Thu 2 Jul 09, 8:50 am
Newbie here. Sorry for the long-winded post, but I don’t know how to make it meaningful and brief at the same time. Obviously, this query verges on the medical, but is mostly about how to use MyBP software to get an accurate reflection of my BP situation. I have been using MyBP for about one year now, and ironically, because it is such excellent, powerful tool, I am driving myself crazy trying to make sense of my readings!
(1) I am an American in Thailand, and although the standard of medical care is good here, communication can very frustrating, and I am not 100% satisfied with (what seems) the Thai approach to treating hypertension. I don’t know. That is one of the reasons I am writing.
(2) I have one year of hundreds of readings over the past year (some months more consistent than others) and I cannot determine what that reflects as an overall pattern. In other words is my BP under control or not
(3) My readings have always varied tremendously, and are time/event related.
112-120/___ Usually very low after bike + yoga
150-160/ ___ High first thing in a.m. before meds, also in p.m.,
150-160/ ___ High in the p.m., although I am a bit remiss in taking p.m. readings
160-170/___ At docs office
120-140/___ At various times during the day not specified above.
(4) Doc seems interested in and satisfied with my averages which have always been somewhere in the 130s/___ , and feels this reflects BP under control. My concern is that averages may be helpful when there is only 20 mm fluctuations, but if I still get frequent readings in the 140s, 150s, and 160s doesn’t that indicate that I am still hypertensive regardless of the averages Or what
(4) In using MyBP software, when I get a high reading, I am naturally alarmed, and have the urge to take another reading 30-60 min later. When I do, the reading is usually lower, thankfully, but what does this mean And doesn’t the “extra” reading skew the average?
SIMPLE QUESTIONS :
(1) How often should I take readings?
a. How often (how many times during the day)
b. At what times of day
c. and/or preceding what events/activities? Before meds, after, after exercise …
d. How many days/weeks/months of readings establish a reliable, accurate, meaningful baseline that doc and I can work with?
(2) What numbers are a reasonable end goal of successful treatment? Considering what I have already explained, how aggressive should we be about changing dosage and or changing meds over say one year ?
Health : good, generally
Height : 5’6”
Weight : High school weight was 150#. Today 178, down from 185 one year ago. Most of weight seems to be in my gut, unfortunately.
I am an American living in Thailand, and some or much of my questions relate to concerns over Thai medicine and limited communication with my Thai internist. If I had a good, working relationship with a doc in America, I would probably not be posting here, and probably would not be making myself crazy!
One year ago, started with 7.5 mg. ramipril (TritACE) and 5 mg. amlodipine in a.m.
A few weeks ago, changed to 5 mg. ramipril and 5 mg amlodipine in a.m. + 5 mg. amlodipine in p.m. due to high morning and evening readings.
Too soon to tell if that is making a difference.
Probably hypertensive most of my adult life. When docs first started pointing out high readings to me in the 1970’s, 150/__ was not considered high, and I only got “Harrumph! You’re a little high.” from docs, but no treatment. Decades passed.
About one year ago, got routine reading of (if I recall) 180/110 which alarmed me and caused me to decide to treat this seriously and aggressively, as follows:
STEPS I AM TAKING
1. Have not had a drink or a cigarette in 25 years.
2. Meds as above, past year, + .5 mg Xanax for insomnia. No other except aspirin.
3. Diet, about 50%-75% vegan. Some months more consistent than others.
5, Weight slowly down from about 185 one year ago to 178 today.
6. Daily green tea and grape juice
7. Salt minimal, although Thailand is a “salty place” and it’s difficult to control.
8. 30 min. stationery bike ride + 30 min yoga, five days per week (consistent past 12 weeks, although some months more consistent than others)
9. Employment is inactive; at my computer many hours per day, at home.
Any general insights and info greatly appreciated, but to restate, the thrust of my post is to get very definite, specific instructions of when/how often to take my BP as explained earlier.
Thank you very much for your help.