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Forum Name: Hypertension

Question: High Diastolic Pressure While Resting?


 mexigrl64 - Fri Dec 04, 2009 12:41 am

I'm 45 yrs old, 5'4", 155 lbs - my BP has always been normal until lately. I've been keeping a log and my diastolic pressure ranges from 92-110 in the evening only, during the day it is generally 88-92. My systolic varies from 118/148 so that doesn't seem to be an issue.

Today I had a stress test and echo - both seemed to have gone well. My Bp while in the office was normal ranging from 118/78 to 135/88. Normally a person would be stressed while at the dr's...not me for some reason my BP was great.

I shared my daily results with the cardio who pretty much brushed them off - said something must be wrong with them. I have used 3 different monitors over the course of the last month, to be sure, and even had others take it for me. I just took it now and it was 148/98.

It really seems that in the evening it is high - while I am resting, watching TV, hanging with my cats. My cardio seems to think that I'm imagining it, or that my monitors aren't correct (not likely as I mentioned before I've used different ones to make sure).

Where should I look next for help? Are there any known reasons for diastolic BP to spike in the evening or while at rest?

I appreciate your help - I'm frustrated by my doctors reaction (or non reaction) and his unwillingness to try any medications with me. I can't imagine that a low level medication to start would do any harm.

Thank you in advance for your time -

Laurie
 John Kenyon, CNA - Mon Dec 07, 2009 11:43 pm

User avatar Hi Laurie -- That's certainly an unsual presentation you describe, mainly because it's in the evening that it seems to peak, while most people with elevated BP have it highest in the AM. Still, since you've checked it with multiple devices, it's probably pretty accurate. Some of those numbers are high enough to warrant a second look at least. However, there are some things that could contribute to this peculiar issue. For instance, caffeine in what you drink with dinner could be contributory; any sort of stimulant could cause this. Anxiety could also cause it and for some anxious people quiet time is actually when things start to get tense. I notice Lexapro among your routine meds, which of course could be intended for anxiety as well as depression and even other things. Then again, in a few people SSRI meds like Lexapro can result in a situation called seratonin syndrome, of which one feature can be elevated blood pressure. Usually there would be other noticeable changes as well, including agitation, nausea, quite a few potential symptoms. If this were the case (and given elevated evening BP being the only one mentioned it seems unlikely) this could be serious and would require stopping the medication. It doesn't seem to be the case.

While your BP elevation doesn't seem to be extreme, there is enough there to warrant at least a look at your log. If your doctor won't do this or feels it isn't relevant you may need to take this to someone else, a GP or internist for instance. It may not be indicative of a serious problem, but it certainly shouldn't be blown off. Even the fact that you keep company with cats (which is known to lower the blood pressure in many people for reasons not entirely clear) doesn't seem to offset this odd uptick.

Have you tried checking the BP just before going to bed? If it is a very transient thing it may be of no importance. We all do have fairly significant BP ups and downs during the course of a day, but you've found a distinct (and again, rather odd) period of the day when it gets up into the Pay Attention zone. The fact it's behaved well in the doctor's office doesn't help, and it can be difficult to get a doctor to listen to one's personal observations. He may be right about it, but he also may not. If a doctor would at least take a moment to look at your numbers and give you a rationale for why this happens,that would be progress. Otherwise, yes, some low-dose medication might be worthwhile. It's a difficult call when it's a part-time condition, but it's also interesting and if a medical person were to take your BP during the evening that person would likely suggest you follow up with your doctor.

While I'm not overly concerned for your welfare right now, I am concerned for your relationship with your cardiologist, since this is something which sits on that fine line between benign neglect and just plain neglect. Unfortunately you've already brought it up and haven't gotten a satisfactory response, so assertiveness may only cause strained relations. I'd consider just bringing this to the attention of a generalist. You may get more direct attention that way.

Hope this is helpful. Good luck to you and please follow up with us here as needed.
 Lacy Darren - Sat Mar 06, 2010 10:33 am

Once in a while, as soon as I wake from sleep, my b/p soars through the roof. My face burns, my heart races, and have trouble breathing. It feels as though my lungs are full, and my head is going to blow off. Ive taken my b/p a couple times while this was happening and it was 210/110. This only last a couple minutes, and drops rapidly. After a few minutes, I cough up mucus. Is something wrong with my lungs causing this, or my b/p? It only happens after I wake. All through the day I am fine and my b/p is normal. I seen a doc., but b/p was fine at the time, of course, so he said I did not need meds for it. Please help before my head pops off!
 Lacy Darren - Sat Mar 06, 2010 10:41 am

I am a 39 yr. old female,and once in a while, as soon as I wake from sleep, my b/p soars through the roof. My face burns, my heart races, and have trouble breathing. It feels as though my lungs are full, and my head is going to blow off. Ive taken my b/p a couple times while this was happening and it was 210/110. This only last a couple minutes, and drops rapidly. After a few minutes, I cough up mucus. Is something wrong with my lungs causing this, or my b/p? It only happens after I wake. All through the day I am fine and my b/p is normal. I seen a doc., but b/p was fine at the time, of course, so he said I did not need meds for it. Please help before my head pops off!

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