Last night was a rough one for me with symptoms, and after hours of feeling generally ill, I decided to take a BP reading to see how bad things really were. Even though I'm on beta blockers, my BP reached 159/112. This startled me and got me wondering, when are we in immediate danger from our blood pressure? Is BP something that usually only hurts us if left untreated for months or years, or is a high reading like the one I had last night a reason to run to the ER, or even call 911? Can a reading in the 150s or 160s/112 or even slightly higher than that actually harm me at that very moment, or is fine to "ride it out", knowing that I am on an anti-hypertensive drug anyway and my readings are usually not quite this bad? My fear comes from not understanding if I am in immediate danger at these moments. Thanks.

Gillian

I know that those of us with dys. are different but this blood pressure chart was very interesting. It does answer your question I think gillian. Also, I know that I was told that as long as that very high reading comes down I can wait it out a bit. If it stays that high though and your heart is racing, I would probably call. Anytime your bp is that high, you will feel lousy. Hope the chart helps...
http://www.vaughns-1-pagers.com/medicine/blood-pressure.htm

Gillian,

From my understanding, a high blood pressure is usually a problem if it is always high, or drops more than 20% when moving from a laying or sitting position to a standing position.

On the other hand, I had a heart attack a few years back, and it should have/could have been prevented if I had insisted on going to the ER and having my blood pressure monitored for a while.

What does your intuition tell you? Go with that. You are usually the best judge of what is really going on with your body.

Thanks for the replies thus far.

So, if a person has a very high reading but that reading drops within an hour or two or even less than that, is that known to be rather harmless then? I'm trying to figure out if a stoke or heart attack happens due to these really high BP readings being left untreated over time, like months or years, or if one single reading is a danger to the patient.

Can one single reading of BP in the 150 or 160s over 112 or so actually cause a stroke at that moment, if the patient is young and otherwise "healthy" other than Dysautonomia? My gut instinct is to wait these things out when they happen and just treat myself if needed with an extra half tablet of beta blocker, but I never know if I'm in more danger than I think I am with readings like these when they happen, even though my experience has always been that it does pass in time. I'm asking my dr all these same Q's of course, but it will be a few weeks before I see him.


Gillian

Again, this group just amazes me!

Just last week my hubby asked the Cardio doc the EXACT same question. What's the magic number that means GO TO THE HOSPITAL NOW!

His answer was, "There is no number, it's all about how you feel." Pain is the warning you should NOT ignore--as well as changes in communication ability.

But if you feel bad--go.

Gillian,
As an RN, there are really just way too many different scenarios that can occur with the likes of us; however, let me just throw some info out that I have experienced.
Hypertension has recently been defined at 130/80. Treatment to begin at 140/90 and up. The higher the bottom number, the higher the concern level.
AS dys. patients, we have a tendency for both orthostatic pressure changes (lying, sitting and standing)as I'm sure you know, and they either can go sailing up, sailing down or become labile (rapid ups and downs). Warning signs with BP changes, specifically high are chest pain and severe head pain, and sensory changes (visual, auditory, sensory - like numbness and tingling or weakness on one side or the other or all over).
With my illness, I was hypotensive to non-palpable BPs in the beginning. However, during treatment trials, I sometimes would experience labile BPs that were dangerous. My clue to the shooting up BP was ears turned hot and red, and then a sharp knife-like pain shot through my brain on a criss-cross line starting from back to front. This pain was unbelievable, not like any migraine pain I have ever had. Then I would scream, and my BP would drop just as suddenly, and I'd black out, just to come to to have it shooting up again. We rushed to the fire station and my BP was soaring to 240/120 then dropping to 50/30 - I was immediately treated with IV and meds and taken to the hospital. The medication normalized my BP, they did an MRI on my head (pre-pacer), and admitted me for observation. The high BP symptoms I experienced were consistent with stroke symptoms - I was lucky to bottom out rapidly - in a weird sense - my body did finally figure out a way to try to save itself.
I did not stroke, and a plan was made with my cardiologist to carry a rescue med with me if this ever happened again. 0.1mg Clonidine. It did happen again, but the rescue med got it right under control.
Anytime we had a patient spike a BP with the bottom no. 100+ - it was a STAT "call the doctor now and treat" on my floor. Some patients had rescue meds already ordered for certain pressures, esp our cardiac or hypertension patients.
I had a 38yr old female ranch hand on my floor. This girl was rock-solid muscle, but had "the worst headache ever" in a very specific spot in the back of her head. Her BP at admit was 240/128. Her veins were so tight it was hell getting an IV restarted on her. She had had a small hemorrhagic stroke (bleed vs. blood clot) in that region of her brain where the pain was. She was very lucky that it was in a fairly benign area and a small bleed that didn't "blow out."
Oh, and the most important red flag warning I know with any big bad episode about to occur in the body is a "feeling of impending doom." In ICU, it was usually when the patient said, "uh-oh...."
Ya know, I've taken more than a few trips to the ER in which the symptoms have simply resolved on their own as suddenly as they started. But, being watched in the ER is preferable to being alone at home and something happening.
I think the best thing for you as an astute dys. patient is to call your doc and get a "rescue remedy" in place until you see him/her. A half more beta-blocker is a good idea, but they do take time to get to therapeutic levels depending on the med.
As for long-term, how long can it go on with or without harm? is 356 shades of gray instead of black or white. It just depends on your body and its coping abilities. Can't give you an answer on that. Extremes over time are not good for anyone...and then there's our strange universe of dys. we're living in.Blessings, C.

that's a really great question. my blood prsesure doesn't skyrocket nearly as often as yours, fairly rarely in fact, but when it does, it's usually around 180/110. when i had the bad effexor reaction, it was around this. and then sometimes when i have episodes of IST, it shoots up to about there. from around a normal of 90-100/50. quite a jump!!! i never know if i should be alarmed about this huge jump either. to be honest, i usually get much more concerned about a heart gone wild, but that is only because it is more evident to me physiologically.

My blood pressure is either too high or too low. I take midodrine on a sliding scale, lower doses on days I don't drive or go out, more when I need my bp not to crash. But my highest bp readings were 220/160, and I had a crushing headache. I called my primary dr who told me to go to the er. I didn't have a stroke but had some brain issue I still have to deal with. Usually, the bottom number goes between 90-120.

michelle

Some good info here, thanks to all.

Michelle--you say your bottom # is usually between 90 and 120. Do you live with that, or treat that with Clonodine or a bb?

I keep seeing over and over again that Clonodine seems to be overwhelmingly the "drug of choice" when it comes to geting high BP down fast, but I'm so hesitant to go that route since I'm so much more familiar with bb's, and I know they do the trick within an hour or two, and usually my BP slowly goes down a little at a time even before the bb hits my system anyway. Seems there's no easy answer, other than to listen to one's instincts and don't ignore certain warning signs.

Gillian

I'm on a bb, Corgard. I have low heartrate but high bp. Went to cardiologist yesterday for an emergency visit and he increased my norpace.

michelle

I have POTs and I know not everyone here does - they have different types of dys. What type causes your bp to go high? I never had high bp in 14 years of POTS - only low and sometime close to normal.

I also have POTS, and originally had Neurocardiac Syncope, too. Can you believe that, lol? Started off low, and after 4 years of bb's to control the HR, I'm now a high BP patient. The drs have put the idea out there that this may be PAF, too, but that hasn't been confirmed, so for now my official dx is still POTS and NCS. My BP is terrible the past few days--I never have recovered from the highs I had a few nights ago, and I had a reading of 132/105 only 2 hrs after taking my bb this morning. I called the on-call physician and he didn't seemed concerned....just told me to take an extra half a pill, which I did. I've only been on this bb for 2 months, and it's already starting to crap out on me. I have no idea how to control my BP now, and I'm constantly afraid.

Gillian

My problem with BP seems to be just the opposite of most of yours, it simply is not there sometimes. If I get a reading of 80 /50 it is pretty good on and usually is not that high. After running for about 20 minutes or shorter in the heat it actually is so low that it can not be measured. I take Clonozapane and Midodrine for this, anyone have suggestions as to what the side effects might be that the doc,s are not telling me?

D Rose

quote:

Originally posted by D Rose:I take Clonozapane and Midodrine for this, anyone have suggestions as to what the side effects might be that the doc,s are not telling me?

I've noticed that sometimes, instead of helping keep my blood pressure up, midodrine will lower my heart rate just enough that I have a more noticeable fall in BP when I stand up.

I have wondered, what happens if there's a combination of adrenaline and midodrine both acting to constrict vessels?...

For all side effects, drug interactions, and food interactions, simply type in the drug at www.drugs.com and read for free. Then save it so you can check again later if adding a new med or you want to take an aspirin and check first.

Hope this helps!