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High Blood Pressure

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psbridge

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I was diagnosed with type 2 Diabetes 3 years ago and have 6 monthly checkups by the Practice Nurse who is trained to deal with Diabetes patients. As a side issue, I was later diagnosed with High Blood pressure and have been regulating that with Irbesartan. I check my Blood pressure approx weekly, and it is usually between 125 - 135 / 60 -70. My meter is an Omron, battery operated, and about 18 months old. I did notice that my GP used exactly the same model! I have also cross checked the readings using another similar meter, with virtually the same readings. When I have my 6 monthly check-up, my readings on the Nurse's Mercury column old fashioned, but obviously completely accurate instrument, read 160 / 90 yesterday! They call it the "White Coat syndrome"! As always, I will now have to return in 4 weeks, then another 2, then a visit to the GP another 2 weeks later. The more times I have to return, the higher the readings become. I am always locked into this sequence of 4 visits to carry out what should be one 20 minute assessment. By the time I return home it is going down nicely, and always below the 140 /80 borderline!
What can I sensibly do to keep the pressure below the borderlines on the appointment day so that I can escape from this regular chain of repeat visits please?
Peter
 
Hi Peter

I suffer a bit from 'white coat syndrome' myself, so can see where you are coming from. I'd be inclined to take my own meter to the surgery on your next visit and show the readings you have been getting at home. There is a problem with some machines being 'unverified' but as yours is the same as the one the doctor has, this shouldn't be a problem. You could also have your blood pressure taken on your machine after the nurse has done it on the old fashioned machine and see the difference.

You don't want to be put on extra medication because of 'white coat syndrome'. I have read on here about a monitor that you can wear for a 24 hour period that records you over that time.
 
I have exactly the same problem Peter . I am ion 5mg of ramipiril as a precautionary measure because I have macular oedema.
When I go to the surgery my readings are at the top of the scale. At home they end to be in the order of 115/65.

I took my monitor in to the doctor at my llast annual review and the doctor accepted my readings as I had taken one just before i left home and she could see it had been 190/95 as opposedd to previous reading of 110. I thought that was the end of the matter but no!

I have 3monhly HBA1Cs . I used to just have the blood test but the nurse has jhighjacked his and insists on weighing me and taking my BP each time. No doubt this is connected with funding in some way. I am only 71/2 stone so weigh is not a problem

Blood pressure is not a problem either until I go ino the surgery. Even when I have to face stressful procedures in he hospital concerning my eyes my BP is at an accepable level.

You certainly don't want medication for BP if it isnt necessary, When I was fisrst pu non a lower dose of ramipril I suffered a deep faint 3 times in a week. Eventually I got used to it.

Then I changed GPs and all he fuss started again. MyBp does end a little o be labile {goes up and down } I went to the nurse one day and my BP was 200 then she insisted I see the doctor the next day. It was the same alhough my two monitors had shown my BP had returned to normal at home.
They insisted upon doubling the dose of medication . For the first two days my BP stuck at 110/60
I checked several times during the two days and unusually for me it didn't move even after exercise.
The worst thing was hough, that on the second day , when I went out I could hardly see at all in my left eye and he hospital confirmed I had suffered a massive bleed. Coincidence? Hmmmm
Now the nurse is fussing again and wants me o ake in my meter o check against the digital one.
As I have posted elsewhwere Both meters are verified and I have contacted he manufacturers o check.
They,at least are aware of the new guidelines abou home esing or 24 hr ambulatory test, Of ccourse they would be - it is in their interest just as it must be in the nurse/s inteest o fill he appointment book.

It is not in mine however. I shall take in a printout of the NICE guidelines when I return in January and sdemand an ambulaory est as I know full well that however much medication I take the reading, in the surgery will be he same, Do i let hem coninue doubling the dose for ever ?

I can do without iall he hassle. I am aware hat I need o keep my BP under control and would contact he surgery immediately if I thought it was rising.

I have another appointment with the eye surgeon next week and face my 3rd Chrismas temporarily blind. It is especially hard as my only child has been working abroad and is coming home hen.

I can do without exra hassle purely for the benefit of practice staff.

of course they have o check tthese things but to sugget hat all home monitors are rubbish as she did and to say that they throw hem away every 6 months and so should I is nonsense. She must feel threatened by the new guidelines.

Just lie the bg meters hey show rends if not 100% acccurate and can be a useful tool. Why else would my GP have recccommended I buy one when I was first diagnosed?
perhaps the nurse's raining does not include any information about White Coat Syndrome as the drs seem to be aware of it while he nusrses are not.
 
Hi Peter,

'White Coat Syndrome'...... :) Yes there's quite a few of us suffer from this when visiting their GP, like you I check my bp at home and my reading are always below 120/70 but when having clinic checks it can rise to 150/85!

What I do is take my home readings in to show my gp/nurse and they happily accept them......hopefully yours will do like wise! :)

The best way to keep bp low is to stop smoking, limit alcohol, exercise regularly and eat a healthy well balanced diet.
 
To make sure my BP readings were OK my doc. asked me to do about 12 readings over a day. He then averaged them out ignoring the highest and lowest and declared my BP as OK.

Doing it that way is much more representative of what is going on.

H
 
hallii said:
To make sure my BP readings were OK my doc. asked me to do about 12 readings over a day. He then averaged them out ignoring the highest and lowest and declared my BP as OK.

Doing it that way is much more representative of what is going on.

H
Click to expand...



Not a bad idea, the monitor I use does have an average facility which takes into account the last few readings.
 
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