Hi. I was listening to your latest podcast on blood pressure and have a few questions. I have slightly high BP around 130/80. I’m 67 years old, male, and otherwise in very good health. My cholesterol numbers are fine (Total around 160), fasting glucose typically around 85. I’m 5’10” and weigh around 185. My body fat is around 15% as measured on a Dexa recently. I’ve always been very active so I don’t think I have any other risk factors other than the BP. One other thing to mention is that I’ve suffered from insomnia for most of my adult life (started in mid 20’s). To this day I sleep badly. When I was younger in my 20’s and 30’s I always had lower BP typically under 115/70. Then around 20 years ago at a health check at the company I was working for had a blood pressure check that was on the high side. I’d. never seen that before. The nurse did the check again with the same result. At my next Dr visit it was in the 130/80 range. He was also surprised as it had typically been much lower. Since then we’ve kept an eye on it but no medication was prescribed.
So, my first question is can you think of anything that was cause a sudden jump in BP? I currently take no other meds and would like to keep it that way. Do you think that is reasonable?
It’s hard to speculate about potential causes of this blood pressure increase without more detailed information, but we do discuss common causes/contributors to high blood pressure in our article here: Blood Pressure - Causes, Prevention & Treatment
As far as what you should do about it, this depends on your overall risk profile (which sounds to be relatively low, based on what you’ve provided here), and your personal preferences regarding aggressiveness of treatment. It would likely be reasonable to forego medical treatment here, but again we can’t provide direct individualized advice via the forum either.
To your first question, assuming no changes in activity, fitness levels, environment, and so on, an increase in resting blood pressure is most likely due to measurement error, age-related changes, new condition, or the sleep issue as you mentioned.
Age-related changes would include alterations in kidney function (e.g. less sodium excretion), increased arterial stiffness (e.g. less NO production), and the body getting efficient at managing resting BP. Whether or not this happened on your specific timeline is unknown to me, but it’s possible.
The sleep piece is interesting, wondering if there’s some reason for the insomnia and/or its contribution to your resting BP.
As far as whether or not you would benefit from medication, I suspect you would based on the information listed here, though it doesn’t align with your preferences as stated. You can plug your info into the PREVENT risk calculator if you like and see what I mean. I think discussing risks and benefits with your physician would be a good idea to avoid unnecessary risk. We can also dig into this further via a consultation, as we’re limited on what we can do via the forum.
Thank you both for your replies! To the best of my recollection there were no changes in activity around the time of the blood pressure change 20 years ago. Not sure how good my memory is though…
The sleep piece is interesting though. Basically I have a fairly unique sinus condition that wakes me up every 2-3 hours (kind of like having a newborn in the house!). I have had several procedures to address the problem such as a deviated septum operation and swollen turbinate reductions. None of the procedures had any impact on the problem. Over the years I’ve gone to MANY EN&T Dr’s and nothing has ever helped. I’m sure this has a impact on my BP…
I have another appointment with my PCP next month and I’ll bring the BP up with him.
Thanks again for your help