# Blood pressure - When to medicate ?



## kingrollo (18 Feb 2019)

55 year old geezer here - my cycling has decreased recently due to a back injury - last summer when I was doing 100 miles per week my blood pressure was around 130/70 with a pulse of around 60

I have put on a stone and half since then - but still only weigh 12st 5 - I am skinny bloke - but seems to get a belly quite easily - but as of yesterday/today my blood pressure is 145/88 - the pulse has gone right up to 91

GP has said in the past is borderline whether to medicate or not - they have left the decision with me - given that the latest stats should I take some BP medication ?


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## Drago (18 Feb 2019)

Blimey matey, sorry to hear about your back. As hard as it might be I'd try and drop a bit of weight first, and only take the tabs as a last resort.


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## ColinJ (18 Feb 2019)

I hope the back problem isn't permanent.

Why not lose the extra weight and see what that does for your BP?

Do you have a very healthy diet - not too much salt, lots of fruit and veg etc.?

I second Drago's opinion - pills as a _last _resort not a _first _one!


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## vickster (18 Feb 2019)

Personally, I wouldn’t take medication for that BP given the potential side effects but you need to take your GPs direction. Is there a history of CV disease /stroke in your family which might influence the decision?


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## kingrollo (18 Feb 2019)

I hope the back injury isn't permanent - but its looking 50/50 - as its arthritis related.
My dad had similar BP reading - but lived to a good age.

I was also diagnosed with a heart murmur last year - scans and echo's said it was only minor - but I wonder if high BP could make it worse - GP in the past have said Im borderline and can have the meds if I wish.


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## vickster (18 Feb 2019)

kingrollo said:


> I hope the back injury isn't permanent - but its looking 50/50 - as its arthritis related.
> My dad had similar BP reading - but lived to a good age.
> 
> I was also diagnosed with a heart murmur last year - scans and echo's said it was only minor - but I wonder if high BP could make it worse - GP in the past have said Im borderline and can have the meds if I wish.


Have you seen a cardiologist? Or does your GP (or another in practice) have a special interest in cardiology?


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## classic33 (18 Feb 2019)

Are you getting yourself worked up, turning up/over in your mind all the past events? Maybe checking dr google even.

If you want your mind putting at ease see the doctor, or another at the same practice.


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## kingrollo (18 Feb 2019)

vickster said:


> Have you seen a cardiologist? Or does your GP (or another in practice) have a special interest in cardiology?



Yes - leaky aortic valve diagnosed, no problems - yearly scans\echos.


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## kingrollo (18 Feb 2019)

classic33 said:


> Are you getting yourself worked up, turning up/over in your mind all the past events? Maybe checking dr google even.
> 
> If you want your mind putting at ease see the doctor, or another at the same practice.



not really - problem with google \ internet is there are so many opinions from different countries at what BP readings you should go on medication


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## classic33 (18 Feb 2019)

Any concerns/worries get yourself seen.


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## PK99 (18 Feb 2019)

kingrollo said:


> GP has said in the past is borderline whether to medicate or not - they have left the decision with me - given that the latest stats should I take some BP medication ?



Doctors are very reluctant - and rightly so -to give direct advice in borderline cases. A form of words I have found useful a number of times is: "If you were in my position, with these readings, what would you do?"


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## fossyant (18 Feb 2019)

Also take into account 'white coat syndrome'. Never had it myself until a couple of years ago - subsequently high readings at the doctors. A 24h test showed my BP dropping dramatically once I'd got home from work, and quite low overnight.


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## kingrollo (18 Feb 2019)

fossyant said:


> Also take into account 'white coat syndrome'. Never had it myself until a couple of years ago - subsequently high readings at the doctors. A 24h test showed my BP dropping dramatically once I'd got home from work, and quite low overnight.



I do my tests at home - over a week or so...


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## vickster (18 Feb 2019)

kingrollo said:


> I do my tests at home - over a week or so...


So that’s an average? How high does it get?
I’d look at UK guidance for your ethnic group / age. Too many (not necessarily relevant) variables if looking at other countries


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## Bazzer (18 Feb 2019)

I understand 140 is borderline. There was a Radio 4 programme (Inside Health), broadcast on 9 January 2019. It is available as a podcast, so I would download it. It explains why different countries consider different readings as "high" and gives some very useful advice.
I took readings at various times of the day, (recommended in the radio broadcast) averaged them out and took them to the GP. Meds for me unfortunately as my BMI is slightly below dead centre for my height and weight, I don't smoke, get plenty of exercise, limited sodium and alcohol in moderation. Looks like my genes, but with a family history of heart problems and a Mum who has had two strokes, I am not taking any chances.
Meds have brought it down and have a review in a few days to see if GP wants it lower.


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## kingrollo (18 Feb 2019)

vickster said:


> So that’s an average? How high does it get?
> I’d look at UK guidance for your ethnic group / age. Too many (not necessarily relevant) variables if looking at other countries



150/92 is the highest reading


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## ColinJ (18 Feb 2019)

fossyant said:


> Also take into account 'white coat syndrome'. Never had it myself until a couple of years ago - subsequently high readings at the doctors. A 24h test showed my BP dropping dramatically once I'd got home from work, and quite low overnight.


I didn't know that I suffered from it until my long stint in hospital in 2012. A nurse taking my evening blood oxygen readings finally noticed that the reason they were not improving faster was that I was so nervous that I was holding my breath for over a minute each time the tests were being done!


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## HarryTheDog (18 Feb 2019)

I am a similar age, 56. I have been on Ramipril for around 8 months. I have been monitoring my blood pressure over a few years when it was noticed after both a RTA and a assault that my blood pressure went through the roof. ( 200/120 at one time) however it went back to normal after a couple of months and was put down to pain, then it went back up again due to stress . ( divorce, house selling and buying) then it went down again and is back up again now due to work stress.( company buy out redundancies in the air etc) It could be your back pain causing the elevation in blood pressure, my doctors ( doctors as I moved 6 months ago and have a new doctor) have seemed not to bothered about my BP and virtually ignored the higher figures. ie 140-150 , and were only interested in the lower numbers and only put me on ramipril when I was constantly over 90. ( they were impressed by my cyclists low resting heart rate of 42-45 and said I was fit as a fiddle) . They seem to consider my blood pressure is caused by stress or pain and nothing more sinister. I am lucky that I suffer no side effects from Ramipril ( I know people who do ) and its effect on me is fairly quick in bringing it down ie less than 12 hrs. I would see your doctor and try some meds. I was surprised at work and with cycling colleagues when I mentioned that I was on BP meds that so many other people were on them. Seems a lot of people like to keep it a secret.


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## kingrollo (18 Feb 2019)

HarryTheDog said:


> I am a similar age, 56. I have been on Ramipril for around 8 months. I have been monitoring my blood pressure over a few years when it was noticed after both a RTA and a assault that my blood pressure went through the roof. ( 200/120 at one time) however it went back to normal after a couple of months and was put down to pain, then it went back up again due to stress . ( divorce, house selling and buying) then it went down again and is back up again now due to work stress.( company buy out redundancies in the air etc) It could be your back pain causing the elevation in blood pressure, my doctors ( doctors as I moved 6 months ago and have a new doctor) have seemed not to bothered about my BP and virtually ignored the higher figures. ie 140-150 , and were only interested in the lower numbers and only put me on ramipril when I was constantly over 90. ( they were impressed by my cyclists low resting heart rate of 42-45 and said I was fit as a fiddle) . They seem to consider my blood pressure is caused by stress or pain and nothing more sinister. I am lucky that I suffer no side effects from Ramipril ( I know people who do ) and its effect on me is fairly quick in bringing it down ie less than 12 hrs. I would see your doctor and try some meds. I was surprised at work and with cycling colleagues when I mentioned that I was on BP meds that so many other people were on them. Seems a lot of people like to keep it a secret.



i thought high blood pressure was bad whatever the cause ?


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## HarryTheDog (18 Feb 2019)

That's what I think as well. I was a bit surprised at the lack of concern shown by the hospitals when I was in after my RTA and assault. They seemed to look at me and say nah he looks too fit it'll pass. They may have been right and it did. I only pressed it again when I noticed my blood pressure had soared again at the start of the break up of my marriage, again my family doctor did not seem too bothered and attitude was a bit well you can have it if you want it. I do a fair amount of high intensity excercise and dont want to blow a gasket in the middle of it. My new doctor was more concerned however and is keen fr me to stay on it.


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## fossyant (18 Feb 2019)

Back pain and stress triggers my high BP. Try beetroot, beetroot juice, or if you can't stand beetroot, you can get tablets with extract. It's very good for lowering BP, and increases oxygen uptake in the blood.


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## slowmotion (18 Feb 2019)

I've been on statins, beta blockers and ACE inhibitors for the last six years, following a rather unexpected and sudden cardiac bypass operation. Before then, I would have been horrified at the prospect of taking long term medication, but my views have completely changed. I have been very fortunate not to have had any side effects. My attitude is "if the cardiologists recommend it, I'll give it a go". If you get side effects, they can switch you to something else that might suit you better. Anyway, don't listen to me, listen to the experts.


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## PK99 (18 Feb 2019)

slowmotion said:


> n't listen to me, listen to the experts.



Amen to that!

Everybody is different. Anecdata from one random cyclist may be anecbollicks if applied to another.


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## Drago (18 Feb 2019)

Has the Doc given you any options or advice other than the tabs?


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## kingrollo (19 Feb 2019)

Drago said:


> Has the Doc given you any options or advice other than the tabs?



I am not yet on tablets......

As per most conditions on the NHS nowadays - you get a leaflet !

The GP advice "I can give you some tablets to lower you're blood pressure if you want"


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## vickster (19 Feb 2019)

Have you given all the recommended lifestyle / preventative measures a good go?

https://www.nhs.uk/conditions/high-blood-pressure-hypertension/prevention/

If you have essential hypertension, renal disease, diabetes etc you may not achieve the target without meds


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## kingrollo (19 Feb 2019)

slowmotion said:


> I've been on statins, beta blockers and ACE inhibitors for the last six years, following a rather unexpected and sudden cardiac bypass operation. Before then, I would have been horrified at the prospect of taking long term medication, but my views have completely changed. I have been very fortunate not to have had any side effects. My attitude is "if the cardiologists recommend it, I'll give it a go". If you get side effects, they can switch you to something else that might suit you better. *Anyway, don't listen to me, listen to the experts*.



The experts don't appear to give a toss though - maybe because I am borderline

*I presume you mean GP'S as experts !!!!


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## Bazzer (19 Feb 2019)

kingrollo said:


> The experts don't appear to give a toss though - maybe because I am borderline
> 
> *I presume you mean GP'S as experts !!!!



Without wishing to appear arsey about this, but there are two pages of various suggestions and personal experiences. As has been identified in the thread, there could be any one, or combination of factors, which could be contributing to a higher reading so I for one am not sure what you expect your GP to say?

You know what UK ideal readings are and you know you are higher than those; albeit borderline. It seems to me to be straightforward choice. Live with your current readings and gamble, or take some meds as given the choice by your GP. Changes to lifestyle may be reflected in your blood pressure readings, which may enable you to come off the meds, or you can carry on as you see fit using the meds only to lower your BP.


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## FishFright (19 Feb 2019)

kingrollo said:


> The experts don't appear to give a toss though - maybe because I am borderline
> 
> *I presume you mean GP'S as experts !!!!



I'm not an expert so listen to me , you're going to die .... at some point.


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## slowmotion (19 Feb 2019)

kingrollo said:


> The experts don't appear to give a toss though - maybe because I am borderline
> 
> *I presume you mean GP'S as experts !!!!


Cardiologists are experts. GPs are GPs.


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## vickster (19 Feb 2019)

slowmotion said:


> Cardiologists are experts. GPs are GPs.


GPwSI in between if there’s one at the practice

What has the cardiologist you see advised?


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## Gasman (19 Feb 2019)

I've been retired for a while but I'd have regarded 145/88 as plumb normal, especially at your age. I wouldn't get worried until systolic was over 180 and/or diastolic over 110 unless there are other problematic symptoms like chest pains, fainting, nose bleeds,etc


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## slowmotion (19 Feb 2019)

vickster said:


> GPwSI in between if there’s one at the practice
> 
> What has the cardiologist you see advised?


Sorry @vickster, was that a question for me or the original poster? FWIW, I just take what the cardiologists suggested. They know more about these things than I do. Probably a bit more than the keyboard Doctor Kildares too.


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## vickster (19 Feb 2019)

slowmotion said:


> Sorry @vickster, was that a question for me or the original poster? FWIW, I just take what the cardiologists suggested. They know more about these things than I do. Probably a bit more than the keyboard Doctor Kildares too.


The OP. He said he's under a cardiologist


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## slowmotion (19 Feb 2019)

vickster said:


> The OP. He said he's under a cardiologist


Sorry.


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## classic33 (19 Feb 2019)

FishFright said:


> I'm not an expert so listen to me , you're going to die .... at some point.


Been there, more than once.


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## kingrollo (20 Feb 2019)

Just a few clarifications:-

I discovered my heart murmur last year - Had an Echo - Ultrasound - leaky aortic valve - yearly check ups (and a leaflet!!!!!) - I don't recall but I assume my BP was checked in amongst this - but I was lot fitter than I am now. 

Historically my blood pressure has always been slightly high - A couple of years back I had the offer of medication - but upped my cycling and it come down to my usual slightly high (130 ish) 

Now with my back injury limiting my cycling - I am wondering whether to medicate - although the 150/90 seems like a rogue reading - Yesterday my average was 132/83 - this morning 128/81

It seems to always give a high reading on a sunday - typically my big ride of the week - I have come up with a few queries

1.Dehydration - even though I dink plenty on the ride - and after

2.I am just not fit and my pulse is higher and stays high after exercise

3.Its the biggish Sunday dinner ! (no alcohol though)


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## kingrollo (20 Feb 2019)

vickster said:


> The OP. He said he's under a cardiologist



Depends what you mean by 'under' - Because of my leaky heart valve I am to have a yearly check up. Other than that I don't have access to a cardiologist.


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