NEW UPDATE p. 3: BP at doctor's office

[ETeSelle]

OK. So I've always had "borderline" BP--in my 20s, when I was at normal weight, it was always around 140/80 or so. The lowest it has ever been was in 2000, after I had gained and then lost 70 lbs on my first McDougall go-round -- then it was 120/70. I weighed 128 and was running 40 miles a week (I was then 38).

In the last few years it has been higher--155/98 or so--but I was obese, having gained back all that weight, and I assumed that was why. In 2009 I let the doctor put me on meds--but just a diuretic (HCTZ). In Nov. 09 my BP was 144/72 (on the HCTZ) and I weighed 207.

I ran out of meds and there was a mixup re: doctors and so I was off the meds for several months. When I saw the new doctor in May 2010, I weighed 198 and my BP was 155/96. The doctor wanted to put me on Norvasc and I agreed, but this pushed me into action. I got back on the McDougall plan, and w/in a month I discontinued the meds (going along w/ the studies that indicate that there is no benefit to artificially lowering BP below 160/100 or so ( explained here by Dr. McD in his article about how he treats hypertension: http://www.drmcdougall.com/misc/2009nl/nov/bp.pdf

Since then I have lost 70 pounds. I have a median-normal BMI. I look great. I feel great.

BUT I had a nagging fear that my BP might still be elevated. I can still feel the blood "beating" in my veins sometimes. I wanted to know what it was b/f I went to the doctor (b/c I know there will be a battle).

Went to CVS yesterday and had it done in the Minute Clinic. They use a real BP machine--she even re-did it using a manual one b/c I was so freaked out.

My BP yesterday was 158/98. Now, my heartrate was only 51 (down from 88 in May), but that's small consolation.

Let me just add that I not only McDougall--I am on MWL and I restrict sodium to an extreme degree!! I add no salt to my food. I stopped using Braggs months ago. I buy only no salt added tomatoes and beans. I eat almost nothing processed and if I have to, I read the labels obsessively.

I CANNOT understand how my BP can be essentially the same NOW, having lost 70 lbs and having restricted sodium to this degree as BEFORE, when I was fat and not worrying about sodium at ALL (and eating lots of processed and prepared foods).

I'm really pretty upset. I am dreading going to the doctor now--I know my cholesterol will be down, it's nice that my HR is down, etc., but I don't know what else I can DO.

ALL I CAN COME UP WITH SO FAR:

(1) I eat the salad bar at work for lunch every day and there are beans on it. I usually have a good helping of those. I'm sure they don't pay extra for no-salt added, so that may be a trigger.

(2) This article says that potassium lowers BP. Of course, I already eat TONS of the foods that they mention as being high in potassium (except fish, poultry, yogurt and bananas). But maybe I should take a potassium supplement?? http://www.health.harvard.edu/fhg/updat ... 705c.shtml

(3) Caffeine. I gave up coffee more than 6 mos ago--I still occasionally have a cup (like once every 2 weeks) but I DO still drink tea -- 2-3 cups a day of caffeinated in addition to some herb tea. Is this enough do you think? I can cut out the caffeinated tea altogether.

(4) When I go to the doctor (which I guess I have to do in order to get my bloodwork re-done and b/c I can't put it off forever), I could say OK to chlorthalidone, which is the drug of choice per Dr. McD. He would probably NOT treat me at this BP, but the risks of chlorthalidone are low and it would make the doctor happy and alleviate my worries a little.

(5) I bought a BP monitor this morning and will take it at home a number of times to see if I get the same result.

(6) Exercise more. That may have been the one deciding factor when my BP was lower in 2000. I have no desire to run 40 miles per week anymore, but I can go to the gym. I live on a farm, I ride horses, and my second job is as a barefoot hoof trimmer (horses), all of which count as exercise, but it's not sustained cardio. So I did bring my workout clothes today and will try to do the elliptical 3X a week.

I know I can write to Dr. McD, but I already did that a while back and he pretty much reiterated what is in the article I linked to above (re: how he treats BP). I know he can't make specific recs over the internet, so I'm not sure there's much point in asking him again.

Does anyone have suggestions? I really am just so bummed about this.

[Burgess]

You have covered all the bases except one. You have covered exercise, weight, fat, and salt.

How skilled are you at reducing stress?

I can jack up my blood pressure by 30/20 just by worrying about my blood pressure! I have gradually learned to let go of problems in the world that are not directly my problems and that I can't do anything about directly. That doesn't mean I am not working to change the world for the better. What it means is that I do not evaluate my efforts based on immediate results -- and then feel frustrated.

P. S. -- When you take your own BP be sure to keep a log and be sure to take it at about the same times (multiple) each day. My BP is normally higher at 7 am than at 7 pm, for example.

[ETeSelle]

Actually, I should have added

(6) Exercise more. That may have been the one deciding factor when my BP was lower in 2000. I have no desire to run 40 miles per week anymore, but I can go to the gym. I live on a farm, I ride horses, and my second job is as a barefoot hoof trimmer (horses), all of which count as exercise, but it's not sustained cardio. So I did bring my workout clothes today and will try to do the elliptical 3X a week. I'll add this to my post above.

I don't think I HAVE a lot of stress. No more than the average person and probably less. I no longer have a verbally abusive husband (ditched him in 2001), I live in a place I love and I have 2 jobs I enjoy. I'm busy, but I have plenty of down time. I don't see how I can change any of that, really.

But I agree that there may be at least SOME aspect of white coat syndrome involved here, which is why I bought the monitor this morning. If I do it at home many times I may find that it's NOT usually that high.

[serenity]

I agree; you've covered the bases. I do think the most important to try is the cardio and eliminating all caffeine. And can I caution you about the potassium. Supplementation can be dangerous and throw your electrolytes off. As you noted, this way of eating provides plenty.

[ETeSelle]

Doesn't it just seem bizarre, though, that my BP is the same NOW, when I've already reduced sodium way down as well as reducing caffeine, as it was when I was fat and not worrying much about either? How can that BEEEEE????

I'm super-healthy, BTW. I always have been. This is really the ONLY thing even remotely wrong w/ me. I'm the healthiest person I know.

[Gweithgar]

Remember, too, that BP can fluctuate a lot depending on so many factors, stress, or just being in an animated conversation can cause it to go up. Don't let one reading freak you out! If you are really worried, buy a home BP monitor and chart your readings at home. Mine is always highest at the doctor's office, where they walk me from the waiting room, weigh me, and get me all chatty before they sit me down and slap the cuff on my arm. At home, where I can relax and just breathe a little while before I test, it reads much lower.

[ETeSelle]

Remember, too, that BP can fluctuate a lot depending on so many factors, stress, or just being in an animated conversation can cause it to go up. Don't let one reading freak you out! If you are really worried, buy a home BP monitor and chart your readings at home.

As I said above (item (5) in my list, I did buy one this a.m.

[Vegankit]

(((HUGS)))) I know how frustrating this can be - I went through something similar with my cholesterol levels. I reached a point, after info from Dr. McDougall and others to just live with slightly higher cholesterol knowing that all my other markers are normal, I'm eating the healthiest diet (MWL) and I'm now below my goal weight. To tell you the truth at this point I have no idea what my cholesterol is, but it's what my body makes naturally.

You have very thoughtfully analyzed a few potential small areas to work on so I hope they make the difference.

[ETeSelle]

I guess I kind of feel as if I'm letting the side down, too. You know, how so many people have dramatic reductions in BP, etc. on the plan. And I'm 120% compliant--I should have that, too. I feel bad that I can't report that.

[stirFry]

(5) I bought a BP monitor this morning and will take it at home a number of times to see if I get the same result.

What BP monitor did you buy? I'm curious about my BP and might buy one too.

[ETeSelle]

Not sure--it's in the car. It was $59 and was the nicest one they had at Walgreens. I'll get the name and let you know.

[ETeSelle]

Your stressing about one reading?? Did you know holding your breath causes your BP to rise??

What have you been telling me for months to do???? RELAX!!! Use your machine a few times a day for a week then see what the trend is. If most of your readings are still high, the worry.

Well, I doubt I'll do it tomorrow and find that it's low. That's just not gonna happen.

But I know what you're saying. I emailed Dr. McD again. I referred him to this thread and he reiterated what's on the page about how he treats hypertension. I emailed back and whined, "I don’t understand how it can be the same NOW, when I’m thin, limiting caffeine, and watching sodium to an absurd degree as it was in May when I weighed 70 lbs more and wasn’t worrying at ALL about sodium or caffeine. Am I just cursed?"

And he said: "Maybe cursed to worry, but not to be unhealthy."

Felt a little better then. You gotta love him!

I know--51 HR!!!??!?!?!? Heck. I guess I'm o.k.

[f1jim]

Some people have the same issue with BP as they do with cholesterol. While many make small changes and see large fluctuations in BP others have to grind out every last small detail. I would definitely look at the tea as a possible issue. Also many find they don't see the big benefit till that last few lbs comes off. For some, that means being in the lower range of normal BMI. It's a pain for many, to be sure, but I bet you can lick this thing with some detective work.
f1jim

[ETeSelle]

Thanks Jim. I'm on it. Tea (other than herbal tea) is now outta my life. I'm continuing to MWL, so I should lose a few more pounds (although I don't want to lose too many!). And I'll bring my own beans from now on to add to my salads at work.

I'll report back.

[Love the Lorax]

Well... hmmm.... I have to admit I never saw that BP coming. I can only imagine how frustrated you must feel.

I've been reading a LOT about BP because my BP tends to be stubborn about coming down, and I wanted to know what I could do besides drugs that might help. I have read about so many things.. like eating plenty of celery, etc. One thing that got my attention is that being chronically dehydrated can result in increased BP (and not just a tiny bit) because the body has to compensate. Now, that is a huge simplification of the process of course. I am not a doctor, I haven't done lots of study on this, and I am not making any sort of dogmatic statement. I simply thought I would bring it up as maybe a possibility, since you have done SO much right. Do you drink lots of plain ol' water? I know for me that when I starting making a conscious effort to down lots of water, after a while my BP started trending down, my headaches became much less frequent, I'm less achy, etc. It really did help me. I know, perhaps my exercise and diet would have kicked in and the water had nothing to do with it. I know in the past I had been very good with my diet and still had trouble with BP, and then falling off the wagon certainly never helped LOL!! I've had BP's up to 170/106, although that wasn't on a great diet.

When I first read about this idea, I decided that drinking an extra 3-4 glasses of water a day wasn't going to hurt me, and could only help. Now, drinking water is almost a habit... (Ok, have to be honest.. I still find water to be a bit bland, but it is worth it).

Oh well, just a thought to throw in the mix.