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Friday, December 19, 2014
High Blood Pressure
200 / 90, Diuretics and Fluid intake levels ?
200 / 90 - THIS IS MY MOTHERS BLOOD PRESSURE AND HAS BEEN FOR A NUMBER OF WEEKS ( AGED 64 OVERWEIGHT AND WHEELCHAIR BOUND HAVING SUFFERED MOST OF HER LIFE WITH ARTHRITIS AND OVER THE LAST 15 YEARS WITH TWO MAJOR AND NUMEROUS TIA STROKES ): Q1 - She is on diruretics as well as other medication to try and control her blood pressure, however, I recently found out that she only consumes 2 cups of tea per day, is this compatible with diruretics or can the lack of fluid intake be a contributory factor of the high blood pressure level ? Q2 - Is 200 / 90 a dangerous leveL AND should she be in hospital ?
A blood pressure of 200/90 is clearly too high. Initially, it can probably be treated as an outpatient. However, if the blood pressure cannot be controlled after several weeks on medication, hospitalization may be needed. In cases of severe high blood pressure, diuretics are almost always necessary usually in combination with other types of blood pressure medication.
Someone who already had a stroke should have a blood pressure of 130/85 or lower. If an appropriate trial with medications cannot reach this goal, blood tests and possibly x-rays may be needed to determine why the blood pressure stays so high.
Fluid intake is generally not a problem as long as the patient follows a low salt diet. Low fluid intake does not cause high blood pressure by itself. If fluid intake is too low, the blood pressure can drop and the patient can become lightheaded of feel faint.
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati