High Blood Pressure: How do you figure out the cause?

Hi, @gcranor. I'm a decades long hypertensive individual, age 86 now, and I have had a lot of experience with medical care for the condition over the years -- mostly with medications (a dozen or more different ones). Here are some things I learned (I'll tell you more if you are interested):

First, my cardiologists treated me with the usual medications -- diuretics and calcium channel blockers. Neither of the medicines or the medical specialty of cardiology solved my problem. My HMO urged me to get diagnosis from a nephrologist, a kidney doctor, on the basis of the fact that kidneys and their jockeys, the adrenal glands, are more responsible for hypertension. My switch occurred after we (my medical team and I) tried a half-dozen different medications to little avail. After 10 years with a nephrologist heading my medical team, I'm still here, under different medication, and with diet and behavioral instructions that keep me focused and healthy. And my nephrologist deserves all the credit for relentlessly studying me until she found an inherited kidney problem that contributed to the other symptoms. She partnered with an endocrinologist to conduct the extensive research that tracked down the causes and the treatments for my disease.

Second, I could not have survived without my medical team. It was crucial for us to scope out the foundation for my problem, because treating it depends on concrete and comprehensive understanding of what's wrong with me. As medical tests provide more information over time, it's vital to know where I came from, what changed, and what caused the changes. That led to totally logical therapies, some of which worked better than others.

Third, after 30 years of therapy, cardiologists were added back into my medical team, because I developed Atrial Fibrillation, a heart rhythm problem that sometimes allows blood to hang around in an upper chamber of the heart -- long enough to turn out small clots. One of those clots traveled to my brain and blocked a small area, causing a small stroke, the impact of which is still with me but not with extensive problems. Given the brain involvement, though, a neurologist is also a member of my team now, and that has helped me deal with relatively minor nerve problems elsewhere in my body.

I hope you can see some indications in my experiences of what might be helpful to you. I'll be pleased to communicate further with you if you have any questions and think I could help. Martin

You should talk to your provider about the change. There could be many reasons (weight gain, stress, increased salt, change in a medication or supplement, etc…) but could be an underlying medical problem. Do not ignore. Ignoring it can lead to other problems.

You are correct to record your blood pressure, because that is first thing they will ask.
Make sure record date, time, which arm, blood pressure reading and notes about anything that you thing maybe effecting pressure. Some websites suggest measuring blood pressure in both arms.

Is there a chance that your home blood pressure machine is inaccurate or has changed? Is there some place local that does free blood pressure checks? Then can compare your machine to another. I have a blood pressure check with nurse this week and they suggested bring my home monitor with to compare readings.

Do you have ability to send message to provider or nurse to ask about the change without traveling to an appointment?

Laurie

From my own experience as a patient, take your blood pressure monitor with you to the pharmacy or doctor’s office and have them check your monitor for accuracy. To do this you will take your blood pressure on your monitor and they will also take your blood pressure on their monitor. Once you have found that your monitor is accurate (buy a new one if not), watch your salt intake. Keep taking your blood pressure regularly to see if this helps. To lower your salt intake learn to read labels for hidden salt. You can also take your blood pressure every day but at different times to study the effect of work and stress on your pressures. Ask your doctor what your blood pressure limit should be. If your readings are over that limit then get an appointment. Most people are having to wait longer now for appointments. You can use that time to take regular blood pressure readings which you will bring with you to the doctor’s office. If you lower your salt intake that will show up on the blood tests that the doctor will probably order.

Thank yoy

During a out patient procedure is where they discovered 152, since then my daily average 149 except yesterday which was back to normal 125.

Martin, you are an inspiration to us. What BP meds have you found worked best for you.?

Hi @sallie70. Right now, for hypertension I'm on Coreg beta blocker, Amiloride diuretic, Lisinopril (an ACE inhibitor for my kidneys), and Hydralazine (a vasodilator to relax my arteries). This morning, my BP read 120/80 for the first time in many years! A couple of other meds work well but had to be dropped because of other symptoms that need focused treatment. Spironolactone and Eplerenone side effects might cause me trouble due to a rare genetic tendency (Gynecomastia inherited from my father).

I know what you mean about side effects, etc. I take Telmisarten 80 mg (ACE competitor) and Bystolic 5 mg. Those work well unless I take even one ibuprofen, which I do when I play a tennis match (I’m 70 so…) and then my BP shoots up to about 140/90. So in a week I take 3 tablets but I know I shouldn’t because my eGFR is below what it should be. I’ve got an appointment with a nephrologist soon. Hopefully, we can figure out how to manage all the drugs I take, including Crestor, which can be hard on the kidneys.

Martin, thanks for sharing 🙂

Hi all you blood pressure people. I'm part of the group. A major problem that I find is not the medicines. There are many to be tried. It's the fact that the group of doctors caring for the patient don't speak to each other periodically. Then, the patient becomes the information conduit. This doesn't seem right to me. If you have a blood pressure problem and your medicines aren't working, the physicians should be contacting each other. I realize that the
past two Covid years are not normal years. Howwever, the health of the each patient regardless of his or her or their Covid status remains vital. Texting, faxing, phoning reports once every few months should be part of the treatment. However, I've found it isn't. So, right now, unless you're very fortunate,
you're the messenger. A pain, I know. Each of your doctors needs to know what's happening. In other words, I'm talking about a team. Team medicine
doesn't seem to exist in America anymore except at major hospital centers. Don't understand this. Wish you the best. You're on your own like most of
us. Hope you do well.

I am 87. Suffering from high BP for a long time. As a marginal case of BP, the doctor prescribed a limited dose of medication. Additionally, I used to walk daily and practiced breathing control regularly. It worked till recently.
On the 29th of Dec.2021. I was admitted to the hospital for 3 days as a patient of Covid-19. I am now back home and recovering.
Till Last week my BP remained as high as 150 to 160. I have been taking the prescribed medication regularly.
As soon as I gained some physical strength. I have started walking inside the house. In addition, I am following the breathing control techniques. it
has brought down the high BP level within the range of 130/140.
I think physical activity and breathing control techniques are effective in case of high BP patients