Blood Pressure?

[JediSurfer]

Had my annual review at the diabetes clinic yesterday. All appears to be well apart from my blood pressure. The reading was 157/85. target range for a diabetic male is 140/80. The consultant wants me to have a reading taken once a week at my local GP's office. To see if I require meds. I DONT WANT MEDS.

My Blood pressure is normally around this level when ever I have been in the clinic and has always been a false alarm. Hospitals freak me out to the point where I wanna punch the doctor and run far far away. those places have always scared me. so my BP wil be high.

Gonna buy a BP monitor this morning so I can keep an eye on things. I am a little worried that after 29 years of diabetes this condition is finally taking its toll.
Not a favourable start to the year.

Any advice from those with high BP would be greatly appreciated.

Rich

[beau91]

Hi Rich, I have high blood pressure.But the same thing for me
.Have the white coat syndrom. My pressure is always higher at the doc's office.I bought a machine and the pressure is always lower.Has for advice .Try to cut on salty food ,exercise and a take a supplement of garlic Good for the pressure.Another thing stress is bad for blood presure.Good luck.Bye Ricky

[Funnygrl]

Ace inhibitors are provent to help prevent kidney damage from diabetes anyways, so why not go on a low dose of one?

And I feel that the "target" blood pressure you cite of 140/80 is too high for a diabetic.

[JediSurfer]

Seem like my dislike of the docs and hospitals is very well justified. scaring me like that. huff.

Got myself a neat Omron digital blood pressure monitor and have taken a few readings at different times of the day.
average reading is 124/63....
yipppeeeeeeee.
Looks like it was white coat hypertension after all.

thank for the input you two.

peace

rich

[gambi]

You probably get a higher reading at the doctor's office anyways since you may be under more stress. I know I get a little stressed when I am kept waiting forever and then I'm thinking about all the stuff I have to do when I get back to work!

The last time I was there I had the day off and my BP was 111/73.

The machines are probabaly just like out blood sugar monitors. Always a 20% variance.

Well I hope you can stay off the meds!

I guess in meantime to help prevent it you can exercise and watch you diet. But with diabetes I'm sure you do that anyways

[REDLAN]

Readings at the doctors are almost invariably higher than readings at home.

I had 180/105 at the GP's once - the clue that I was a bit stressed - my pulse was 95 - normal resting pulse for me is between 60 and 65.

White Coat syndrome is raised BP when measured in a clinical setting. However people with White Coat syndrome are not tachycardic (fast heart beat) when measured i.e. they do not show the normal signs of stress.

I don't have white coat syndrome, I just get stressed when I have my BP taken.

about 15-30% of people with mild hypertension, are normotensive when measured at home - source wikipedia

White coat hypertension - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/White_coat_hypertension)

my normal BP at home is 115/65 which is fine.

on the taking of meds - ACE inhibitors do help to reduce your risk of nephropathy in the short term 3-5 years, and they do slow the rate at which someone with albuminurea will progress onto ESRD (end stage renal disease) i.e. they protect kidneys. There is some question about how effective/safe they are in the longer term 5+ years - they might actually make kidney function worse, but this is unproven (there were issues with the paper and choice of end-points).

ACE's do have side-effects, and there is a high drop out rate (the longer you are on them the less well tolerated they tend to be). Generally however they are well tolerated by most people.

[Jan B]

I take Accuretic (ACE) which keeps my bp about 115/70. I also have white coat syndrome, even on the ACE inhibitors.

I don't get the big deal about taking a pill if it helps, unless the side effects are bothersome. I've never had any side effects, and don't even know what they would be.

I've complained about "all the pills" I take, but have been assured (and I agree) that it's a lot better to take what you need than argue about having another pill.

However I can understand a person as young as you Rich, not wanting HBP medicine. I have read (and I don't remember the source) that if you do have White Coat Syndrome, it may be a precurser to true high blood pressure (?!)

[Penny]

My husband was told to keep his BP under 120/75. He was concerned after starting on BP medications because he could be 98/55. This is a pretty common reading for me, so I did not see a reason to be upset, and teased him by saying "Well, eat some salt!" Which he promptly told his doctor, who lectured him saying salt does not cause high blood pressure. Why don't heart doctor's have a sense of humor? :D I have been taking BP meds for about 10 years, my BP was good before I started on them, but stays very low now. I am starting to have the dry cough I had when taking Altace (now taking Avapro), I thought maybe it was because of the cold I had in November, but the cough is still here. I am wondering if it would be a mistake to quit taking BP meds altogether.....I know the heart doctor will say NO, but if I stay normal or low, would it hurt to try?

[Evermont]

I'm not sure if this technique is useful, but I sure find it interesting. Given that stress is known to raise both blood sugar and pressure, I got myself a book-on-mp3 about meditation and tried it out.

My blood pressure usually runs just a little on the high side both at the doctor's office and in home testing. Doctor visits don't really bother me so the numbers are consistently like 145/90 give or take.

Twice now I've done this experiment. I get to the doctors office 10-15 minutes early and practice a relaxation breathing technique I learned. The results are impressive, lowest numbers I've ever seen. 120/68 for example. The doc didn't like the nurses reading so she retested me and it was yet slightly lower.

I think doc was skeptical when I told her what was going on, but she sure backed off of the idea of putting me on meds for blood pressure.

To find out if this is truly useful I need to experiment more to see how long the effects last. It's just not my highest priority right now but I'll get to it. The question is if this is only good for faking out the doctor or if I can make it a habit and use it to keep the numbers lower all the time or especially to shave off the peaks when stress is at its worst. Too bad there's no A1c-like 3 month average for stress or BP.

Either way, its easy to do and it's free. Actually it generally feels good too so I have a hard time imagining why more people don't do it regularly - myself included.

[JediSurfer]

I beleive the type of meditation you are talking about is very useful for combatting strees.
Meditated regular myself since being young. learnt from my karate sensi. I also use this techneque before surfing as it clears the cobwebs and gives mind focus.
Plus the BP is significantly lower after these exercises.
love my new gadget.

[cheryl]

Now what have I told you, You are a fighter..........Don't be getting all nervous about blood pressure now....

Mine is extremely low now, cause of being so thin the wind will knock me down LOL...

I know your ok.....dr's are making ya nervous.........

Cheryl

[mg_2204]

Any advice from those with high BP would be greatly appreciated.

A few years ago, when living in England, my BP suddenly went up. I had to go in every week to have a reading. I should have got myself a BP monitor back then. Anyway!

The nurse told me : walk! Brisk walks. At least 30 minutes a day. Apparently it helps greatly with BP. So I did. By the 3rd week BP had dropped significantly.

I was drinking way too much coffee too.

I was always under great stress when living abroad. I missed home, I missed family and friends. I wanted to come home so much! Although I walked a lot and did a lot, BP was always 'normal high'. When we moved back to the homeland... BP averaged 115/75. Incredible! So I guess stress has a certain impact...??!

BP monitor : If I read the instruction leaflet with my machine... it says you need to relax for at least 15 minutes prior to taking your BP. You must not eat or drink 15 minutes before taking your BP either. Do not cross your legs. I guess that way you have a better reading, a more accurate one. At the doctor's my heart pounds so hard I think everybody in the waiting room hears it......

[nono87]

Had my annual review at the diabetes clinic yesterday. All appears to be well apart from my blood pressure. The reading was 157/85. target range for a diabetic male is 140/80. The consultant wants me to have a reading taken once a week at my local GP's office. To see if I require meds. I DONT WANT MEDS.

My Blood pressure is normally around this level when ever I have been in the clinic and has always been a false alarm. Hospitals freak me out to the point where I wanna punch the doctor and run far far away. those places have always scared me. so my BP wil be high.

Gonna buy a BP monitor this morning so I can keep an eye on things. I am a little worried that after 29 years of diabetes this condition is finally taking its toll.
Not a favourable start to the year.

Any advice from those with high BP would be greatly appreciated.

Rich

i was told exactly the same thing at my review in December my BP is always ***/80 something and they feel this is too high. wanted to start me on meds but i refused so its been agreed that by my next review i will have reduced my salt intake (which is already low), i'll have a 24HR BP machine to monitor my blood pressure for a day (did that last week waiting for a print out from my GP) but the major deciding factor is my urine test if they find protein ...even a trace of it...they said they would start me off on meds :( not a good sign.

back to your actual question the best thing to do is reduce salt intake if you can get it as close to zero as possible you'll be sorted...try using a book call cooking without it shows you how to flavour you food without the need for any salt! :D

[JediSurfer]

Thanks for all the replies...

I guess the problem I have with the doctors is that after being type 1 for nearly 30 years their science tells them I should have high blood pressure and neuropathy and all the rest of the complications associated with long term diabetes.
Fortunately I have none. after a few days testing my blod pressure is well within range. I have nothing to worry about. I exercise daily with at least an hours power walk and a 1 mile run. always been obcessed with eating and living a healthy lifestyle. plus my bg control has always been good.

Makes me wonder how many people are taking meds when there is no actual need.


peace

Rich

[cheryl]

Makes me wonder how many people are taking meds when there is no actual need.

Be careful with that remark, a lot of people are pro-drug.....I got blasted by a few on another forum, cause I was sooooooo anti(for me not them), taking any form of pills at this point in my life.....boy was I put through a ringer.....Hey maybe I am onto something the people who really don't need become absolutely viscious when you talk about not or maybe perhaps not needing it LOL.....

I don't think everyone needs them personally....their is not enough data, or years to show me the true significant benefits, versus, when the people who take med's actually drop dead....My Nani, no bp meds still alive, grandma dead at 72 with all the magic pills....one can manage to take....both of them had extremely different diets too, so I tend to lead towards, my nani's diet....and making sure i am thin and trim for health reasons......not for looks.....I don't want to be popping these pills and still think well I take a pill I can indulge now....nor do I even want to take em....maybe if all I do that I am supposed to do, does not work I might consider it, but I won't until that point comes...

Cheryl

[JediSurfer]

I remember a few months ago Cheryl when the docs wanted to give you, what was it? anti cholestorol drugs or something. And you got the levels down by yourself without the drugs. So it was obvious that you didnt actually need them.
I thinks drugs and medications should be the very last resort and if the problems can be solved thru lifestyle changes all the better. Maybe some people feel better taking pills. Personally I dont.

[Jan B]

I say, congratulations to anyone who manages to lower their blood pressure through natural means. Meditation is great; yoga is fabulous. Since I quit smoking, my heart rate has dropped 10 points. My blood pressure climbs when I miss a pill or two, so I'll keep taking the pills for now.

I would be thrilled to no end to really get off ACE inhibitors, but I won't consider it until I get low/normal readings.

Cheryl, it's not right that people on pills are bashing you (other forum!) -- maybe they just mean to say they are the ones who can't accomplish that and don't want you putting them down. However, in reading your posts, I've never had the idea you were putting others down. You always bring up how we are all different.

Good job Rich.

[Funnygrl]

There are just some people who feel that drugs ARE proven effective. High blood pressure damages kidneys- any variance over like 120/75. Since diabetes already damages kidneys also, why not take a low dose of an ACE inhibitor. I was too prideful to at first, then I realized my kidneys were more important than my pride.

The same goes for a statin, only for the heart. I don't personally take a statin though.

[JediSurfer]

I don't think my endo would even consider ACE inhibitors without an increased creatine levels at this point.

[cheryl]

There are just some people who feel that drugs ARE proven effective. High blood pressure damages kidneys- any variance over like 120/75. Since diabetes already damages kidneys also, why not take a low dose of an ACE inhibitor. I was too prideful to at first, then I realized my kidneys were more important than my pride.

The same goes for a statin, only for the heart. I don't personally take a statin though.

It's not pride LOL...for me, it's like ok had diabetes since the age of 12. Giving birth to children is supposed to over work the kidneys, so a lot of diabetics after multiple pregnancies will see an impact on numbers to thier kidneys....

Me, Cheryl horrible a1c's in the past....four kids run thru this body....four pregnancies.....kidney function is excellent, doesn't even show they had ever strained an ounce while pregnant. For me, I don't think, that I will personally suffer the kidney aspect of diabetes....I am way concerned over my heart, but then again, I see what the statin really did for my grandmother(aka type 2 diabetic), so I dunno if it's worth risking not getting a heartattack over CHF, which that has shown to happen to people on Statins, because of the vitamins b-12 getting a bit deprived from the system....and you know I just put it all together, knowing my grandma's numbers were perfect all her levels, and then blew up like a whatever had over 6 gallons of water come out of her, her body couldn't handle it, and she passed away a month later....

My point is, that I am so unsure of what the right thing to do is, for me it is so not my pride....it is more, I just hope I don't get any of that, and trying very hard to stay with great numbers thru, keeping bg's in check, exercise, and my diet....I hope I can.....if I do need the med's I will, but up until that point, I just can't, I am very leary of it all....

Cheryl

[Alice]

I'm one of those "Ace" people who take Lisinopril daily as a preventative. There is something in the compound that actually protects the kidneys from damage. Doctors prescribe it for long-term prevention...along with the immediate need, for some, to lower blood pressure.

I take it strictly for preventative measures as has been proven to be helpful. I have no problems taking it and don't see the big deal...especially if you already have high blood pressure.

For me, the "death & damage" of diabetes when we are older seems to originate from heart and kidney damage which are related to each other very closely.

We don't drop dead from "high blood sugar". We die from slow tissue and organ damage. Face it.

Why not do the the easy things now to prevent major problems later? I just dont' see the big deal in taking daily cholesterol and blood pressure meds.

I think if you're anti-med anyway...a doctor isn't going to change your mind.

Note: I'm not a pill-pusher...just know that almost every endo I've seen in 8 states basically says it's a no-brainer for preventing kidney problems later...I've also been on Zocor since my 20's for the same reason.

Maybe that's a small way I've made it 42 years without any damage...who's to know...but I don't want to risk anymore than I have to...

[Evermont]

I'm with Cheryl on this one. I'm not anti-drug, I'm more anti-drug-if-you-don't-NEED-it.

What I mean is that if I can make healthy changes such as eating healthier, exercising, using relaxation techniques, getting adequate sleep, avoiding harmful environmental factors, etc. I'm doing those things first. I'm doing all of those things to the greatest extent that I can. This is the first line of defense. By the way, I'm quite a skeptic too. I know that rip-offs and wackos are all too common when it comes to these things. I start at the local farmers market if I didn't grow it myself.

If I need a pill I'll take a pill. I'm all too familiar however with the folly of modern medicine. So what if it's by proxy, I'm a big fan of learning from other peoples mistakes. I've seen meds do bad things to people I care about. Oh sure, meds are not always bad and when bad things happen, you can't always know the cause. My position is that meds should always be the second line of defense. Too often we go there first.

If a pill helps 100,000 people and kills only one that's not so bad, unless that 1 person is somebody you care about.

[BlueSky]

I also have an issue with White Coat Syndrome. Fortunately, the endo recognised that this could be the case when he got a very high reading a few years ago(it was 164/83). He asked to me to relax so he could do it again. I used an NLP technique that instantly puts me in a light trance state. He did another test, which came out at 135/72. I now do this whenever I have my blood pressure taken and get a similar result.

Our blood pressure changes the whole time, depending what we are doing. The test is supposed to measure blood pressure at rest, so using a technique that creates this situation must be appropriate. I suspect there are a lot of people out there who have been put on drugs unnecessarily because there blood pressure appears to be higher than it really is. And, IMO, the notion that these drugs should be used anyway by diabetics is just a big pharma money making ploy.

[cheryl]

It's honestly not a big deal to some but it is to others...It depends on the person and their situation....That's the point, I am all for whoever wants to do whatever....that's their life, but for me, and personal experiences, and just seeing the way natural ways of eating and keeping your self well maintained so benefits....

I just don't want to do it....it didn't prevent grandma from anything, She still had a heartattack in 2001, she still died of CHF, she tried desperately to keep her bg's in check her a1c's were better then mine....I dunno anymore....it is an individual thing, then I look at my Aunt, ok this is not a diabetic story, but she had Breast cancer, in 1978, went the all natural eating route quit smoking all that, never ever had radiation or kemo, just the one breast removed, still cancer free....

I am just saying when you see one way personally versus another way, you tend to want to sway the way, where the people are actually living....if you get my drift....

But I am sure drugs have helped many people live a long long long time....I think it is a decision, that well is it could benefit one, but not the other, for me, I am not sure it would benefit me, I think it would harm me, especially since the bp, is only 100/60 most of the time....LOL...

Cheryl

[Alice]

I think the main goal of diabetics on ACE inhibitors is the "preventive" goal...before damage occurs.

[JediSurfer]

Just seen my GP about the blood pressure and he says all is well. But I will be monitoring my blood preesure myself over the next three weeks and take the results back to the doc. So far all my numbers have been good.
So looks like I'm ok for now.

[Gary_W]

There aren't THAT many drugs that you can take which have positive benefit X which do not have some impact on Y and Z....

My own personal feeling is that if you absolutely need help with X then you take the drug and take the hit in terms of its unwanted side effects. This gives you a problem from a prevention point of view.

There are some docs in the UK that will automatically prescribe a statin if you have diabetes; the theory (as I understand it) is that lower 'bad' cholesterol for someone in our boat is likely to ward off complications as far as the heart and circulation system goes. Indeed a few years ago I knew quite a few doctors in their 30's and 40's who had no known health problems that would routinely drop a statin and 1/2 asprin chaser to ward off the long term risk of heart failure and all the delights that go with...

Not so common now, as I've heard a few reports of possible renal damage with long term statin use. We kind of need our kidneys too.

I was put on a statin 3 or so years ago as a preventative. I took myself off it as I heard the renal queries and also they made me feel rotten. Yes, another subset of the drugs may have suited better but as my cholesterol is good at the moment I figured I'd do without them for now.

I would not rule out drugs in the future. Indeed, I welcome them at a point when they become needed. Each individual has to weigh up their feeling on benefits vs risks of taking / not taking a drug. IMO there comes a crossover point when the long term risks of taking some of the preventatives is outweighed by the risk of not taking them. I'm not quite at that age yet, but I'll keep an open mind and thank heavens for medical science being able to aid and abet when my age / attempts at a healthy lifestyle no longer do the trick.

Oh, and regarding the home blood pressure monitors. Do make sure you line up properly with the artery and do not move whilst using it. The little microphone which acts as its 'set of ears' is back in the machine and it is listening via the air hose. If you jiggle the air hose, you can get a false reading. They are never as accurate as a trained clinician with a manual meter and a decent set of ears, but if you do suffer from white coat syndrome then they are a godsend if used correctly. What really cheeses me off is when some badly trained fool at a clinic uses a £9.99 battery operated blood pressure monitor and puts the cuff on incorrectly. Which they nearly always do. And they always look at me with complete loathing when I tell 'em... In their case, they have low quality gear used incorrectly and then many patients get white coat syndrome anyway. It's a 3 way route to inaccurate readings.

Gary

[JediSurfer]

I have the exact same Omron monitor my doc uses. Cost quite a bit of money but for me it was money well spent.
I remember my father didnt suffer from high blood pressure til the aged of 38 and he was seriously ****ed up and only live another 12 years. I am in far better shape than my old man was at my age. Seriously far better shape. I reakon I can get another 20 years outta this body without any complications no problem.

A lot of renal damage is caused pre diagnoisis. Lucky for me I wasnt in that situation and all the organs are working very well indeed. But my kidneys are slighty small for my size 9.5 cm left and 10.5cm right side.

[Funnygrl]

I think the main goal of diabetics on ACE inhibitors is the "preventive" goal...before damage occurs.
Bingo.

Waiting till you have kidney damage to start an ACEi is like putting your seat belt on after you're all bloody from a car wreck.

[cheryl]

Well I am just that risk taker now am I.......I already suffer low blood pressure spells, yea, me being dizzy all day because I am preventing my kidneys from something that might not ever happen is so not worth it for me.....sometimes my bp is a lot lower then 100/60....and even a minimal dose of ace could possibly lower mine...since I am quite truthful, sensitive to a lot of things......a little hydrocodine pill makes me high, two drinks and I am way beyond tipsy...I have low tolerance....so I know I'll be dizzy girl for a long long time if I even attempt that...I honestly am not against the ace....I have more issue's with the statins...in all actuality.....

Back to the point, I made earlier if four kids and a1c's in the 12's in more years I have been diabetic then them being good, hasn't even done a thing to them, I really am not worried about the kidney for myself...and also....i don't know why unless your not gonna have kids you'd go on that until your done having kids, then you have to be really really careful, not to ever ever get knocked up until you weene yourself off of it, and also if you even have one alcholic drink your risking your liver and your kidneys....think about that one....if any of you drink....not wise to do, to the organs....I won't touch anything anymore nada thing....so drinking I guess implies to the remarks too no drinking period end of discussion or your taking a risk.....I am not implying anyone drinks alcohol but it can damage ya too, if you think about it....and no pill is gonna stop that one seriously....

Cheryl

[JediSurfer]

The creatine blood test would indicate kidney disfuction at which point meds could be given to hopefully prevent damage.
After nearly 30 years of the big D and no such damage I'm willing to carry on as I am without meds until they are needed if at all.

[BlueSky]

... Waiting till you have kidney damage to start an ACEi is like putting your seat belt on after you're all bloody from a car wreck.
While there is no doubt that reducing high blood pressure protects the kidneys, there is no compelling evidence that taking ACE inhibitors while blood pressure is normal provides any benefit. Of course, the drug manufacturers would like you to believe that there is, which is why doctors get bombarded with studies that support this position. And why drugs of this nature are over-prescribed. I like to think that, the less I interfere by putting drugs into it, the better my body is at looking after itself. We really don't achieve anything by interfering with something that is working well. If it ain't broke, don't fix it.

Here is a recent study that highlights the dubious benefits of using ACEIs and ARBs in the absence of high blood pressure.
Medical News: Meta-Analysis Finds No Kidney Benefit for ACE-Inhibitors or ARBs - in Cardiovascular, Hypertension from MedPage Today (http://www.medpagetoday.com/Cardiology/Hypertension/tb/2292)

[Alice]

My endo's have all stated they would like to see Type I's (don't know about 2's) actually below the recommended blood pressure range. Therefore, the dose of Lisinipril (minimum for me is 10 mg)...I see no reason to wait for "beginning signs" of kidney damage.

I have a friend who is Type II, who wishes for the preventative care he never received. He now has only 30% kidney function and congestive heart failure. Like most of us, he had his "healthy" days. Oh, he has a bad foot as well...I just don't choose to ignore my docs, but I'm ok with everyone making a personal decision that is right for them.

I'm not bashing those who aren't taking them, but just want a voice on this forum that is repeating what many endo's have told me personally.

[Evermont]

... I like to think that, the less I interfere by putting drugs into it, the better my body is at looking after itself. We really don't achieve anything by interfering with something that is working well. If it ain't broke, don't fix it...

I think like this too. Can't back it up really, well, I haven't tried to.

Perhaps the other side of the same coin: I also wonder if the drugs I do take work better on me because I rarely take any. I got Arestin for early periodontal disease and was given a 50-50 shot at having it do any good. Well, I got 2mm resolution in many places and 3mm in some others. My dentist was very pleased. I have other examples. I find that pain meds are completely effective on me, I think it is well known that they lose efficacy with repeated use so this fits the model.

[Jenn L]

Aside from all the ace inhibitor talk, (I won't say how I feel on the topic) Get a blood pessure machine and take your pressure at home. You need to do it under different circumstamces to get an accurate reading. Every time you do it, take a picture with your phone.(or write it down) When you go in, and maybe doctoritus sets in, show them your pics, then you can talk to them about what you need to do or not do. Don't let it stress you out, thats worse! What works for one may not be what works for you.

Every time I go into the doctors office, I get doctoritus, but checking at home, I am fine, no worries! They have noted it in my file. And that by itself has helped my doctoritus!!