BP Advice

At my Doctors appointment 3 weeks ago my HBA1C was 5.9 which my GP was pleased with, but said i should think about starting to take tablets for blood pressure as when i attend surgery and have it taken it is always high. I put this down to "white coat phobia" which i have always had, but when i take my BP at home it is always around the 120-130 mark.

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Hi Robbo.
Welcome to the forum. Have a good look around and ask any questions that you wish.

In regard to your 'white coat syndrome' I too suffer from this.

Years ago I was continually being told my blood pressure was too high every time I went to the Nurse/GP. I went out and bought myself the best quality upper arm BP monitor I could afford and took readings at various times of the day. They were all MUCH lower than the Gp's readings. I finally got referred to a Consultant who fitted me out with a 24 hr BP monitor. This proved categorically that my readings were fine and I definitely had the 'syndrome.'

So now I take a list of my readings in the week running up to the appointment and these are happily accepted as gospel ! I now use the same machine that my GP uses. Every time it is taken there or at the Hospital I am always looked at as if I have grown two heads, blood pressure high. I have no idea why that happens.

I take BP meds because of a major heart op in 2004 so they are mainly preventative as since the op my BP is usually around 110/70. I am happy to take them and feel fine, no side effects at all.

Hi Robbo,

I've been on blood pressure medication since diagnosis nine years ago and I've never been aware of any side effects. In fact, my blood pressure is now staring to get on the low side and, at my last medication review, my GP started to cut backs on the dosages prescribed.

By the way, congratulations on your latest HbA1c and also for becoming a member of the 5% Club.

Best wishes - John

Robbo, I'm guessing that the 120-130 figure you're referring to is the systolic value (1st number)? It's actually the diastolic value (2nd number) that is more significant in terms of evaluating individual readings. Anything that is consistently more than around 75 for this might warrant medication, but should certainly trigger an initial referral for a 24 hour monitor, just to get a more complete picture. There are many other factors to consider too - age, weight, diet, lifestyle, history, all of which will be taken into account by your GP or consultant before prescribing anything.

White coat syndrome is surprisingly common, so it's definitely worth investing in the best upper-arm monitor you can, at around £100. I've been on 3x different bp meds for 8 years or so, and experience negligible side effects. Definitely worth keeping bp under as stringent control as you would blood sugar, the potential benefits to your microvascular system (e.g. eyes, kidneys) are huge.

kegstore said:

Robbo, I'm guessing that the 120-130 figure you're referring to is the systolic value (1st number)? It's actually the diastolic value (2nd number) that is more significant in terms of evaluating individual readings.

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Hate to disagree with you Keg, this is from the Blood Pressure Association site about which is more important. Systolic or Diastolic ?
Extract:
Which is more important, the bottom or the top number?
We have discovered that systolic blood pressure (the top number or highest blood pressure when the heart is squeezing and pushing the blood round the body) is more important than diastolic blood pressure (the bottom number or lowest blood pressure between heart beats) because it gives the best idea of your risk of having a stroke or heart attack.

Plus:
However, there are some circumstances where diastolic blood pressure may be more important than systolic. For example, some studies suggest that, in people aged younger than 40 years, diastolic blood pressure is a better way of assessing risk.

The conclusion is this:
However, current evidence strongly suggests that, over the age of 40, it is systolic pressure that is most important.

So it all depends on your age really.

Oh dear, it always comes down to age. Desperately trying (and failing?) to cling on to my youth - I'm "only" 41! :lol:

Odd though, all my regular HCPs still insist on the diastolic figure. I guess maybe it's down to who you believe, after all, look at all the healthy T2s strictly following DUK's dietary advice... :roll:

Blood pressure tablets ending in "pril" (ramipril, lisinopril, perindopril) have a protective effect on diabetic kidneys so may be prescribed in small doses even if your blood pressure is fine.

Various upper limits for BP are suggested, but there's no fixed lower limit because everyone's different. A reading that would be fine for me might have you dizzy and blacking out. BP is best kept as low as you can but not so low that you get symptoms.

You could stroke a pet instead but I don't think they protect the kidneys :wink:

This is how i counter by anxiety and bp

i) do not allow your mind to consistently dwell on past /recent incidents. this may draw much blood to your brain and your heart may have to pump stronger.Instead, live and feel each moment with all your senses...i.e while driving, do you smell the distinct aroma in your car, can you feel the tires hitting occasional pebbles on the road, do you notice the pedestrians and other drivers on the road, notice the swaying leaves and branches, notice the birds circling above....

ii)while you are sitting,standing or lying, try noticing that some muscles in your limbs actually remain tensed..it will take a while to notice or come to a realization of it..feel and allow your limbs to relax and always remember to deliberately relax all your muscles..this helps the most to reduce bp.

iii) when you sleeping, try sleeping in the corpse pose...
you'd feel the difference in the morning..try googling for "yoga corpse".

iv) go for brisk walks..the docs are correct on this..and while you are on it...do not work you mind...instead awaken all your senses and embrace the joy of walking and being alive...working your muscles improves blood circulation and faraway cells will soon stop asking for more quota of blood,nutrients or oxygen..

v) be active at your workplace/home or whatever you do...do not delegate if you have the time to work it out yourself.



vii) fruits , milk and vsop did help me a lot too. not related to bp, but avoid processed/gm food , go natural.

viii) notice your breathing pattern..do not breath shallow(most in later years do it only to the level of thorax unconsciously).Make it a habit to inhale deep drawing more oxygen and exhale out more of CO2.. this also helps with metabolism to keep you lean and cells more energy efficient( less of glucose in bloodstream). this may explain why smokers (deliberately inhaling deeply) put on weight upon quitting...

vi) realize the ultimate truth...all problems vanish when you die ...which means, whatever problems you are seeing now are only a projection of your perspective in current circumstances and by shifting your perspective you can face or solve the problems in a much relaxed manner..