Last year my untreated BP was 200/110, but it is now between 108/65-134/85 most of the time.

However, yesterday I was under a lot of stress at work and started to get similar chest pain to that which I do on exertion - central pressure going up into my neck. My BP was 157/100. In the end I used my GTN spray, which cleared the pain. At the moment at work it is 153/93.

Do I need to worry if it is spiking like this and causing pain under stress, or is it just something I have to live with? If my meds are adjusted more then it may drop lower at the more relaxed times. I cannot take beta blockers and have lisinopril and dilitiazem.

Ann,


I know I'm new to the whole medication thing but one thing I know about blood pressure is that it can go up many times during the day in response to many things. The number one trigger for a spike is stress.

As for the pressure spike I would think that it's something that is a normal benign occurance as long as you recovered to your normal in the proper time. The whole fight or flight thing is normal and part of that is a jump in pressure...

As for the chest pain you probably want to ask your Doctor because while blood pressure variances are normal the chest pain due to stress should be discussed. It could be absolutely nothing to worry about but certainly should not be ignored.

I hope all is well for you!

I'm waiting for an appointment with a cardiologist (NHS) and my GP expects him to arrange an angiogram. A nuclear scan in the spring didn't show anything significant - I went for a period of about 9 months symptom-free but they came back about 6-7 weeks ago and I had one really bad episode. One GP says it can't be angina because of the test, the other is pretty sure it is in spite of it! All I know is that central chest pressure on exertion or stress, radiating to the neck and jaw and easing with GTN or rest sounds very like it and is very unpleasant. Over the last few weeks I've had some chest pain on more than half the days, although apart from the one severe episode which lasted 25 minutes not severe. Nearly all have been exercise-induced, three by stress.

I'm 61, female, a non-smoker, blood sugar slightly raised but not diabetic, on treatment for hypertension and raised cholesterol and with an almost 100% incidence of coronary artery disease on Dad's side, so I've always known I was likely to get it. An echo showed slight left ventricular hypertrophy from the hypertension. I'm on lisinopril and diltiazem. I try to eat healthily and am increasing my exercise.

Although I suffer from long-term dysthymia/depression I would not say I am an unduly anxious person. However, that one attack when I ran for a bus was REALLY scary.

This morning I had it very mildly on exertion.

Asc, :)

You have a lot going for you. Your blood pressure seems to be well controlled. That is the main thing. Going by your previous posts, I think you should be very careful when exercising at the gym. You sounded as if you had stable angina, getting it only when exercising.
Try to reduce your stress levels. Whether this is achieved by exercise or other means (such as relaxation) is not that important. Stress is not good for anyone. Your exercise should help in the reduction or a complete reversal of your LVH.
Blood pressure fluctuates during the day, depending on many factors. Stress in not good for your blood pressure and will cause elevations. Most people with high blood pressure get blood pressure spikes.
During your angiogram, you will be able to see your arteries on the monitor. If there are any blockages causing your angina pain, they will be clearly seen and pointed out to you. Elevated blood pressure does not usually cause angina pain. Often, an ischemic disease is the cause. This pain is a result of the heart being deprived of a sufficient blood supply because of arterial blockages. Doctors disagree frequently on the test result interpretation. Just because you nuclear test came out normal does not mean you can't have an undiagnosed irregularity. The doctors can be (and often are) wrong, but will not admit it. It's the patients that often end up paying the price. The angiogram should give you a better idea about the health of your arteries. I am glad you are having it done.

Good luck with that!

flowergirl

Elevated BP does not cause angina pain, BUT elevated BP may be a sign of blocked arteries, which of course do cause angina pain. It is good you are getting these tests. They are clear and definitive.

tamuprof45