High Blood Pressure

[ProThaiExpat]

Sheryl: Many thanks for reading my post and pointing out the "mis-speak" of my description of the drug I had in mind. Clearly, a protease inhibitor is an hiv drug and what I meant to allude to was an ace inhibitor, as described in the following:

"The first step is usually a prescription for one of five types of medication: a diuretic, a beta blocker, an ACE (angiotensin converting enzyme) inhibitor, an angiotensin II receptor antagonist, or a calcium channel blocker. If these drugs, either alone or in combination, fail to bring blood pressure under control, other classes of drugs may be prescribed."

Sheryl, your the best!!

Edited January 11, 2007 by ProThaiExpat

[Sheryl]

Well this thread (plus the fact that I am supposed to be working in something else thast is already overdue!) piqued my interest enough to finally get around to reading the Lancet article which is what set off all the flap about atenolol and beta blockers for hypertension.

What the article actually says is that they(Beta Blockers, of which atenolol is probably the most widely prescribed) were found not to reduce the risk of stroke as much as other classes of drugs did, although they did reduce the risk when compared to no treatment. They were equally effective with regard to reducing heart attacks and overall mortality. It is not clear whether this is just because they are not as effective in regulating the BP (either because they don't work as well or because people are less compliant with them), in which case the slight risk would apply only to people whose BP wasn't well controlled, or whether there is something else at play.

There is nothing in these findings to justify banning the drug, and as far as I know no place has done so. But based on them there will probably be a trend towards using them only if other equally affordable drug groups are not effective (e.g.: diuretics, ACE inhibitors, or both together).

Thai Pauly -- I also got around to reading up on anti-hypertensive meds (anything to avoid doing my work!) in diabetes and as I suspected, ACE inhibitors are often the preferred treatment due to their protectice effect on renal (kidney) circulation. Atenolol is OK for diabetics too (assuming it gets the BP down and well regulated) , but an ACE inhibitor would probably be a better choice. There are a number of Thai made versions of enalapril or you can get the GPO generic, all are quite inexpensive which is obviously a consideration for a drug you'll likely need to take for life.

By the way, a very good litmus test for whether you have found the right doctor is whether or not he or she tells you things like that. Try asking " As a diabetic, are certain drugs more advisable than others in treating my high blood pressure?". Any doc who can't or won't answer that -- with explanation why as well as names of drugs -- is not the doc for you.

Same actually applies to just about any medication for a person with a chronic health condition.

Also good to ask about drug interactions, e.g. "I am taking drug X for my diabetes and Y for my hypertension, is there any problem in combining these with (whatever the doc is giving you for whatever else)"

And lastly, I hate to have to say this but, even if you find a doc who seems right in terms of qualifications and ability/willingness to answer such questions -- you still need to read up yourself on all medications you take or are prescribed: side efects, contraindications and possible interactions with other drugs. In my experience physicians everywhere pay too little attention to these. I have often thought that if for no other reason it was worth becoming a nurse just to be able to protect myself, friends and family from major medical goofs. They happen more than you want to know. Remember -- no one has more at stake in your health than you do, and the amount of time you can put into reading up on relevant health topics is a lot more than the amount of time the average doc can afford to allocate to one patient's problems.

You can subscribe for free to a site called www.medscape.com which has a drug reference search function where you can get patient monographs and details on side effects, interactions etc for any drug approved for use in the US. You can also search the general site for information on different illness and treatments. (The search function gives you 3 choices -- drug reference, medcape or medline. The last one is hard for lay people to follow, but the general medscape one often has stuff in everyday language). There are other online drug references too, this is just the one I am most familiar with.

Edited January 13, 2007 by Sheryl

[ashwell]

Yes that reading is definitely on the higher and at present I feel that there are many such people who are affected with this problem one way or the other. Now I am not a firm believer of the conventional medicines to be pursued too long for this ailment. Rather there are many alternatives now, for instance take a look at this blog, http://treat-high-bp-naturally.blogspot.com/ which narrates the story or rather the success story of someone evolving out of the BP problems, so isnt this encouraging?

[ThaiPauly]

Thai Pauly -- I also got around to reading up on anti-hypertensive meds (anything to avoid doing my work!) in diabetes and as I suspected, ACE inhibitors are often the preferred treatment due to their protectice effect on renal (kidney) circulation. Atenolol is OK for diabetics too (assuming it gets the BP down and well regulated) , but an ACE inhibitor would probably be a better choice. There are a number of Thai made versions of enalapril or you can get the GPO generic, all are quite inexpensive which is obviously a consideration for a drug you'll likely need to take for life.

By the way, a very good litmus test for whether you have found the right doctor is whether or not he or she tells you things like that. Try asking " As a diabetic, are certain drugs more advisable than others in treating my high blood pressure?". Any doc who can't or won't answer that -- with explanation why as well as names of drugs -- is not the doc for you.

Same actually applies to just about any medication for a person with a chronic health condition.

Also good to ask about drug interactions, e.g. "I am taking drug X for my diabetes and Y for my hypertension, is there any problem in combining these with (whatever the doc is giving you for whatever else)"

And lastly, I hate to have to say this but, even if you find a doc who seems right in terms of qualifications and ability/willingness to answer such questions -- you still need to read up yourself on all medications you take or are prescribed: side efects, contraindications and possible interactions with other drugs. In my experience physicians everywhere pay too little attention to these. I have often thought that if for no other reason it was worth becoming a nurse just to be able to protect myself, friends and family from major medical goofs. They happen more than you want to know. Remember -- no one has more at stake in your health than you do, and the amount of time you can put into reading up on relevant health topics is a lot more than the amount of time the average doc can afford to allocate to one patient's problems.

You can subscribe for free to a site called www.medscape.com which has a drug reference search function where you can get patient monographs and details on side effects, interactions etc for any drug approved for use in the US. You can also search the general site for information on different illness and treatments. (The search function gives you 3 choices -- drug reference, medcape or medline. The last one is hard for lay people to follow, but the general medscape one often has stuff in everyday language). There are other online drug references too, this is just the one I am most familiar with.

Thank You Sheryl,

You have given me a great deal to think about with your very in depth post.

Your hekp is very much appreciated

[ProThaiExpat]

Brava Sheryl: Your advice regarding involving yourself in your own treatment, especially in medications, is so true. With the internet, we are all empowered.

After all, your physcian has many patients to keep in mind, while you have only one. Who has a better grasp of your condition than yourself.

This principle is used by almost all corporations around the world when they hire "in house" lawyers. Who wouldn't prefer a lawyer who has only one client to think about rather than hundreds.

[Cuban]

This is an interesting thread with much infomation.

I would like to offer a few thoughts.

Firstly, exclude added salt from your food, not very easy in Thailand with the likes of Nam Pla etc. and salt added to much Thai and processed foods but if you nail that it will make a differance to you quickly. Removing salt costs nothing.

Excerise is good for people, do some, start small, but do something. A bike from Tesco Lotus is 2,300 Baht and walking is free.

Asprin is cheap, half or one a day, taking some will thin the blood.

Drink water, or drink more water, better than beer or cola type soft drinks. Good to avoid excess sugar.

If you have high blood pressure it can seriously damage your kidneys, if your kidneys are damaged you develop higher blood pressure etc etc, which can lead to kidney failure. Without kidneys cleaning your blood you die in about three days. Water passing through your system is good for kidneys, drink.

I like a few glasses or red wine, the French men that drink solid red wines have less CV problems in old age. This is down to personal choice. The social act of drinking with friends has a positive affect on people. So no need to cut all alcohol.

Measuring your own BP at home, very wise. Although an upper arm cuff along with a sethoscope is much better than the automated wrist machines. It takes a few minutes practice to learn to use a proper sphygmomanometer, there is no special magic involved. Just listen for the pulse in your artery as you release the pumped air from the cuff, if you do this every day for a week you will be taking the reading in the few seconds as a doctor does, honestly it is easy - does not require batteries and gives a better reading. Useful link.

The above was the basis of my treatment set in place when I saw my doctor after a random BP test showed 170/140. If I had not taken responsiability to cure myself kidney failure or a stroke would have been very likely. I have a friend that has survived a stroke, he is lucky that his wife is prepared to clean him after he soils himself in bed every day, he has no control any more. He does not get up/dress or use the computer any more. The mental problems are an issue too.

I've just measured my BP, 120/75 this evening, it's a bit high compared to late last year when I was getting 115/50 midday.

Not taking any BP medication, but I'm looking at testing Simvastatin for elevated cholesterol, not perfect yet but I'll die trying.

Consider this issue as something you have caught in time and can deal with, better to do something about it than ignore it hoping it will disappear.

[edit/typo]

Edited January 17, 2007 by Cuban

[roderick17]

Greetings

I understand that many conditions will affect blood pressure readings - I assume that having a Blood Pressure test the morning after, being on the town the night before and drinking much alcohol, would probably inflate the reading. On Saturday morning, that's just what I did. I had a blood pressure test that returned a very, very high reading ( about 190) . I am wondering how much of this high figure can be put down to the beer I guzzled on Friday night ??

Roderick

As said check when relaxed at home and do a number of times. Physical activity will greatly affect the readings as will anxiety (worried about family?). Doctors advise is cheap here and there is a wide range of medications if required. But do take a number of readings at different times and record for doctor (as your office readings could be much higher than normal at home level).

[Cuban]

I am wondering how much of this high figure can be put down to the beer I guzzled on Friday night ??

It seems that every TV member willing to post a comment on this forum is now required to add a disclaimer recomending that the OP seek doctor/hospital supervision in all cases, less they come underfire for offering wrong information.

BP figures will vary between people depending on the amount of beer/wine etc consumed, reaction to food and other pre-existing medical conditions.

From an experiment I ran in the past, a bottle of wine (12.5% proof) gave a systolic rise of 5 points after eight hours sleep , diastolic increase was no more than 2 points off of "normal".

Even if you allow for a percentage increase in response to a night on the sauce of say 10% rise, a BP of 190 systolic is still bad news Roderick.

Five minute BP risk/review.

Some thoughts for futher reading:

Chart showing effect of low/high salt in diet.

Food and Health web site talking about salt.

Diastolic BP vs increased death rate.

Systolic 180 mm Hg or higher

Diastolic 110 mm Hg or higher

BP Rating: Critical High/dangerous.

Action required: Medication essential, close monitoring needed.

[ProThaiExpat]

roderick17: There are studies that have proved that alcohol, in and of itself raised anxiety levels and as lopburi3 has posted, stress and anxiety raise blood pressure.

In other words, if you have an anxiety level of 5 on a scale of 1 to 10 when you start to drink, without any additional stress factors or anxiety factors being added, when you sober up, your stress or anxiety level will probably be 7. Those that drink to relieve stress and anxiety only succeed in raising the level of their stress and anxiety by their drinking.

[Sheryl]

Regardless of what caused it, a systolic BP of 190 is dangerous.

What is your BP normally? Are you on medication?

Need to refrain from doing whatever seems to trigger such high pressures and also possibly go on meds.....

[roderick17]

Hi Sheryl

I think I mentioned in my previous post, that I went into Hospital for an entirely different - and rather trivial - reason. When I arrived at the clinic, a nurse took my blood pressure reading as a routine check-up before shunting me into see the Doctor. I guess the main reason for this worrying reading is my lifestyle. I work in a stressfull job, I am a lttle overweight, I'm getting on a bit ( yesterdayI reached 57 years young ) and my exercise regime is minimal. Unfortunately, I can blame no-one else for the predicament that I now face. In his later years, my Dad suffered with blood pressure but then again he lived life to the full, well into his 80's. I guess I thought that I'd folllow a similar ageing path to him. Perhaps Not !!!

The doctor at the hospital in Udon Thani, gave me feldopine ( in 5mg tablet form ) and a direuetic to take daily, for the next 30 days. He also mentioned quite casually that I should come back in 30 days for another check-up and to replenish my drug supply. I thought he was quite laid back about it all, then again, perhaps it was my misuderstanding of his Thai and his confusion with my English !

In the next couple of days, I plan on flying down to Bangkok ( I live in Vientaine) and visiting Bumgramd Hospital to get their take on my parlous condition. As I haven't been through such a medical examintion before , how long is this medical testing and evaluation program likely to take ? After the examination will they chart out a rehabiliation program for me ? If so, how long is it likelly to take to stabalize my problem and to see any immediate improvement to reduce the risk I am now grappling with ? What is the treatment program likely to entail? Will the time-frame for the recovery program be measured in days, weeks, months or years before my condition is brought under some sort of control ?

Another question that has been worrying me is whether it will be possible to make any significant recover anyway given such a high reading in the first place?

If I take a positive spin on the last question -and an effective treatment is possible - is it likely that I would be able to continue sauntering around my office for a while or is work as I now know it come to a complete end for me ??

Sorry for all these difficult questions, but they are an expression of the anxiety and concern that I am feeling at the moment. I'd really appreciate any further insights you can pass onto me

Thanks heaps

Roderick

Regardless of what caused it, a systolic BP of 190 is dangerous.

What is your BP normally? Are you on medication?

Need to refrain from doing whatever seems to trigger such high pressures and also possibly go on meds.....

[Sheryl]

Roderick,

First of all, relax...with proper medical care you should be able to carry on with normal life and work just fine, and no great amount of time is required if all that is wrong is hypertension.

However I am afraid you overestimate the extent of concern and investigation you are likely to get from most doctors. Unless you take the initiative and ask for it, the vast majority are going to spend just a very short time with you and write a prescription and that's it, more or less the kind of response you got in Udon Thani.

At your age, with your risk factors and with high BP, most definitely you should start with a comprehensive physical exam. Bumrungrad would not be my recommendation for that -- they do all the tests OK but I have found that despuite all the glitz, the phsician analysis of the results is quite superficial, and you need someone to really take the time to listen to and think over your history and review the test results in depth with you. For this, the best I have found so far is Samitivej, ask for Dr. Anchalee or Anchanee (I forget which is her name, one of those...the nurses will know). I find her very thorough, good, and enthusiastic -- she takes the time to thoroughly explain all the findings to the patient and also give counselling on any life-style changes indicate. She does tend to talk fast, which is fine for me because as a nurse I usually know what she's going to say anyhow, but you may need to ask her to slow down or repeat a bit.

Wherever you go, it will be up to you to decide what tests you are having, sorry to say. They will show you a menu of check-up packages (to which specific tests can be added on). Choose a higher end package intended for older men that includes echocardiogram and stress test as well as prostate check (manual and PSA blood test). Costs more but worth it at least every couple of years.

Don't eat or drink anything and don't take any medication either un til after the tests (some medications throw off the stress test) and be sure they know all the meds you are on and when you last had them when they do the stress test.

I'm urging the full works of tests as it sounds like you haven't had them, at least not recently. Better safe than sorry.

After you have the results, see an appropriate specialist. If nothing comes back seriously abnormal but the BP then an internist is sufficient. Can ask the doc who does the physical to recommend one, specifying someone trained in a western country and preferrably board certified in one (you can also examine the website to review doctor qualifications yourself).

Then discuss what medication regimen is best for you with the specialist. For which I suggest you read up a bit first. With chronic health problems especiallym you need to play a very active role in your own treatment. Proactive in fact. As you have already nioted, doctors in Thailand are unduly laid-back, perhaps because there is not the concern about malpractice suits here that there is in the West...and also just the Thai culture. Anyhow, no matter what country you are in or how good a doctor you find, no one has more stake in your health than you and no one knows your body as intimately as you do.

With chronic problems like hypertension it is worthwhile to talk the time to find a doctor you are really comfortable with, and living as you do in Ventiane, it needs to be someone who really takes an interest and is willing to be called or emailed for advice if necessary.

But regardless of how good a doctor you get, you should look up whatever meds you are on to be sure you know the side effects and any interactions with other meds (you may be able to get a package inserty with this information from the pharmacist, otherwise go online), and of course you will need to monitor your BP.

Good luck

[roderick17]

Hi Sheryl

Thank you indeed for your helpful and uplifting comment. You are right, the first step in my treatment program is to embrace a positive attitude. Starting tomorrow, this is exactly what I will do !!! Tonight though -I feel depressed- tomorrow will be a better day after I think through your commentary.

I had planned to go down to Bumgramnd Hospital, but I am now more inclined to go to Samitive and ask for the medical people that you mention I have another problem though, I tried to find Samitive Hospital using Google, but couldn't turn up the URL for that place. Do you have any contact details - a phone number, email address or something else I could use to contact them

Thanks again. I really do appreciate the really helpful comments you made in responding to my message

Roderick

[Sheryl]

http://www.samitivej.co.th/sukhumvit/aboutus_en.aspx

Samitivej Hospital (Sukhumvit)

133 Sukhumvit 49, Klongtan Nua

Vadhana, Bangkok 10110

Tel: +66(0)2711-8000

Fax: 662(0)2391-1290

Email: [email protected]

International Service: [email protected]

On this web site, to find a good internist, click on "find a doctor"and then put specialty internal medicine language english. You'll get a list of 80 doctors, which is why I didn't have time to go through and find one to recommend for you. But if you go through this list one by one clicking to see the details, look for someone board certified in the west (or at least having done a fellowship there) with special interest in hypertension and/or cardiovascular disease.

Take care

Edited May 10, 2007 by Sheryl

[Mossfinn]

Well this thread (plus the fact that I am supposed to be working in something else thast is already overdue!) piqued my interest enough to finally get around to reading the Lancet article which is what set off all the flap about atenolol and beta blockers for hypertension.

What the article actually says is that they(Beta Blockers, of which atenolol is probably the most widely prescribed) were found not to reduce the risk of stroke as much as other classes of drugs did, although they did reduce the risk when compared to no treatment. They were equally effective with regard to reducing heart attacks and overall mortality. It is not clear whether this is just because they are not as effective in regulating the BP (either because they don't work as well or because people are less compliant with them), in which case the slight risk would apply only to people whose BP wasn't well controlled, or whether there is something else at play.

Hi Sheryl,

In the time that this thread has been dead, I did not know you had answered the reason for the, 'flap', regarding Atenolol, but have often wondered for the reason why it caused a stir at the time, perhaps I should have continued to read the thread to the end.

Anyway, having seen a Registrar yesterday, over a suspected return of my T.B, and other related aspects, he has recommended I go back on Atenolol, I said I was taken off that med because of the scare some time ago. He looked to the Heavens and without actually saying so, was discrediting the research, he said it was based on what is called Meta data, an amalgam of several research papers, going over a number of past years.

He thought it was more to do with better detection and treatment analysis rather than an out dated drug, why pressure was put on to take this off as a first choice med and to go for more expensive newer drugs, he also mentioned the incentives that might be used to sway a buyers attention away from the drug.

He then went to prescribe, 'Atenolol or beta blocker of similar capability of the GP's choice', just in case he was stilled swayed by the media and sales personnel, I feel I will insist on it.

But you said this and more over a year ago, I wish I had kept reading the thread

Moss

[billd766]

About 18 months ago I was working in Bangladesh, drank a bit too much one night, fell over and bashed my ribs on a chair.

Four days later it still hurt so I went to hospital where the doctor said my ribs were OK but "did you know" that an artery was partly blocked. Er no I didn't but as I was coming home in a week I waited until I got to Bangkok and went into Bumrungrad for a full check up.

At this time and 62 years old I had no idea of any problems and put down the fact that I was too fat as the cause of tiredness and heavy breathing.

I was then about 125kg and far to fat and not exercising at all. I got the price of an angioplasty from them and looked at other hospitals before choosing the Bangkok International Heart hospital off New Petchburi road in Bangkok.

I was staying with friends and my wife and son came down from up country to be with me.

My surgeon/consultant at the hospital was Dr Wiyaya Jongsupangkarat and on the morning of the operation after injecting the dye he casually said "did you know that you have two partly blocked arteries on the left sideand would you like both done at the same time"? Er no I didn't and while I am lying here shaved and naked you might just as well.

Any way he did a good job and I had to go for weekkly then monthly then 3 monthly check ups and I am OK now.

3 months ago I bought a microlife arm cuff blood pressure tester and I regularly take my blood pressure. This morning it was 115/72 with a pulse of 88 and the average for this month is 113/74 and a pulse of 85.

I also lost 19kg but iI have put 7 kg back on and only exercise a little.

I am on 1/2 tablet of Co-diovan a nd 1 of Dilatrend in the morning and 1 tablet each of Orafin and Bestatin at night as recommneded by Dr Witaya.

I was lucky.

I hope that Thaipauly has sorted his blood pressure out.

[moldy]

By the way, it is proven than ones anxiety level can cause increases in blood pressure and it is further documented that alcohol injestion will, in and of itself, raise anxiety levels. Example, if your at an anxiety level of 4 when you start to drink to "relax", when the alcohol effect dissappates, your anxiety level with be higher, 5 or 6 on the same scale. There are studies that support a glass of while a day for those with heart conditions, not those with blood pressure problems.

A few years ago I bought one of those wrist BP machines (after getting 'high' readings in doctors surgeries and waiting rooms) and found that over a month my readings were generally less than 140/90.

The 'worry' I have is that a few times I tested myself shortly after drinking alcohol (multiple units!) my readings dropped like a stone to approx. less than 100/75. Should I be worried about this? (My father has low blood pressure but is 90 years old).

Just glancing around the web sites of major health bureaus around the globe there seems to be a disparity between what each regards as a normal healthy pressure reading, but it seems to be lower than 140/90 on the UK National health site, which also goes on to mention that it aint as simple as that.

Anyway have a glance yourselves, the info is there if you like to search. I don't like to leave links except for breaking news or emergencies.

High blood pressure is a blood pressure that is 140/90 mmHg or above each time it is taken. That is, the blood pressure is 'sustained' at 140/90 mmHg or above. High blood pressure can be:

• just a high systolic pressure, for example, 170/70 mmHg.
  
• just a high diastolic pressure, for example, 120/104 mmHg.
  
• or both, for example, 170/110 mmHg.
  

However, it is not quite as simple as this. Depending on various factors, the level at which blood pressure is considered high enough to be treated with medication can vary from person to person.

Blood pressure of 160/100 mmHg or above

This is definitely high. All people with a blood pressure that stays at this level are usually offered medication to lower it (described later).

Blood pressure of 140/90 mmHg or above but below 160/100 mmHg

This is sometimes called 'mild' high blood pressure. Ideally, it should be lower than this but for many people the risk from mild high blood pressure is small, and drug treatment is not indicated. However, certain groups of people with blood pressure in this range are advised medication to lower it. These are people with:

• a high risk of developing cardiovascular diseases (see below), or
  
• an existing cardiovascular disease (see below), or
  
• diabetes, or
  
• damage to the heart or kidney (organ damage) due to high blood pressure.
  

Blood pressure between 130/80 and 140/90 mmHg

For most people this level is fine. However, current UK guidelines suggest that this level is too high for certain groups of people. Treatment to lower your blood pressure if it is 130/80 mmHg or higher may be considered if you:

• Have developed a complication of diabetes, especially kidney problems.
  
• Have had a serious cardiovascular event such as a heart attack, TIA or stroke.
  
• Have certain chronic (ongoing) kidney diseases.
  

Quite where one poster got a figure of high blood pressure being above 120 I don't know- that kind of condemns most over 30 years old I'd guess.

[moldy]

Actually a systolic of 120 and a diastolic of 80 are considered normal (120/80) New studies show 115/75 to be perfect (though most people don't have that).

Do you mean normal or ideal?

Mine was recently taken at Rama 9 hospital. It was 121/60 and the nurse smiled and said fine. But 60 seems much lower than the 80 often quoted as ideal. Should I be concerned?

[Sheryl]

Not at all. Anywhere 60-90 is fine for the bottom (diastolic) number, altho some groups of people will do better not to exceed 80.

Keep in mind that BPs vary from moment to moment, they are not a fixed figure. Temporary spikes -- especially under stress -- are of no importance as long as your normal resting pressure stays somewhere blow in the ranges mentioned in post#77.

dregarding the lower limits, although generally cited as 90 for the systolic (top number) and 60 for the bottom (diastolic), it is not unusual for these to be as low as 80 and 50 respectively in a perfectly healthy person. Unlike high blood pressure, which can occur independent of other diseases ("primary hypertension"), low blood pressure as a pathological state is virtually always a symptom of something else, e.g. shock, dehydration etc. In other words, as long as you feel well and have no symptoms, there is no need to worry about "low"BP.

[mikethevigoman]

OK, I know its the festive season and we al overdo it...but I have just checked my blood preesure and it is reading 164/96.

That is way higher than any previous reading I have taken

Is that level dangerous, or will it come down normally after I stop "overdoing it" as I am now with all my family here.

Thanks

TP

keep your eye on it, i was 200/98 at my highest, no symptoms of anything really, thats the scary part, if untreated you can have a stroke and all sorts of problems, cut out on salt for a start, keep it monitered,( the bp ) im on 2 pills a day now probably for the rest of my life, stress is the biggest culprit, smoking is also a problem,

[moldy]

Not at all. Anywhere 60-90 is fine for the bottom (diastolic) number, altho some groups of people will do better not to exceed 80.

Keep in mind that BPs vary from moment to moment, they are not a fixed figure. Temporary spikes -- especially under stress -- are of no importance as long as your normal resting pressure stays somewhere blow in the ranges mentioned in post#77.

dregarding the lower limits, although generally cited as 90 for the systolic (top number) and 60 for the bottom (diastolic), it is not unusual for these to be as low as 80 and 50 respectively in a perfectly healthy person. Unlike high blood pressure, which can occur independent of other diseases ("primary hypertension"), low blood pressure as a pathological state is virtually always a symptom of something else, e.g. shock, dehydration etc. In other words, as long as you feel well and have no symptoms, there is no need to worry about "low"BP.

Thanks for the info. Clearly, this is one area where really reliable interpretation of figures is best left to a health professional as there seems to be a wide diversity of numbers that may be considered normal at any one time and from person to person.

[Wrong Turn]

The human autonomic nervous system (ANS) which controls blood pressure (BP) is a highly sensitive machine. Doctors love to prescribe drugs against high BP but it is actually much much better to change your lifestyle - more exercise, better eating (and drinking) habits, cut smoking, etc. than to use drugs.

I've read this thread and understand that:

More exercise

Better eating and drinking habits

Quitting smoking can help lower BP.

Question:

Are there any specific foods that help lower Blood Pressure?

[agudbuk]

Anyone know what the prices over the counter in Thailand are for the following?

Coversylplus ( Perindopril + Indapamide)

Felodipine

Lipitor

[moldy]

By the way, it is proven than ones anxiety level can cause increases in blood pressure and it is further documented that alcohol injestion will, in and of itself, raise anxiety levels. Example, if your at an anxiety level of 4 when you start to drink to "relax", when the alcohol effect dissappates, your anxiety level with be higher, 5 or 6 on the same scale. There are studies that support a glass of while a day for those with heart conditions, not those with blood pressure problems.

A few years ago I bought one of those wrist BP machines (after getting 'high' readings in doctors surgeries and waiting rooms) and found that over a month my readings were generally less than 140/90.

The 'worry' I have is that a few times I tested myself shortly after drinking alcohol (multiple units!) my readings dropped like a stone to approx. less than 100/75. Should I be worried about this? (My father has low blood pressure but is 90 years old).

I think there are dangers in testing yourself and it's not a practice I'd suggest doing. The alcohol would have dehydrated you for sure which as we've discovered is a factor here. The effect, you worry probably without cause.

[moldy]

By the way, it is proven than ones anxiety level can cause increases in blood pressure and it is further documented that alcohol injestion will, in and of itself, raise anxiety levels. Example, if your at an anxiety level of 4 when you start to drink to "relax", when the alcohol effect dissappates, your anxiety level with be higher, 5 or 6 on the same scale. There are studies that support a glass of while a day for those with heart conditions, not those with blood pressure problems.

A few years ago I bought one of those wrist BP machines (after getting 'high' readings in doctors surgeries and waiting rooms) and found that over a month my readings were generally less than 140/90.

The 'worry' I have is that a few times I tested myself shortly after drinking alcohol (multiple units!) my readings dropped like a stone to approx. less than 100/75. Should I be worried about this? (My father has low blood pressure but is 90 years old).

I think there are dangers in testing yourself and it's not a practice I'd suggest doing. The alcohol would have dehydrated you for sure which as we've discovered is a factor here. The effect, you worry probably without cause.

Your posting suggests that whilst in the surgery environment you tend to test a little on the high side. This could be white coat syndrome, ie, the test makes you anxious and as a result your BP goes up. I had a friend in a similar position and so too my mother to a lesser extent. But it must be pointed out that it could also be an accurate reading, in which case you really should listen to a doctor's advice. I imagine a reduction could be effected by regular exercise and watching what you do or don't do, as it's likely your BP is pretty much in the norm.

[Wrong Turn]

I hope it's OK to post this cut and paste. Posters on the topic of BP, seem very well informed, but here's a snippet:

What Is High Blood Pressure (HBP)

And Why Is It Dangerous?

Blood pressure is the force your blood exerts on your arteries as it flows through your body. If you have high blood pressure it means that your blood is exerting too much force on your arteries and is making your heart's job--pumping blood--more difficult than it should be.

Now, your heart is a powerful and efficient muscle, but if it's forced to work too hard for too long it can enlarge, wear out or fail, causing a heart attack, stroke, aneurysm... and an early death.

When you have your blood pressure taken, you're given two numbers referred to as your Systolic and Diastolic blood pressure.

Your Systolic blood pressure is the measurement of the pressure your blood exerts on your arteries when your heart beats, while your Diastolic blood pressure is the measurement of the pressure your blood exerts on your arteries when your heart is at rest.

What's The Difference Between Normal Blood Pressure and High Blood Pressure?

For an average adult:

Blood Pressure Stage Systolic Diastolic

Normal <120 <80

Pre-Hypertension 120-139 80-99

Stage One Hypertension 140-159 90-99

Stage Two Hypertension 160+ 100+

If your blood pressure consistently reads in the Hypertension or Pre-hypertension categories, then you need to take immediate and lasting action if you want to live a long and healthy life.

According to the American Heart Association, about 65 Million Americans over the age of 20 have high blood pressure. That's about one in three adults.

In 2003 more than 52,000 Americans died from complications related to high blood pressure. Between 1993 and 2004 the rate of death from high blood pressure rose nearly 30 percent.

[moldy]

I hope it's OK to post this cut and paste. Posters on the topic of BP, seem very well informed, but here's a snippet:

What Is High Blood Pressure (HBP)

And Why Is It Dangerous?

Blood pressure is the force your blood exerts on your arteries as it flows through your body. If you have high blood pressure it means that your blood is exerting too much force on your arteries and is making your heart's job--pumping blood--more difficult than it should be.

Now, your heart is a powerful and efficient muscle, but if it's forced to work too hard for too long it can enlarge, wear out or fail, causing a heart attack, stroke, aneurysm... and an early death.

When you have your blood pressure taken, you're given two numbers referred to as your Systolic and Diastolic blood pressure.

Your Systolic blood pressure is the measurement of the pressure your blood exerts on your arteries when your heart beats, while your Diastolic blood pressure is the measurement of the pressure your blood exerts on your arteries when your heart is at rest.

What's The Difference Between Normal Blood Pressure and High Blood Pressure?

For an average adult:

Blood Pressure Stage Systolic Diastolic

Normal <120 <80

Pre-Hypertension 120-139 80-99

Stage One Hypertension 140-159 90-99

Stage Two Hypertension 160+ 100+

If your blood pressure consistently reads in the Hypertension or Pre-hypertension categories, then you need to take immediate and lasting action if you want to live a long and healthy life.

According to the American Heart Association, about 65 Million Americans over the age of 20 have high blood pressure. That's about one in three adults.

In 2003 more than 52,000 Americans died from complications related to high blood pressure. Between 1993 and 2004 the rate of death from high blood pressure rose nearly 30 percent.

about 65 Million Americans over the age of 20 have high blood pressure. That's about one in three adults.

Well they would do judging by this table. This is the first time I have heard someone with 130/80 being described as pre hypertension. Only in America I guess, and literally only in America too. What happened did they run out of sick people or something?

[ignoramus]

Night testing of BP, Salt, and dark chocolate, etcetera (quoted studies).

Australian site; abc.net.au. Look for the word health, then go to Health Minutes.

I have no opinion about too much salt, but if you are worried about having too much then extra potassium apparently is the go....as I am lead to understand (let this constitute a disclaimer, dear reader).

[On a slightly mischievous note, I am dead curious about how one manages to be overweight in Thailand. I do not expect to be enlightened).

[Oh, and in the name of information dissemination...and free speech...thincs.org may or may not be of interest to s/he who is overly worried about his/her cholesterol level].

(I had/have high BP).

[Wrong Turn]

I have no opinion about too much salt, but if you are worried about having too much then extra potassium apparently is the go....as I am lead to understand (let this constitute a disclaimer....

I don't have a link for the following statement, so apologies.

Bananas do have lots of Potassium, and help the Potassim : Sodium, ratio.

A person with high BP or a family history of high BP cannot go wrong with eating a banana a day with breakfast. Bananas also raise HDL (good) cholesterol and lower LDL (bad) cholesterol.

[moldy]

[On a slightly mischievous note, I am dead curious about how one manages to be overweight in Thailand. I do not expect to be enlightened).

Steel plated reinforced stomach lining, horse steroids, and crouching inside a refrigerator might add a couple of kilos.

Good banana tip, think I'll give it whirl.

My BP keeps going down, think it must be tracking the stock market.