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Forum Name: Hypertension

Question: pre hypertension, causes?


 sop22 - Fri Oct 05, 2007 7:17 am

Hello, im curious. for the past probably 3/4 months i have been having to check my BP at home, it is consistantly about 135/85, it only ever goes as low as 135/80 i never used to have this problem, whenever i had my pill check up i would always be smack bang in the middle of the ideal range. im only 22, don't drink alcohol, of caffeine, infact i mostly drink water, i don't smoke, never have. the only thing is ive been less active and a bit depressed this past 6 months. but i didnt think stress could be the actual cause of this?
the doctors don't seem concerned by this, but i am!
i know i have put on weight this past year, but im only slighly in the overweight range, my BMI needs to go down probably 2 points if not 3/4 to be excellent. But would this cause it?
i was wondering about cholesterol? i do eat oily fish often and try to eat fruits and veg every day, probably could do witha bit more.
can the pre hypertension range over time have a bad effect on the heart? and if so how long would it have to be like this before it did?
 sop22 - Fri Oct 05, 2007 7:26 am

edit - like i just took it it is 144/72 - why the big difference?
and my beats per minute is 91, im only sat here watching tv. its the beats per minute that bothe rme actually :(
 Parks P, RN - Mon Nov 24, 2008 4:17 pm

User avatar Hello, First off let me say that Stress, inactivity, and being overweight all contribute to hypertension. At your age though having high BP already makes me think you may be genetically predisposed to hypertension. The variance in blood pressure you are having is known as labile blood pressure. I am glad to see you are concerned, I believe people should be health advocates for themselves bravo! Believe it or not although fish oils are very good for the heart they can cause high blood pressure in some people(many studies). I would first start with some walking, this will help your depression and blood pressure. If blood pressure remains elevated over a long period of time years of uncontrolled blood pressure stretch the heart muscle out and make it weak a condition known as LVH left ventricular hypertrophy and also kidney problems/failure. So if you can, walk and keep an eye on your BP if it does not come down after a month or 2 follow up with the doctor and say it did not come down with exercise and weight loss.

Good Luck,

Paul
 Dr. Ramy M. El-Helw - Mon Dec 15, 2008 2:33 pm

I don’t think you should be overly worried. In my years of experience I have noticed that patients pulse are elevated when they are being administered their bp test and pulse rate. For some reason people tend to get a little nervous and this causes a spike in their pulse.

You have been stressed and this is a good reason or atleast part of the reason why there might be weight gain and increased bp along with it. This is something you should pay attention to. If left ignored may result in heart complications down the road.

My advice is that you establish good eating habits. Fish is a fantastic source of nutrition and actually is great for your heart’s health. But t0o much of fish is not good for reasons such as excessive mercury consumption depending on the type of fish you eat. The rule of thumb is, the larger and older the fish, the more its flesh is contaminated with mercury.

After establishing a proper diet, exercise is the best method to help with your depression, and of course will aid in helping you shed of those extra couple of pounds and even bring your blood pressure to where it should be.

Dr. Ramy M. El-Helw
 Aardvarkyan - Fri Jan 09, 2009 5:23 pm

Hello, I was attracted to this topic, because I too have elevated bp and often wonder about its causes and my risks for heart and circulatory diseases as I age. I read as much as I can online, probably too much, but I have recently learned that there is a correlation between something called "hs-CRP," which is a marker in blood for one's risk of these diseases, such as stroke, athereosclerosis, or congestive heart failure. The marker, hs-CRP, is known to be associated with inflammation processes, and seems to be caused by them.

The literaure on this marker is confusing to me, because it seems to say hs-CRP is only a RESULT of these disease states even in their very early stages, but other articles seem to be indicating that the mere presence of hs-CRP COULD be the causative agent. If the latter hypothesis, hs-CRP as causative agent, is correct, that would mean that any irritant or activity that causes chronic inflammation could cause high bp and other conditions related to heart disease. Would this suggest that a reversal of high bp could be affected favorably by eliminating physical activities that cause irritation? Could eliminating certain allergens from one's diet reduce chronic allergic-related irritation and thus lower the concentration of hs-CRP? Logically, this might cause lower hs-CRP => lower bp, etc?

I'd appreciate clarification on this subject, and if there are any sound clinical studies addressing this issue involving hs-CRP?

Thanks.
 John Kenyon, CNA - Sun Jan 11, 2009 9:15 pm

User avatar Hello -

There are two problems which cause confusion regarding the meaning of rs-CRP levels: the first is semantic; the second is that your question hasn't been fully answered as yet.

So far, rs-CRP is regarded as a marker, only, for inflammation. The fact that inflammation in one part of the body can sometimes find it's way to other parts (and our concern here is when it finds its way into the lumens of coronary arteries). Since, for example, inflammation of one's gums can be directly traced to inflammation of coronary arteries (even if it is caused by bacterial infection), this causes the subject's CRP levels to go up and definitely places the patient at higher risk of cardiovascular disease.

What remains to be determined is whether this CRP molecule actually plays a role in inflammation, and if elimination of it could eliminate inflammation, is still open to debate and, more importantly, research. There are studies in progress right now to try and determine this. However, until the "truth" changes, rs-CRP is "merely" a marker for inflammation in the body, and chronic inflammation anywhere is believed to place one at a greater risk of CAD.

That being said, your question about eliminating as many forms of inflammation as possible as a potential means to avoid CAD doesn't apply -- yet, anyway -- because much of the sort of inflammation we endure normally is transient and localized. Allergies, for instance, are usually localized and even when an allergic reaction goes systemwide, it's usually a transient event, as either it gets better or the patient dies from anaphylaxis. There are some sorts of inflammation, mostly rheumatoid (which may be viral in origin anyway), that are implicated in the formation of CAD lesions. This isn't likely because of the presensce of rs-CRP so much as the thing that causes it to form. The inflammation is the end product of a process, perhaps always viral (it will be some time before we know the answer to this and other questions), so for now rs-CRP may be regarded as a sign that there is something going on somewhere, perhaps dormant, but inflammatory in nature, which could "blossom" as heart disease first, before it shows up in any other body system.

I hope this helps clarify, for now at least, what rs-CRP is believed to represent, and therefore answers your questions about reducing other inflammatory processes in the body. We generally want relief from those anyway, but when the causative agent hasn't found host tissue yet, the thing that causes it is still at large, somewhere, and rs-CRP exposes it.

Thanks for the very provocative question. Hopefully some others here may have other, better-informed insights into the subject.
 Aardvarkyan - Thu Jan 15, 2009 8:04 pm

Thank you, Doctor, for your very comprehensive and thoughtful response to my question. OK, I get it that much more research is needed to fully answer it. You mentioned, however, that it is known that inflammation anywhere in the body is a risk for coronary inflammation. You gave as an example that gum infection could cause heart inflammation.

My wife used to take a few-days dose of antibiotics before having a routine dental checkup at USC. She endured stomach upset for a week to assure lower risk from the visit. Recently, she discovered that this practice is no longer advised; that is, the use of antibiotics as a prophylaxic strategy. Apparently, it was found (by research?) that there was really no risk or connection between gum infection and harmful heart inflammation. What recent information do you have on this topic that could clarify this association?
 John Kenyon, CNA - Fri Jan 16, 2009 11:40 pm

User avatar Hello again -

The reason your wife used to have pre-dental antibiotic therapy would have almost certainly been because of her having been diagnosed with mitral valve prolapse (MVP), and there was, for the longest time, a practice of preventive antibiotic therapy prior to any "dirty" procedure (which dental work is considered to be). However, it was not only found that this didn't improve the outcomes , but that overuse of antibiotics was defeating the purpose, and more and more bacteria were becoming immune, so this practice has mostly gone out of favor. (This was done, incidentally, not to avoid inflammation but to prevent bacteria entering the bloodstream, where certain types have a predilection for settling on the mitral valve, or at least this was believed to be the case, and occasionally someone would acquire an infection, endocarditis, this way). The antibiotic wasn't to prevent inflammation except as related to a very specific sort of infection likely to be acquired via dental work, which is directly invasive and can introduce bacteria into the bloodstream via disrupted gum lines. That's why that used to be done, and why it isn't any longer.

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