Doctors Lounge - Cardiology Answers
Forum Name: Arrhythmias
Question: Arrhythmia and Prehypertension
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|GuitarSalad - Mon Sep 08, 2008 7:36 pm||
I am a 25 year old male who is becoming increasingly nervous about his health. I've been checking my blood pressure pretty regularly lately with an electronic blood pressure meter that I bought. This blood pressure meter also detects pulse and irregular heartbeat.
Ever since I started monitoring my blood pressure (roughly 2 months), it's been in the pre-hypertension range. I started around 145/85 and now am down to about 140/80 or thereabouts. I saw a doctor just to establish because I'm living in a new area. For one amazing day my blood pressure was about 120/80, and it happened to be when I was at the doctor. As there was no indication that my blood pressure was high (or borderline high) he made no mention of it. I had been trying to eat healthier and to me it felt as though it was working, and I did not mention that my previous measurements of my blood pressure were not in line with the ones at the doctor's office. I even checked again with my personal blood pressure meter and it was in line with the doctor's (119/75). Ever since then, while it hasn't risen to dangerous levels, I have not seen a systolic pressure lower than 127, and it's typically between 130-135. Diastolic has been pretty close to normal during this time.
I've been trying to eat healthier and have lost around 10 lbs. I've been walking/ jogging close to 4 miles about 4 times per week. I'm 6'1" 190 lbs now. Though I have seen improvement, I'm still worried. In addition to my blood pressure being on the high side, the sensor for an irregular heartbeat has been going off with frequency (though not all the time) on my blood pressure meter. The only time I remember a doctor speaking to me about me having an irregular heartbeat was around six ears ago when I visited my college campus' clinic because I didn't feel well. The doctor described my heartbeat as "regularly irregular" at the time, and I had borderline high blood pressure at the time as well. She kind of brushed it off as nothing to be extremely worried about as I was a stressed college student during finals. At that time I also consumed a lot of caffeine and (very rarely) smoked, which I had told the campus doctor. In the last two months I've had a total of 2 cans of soda and a few glasses of iced tea, and I've had absolutely none within the last week. I've essentially sworn off caffeine, but the irregular heartbeat seems to remain.
I'm currently applying for a job that requires that I pass an annual physical. I don't know if these (pre-hypertension and irregular heartbeat) are things that could potentially cause me to fail that physical. I don't want to lose a job opportunity over this, and I really want to make sure I'm taking the right steps to correcting my health issues moving forward. Any advice you can provide would be greatly appreciated.
|John Kenyon, CNA - Tue Sep 09, 2008 10:43 pm||
You know, blood pressure can vary quite a bit during the course of a day, depending upon myriad factors. This is why people who haven't been diagnosed with hypertension are not encouraged to monitor their own blood pressure, since it is difficult to assign meaning to the findings. You mention your BP has been "borderline" frequently. Actually it may be your anxiety (which causes you to check so frequently to start with) is causing your cardiac output to increase and your pressure to rise a little when you're checking it.
That being said, now that you've established a statistical baseline that's higher than normal, you may as well continue to monitor it, but try doing it this way: do it only once or twice a day, at specific times, for instance in the morning when you first get up, seated on the edge of the bed, and again late in the day, perhaps after dinner or during your quiet time in the evening (if you have a quiet time -- some of us don't). When you're relaxed (and as an anxious person you may actually be more relaxed when at the doctor's), your pressure is likely to be more accurate. There are peaks and valleys during the day, just as with blood glucose. Imagine if people had access to blood sugar testing without a diganosis. They'd discover their BS levels to be quite high at various times during the day and many would diagnose themselves as diabetic or pre-diabetic (a status which is somewhat controversial anyway).
Then there is the matter of irregular heartbeat. First, the electronic home BP testing devices are easily tricked by bodily movement or deep, sighing respirations. Second, we all have occasional premature heartbeats, some of us have them most all the time, while others have them only occasionally. If you're one of those who is actually "regularly irregular" (bigemeny, trigemeny or one of the other variations on the "group beating" theme) then you'll likely always get that alert from the machine. It doesn't mean anything in and of itself, but once one becomes aware of it, it starts to become another anxiety-producing issue. This is one that's much better ignored by the patient unless there are actual symptoms associated with it (such as dizziness or annoying palpitations). Even then they are almost always benign, but with symptoms they become harder to ignore.
An occasional premature heartbeat, which would probably only show up in a very detailed pre-employment physical which included an EKG (rare), would be unliikely to disqualify an otherwise healthy young person. "Borderline high" blood pressure might elicit a comment or a re-check, but likely wouldn't get you knocked out of the process either. Blood pressures consistently above 140/90 are conisidered worthy of following and, if they don't self-correct, then continued, occasional monitoring and possible medical treatment is considered. It's usually only when there is significant elevation on two or more occasions that healthcare professionals begin to pay close attention to BP as a potential problem, and then they want to rule out possible underlying causes first.
Again, if you are going to continue to monitor your own BP, try to do it only 2-3 times a day, and preferably during quiet times, as close as possible to the same times every day or so.
I hope this is helpful. Please follow up with as as needed, and good luck on your possible new job.
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