Wow... I can't believe this but I basically spent the past day or so going through every post in this thread. Thank you to all who have contributed and provided such amazing detail and insight.

44yo male here was at 240lbs but now at around 200lbs, aiming for 180lbs where I was in my 30s.

In my case, I started having high blood pressure readings at doctor appointments starting about 4 years ago, hypertensive around 130-140/85-90, with some readings going as high as 150 systolic. The problem I face is that I have an Omron wrist cuff here at home and it usually reads normal around 120-125/80-85. So I am not sure if there is some form of anxiety that occurs at the clinic, but that appears to be adding to my dilemma here.

Anyways, six months ago I wanted to have "insurance" on my weight loss regimen to help with my efforts in case I was unsuccessful. Part of my freakout was that I was starting to score high BP readings at home with my Omron wrist cuff. I was prescribed Metoprolol Succinate ER 25 MG for once in the morning. In hindsight, I made a mistake as I was able to lose weight and get into a good running routine with a treadmill that I purchased when the pandemic hit.

About 3 months in, my BP was fantastic with Omron measurements, hitting consistently 100-110/65-70. This was actually TOO good for me, so I decided to ween off the "insurance" (Metoprolol) and started at 12.5 for a few days and then stopped taking it altogether. I've had no side effects w/ Metoprolol btw, only that I feel it makes me tired if I do not get a good night's sleep and it makes me take additional naps during the day.

After weening off Metoprolol, I had no side effects and my BP stayed the same: 110/70 @ 45-55bpms. Unfortunately, I did strain a hamstring and that's where everything got a little crazy for me. I ended up not working out as much and I started to freak out and ended up starting Metoprolol again about 2 weeks ago to make sure my BP was controlled while I was not working out as much. Probably not necessary but again, see: freak out.

When I made the appointment six months ago for my "insurance," my doctor wanted me to return in six months to check back in with how I was doing with Metoprolol. For those paying attention, that makes this week that six-month point. I had that appointment on Tuesday and that's part of the reason why I am here even reading this thread. The appointment was shocking. I took my BP before I left home and it was 107/63 @ 70bpms (this is on Metoprolol). However, at the clinic, it was 160/82! They did a subsequent reading (after I had "settled in") that was 155/90.

I am not sure if it's that machine or what it is. I simply do not score well with these new fancy automated BP machines but with the wrist cuff at home, I am scoring what seems to be very healthy/normal. I would love to see how I do with the old-school cuff with a squish-pump at the clinic, but alas these new automated machines are all they have now. One thought I have about this is that I do not talk as much at home, where I work, and am mostly "in my head" as a software engineer. So, talking and describing things is "different" from my typical schedule and is a "stressful" event, for lack of a better expression, leading to high BP. Also, at the clinic, it seems that BP is taken after a long bout of talking about things, where I am usually animated (talking with hands, etc), and I can tell that I am a bit elevated.

Anyway, I am in a bind now. My doctor has me returning in a few weeks for a BP clinic with the nurse, where I will basically get a BP reading, hopefully without any sort of hand-waving and song+dance. I told her about stopping Metoprolol and then starting it up again, and she was not a fan of that. Basically, you can worsen or invoke afib, is what she said. To be sure, I do not have afib but do get PACs. Another interesting note is that she said that these are ER tabs and that by breaking them in half that ruins the "seal" around them that makes them ER. But, I don't get that as the pills themselves have a crease in the middle, basically asking to be broken.

As I mentioned, I do get PACs, they started a little before the time that I started getting my high BP readings, about five years ago I want to say. I've noticed that Metoprolol makes them less frequent, and when they do occur they are less intense.

Regardless, I would like not to be on a daily chemical if I can help it. My plan right now is to lose another 20lbs to get me to 180lbs and see how things are then. After this BP clinic in two weeks, I have another follow up in 3 months with my doctor discuss. I plan on taking Metoprolol during this time, but would like to ween off of it if I do not need the "insurance." Having wild, inconsistent BP readings through all of this does not help with my stress! I am almost wanting to purchase another wrist cuff to confirm any sanity present.