Pre-hypertension...when should I be concerned

mwcontois

I'm a 52 male and been diagnosed with pre-hypertension. My doctor has asked me to watch this for the last couple of years. Started dieting and exercise regularly in August...not seeing any changes in my BP...it is consistently around 138/85. He tells me to get attention if it goes over 140/90 (either number).

Because I am actively exercising and watching sodium intake, and my BP is not getting better, should I be proactive and get medication to lower it? I'm worried about it because renal failure runs in my family, specifically from high BP and my dad is dying now from end stage renal failure after a lifetime of high BP. He is suffering greatly and I don't want the same fate. I swear I will never do dialysis.

Feedback? Should I go to the doc and see about BP meds? Is it too early in my exercise/diet changes to see a dramatic shift? I have lost almost 20 pounds and exercise 6 or 7 days per week. Despite being worried about this, I hate incurring $50 copays to get my BP checked and talked about...I can check it at home...

Thanks in advance.

20yearsyounger

You probably should own a BP monitor if this runs in your family and you are at the pre-hypertension stage. Checking mine everyday is part of my life. When I was playing sports in college, I was 130/70. The nurse always used to say a little high but the bottom number is low. Over the years, the bottom number kept moving up.

This is really something you should talk to the doctor about. I only see my doctor twice a year, but I always know what my BP number is.

Edit: Didn't see that you could check it at home. If the doctor doesn't recommend it on your visit, maybe you don't need to ask for the medicine. However, keep watching it.

CipherZero

At this point you're on the high side of the normal range. Diet and exercise can turn the tides for you.

Also, you don't have to see the doctor constantly for what's - at the moment - a non-problem. Simply because he has a car payment to make is a poor reason to see him.

If you're tracking your own BP, and you should be, I wouldn't get concerned unless you start to see it changing in the wrong direction.

mwcontois

Thanks everyone...I was just hoping to see it lessen over the past two months of exercise and diet watching...it doesn't seem to be changing at all. Trying to preserve my kidneys. I have a wrist cuff at home that is fairly accurate. I'm going to start checking it 2x daily, in the morning and evening...

BrianSharpe

How much potassium are you getting? Everyone knows about watching sodium (I try to stay under 1,500mg per day) but a lot of people don't get enough potassium.

The American Heart Assoc recommends about 4,700mg of potassium per day (you can get it all from food sources - low sodium V8 has become my best friend) when I started paying attention to my potassium my numbers dropped to where I'm consistently at or below 120/80 (I've also been taking 8mg of Atacand daily for years and my dr wanted to increase the dosage before I started upping my potassium)

cwolfman13

I'm hypertensive and even with meds I'm around 133/82. You're on the high range of what is considered normal (pre-hypertensive) and I don't know of any doctor who is going to treat that with medication.

I'd get a BP monitor and just keep an eye on things. In addition to watching your diet and exercise, I'd recommend also watching your potassium intake and making sure you're getting plenty of veg and whatnot. I drink low sodium V8 pretty much daily to help me hit my goals of around 4,700 MGs.

bfergusonii

When I weighed 245 my BP was pretty high so my doctor put me on medicine. Over the past two years as my weight has come down to 197 he has slowly taken me off the meds. On my last visit it was 114/72 so he cut it down to a single dose of the lowest size. My hope is that as I lose the remainder of my weight I will be able to get off of it completely.

Keep watching the weight and exercise, it worked for me.

blink1021

I was diagnosed 2 years ago with meds I am usually around 131/80. Usually medication isn't brought in until its 140/90 or higher. I would just check it at home and if you see a consistent pattern of it being high call your doctor. One high reading doesn't necessarily mean its high I was told to just keep an eye on it. I also only have one kidney so I know all about how blood pressure affects the kidneys its scary but a reality. Who knows keeping up with diet and exercise you may lower it all on your own before you reach the high stage.

Sedna_51

First off, I am not a doctor...but I am on meds for hypertension related to a kidney transplant. So I understand and cheer on your urge to protect your kidneys! Go, kidneys!
The Merck Manual (http://www.merckmanuals.com/professional/cardiovascular_disorders/hypertension/overview_of_hypertension.html), which I've found to be a pretty reputable source of medical advice, says to start considering drug therapy if BP hasn't decreased after 6 months of lifestyle modifications. So if I was in your situation, I'd continue with another 4 months or so of your lifestyle changes before you begin to consider drug therapy. In the meantime, though, it sure sounds like you're doing everything right- increasing exercise, decreasing sodium, and tracking your BP regularly. Well done! Keep it up!
Also, for what it's worth, my BP did go down, but it took probably 6-8 months after I started my lifestyle changes to really do so (my other health stuff might have made it slower though). It did go down though- so much that I was getting dizzy and they had to cut back on my hypertension med. I'd also like to second the person who said to look at increasing potassium, as well (if you can safely eat more potassium).

goanothermile

mwcontois wrote: »

I'm a 52 male and been diagnosed with pre-hypertension. My doctor has asked me to watch this for the last couple of years. Started dieting and exercise regularly in August...not seeing any changes in my BP...it is consistently around 138/85. He tells me to get attention if it goes over 140/90 (either number).

Because I am actively exercising and watching sodium intake, and my BP is not getting better, should I be proactive and get medication to lower it?

I have a very similar story.

High BP runs in my family. Father is in his mid-70s and having kidney issues.

Exercise used to moderate my BP, but as I reached my mid-40s, that no longer seems true. I was 20-25 lbs overweight and seeing my BP steadily creep upwards.

I threw in the towel this year and asked for BP meds. I'm on a low dose. It took several weeks for the meds to reach full effect. Now it is sticking in the 130-135, 70-80 range. Sometimes it will be a little lower. Very rarely a little higher.

I have lost most of that weight and really ramped up my exercise. At this point, my BP isn't dropping like I had hoped it would. Maybe the time will come when I've lost enough weight that BP will naturally take care of itself, but I'm glad I didn't wait.

mwcontois

I don't understand the potassium thing. I thought my Dad was on a low potassium diet because of his end stage renal failure condition? Am I wrong? He's in the hospital now, and might not make it out. He's been getting dialysis for 4 years. He is suffering from his condition, and complains about always getting the same food in the hospital...pasta, chicken or turkey. He doesn't have much life left so I was planning on bringing him some TX BBQ Beef brisket with a couple of sides. I was looking up the side options and looking towards low potassium items, as I thought that was his requirement. for instance, I don't think he is allowed any potato product...am I wrong?

Sedna_51

mwcontois wrote: »

I don't understand the potassium thing. I thought my Dad was on a low potassium diet because of his end stage renal failure condition? Am I wrong? He's in the hospital now, and might not make it out. He's been getting dialysis for 4 years. He is suffering from his condition, and complains about always getting the same food in the hospital...pasta, chicken or turkey. He doesn't have much life left so I was planning on bringing him some TX BBQ Beef brisket with a couple of sides. I was looking up the side options and looking towards low potassium items, as I thought that was his requirement. for instance, I don't think he is allowed any potato product...am I wrong?

No, you are very much in the right there! High potassium is one of the many, many things folks on dialysis have to watch out for, along with stuff like high sodium, high phosphorus, low calcium, low protein...the dialysis diet is very complex, as I'm sure you know! But (a) food requirements change based on individual situations and different stages of chronic kidney disease, and (b) your food requirements as someone without CKD are different from those with it.

There is data here at UpToDate that explains the potassium-hypertension link pretty well. Briefly: "A low dietary intake of potassium may increase the blood pressure, and potassium supplementation almost always lowers elevated blood pressure." As folks here say, this suggests that for individuals who don't have to restrict potassium intake for other reasons, increasing potassium through your diet may help reduce blood pressure. Unfortunately for those of us with high potassium levels- including folks with CKD like your dad, or those of us on medications that raise our potassium levels like me- that's not helpful information; we're worried about REDUCING potassium. But if you're able to safely put more potassium in your diet, it's a good tactic to try.

TL;DR- kidney patients (especially those on dialysis) have different nutrition requirements from the rest of the population.

And I'm sorry to hear about your dad. I hope he's as happy and comfortable as possible and he has an easy time of things.

mwcontois

Thank you Sedna_51, very helpful.