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    Old 08-23-2005, 05:56 PM   #1
    gop
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    Widely fluctuating BP readings. Please help!

    I am 44 yrs old male with active lifestyle, not overweight, non smoker.
    I bought a Omron BP monitor and have been using it regularly to
    check my BP.

    In the morning, after I wake up, I get readings between 110/75 to 135/90.
    However as the day progresses, my BP gradually increases. When I take the readings at night, I see it sometimes soar to 160/95 but within a few
    readings comes back to 120/75. Out of 10 readings at night, most of them are
    higher than 140/85. So, my question is am I hypertensive? Do I need
    to start taking medication. My doc says I need not take medication yet.
    But I am worried that if I don't bring down the BP to normal (< 115/75 even
    during nights), I may run into serious problems later on in life.
    I have a stressful job and get anxious pretty quickly. Does anyone think this
    could be the reason for the widely fluctuating BP readings?
    Recently I have started experiencing mild tingling in my left fingers? Do you
    think this is a symptomn of high BP?

    Thanks in advance!

     
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    Old 08-24-2005, 07:00 AM   #2
    Mellie310
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    Re: Widely fluctuating BP readings. Please help!

    I'm no authority on blood pressure, right now I'm over medicated and mine's running way too low. I'm about to drive some of the people on this board crazy, and I feel bad about that.
    You mentioned tingling in your fingers. Now THAT I know something about. Is it all your fingers? Do you use your hands a lot i.e., weight lifting, typing, anything repititious with them? I'm just wondering, because I have intermittent tingling in the fingers of my left hand, and it's due to both a compressed ulnar nerve and carpal tunnel syndrome.
    I've never heard of anybody saying their fingers tingled with high blood pressure, and I'm pretty sure that when the senior veterans of this board start responding to your post, they are going to tell you that your readings aren't all that high.
    All I know for sure about is the finger tingling. If it's your thumb, index, middle and the upper part of your ring finger, then it could be carpal tunnel, if the tingling is in your pinky and the lower part of your ring finger, you could have a messed up ulnar nerve.
    Sorry I couldn't be of more help to you with the BP issues, however, I don't think your readings looked all that bad. But, ask anybody on this board, being the hypochondriac that I've become, if those readings were mine, I'd think I was dying!!!!!!!!!!!!!! Because mine's been running as low as 70's/30's or 80/40something.

    Good luck and be patient. The people on this board are very smart, they know what they're talking about and they'll be a GREAT help to you. This is just all the input I could give you.

    All the best,

    Melanie

     
    Old 08-24-2005, 09:17 AM   #3
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    Re: Widely fluctuating BP readings. Please help!

    I can't answer the question about the tingling in the fingers because I have never experienced that myself but your readings don't look to bad to me. Of course I am not expert because I have issues as well, but they look pretty normal to me and my Dr.'s would probably be tickled to death if I had those readings.

    Sorry I couldn't be of more help but as I said the readings look pretty good to me.

    Good luck!

     
    Old 08-24-2005, 10:24 AM   #4
    mgraylorn
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    Re: Widely fluctuating BP readings. Please help!

    You may be recording residual stress reaction when you come home and decompress after a stressful day. Your higher readings might also have something to do with when and what you have for dinner. Can you relate any particular activity to your higher readings? Does your work stress give you headaches that you come home and pop an Advil or something? Some of these drugs will raise bp.

    At this point I also don't think you have anything to worry about bp wise.

     
    Old 08-24-2005, 11:24 AM   #5
    gop
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    Re: Widely fluctuating BP readings. Please help!

    Quote:
    Originally Posted by mgraylorn
    You may be recording residual stress reaction when you come home and decompress after a stressful day. Your higher readings might also have something to do with when and what you have for dinner. Can you relate any particular activity to your higher readings? Does your work stress give you headaches that you come home and pop an Advil or something? Some of these drugs will raise bp.

    At this point I also don't think you have anything to worry about bp wise.
    Thanks for all the responses. Yes. I am sure stress plays a major role in higher BP readings during the day and later on in the night. I don't get headaches too often. But my questions are:

    1. At what point do I need to start taking BP medication? If the readings are consistently over 140/90 over extended period of time (few hours/day)?
    2. Since I do get normal readings (120/80 or better) at some point during the day, is it safe to assume that I am not hypertensive (though I may be seeing higher readings at different times)?
    3. Are there any tests available to gauge if high BP has affected the arteries (loosing elasticity) or has caused organ damages?

    Though I am perfectly healthy now, I am still concerned about long term effects, especially since high BP is nicknamed "The Silent Killer".

     
    Old 08-24-2005, 01:52 PM   #6
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    Re: Widely fluctuating BP readings. Please help!

    I'd say yes, when the high readings are constant, at the moment it seems like you are getting high readings due to stress, etc. They can do a echocadiogram, ultrasound of the heart, to make sure no damage has been done there, to your valves etc, ask your doctor if he'll do one if only for your own peace of mind. Maybe try some sort of breathing exercises or something to relax you when your BP does come up as a high reading then check it again after 3 hours or so to make sure its come down or if that has helped it. Also things like caffiene can affect your BP for up to 2 hours so keep that in mind too.
    Goodluck with it
    Sarah

     
    Old 08-24-2005, 02:00 PM   #7
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    Re: Widely fluctuating BP readings. Please help!

    Quote:
    Originally Posted by sarahjean
    I'd say yes, when the high readings are constant, at the moment it seems like you are getting high readings due to stress, etc. They can do a echocadiogram, ultrasound of the heart, to make sure no damage has been done there, to your valves etc, ask your doctor if he'll do one if only for your own peace of mind. Maybe try some sort of breathing exercises or something to relax you when your BP does come up as a high reading then check it again after 3 hours or so to make sure its come down or if that has helped it. Also things like caffiene can affect your BP for up to 2 hours so keep that in mind too.
    Goodluck with it
    Sarah
    Thanks everyone for the wonderful responses.
    My doctor ordered a echocardiagram (on my pestering) and it came out normal, except for heart murmur, which he said is normal. My stress EKG also came out normal.
    So, I guess my stress level should come down as I need not worry about my high BP numbers!
    Thanks again! Wonderful board!!

     
    Old 08-26-2005, 02:44 AM   #8
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    Re: Widely fluctuating BP readings. Please help!

    Do what you can to control your stress and anxiety, which might include forgetting about your bp few a couple of months? Obviously the experts disagree on what hp is, but I think the dominant opinion still is that you shouldn't take bp medication unless your readings are consistently over 140/90.

     
    Old 08-26-2005, 05:03 AM   #9
    Lenin
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    Re: Widely fluctuating BP readings. Please help!

    gop,

    My standard is that it is hypertension and drugworthy if the AVERAGE of relaxed readings over a month is over 140/90 on either number.

    Don't take 10 readings at night. THat's too many and too anxious-making.

    I think you're more apt to run into problems down the road from decades of medication rather than by ignoring a borderline hypertension. These drugs aren't a "walk in the park."

    Weight loss, salt restriction, and alcohol avoidance are all good methods for getting marginal readings down into line.

    Last edited by Lenin; 08-26-2005 at 05:05 AM.

     
    Old 08-26-2005, 11:00 AM   #10
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    Re: Widely fluctuating BP readings. Please help!

    My blood pressure also fluctuates between 123/83 up to 140/90. I think it probably is stress related. I am thin, do not drink much, and also exercise a lot. My doctors also did an EKG and everything was normal. I don't think you have anything to worry about unless you have high levels consistently.

     
    Old 09-07-2005, 12:17 AM   #11
    gop
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    Re: Widely fluctuating BP readings. Please help!

    I am back again!
    Today, I went to my doctor for getting my blood work results.
    When he took my BP. They were really high - 170/110 and 169/105.
    I was really tensed at that time. My pulse rate was something like 110.
    My doctor said my BP was extremely high and put me on hyzaar (50,25,12.5).
    I told my doctor that my BP readings fluctuate wildly and that this morning
    my readings were in the 115/75 to 137/82 range and tend to go up
    gradually during the day. But he said that I should start taking medications
    right away.

    1. If I take start taking medications, won't my blood pressure get very low,
    since I still believe that I am not hypertenive?
    2. Does the BP readings depend on the pulse? Whenever my pulse gets
    over 90, my BP readings are way off

     
    Old 09-07-2005, 05:54 AM   #12
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    Re: Widely fluctuating BP readings. Please help!

    Quote:
    Originally Posted by gop
    I am back again!
    Today, I went to my doctor for getting my blood work results.
    When he took my BP. They were really high - 170/110 and 169/105.
    I was really tensed at that time. My pulse rate was something like 110.
    My doctor said my BP was extremely high and put me on hyzaar (50,25,12.5).
    I told my doctor that my BP readings fluctuate wildly and that this morning
    my readings were in the 115/75 to 137/82 range and tend to go up
    gradually during the day. But he said that I should start taking medications
    right away.

    1. If I take start taking medications, won't my blood pressure get very low,
    since I still believe that I am not hypertenive?
    Well, you appear to have white coat. But, I suspect that you may actually have hypertenstion as well. While your morning readings might be fine. If they are going up from there throughout the day, I'd have to say you have hypertension. You should take an average of these home readings. Include morning, afternoon and evening samples. Use the average for evaluating where you stand. Ignore your doctor's office reading. It most likely will not change even after medication. All that will happen is that your doctor will continue to pile on more and more drugs.

    Quote:
    Originally Posted by gop
    2. Does the BP readings depend on the pulse? Whenever my pulse gets
    over 90, my BP readings are way off
    Your high pulse is probably just another indicator of anxiety. If you are only seeing this at the doctor (and while exercising, of course), I wouldn't worry about it.

    Now, there is one thing I have a big problem with. And, that is starting you off on a combo drug. Either drug, the ARB (Cozaar) or diuretic (HCTZ) is suitable for starters. From the Hyzaar label:
    Quote:
    HYZAAR is indicated for the treatment of hypertension. This fixed dose combination is not indicated for initial therapy of hypertension, except when the hypertension is severe enough that the value of achieving prompt blood pressure control exceeds the risk of initiating combination therapy in these patients (see CLINICAL PHARMACOLOGY, Pharmacodynamics and Clinical Effects, and DOSAGE AND ADMINISTRATION).
    Hmmm, I don't recall seeing the part I highlighted in red there before. Merck must have added that part recently. However, you still don't meet the requirements for "severe hypertension". On the label, it states that severe hypertension is defined "as a mean SiDBP ≥110 mmHg confirmed on 2 separate occasions off all antihypertensive therapy". I don't think you met this criteria. Therefore, your doctor did actually prescribe this to you off label.

    In any case, I still think it's a bad idea - especially from a side-effect standpoint. You won't learn anything. You won't know which class of drugs is responsible for any side-effects you may have.

    I can relate a little of my experiences with Hyzaar. Actually, my BP used fit a very similar profile to yours. My doctor also prescribed Hyzaar for a "starter" drug. It was generally tolerable. But, it flat out didn't do anything for my BP. Also, I gained 10 pounds in the one month I was on it. For this reason, I decided this drug was not a good choice for me. In any case, I ultimately (after many more experiments) ended up on plain old Benicar 20 mg (with no HCT). And, it is working wonderful. I can't fully explain why Hyzaar (ARB+diuretic) did nothing and Benicar (ARB only) works. From this experience, I don't think all ARBs are equal.

    Pal

     
    Old 09-08-2005, 09:06 PM   #13
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    Re: Widely fluctuating BP readings. Please help!

    Look at it this way. For every 20mm systolic or 10mm diastolic you are at a two-fold increased risk than the next person. Look at what BP goals were only ten years ago. Doctors are getting more and more aggressive every year for a reason...because we know more now than we knew ten years ago. High BP is not an issue to take lightly. You should really consider controlling your BP to at least 120/80, and follow direction of your MD.

     
    Old 09-11-2005, 07:21 AM   #14
    gop
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    Re: Widely fluctuating BP readings. Please help!

    On my doctor's insistence, I had to take Hyzaar - 50-25-12.5.
    On my second day of starting on this drop, my BP dropped to as low
    as 106/66. I regularly monitored my BP (to make sure if the drug
    causes low BP) and found all my readings ranged between 106/66 to 131/77.

    1. I am not sure if this drug (Hyzaar) caused these low readings? This happened on just the second day of taking this drug. I read on this board that it takes 2 weeks for this drug to start showing results.

    2. When is BP considered too low? Is 106/66 too low?

    I haven't seen any side effects from this drug. If my decreased BP is
    indeed due to this drug, then this is clearly a wonder drug for all
    suffering from hypertension.

    Last edited by moderator2; 12-09-2005 at 01:36 PM. Reason: please delete long quotes from your replies

     
    Old 09-11-2005, 11:50 AM   #15
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    Re: Widely fluctuating BP readings. Please help!

    I've never used Hyzaar and am not familiar with it so can't answer your first question.

    A BP reading of 106/66 is terrific. When my SBP was down to under 110 quite consistently while I was still on Lisinopril, I found that I felt too lethargic to be comfortable, but suspect that if I had still been working instead of retired, the added stress would have easily overcome that feeling. Unless you start showing symptoms of fainting or the like, there is little to worry about with BP getting too low. If you see symptoms or if your BP gets less than, say, 90/60, you should probably have your dosage adjusted.

    Glad the medication seems to be working for you. Not everyone has side effects from meds.

     
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