Blood pressure - what on earth am I doing wrong?

[bran]

Quick synopsis. Earlier this year we were supposed to go to panel for approval as adoptors but it was delayed because I'm too fat. We have since found out that they had a child in mind for us who has now gone to someone else. Then just after Easter I was diagnosed with type 2 diabetes, now taking Metformin.

I gave up work the week before Easter and I have been training with a personal trainer twice a week since then. I also go to the gym on my own once or twice a week to do cardio stuff (cross trainer/speed walk on treadmill/rowing machine) for about 45-50 mins. I also walk either to or from ds school (1.55 miles) 3 or 4 times a week (more when it's cloudy but less when it's hot or sunny as I'm a delicate flower in the heat).

My blood sugar is pretty much under control with the Metformin, my diet is low gi/low fat and I have 5 portions of veg a day (hardly any fruit because of the diabetes). On a high salt day (when we have sausages or similar) my salt intake is still 6g or less, on a day when I do everything from scratch it's about 3g.

I'm losing about 2-3kg a month at a fairly steady pace, I've nearly lost 10% of my starting body weight.

I have less than 10 units of alcohol per month, always in the form of one or two glasses of wine with a meal.

I've given up coffee completely and drink water and green tea. I have even cut my Pepsi Max habit down to one or two cans a week.

My problem is that since March/April my blood pressure has shot up from a normal 137/high 80s to 157/101 a fortnight ago, a very shocking 172/118 last Wednesday (for another adoption medical) and 157/110 today. What can I do to bring it down?

It has to be sorted out because there is no way we will get approved as adoptors while it's unresolved and the guilt is crushing me because dh and ds are so keen to have another child and it's entirely my fault that we don't already have one. I think about it all the time and find it hard to sleep with my brain whirring with the guilt of how I'm going to explain to ds why he's an only child when he asks in the future.

I do have a home one, but I'm not sure I trust its accuracy. If I do two readings one after the other I get entirely different pressures (last week I got 205/something and then 10 secs later 132/something).

I'm inclined to think that it's not entirely white-coat syndrome as my pressure has always been normal before so I wasn't expecting it to be high a fortnight ago. It might explain the incredibly high readings for my adoption medical though.

Well done on your weight loss, 10% weight loss is fantastic! Usually you would see a corresponding reduction in BP, so I wonder why yours has gone up. Are you rested before you are having it checked?

You could ask your GP for a 24 hour BP monitoring - some surgeries have their own machine, or the hospital can fit it. That will give a more accurate picture than one reading in the surgery - white coat hypertension really does exist!

Anxiety will push it up too, and it's a vicious circle for you - can you try relaxation therapies, massage, meditation?

Sorry to hear about your BP. Bananas are very good for lowering it.

Brilliant weight loss! Keep up the exercise regime too. You are doing really well.

Only one bit of advice (apart from the bananas) is try and increase your walking. Get a pedometer and aim for a mimimum of 10,000 steps per day (about 4 miles).

It's funny about bananas hf because I used to have one or two a month but with the new regime I have been having 5 or 6 a week with my morning oats (I used to be a bit bad about breakfast but I always force it down now). So that should already be working in my favour, but it isn't. I can't have anymore than I already do because of the sugar content.

I do need to walk a lot more, I know, I do walk more in the winter but I just hate being outside in the sun. I might do more treadmill walking. I haven't yet found a pedometer that works for me, I must have a very smooth gait or something but I can walk for 10 mins and only register 100 steps so I find it easier to calculate distance on Google Earth and work from that.

When dh moves back from working abroad (and will hopefully be around in the evenings) I am planning to go walking with a friend but at the moment I can't go out in the evenings unless I hire a babysitter.

Bran - have you got the pedometer in the right place? If I remember rightly it has to be vertical with your mid-thigh.

I would also suggest you have white coat syndrome with your BP, I would speak to your GP get their thoughts on it.

You've done so well already, you should be proud of yourself.

It might be white coat hypertension as someone else has mentioned. 24 hour monitoring can give a more accurate reading so I would ask your GP if they can do this for you. It's a bit weird as every so often the machine bleeps and you have to not move so much as too much movement can disrupt movement, but it will show what your bp does during the course of a normal day.

Fitbug does a really good pedometer - pricey though, but worth it I think.

Thanks everyone. I have a plan of action (I think). I probably have until mid August to sort this out as we are booked for panel on 17th Aug but we will be cancelled once the medical advisor sees my medical. The next one is in September so I will need to either be medicated or have lowered my bp in time to do a medical in the second half of August.

I'm going to step down my high-intensity cardio stuff, the gym here gets very hot in the summer so it's getting quite uncomfortable anyway. Instead I'm going to do 4 miles a day 5 days a week, probably in the evenings when it's nice and cool, if necessary I will book a babysitter as dh is a total workaholic and not reliable about coming home (and working abroad at least 2 days a week doesn't help either). Hopefully I will be able to persuade a friend to join me once or twice a week. I will do a walking route by distance rather than by number of steps as I suspect that it will be even more anxious if I keep checking how many steps I've done all the time. I'm trying to reduce the number of things I'm obsessing about, not add to them.

I'm going to check out some bio-feedback systems, I might start another thread about that asking for recommendations. I may also investigate relaxation/self hypnosis cds/dvds.

I'm going to make a big effort to have more fun this summer and meet up with friends as much as possible. I like a good natter and it will stop me thinking about the adoption all the time.

I'm going to drink a bit more, I'll have a glass of wine with dinner or in the evening two or three nights a week. If I really want to have a coffee then I'll have that too, although probably only one or two a week.

After today (I have a gp appointment this afternoon) I'm not going take my blood pressure for at least a fortnight and I'm going to try not to think about it.

Anything else that anyone can think of that I can change?