record of all the weekly readings and try not to panic. As others have said, it’s only the long term average that matters - not individual readings. If the long term average is over 135/85 then your GP is likely to suggest adding a 2nd med or going to a higher dose. But that’s totally fine too!

Also do 2 or 3 readings when you do test and discard the first one, as others have said - this is NICE guidance.

Thank you, that’s good advice.
My BP was normal in March 25 - I’d lost two stone by then but by October it had shot up after losing more weight so I’m not sure if weight loss will help. My first reading is usually higher, goes often much lower but then what I think happens is I start panicking again and the third is a bit high again. But I guess the last two average isn’t as bad. I read that diastolic takes longer to decrease if you manage to calm but systolic change quite rapidly.