White Coat Syndrome NEWS TODAY

[salymap]

I see the NHS have caught up with me at last. I do have high blood pressure but it is always much higher when tested at the Surgery.
I got so fed up with constant visits and threats of more and more tablets that I bought a BP monitor that my nurse checked out and approved.
The only thing now is to remember to test it at home,it is still too high.

[rauschwerk]

I don't mind pills as long as the side effects are bearable. One drug I was on for my hypertension made me tired all the time and I put it down to ageing. When after two years or so I complained to my doctor about swollen feet he substituted another drug and I was amazed at how much better I felt, and how quickly.

[VodkaDilc]

It must be at least twenty years ago that my wise old GP, sadly no longer with us, observed that I suffered from this syndrome; but, as he put it, "I would never put you on medication without giving you a monitor to take home and use for a week." Now research (costing how much?) has proved this commonsense approach right.

In my case, I am sure that it all stemmed from the insensitive doctors of the 1950s and 60s, who, seeing a slightly high reading, would draw in their breath and take another measurement, with a look of grave anxiety. I even remember the threat, "If it's no lower this time, we will have to admit you." That led to a three-week hospital stay, during which no problem was found.

[Dave2002]

I am suspicious of claims re BP. Since starting to check this out I've discovered that BP readings at different times can be significantly different, and that's not including the times when the readings go wrong and you're either dead (virtually no pressure, no pulse) or your heart rate is 300+ - I exaggerate, slightly! Exercise does seem to make a difference though, but not always in an obvious way. For those who can cope with exercise, such as walking, I strongly recommend it, though obviously some people are not fit enough, and it could be hazardous for them to attempt significant exercise without great care. You might find that immediately after exercise your BP is higher (though not always), but later on it may have dropped considerably.

One possible effect of exercise is that it tires you out, and then you may sleep better. Some benefits may arise from better sleep.

For those who have BP monitors try testing at different times of day, before and after exercise etc. Also, the wrist units are reportedly less accurate or consistent. I have a very cheap one from Lidl (may have been £5) and a more expensive and approved futuristic looking one from Argos (around £20).

You may get more insight into whether your doctors are helping you by trying this yourself.

[Alain Maréchal]

<The only thing now is to remember to test it at home,it is still too high. >
Not the only thing: get the gadget calibrated regularly at the practice. All of them waver over time.

<When after two years or so I complained to my doctor ..>
Your doctor might have appreciated earlier intervention.

<BP readings at different times can be significantly different>
That's been known as long as BP has been known about. What is important is that the reading is taken at the same time every day, for consistency, and first thing in the morning is a good time to check the underlying rate, before starting the day's activity.

Full disclosure: I'm not a clinician, but I work alongside them and I have been managing my own hypertension for ten years. Don't ignore it, it can significantly affect your health in ways that may not be apparent for some years.

[Anna]

Not sure, when salymap said News, she meant to link to this article on the BBC frontpage

http://www.bbc.co.uk/news/health-14629425

Our surgery is now very insistent on regular BP and blood tests every 18 months (the cynics amongst us think it's because they get paid more for doing so ......) However, I had bloods two weeks ago and was pleased my cholesterol was reasonably ok at 4.8 and perhaps that's the thing to keep any eye on as a middle-aged overweight friend had a very high reading some years back, refused medical help, and now is suffering very badly with diabetes and atherosclerosis

[scottycelt]

I'm in agreement with Dave. High blood pressure on occasion is perfectly normal it's only when it's permanently high that it's a problem.

I used to be on beta-blockers which didn't significantly lower my rate and made me feel like a zombie. An alternative drug had no side-effects but again its effectiveness was almost zero. I then decided to take matters into my own hands and to go on a diet (though not particularly overweight), eating plenty of fruit and veg and completely cutting out alcohol (drat!). I also stopped taking the drugs. After a couple of days my BP was miraculously back to normal and has stayed there ever since.

It has long been my suspicion that the solution for many probably lies in a change of lifestyle and diet, as in controlling some forms of diabetes. A period of exercise definitely lowers BP as any check afterwards will reveal. Again I've noticed disturbed sleep can raise it in the morning

I'm not suggesting that the minority who suffer from extremely high blood pressure should suddenly stop taking the tablets ... that would obviously be very silly and dangerous indeed! For these cases doctors' orders should always be followed!

However, I do wonder if those on the borderline of the condition are advised to go on drugs unnecessarily. When my 'condition' was first revealed many years ago the 'normal' figures quoted on monitors were 160/90 and then that suddenly changed to 140/90 and I've even seen 130/80.

If I find my figures are within any of those ranges I'm more than happy!

[Anna]

Totally agree with scotty, diet and lifestyle (both for BP and cholesterol) although the figures he quotes don't match this chart from The Blood Pressure Association.

http://www.bpassoc.org.uk/BloodPressureandyou/Thebasics/Bloodpressurechart

[VodkaDilc]

I was basing my information on R4 just after 7am - and later:

http://www.guardian.co.uk/society/2011/aug/24/blood-pressure-test-changes-misdiagnoses

As regard what is normal. I used to be told that age+100/anything under 90 was OK. I think that's out of date though.

[scottycelt]

Totally agree with scotty, diet and lifestyle (both for BP and cholesterol) although the figures he quotes don't match this chart from The Blood Pressure Association.
http://www.bpassoc.org.uk/BloodPress...dpressurechart

Anna, so the 'ideal' (which I assume is the new word for 'normal') is now 120/70? .

I'm no doctor, but as even they concede that BP increases with age, then the 100+age/90 model might appear to the layperson to be rather more logical and realistic.

Sometimes I think the modern medical profession will not be content until we all start 'suffering' from low blood pressure ..

[Lateralthinking1]

Sometimes it is better to ask for the white version of any tablets rather than the yellow ones. The yellow dye can have strange effects on some people (but not that severe and not in the case of many people so no need for anyone to panic).

[aka Calum Da Jazbo]

my BP was taken in USA [had an eczema problem ... they weigh, measure and BP you with an instant and overwhelming efficiency] and American nurse looked me in the eye and said your BP is too high ... i said i would check when got back to UK and saw medic a month back ... it was very high [190/110] ... no messing about then ... instant diet and started walking more [after a fifty year smoking habit it is my veins that are giving me gyp] i am a believer .... yep i believe in lifestyle issues but my diet was basically ok but weight and exercise not ... [my cholesterol was well within 'normal' limits and all the standard blood tests, ecg and chest xray nil found] and no i do not like the sound of beta blockers .... but i was interested in the cognitive enhancers that also reduce BP ... also bought myself a monitor but yet to use it .... i find it all intimidating and scary ... i feel better for the tablets effect but it is really difficult to know you have BP issues and the consequences are singularly unappealing ... i have a target weight to get to [actually a trouser size, vanity helps] and then i will tackle the weed ....

[Ferretfancy]

I use doxazosin and bendroflumethiazide, and have asked my GP several times if it is really necessary to do so. The standard answer seems to be that once you start you have to continue. I have tried the experiment of coming off the pills and checking the BP at home for a week or so, and the average level does rise over time without them. The question is, how significant is it? I reckon that BP rises with age, and that nobody seems to know what it should really be.
The medical profession bangs on about it, because they don't want to see a raised incidence of strokes, and the increased costs of treatment, but I'm still confused and sceptical.
scotty, I've just seen your message 10 while composing this. My doc seems to think that 140/80 is perfectly OK, so what are we supposed to believe?

[Anna]

Possibly surgeries vary in what they term desirable for BP. The diastolic is the most important I think and my doctor says anything over 80 is classed as high, but that doesn't seem to factor-in old age does it (if it rises with old age), surely blood pressure cannot be one size fits all? High cholesterol can be hereditary, can BP? Weight (the tendency to gain it) certainly seems to run in families.

My neighbour (he of the theories about Wagner) was very overweight (6'3" and built like a brick netty) and on the cusp of diabetes. His doctor gave him a copy of the G.I. diet and sticking to it rigidly he lost loads (3 stones) of weight and initially it controlled his blood sugar levels but not enough to eventually prevent him going on medication for type 2 diabetes. It's a very nice diet actually, loads of pulses and wholegrains

[scottycelt]

You tell me, ferret!

I possess a medical manual at home where the doctor writer also confesses to a degree of scepticism about the current official 'zero-tolerance' view on HBP.

He states that, while it is true that the condition may increase the risk of serious illness, the increased risk is not hugely significant, and he even goes on to say that some people may even require a certain degree of HBP for their bodies to operate satisfactorily.

I suspect, as with so many things in life, the most sensible position for the rest of us to take up is probably somewhere in the middle of two extreme viewpoints!