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Old 11-02-2004, 09:57 AM   #1
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What is considered high blood pressure?

I'm writing on behalf of my 95-year old friend. This year, her GP tells her she has high blood pressure and has put her on meds. She was put on the patch and things didn't change. She was put on Lisinopril 5mg which made her sick. She is now told to take 2.5mg only.

Her reading yesterday was at 170/70 and 15 minutes later it was 134/64. She is somewhat nervous/anxious when she is at the GP's which she thinks can cause her BP to go up. She does have a pacemaker at which her cardio dr. said her BP was normal, and when she stayed in the hospital for 5 days, her BP was normal the entire time.

Her GP is asking her to go in to have her BP taken almost every week which is also stressful to her. She is basically a vegetarian, walks daily, stays active, is not overweight at all, and will be 96 in January!

In the past, 120/80 was considered normal and now it is considered borderline. At what stage do drs. normally start putting you on meds? Do you have to be consistently high? Can anyone explain the difference between the first number and the second number in layman terms? I know her first number is high but I've always it was more of concern if the second number is over 80. She never asked what her readings were in the past - only yesterday did she have them write it down.

Thanks in advance for any input!

 
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Old 11-02-2004, 11:24 AM   #2
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Re: What is considered high blood pressure?

Molly,

I am not a doctor but if I had a patient of 96 who is still going strong I'd think twice before putting them on BP meds unless their BP was catastrophically high. What was her BP when the GP decided she needed them?


Anxiety at the doc's office can definitely raise BP...You don't even have to be 96 for this phenomenon to happen (white coat syndrome).

Her blood pressure appears to be somewhat labile (which is normal in the elderly) and in my opinion, only if high readings are sustained at rest should meds be given.

Is her cardiologist involved in any way with this decision?
If not, I would get his opinion about this.
And having her schlep once a week to the doctor's office just to get her BP monitored is insane.
My guess is that her cardio would tell her to invest in a home BP monitor. OMRON makes very good ones. Arm cuff. Fully automatic, and has a digital read-out. You just put the cuff on and push a button. Virtually fail-safe and fool-proof. She can monitor her Bp is her own home...controlled environment...relaxed. Much more likely to give one an accurate picture of blood pressure rather than in the sterile and anxiety-provoking environment of a doctor's office.

Was her normal BP in the hospital on or off medication?

Even though normal (or "optimal") is now considered to be below 120/80, the "rules" are certainly less rigid in someone your friend's age!

The new guidelines are there to help us all GET to 96!!!!!
If we're lucky!

Your friend obviously has been doing SOMETHING right all these years. It would be a pity if the meds are unwarranted and make the next few years miserable for her.

Please ask her cardio for additional input.

zuzu xx

 
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Old 11-02-2004, 11:58 AM   #3
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Re: What is considered high blood pressure?

Molly,.

P.S. Here's some basic info about blood pressure and what those #s mean:
.

Blood pressure is the force of the blood pushing against the walls of the arteries.
Each time the heart beats, it pumps out blood into the arteries.

Your blood pressure is at its highest when the heart beats, pumping the blood. This is called systolic pressure and is represented by the top number.

When the heart is at rest, between beats, your blood pressure falls. This is the diastolic pressure and is represented by the bottom #.

A blood pressure reading below 120/80 is considered "optimal". In general, lower is better. However, VERY low blood pressures can sometimes be a cause for concern and should be checked out by a doctor.


Used to be that the medical community thought the diastolic was a more significant and important #. But today, the proverbial wisdom is that while both are important, a significantly raised and sustained systolic (top #) is a greater predictor of possible future cardiovascular problems.

Doctors now classify blood pressures under 140/90 as "prehypertension."

"Normal" blood pressures are lower than 120/80.

"Prehypertension" is blood pressure between 120 and 139 for the top number, or between 80 and 89 for the bottom number.

FOR EXAMPLE: blood pressure readings of 138/82, 128/89, or 130/86 are all in the "prehypertension" range. If your blood pressure is in the prehypertension range, it doesn't mean you have high BP but it is more likely that you will end up with high blood pressure unless you take action to prevent it, like doing regular exercise, eating a good, balanced low-fat diet, reduce sodium intake to no more than 2400mg a day (read labels and don't add table salt to your food if you can help it), alcohol and caffeine in moderation and lose weight if overweight.

Hope some of this helped.

zuzu xx

 
Old 11-02-2004, 12:35 PM   #4
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Re: What is considered high blood pressure?

Hello Zuzu,

Thank you so much for your response! My friend truly appreciates the time us "young folks" are spending to help her understand better so she make better decisions for herself. I will be printing your postings for her and go through it w/her and get some more info in order to answer some of your questions. I also thought her GP might be giving her meds that is not necessarily warranted that is why I thought I do a little asking around. I did some research on the med she was prescribed and it clearly states that if you're over 65, you should start at 2.5mg; well, her dr. started her at 5mg -so this makes me wonder a little bit more about this dr.

I will repost once I get some more info from her! She is a really amazing, even at 95 (going on 96!). She still have all her marbles, walk steadily, and made from good stock!

molly

 
Old 11-02-2004, 12:51 PM   #5
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Re: What is considered high blood pressure?

If she has made it to 96, than meds. would not be a good idea imo, but I'm not a doc. With those readings, it sounds like white-coat. They are now saying that 115/75 is normal. I truly believe that they create these guidelines, so that everyone would have HBP. My 23 year old g/f has readings like 142/75 after a stressful day at work. My Mom has 150/100 at her last docs. appt. after a 30+ minute drive through traffic. My g/f's Dad got a reading of 160/100 after work. Should all of these people be on meds. as well? I guess we should put everyone on meds. We don't know what the long-term effects of these meds. are. They all have side-effects despite what the docs. say & if I am lucky enough to live to 95, than I wouldn't want to be on meds. with those reading. Come to think of it, if I could do it all over again I wouldn't go on meds. either. I would have changed my lifestyle & gone on some sort of anxiety med. that isn't addictive that works with no side-effects. Anxiety meds. like Xanax keep my B/P around 116/66. When I tried to wean, my B/P went back up to 127/77 & etc with a higher 1st reading. I wouldn't recommend Xanax. I wouldn't recommend Paxil or an SSRI either. They made me feel like I had a 5 day stomach flu. A longer lasting med. that isn't nearly as addictive would be my choice.... BTW, My Mom, My G'F's Dad & my girlfriend all refuse to go on B/P meds. I don't blame them.

 
Old 11-02-2004, 01:01 PM   #6
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Re: What is considered high blood pressure?

I was just wondering about your Xanax. I used to read on an anxiety board, and a lot of those folks were on Xanax. Some of them had taken it so long that they were not getting any results and their dr.s were refusing to up their doses. What do you think you will do if this happens to you?
My dr tried to get me to take Ativan because of my White Coat but I refused.
Just curious,
Cass

 
Old 11-02-2004, 01:29 PM   #7
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Re: What is considered high blood pressure?

My mother had difficult to control high blood pressure, which I seem to have inherited. She went on to develop senior dementia and Alzheimer's, spending the last 5 years of her life utterly miserable in an Alzheimer's ward before dying of complications of a bladder infection. Some senior dementias are a consequence of years of uncontrolled high blood pressure and there is some evidence that Akzheimer's might also be in part a result of damage from high blood pressure.

I am not going to end my life like my mother. I am going to try as hard as I can to control my high bp, and hope the side effects from these drugs I'm trying don't kill me first. I'm still trying to find the perfect drug, or drug combination.

Now, as to the little old lady almost 96 years old, unless her bp goes way up, I say leave well enough alone. If her readings are only in the "pre-hypertensive" stage, leave it alone and recheck in 6 months. She should definately get a second opinion from her cardiologist.

 
Old 11-02-2004, 05:24 PM   #8
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Re: What is considered high blood pressure?

Thanks for the responses regarding my 96 year old friend. I'm sure she will find this board posting very interesting! I am meeting her tonight, with a printout of your responses, and will also lend her my blood pressure wrist monitor so she can get a reading while at home. I am going to also suggest that her daughter make a phone call (she lives in another state) to her dr. and see if it is really necessary for the meds. and somehow get the cardiologist involved. Personally, I think her cardiologist should be the one making the decision instead of her GP. My friend is from the "old school" and was raised to not question those of "higher authority," so she has never challenged or questioned her drs. on some of the treatments she have been given. I told her it is OK to do so - it is actually something we all should do these days.

Again, appreciate you all taking the time to post.

Have a good day, everyone!

molly


Quote:
Quote:
Originally Posted by mgraylorn
Now, as to the little old lady almost 96 years old, unless her bp goes way up, I say leave well enough alone. If her readings are only in the "pre-hypertensive" stage, leave it alone and recheck in 6 months. She should definately get a second opinion from her cardiologist.

 
Old 11-02-2004, 11:59 PM   #9
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Re: What is considered high blood pressure?

Molly,
I tend to agree with you that her cardiologist might be the person to deal with, especially since they know hypertension better than most GPs.

Warning about wrist monitors...they are notoriously inaccurate and inconsistant. I would seriously not bank on the readings you get from them.

zuzu xx

 
Old 11-03-2004, 06:21 AM   #10
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Re: What is considered high blood pressure?

I think that putting a 95 year old on a drug that is supposed to lower the risk of long term illness is positively INSANE. What the doctor should do is aske her what she does and then try to EMULATE her.

Subjecting a person nearly a century old to these ghastly drugs sounds almost criminal to me. Certainly any drug that might contribute to a fall and a blown hip that always hastens death in the very old would deserve pulling the MD's license to practice.

Unless she shows CONSISTENT readings of over 150/100 when relaxed at home, leave her be!

Last edited by zip2play; 11-03-2004 at 06:24 AM.

 
Old 11-03-2004, 07:27 AM   #11
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Re: What is considered high blood pressure?

Zip is like me. Don't let her go on the drugs, unless it is consistently over 150/100... I agree. It's not worth the side-effects & the torture to find the right combo. Sometimes the right combo is no combo.

I was just wondering about your Xanax. I used to read on an anxiety board, and a lot of those folks were on Xanax. Some of them had taken it so long that they were not getting any results and their dr.s were refusing to up their doses. What do you think you will do if this happens to you?
My dr tried to get me to take Ativan because of my White Coat but I refused.
Just curious,
Cass

Didn't take any before 2 doc appts. ago & my B/P was 158/80 at the doc. after averaging 116/66. Took 1 MGS before the last one & it was 120/78. White Coat.... sure sounds like it. Why don't they treat the friggin anxiety 1st & the B/P second. I don't get it. Docs. appt. next week. It will be the same typical B.S. They will weigh me. My 1st reading will be 134/82 due to white-coat... 10 minutes later it will be 120/78. I will ask the doc. to be weaned from the Atenolol & he will say no " who is getting lunch". I'll ask him if being 150 pounds is too light for me "he'll say no, come in whenever you want next time". I will go back to work & ask myself why I set this appointment in the 1st place. "You can wean off the xanax though if you want". Thanks Doc., I came in here, because of the side-effects of the Lotrel & Atenolol & you won't let me wean with an average of 116/66, but you'll wean me off of what really is the cause that you stated... white-coat. "We have given you enough tests. We have tested for everything & everything is fine. There is a Psychologist that I can recommend. I don't need a Psychologist. I need a capable Doc. who actually understands the side-effects of meds. & how they affect one's job. Has he asked me once what I do? No. I am in a high stress career. My face was flushing in the mornings & I wondered if it was the meds., the heat or a combo. He looked & said "You don't have Roscea. Buy some Oil Of Olay with SPF 15." I could go in with my readings, but they are just disgarded like his lunch from that day. I have an appt. next week & don't even know why I set this up. I saw him 3 months or so ago. Wasn't supposed to go until Jan. If he doesn't help with some meds. that don't have as many side-effects or a weaning schedule or some sort of schedule to get me off of these meds, as well as a target B/P (120/78 isn't low enough in his office???) than I guess that I have to switch for the 4th time in 20 months.

 
Old 11-03-2004, 10:53 AM   #12
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Re: What is considered high blood pressure?

Hello everyone,

This morning, my 96 year old friend called and said she is NOT going to take the Lisinopril med anymore. She is also not going to call her dr. and tell her about it either. She is just going to show up at her Monday appt. next week and see what happens then. I will see how she feels later today when we go for our walk. She doesn't know what her average BP readings are - she never asked and was not told. She has my wrist monitor so if she's curious, she can take her reading at home (she knows it might not be always accurate either). Again, thanks for all your input - it really helped me help her open her eyes about this whole thing.

Have a good day,

molly

 
Old 11-03-2004, 11:24 AM   #13
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Re: What is considered high blood pressure?

A lot of older people have isolated hypertension. If I live until 96, the last thing that I want are some B/P meds being prescribed to me. If I have done well for 96 years, what is the point. Wrist monitors aren't typically accurate as well.

What might by HBP for a 40 year old wouldn't be the same for someone that is 96 with isolated hypertension. I'm not a doctor, but I have learned a lot from this board & reading a lot.

 
Old 11-04-2004, 07:21 AM   #14
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Re: What is considered high blood pressure?

I go along with all these other posts that say if she has made this far she is doing something right. I would not want to start on a medication at this age. One poster said that they lowered the guidelines so we all have high blood pressure. I believe that. It's all about the drug companies and making more money.

 
Old 11-04-2004, 01:26 PM   #15
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Re: What is considered high blood pressure?

I too believe that the drug companies are just into making more money - but why do drs. push us to take so many meds these days? Do they get $$ on the drugs they push? Geez, are drs. becoming drug pushers?



Quote:
Quote:
Originally Posted by Rick7799
I go along with all these other posts that say if she has made this far she is doing something right. I would not want to start on a medication at this age. One poster said that they lowered the guidelines so we all have high blood pressure. I believe that. It's all about the drug companies and making more money.

 
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