Since I don't have a doctor at the moment, I went to the walk-in-clinic to get my prescriptions renewed.
I feel lucky to have received a prescription for 1 month. The doctor I saw was very hesitant to write it. After reviewing my recent bp measurements, recorded in my journal, and taking my blood pressure, the doctor said my blood pressure control was not good and would have to be ''sorted out".
I find it hard to understand how such consistent readings can be BAD (as opposed to having my blood pressure consistently higher by 30mmHg or so).
Frankly, I am shocked. :confused:

My question is: what is the optimal blood pressure level? Is it the same for everyone? What are the criteria for determining a satisfactory blood pressure control? Do you guys have any thoughts, ideas or comments? I feel lost.

There wasn't a chance to ask even a single question before being shown out of the office. A name of a doctor taking on new patients has been provided along with instructions to see him within a week. The earliest appointment available is for the end of the month. I hope everything works out this time.

flowergirl

FG,

You have my empathy!!! Which is worse,not having a Dr. or having one? I've been in a similar situation before.

I don't know what to say. My 2nd expert said that my ideal b/p would be 114/70 but given my b/p history etc. He would be satisfied if I reached 160/70. I've gone below that once I got free from going to see him as he made my b/p go higher & higher.

He is a professor of medicine at a well known Medical School who is very knowledgeable but gets an F in DR/patient communication!!! My husband who is a tough retired military type said he wouldn't take me back to that DR. again after my 3rd & last visit.

But he did come up with the right combo-he just didn't know how to get the job done in light of my drug reactions. He was clearly perplexed by my b/p & drug problems.

That's when I really decided I had to take charge & put my brains to work to educate myself as much as possible. There just hasn't been enough basic research for those of us with resistent b/p problems. Most of the work done is for treating the symptoms but not getting at the whole scenario of what is causing HBP. Fam

Fam,

thank you for your thoughts. I am a little dissapointed about not having my blood pressure well controlled (in one doctors' opinion). I still wonder what might be considered a good blood pressure control in people with problematic blood pressure. Is there such a thing?

I did not take my meds this morning. The doctor I saw would not say whether or not I should. My blood pressure is 120/81 and 126/78 right now. That is close to perfect as far as I know.

It was 110/70 and 112/70 at 11:00 p.m. last night and 110/74 and 115/73 at 5:00 a.m. this morning. It had hardly changed at all during the night. The only change I see is in my heart rate, which is way up without my meds. I think I should take the beta blocker or a CCB tonight to keep the heart rate reasonable. I guess I should aim for the lowest possible reduction in blood pressure - so which one??? :confused:

I know things will clear up eventually. It took you a while and a few doctors to find the right combination of drugs. I hope your blood pressure has remained good in spite of your thyroid problems. I know you've stopped taking bp readings. Perhaps I too need to start over with a new doctor, fresh outlook and fewer meds.

I'll try to educate myself as you suggest. Like you, I've noticed that there is not much written about resistant hypertension outside of a hospital (clinical) setting. All of my books have a chapter about it though. Maybe they'll offer some insight as to its proper management. Perhaps I should also check out the renal aspect of managing resistant hypertension.

flowergirl

Hi Flowergirl,

I'm truly sorry you are having such a rough time.

I'm no expert but I think your BP numbers look pretty good.

My BP has come down to acceptable levels but my heart rate is too high. It's been pretty good but I've been feeling a lot of anxiety and my heart is reacting. It's the week I get my period too and things are always worse then.

I hope things get better for both of us soon.

Chantal

FG,

You have my empathy!!! Which is worse,not having a Dr. or having one? I've been in a similar situation before.

I don't know what to say. My 2nd expert said that my ideal b/p would be 114/70 but given my b/p history etc. He would be satisfied if I reached 160/70. I've gone below that once I got free from going to see him as he made my b/p go higher & higher.

He is a professor of medicine at a well known Medical School who is very knowledgeable but gets an F in DR/patient communication!!! My husband who is a tough retired military type said he wouldn't take me back to that DR. again after my 3rd & last visit.

But he did come up with the right combo-he just didn't know how to get the job done in light of my drug reactions. He was clearly perplexed by my b/p & drug problems.

That's when I really decided I had to take charge & put my brains to work to educate myself as much as possible. There just hasn't been enough basic research for those of us with resistent b/p problems. Most of the work done is for treating the symptoms but not getting at the whole scenario of what is causing HBP. Fam

Hi Famn,

I know what you have been through, I had the same problem. drs who think they are more human than us, and they don't like anyone to question their methods. I have seen over 60 drs to get my bp to a normal range, everyone tries a different combination and send me to have some blood work and scans. Thyroid, kidney and so on. Of course I was paying a lot of money because I don't have a health insurrance.
Anyway, I took Ditiazem on my own and I was fine few few years :D.
Good luck all,
Michael

Hi Chantal, :)

things will get better. I think that our doctors sometimes make them out to be worse than they really are.

I'm no expert but I think your BP numbers look pretty good.

I happen to think so, too. :) We are told we have to take our medications for life. Says who? I don't think I need any today with a reading of 113/75 and 118/75. If I take my handful of pills (as I am supposed to), what is my blood pressure going to be like a few hours from now?
I did just fine yesterday on 5mg dose of a beta blocker, taken at bedtime (and NOT because my blood pressure was high). I was very tempted to take my CCB as well because I was not sure I could get through the night without it. It worked out OK. I was just thinking while having a bath that perhaps I no longer need ANY medication. What if the cause of my high blood pressure has resolved itself? I wonder if it's possible?

My BP has come down to acceptable levels but my heart rate is too high.

I am so glad to hear that! Hopefully, you will be able to reduce your anxiety and get that heart rate back to normal. :)
I wonder if acceptable levels of blood pressure vary according to each individual's health profile and personal characteristics, and are not necessarily identical to the blood pressure goals set out in the hypertension treatment guidelines.

flowergirl

Michael,

How dissapointing that must have been! I am sorry about the time, effort and money expended to get you to where you are today. It sounds like quite a merry-go-round! One thing I am determined to avoid. Having a knowledgable doctor who cares about his patients (and not just the numbers treated each day) makes all the difference. Unfortunately, we don't often have a choice in the matter. :( I hope my new doctor is experienced enough to treat me effectively (if and when I need treatment).

flowergirl

FlowerGirl,

Your BP readings look darn good to me! I would think "normal" or "good" readings would have to be on an individual basis. A person with extremely high readings and difficult-to-control BP might have to be satisfied with readings that are somewhat higher than another person's. When I was going through a period of very difficult to control pressure and no combination of drugs (that I could tolerate) was effective, I asked the cardiologist what is done if we can't get the pressure down to "normal acceptable levels". His response at the time was, "We just do the best we can."

Like you, I've recently discovered that I don't need the heavy duty drugs I've been taking. For some odd reason, my bp readings have been really good (so good that it worried me!) while on less than have the dosage I'd been taking.

I suppose our bodies can change or else we were overmedicated to begin with?

Edelweiss,

I suppose our bodies can change or else we were overmedicated to begin with?


I belive you are right on both counts. Perhaps we have improved and don't need as many meds as we once did. I know getting my hopes up and thinking I don't need any meds is a bit premature. Time will tell. I should have a better idea once the effects of the meds start wearing off. It's too early to draw any conclusions.
My blood pressure is good (almost unchanged since this morning). I just got back from a long walk. I thought it would be up. It isn't. Only the heart rate is, of course, just like yesterday. I guess I'd better take the beta blocker.

I will take the meds to work with me tomorrow and perhaps even the blood pressure monitor. This is an uncharted territory for me, and I don't know what to expect. Thank you for your kind words and the encouragement. I am glad your blood pressure has behaved! :)

take care,
flowergirl

Michael,

How dissapointing that must have been! I am sorry about the time, effort and money expended to get you to where you are today. It sounds like quite a merry-go-round! One thing I am determined to avoid. Having a knowledgable doctor who cares about his patients (and not just the numbers treated each day) makes all the difference. Unfortunately, we don't often have a choice in the matter. :( I hope my new doctor is experienced enough to treat me effectively (if and when I need treatment).

flowergirl

flowergirl,

I think your blood pressure is great, why would a dr say that you need to lower it more than that :confused:
What they want you to do?
It was great that I found those boards few years back, it helped me to improve my English :D and know more about blood pressure. I'm even thinking about translating a book about High BP to Arabic, I'm a translator :).
good luck dear
Michael

I thought I would remind you about how my Mom's b/p came back down after being on meds for about 10 yrs. It stayed down the rest of her life. Her's was never as high as mine though. I pray that your will stay down. You've been through enough.

There are so many unknowns regarding b/p. Fam

Without knowing what your reading was or has been it is hard to know what to say. But mostly the ideal is like 120/70-80 any readings over that is starting to be suspect...and the lower number is just as important as the top number. Walkin clinics are suppose to treat you as a regular patient so I'm not sure why this doctor felt he couldn't adjust your heart medicine to what he thought it should be? But for sure you need to always have a doctor following you when you are on heart medicines.

Doesn't your blood pressure and heart rate vary throughout the day and night? I have been on metoprolol since January. My bp and heart rate will vary. Before I was on lisinipril for a month- it lowered my bp too much and heart rate was up. I am on a very low dose of metoprolol now. I would not know normally what my bp would have been before this as I never monitored it before like I do now. Does a person with normal blood pressure and heart rate-doesn't that now vary through out the day and night? Thanks, Pam

My doc was aiming for "as low and as slow as we can go without you passing out" when we started as I already had an enlarged heart. The heart rate came down right away, but even with a bunch of meds we have been unable to get the pressure below 130/85 on a consistent basis. He seems happy with that now and said the goal is consistency.

Thank you for your replies.

It's good to know that some people can beat this thing. It does happen. Fam, thank you for giving us hope. I am glad your Mom was able to live a part of her life without the meds. :)

Anne, my blood pressure varies. It will get to a certain acceptable level, even a perfect one, remain at that level for some time and then gradually start rising. I have been fooled into thinking that my blood pressure was well controlled so many times. Each time I realize it isn't, I get really dissapointed.
I feel best when the readings are in the high 120's or low 130's/85 or so. Anything below the normal levels (120/80) can and does cause symptoms of hypotension. For the last five weeks or so, my blood pressure have readings ranged from 90/60 - 125/75, mostly remaining around the 105-111/60-75 levels. After two days without most of my medsm I had to take some(not all) last night. My blood pressure was in the high 130's and then low 140's and appeared to be rising. Of course, I was up half the night (from the beta blocker?) so took several bp readings. I woke up with a blood pressure of 123/75 and 126/72 at 5:00a.m. I don't think I should take any meds. I guess I'll have to wait and see what the blood pressure does.

flowergirl

Hi pemmy,

the blood pressure in most people varies during the day and drops at night. I am sure mine varies, too. It does not seem to drop much during the night. I often think I'd like to stay up all night in order to take bp measurements hourly and see its patterns.
I am glad to hear you now monitor your blood pressure. We have to be careful not to lower it too much.

GoJoe,

when I get a consistent 135/80, I am happy. Your blood pressure sounds pretty good to me. I know that most doctors want it lower, but one has to be realistic. Perfect bp levels are impossible to achieve and maintain for some people. Thanks for sharing.

flowergirl

Thanks flowergirl2day! I used to take my bp constantly but have since try only to do it once in the morning and once at night.