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High Blood Pressure

Increase in blood pressure

09/27/2000

Question:

My BP reading from a grocer BP machine indicated that my BP was 136/90, with a heart rate of 98. Two minutes later the reading was 134/92, with a heart rate of 102. Finally, a final reading was taken three minutes from the first reading, indicating my BP at 138/97, with the heart rate at 101.My primary care physician told me in June that my BP was elevated and that he would give me an opportunity to lose weight before he prescribed an RX. He said that insurance companies consider a client to be "high risk" if they had high BP. At this point, I am 70 lbs. overweight. I have been walking recently at an average of 20 minutes, 4 times per week. My job as a secretary is a very sedentary one and I take birth control pills to help with a horomonal imbalance. What do you recommend I do? I have a follow up appointment with my doctor in October. I should have made the appointment sooner, but with the way I work it is extremely difficult with all the deadlines I have to find the time during office hours to go to the doctor. Should I be alarmed??

Answer:

It is normal for blood pressure to vary a little bit from reading to reading, even if the readings are only minutes apart. The average blood pressure from your three readings is 136/93, pulse 100. The systolic (the upper number) is the main determinant of cardiovascular risk, and 136 is high normal. It is therefore reasonable not to prescribe any medication at present.

If you are 70 lbs. overweight, you ar at risk for long term health problems. If you are of average height, your body mass index is about 37, giving you an excess mortality risk of 60% (i.e. you have about 1.6 times the risk of dying during any given time period when compared to a person of normal weight). In your case, weight loss is indeed more important than lowering your diastolic blood pressure (the lower number) to normal. In addition, it is likely that weight loss would also lower your blood pressure by itself.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati