After reading and listening to the podcast on blood pressure, I had a few questions related to my situation. I had several blood pressure readings by my doctor in the past 4 months that were high. I ended up purchasing a monitoring device for home use and regularly test in the 150/80 to 160/80 range. I have high blood pressure in my family (even those who are very healthy), so I figured I may face this at some point.
How long do I have to work on lowering my BP at this level? I’m 39 and live a healthy lifestyle, but would obviously like to see if there are some changes I can make to seep, life stress, and other things before jumping on medication. Am I going to do any damage by taking another 6 months or so to see if I can lower it?
Is there a specific reason my systolic is so elevated compared to diastolic? From my understanding diastolic is within range but systolic is high, not sure if this means anything specific.
Should I refrain from caffienated pre-workout stimulants? I don’t drink coffee or anything so this 200mg is about all I get daily.
I would not recommend this strategy. There are things that you can do immediately (e.g., marked improvement in sleep habits/quantity/quality, increasing physical activity, and decreasing/eliminating alcohol use, for example) that would generate notable improvements in blood pressure within a few days to weeks. However, 6 months is far too long for this process. If it were me with a blood pressure in the 160s, I’d likely be starting medication up front along with the lifestyle measures, and if things come under perfect control could consider weaning off of the medication later on, if possible.
This is more often seen in older adults. Hard to say what significance it has in your demographic. Either way, this doesn’t change our recommendations.
I would not attribute your blood pressure exclusively to this level of habitual caffeine intake.
Thanks a lot Austin, I have an appointment with my primary doctor next week. What would be the goal once on medication, before trying to lower the dose slowly and monitor? For the last question, I wasn’t implying it was the cause, but more so asking if this is something you would suggest eliminating given my current situation.
So I met with my doctor today and tested at about 160/80. She prescribed my 25mg of hydrochlorothiazide and said we could monitor and adjust as needed. Also ordered full labs. One thing I didn’t see discussed in the article regarding medication types is long term health effects. Obviously long term high blood pressure is dangerous, but in looking through pubmed, it seems a lot of these high blood pressure medications have the potential to increase risk of cancers and other serious illnesses. Are there certain BP medications you would catagorize as safer than others in regard to long term use?
So I met with my doctor today and tested at about 160/80. She prescribed my 25mg of hydrochlorothiazide and said we could monitor and adjust as needed. Also ordered full labs.
This would not be my typical/recommended strategy in this situation. It’s also unclear what is meant by “full labs”, and whether this includes screening for hyperaldosteronism or sleep apnea, for example.
One thing I didn’t see discussed in the article regarding medication types is long term health effects. Obviously long term high blood pressure is dangerous, but in looking through pubmed, it seems a lot of these high blood pressure medications have the potential to increase risk of cancers and other serious illnesses. Are there certain BP medications you would catagorize as safer than others in regard to long term use?
Typical/common blood pressure medicines do not confer a significantly increased risk of cancers or serious illnesses, especially when compared with the fact that uncontrolled high blood pressure is among the leading causes of premature death worldwide.
Austin, just to clarify, you’re saying that medication wouldn’t be your strategy, or the dosage, or something else? It seems from the article that this is a common “first step” medication, so I just want to be sure I understand.
Regarding sleep apnea, I do have moderate sleep apnea and am working with my dentist on a dental device as I can’t seem to get used to a cpap after months of trying, different masks, etc. I’ll call and ask that she add hyperaldosteronism to my lab.
A resting systolic blood pressure that is persistently in the 160s is unlikely to come all the way down to goal with one blood pressure medication. From the article:
Blood pressure drugs often show the effects of diminishing returns. A small dose of a medication will tend to produce a significant effect. Increasing the dose will continue to lower blood pressure, but not nearly as much as the initial exposure. As dosage increases, the risk for side effects also increases. Researchers have looked at using small doses of multiple medicines to exploit this. This strategy can result in the same or better reduction in blood pressure, with lower chances of experiencing side effects.
Of course, your physician may be used to a different practice pattern, or may not be as up to date on this evidence (this also applies to the aldosterone screening). As long as you are continuing to monitor and follow up they should be able to get your blood pressure controlled eventually.
Thanks again. Can I consult with you regarding this further? I appreciate the free advice thus far but I’m sure I’ll have more questions when I get my labs and see how medication is/is not working, lifestyle modifications, etc. If so, do I just submit a coaching request?