Thursday, October 23, 2014
High Blood Pressure
Fit but BP is often high.
Hello I am a 62 year old male. I occassonally have high BP around 140: 90 or even higher but at other times it is 128:86 or so. I am very fit take regular exercise I run (not jog) around 5 miles most days and sometims futher. My resting pulse rate reflects this fittness and is around 44bpm and has slowely fallen scince I started regular exercise again at the age of around 36.
All the information sems to suggest I have a problem and when measure by a Doctor or a nurse my BP appears to be high. When measure on my own BP meter (this has been calibrated) it is more like the lower figures above and just after exercising even lower with a pulse rate of about 62 bpm.
How can this be ?
If your blood pressure is consistently higher at the doctor's office than at home, you have "white coat hypertension". White coat hypertension is defined as having a blood pressure above 140/90 in the doctor's office, but below 135/85 at home.
The significance of white coat hypertension is unclear. If you are otherwise healthy and have no sign of vascular damage from hypertension, you don't need treatment.
Vascular damage can be assessed by ECG or echocardiogram, showing an increase in left ventricular size, by a simple eye ground exam, and by looking for protein in the urine (microalbuminuria) and by a blood test looking at kidney function.
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati