Hi. I'm a 26 year old male. 5'10, 250 pounds. Not physically active.

I've been to see a cardiologist about 2-3 years ago and was given a clean bill of health, with the exception of high blood pressure.

Since then, I've stopped drinking, stopped chewing tobacco and stopped drinking/eating anything containing caffeine.

My blood pressure used to normally run in the 170-180/95-110 range.

Since I've cut out these stimulants and poisons, I've been consistently getting readings in the range of 140-150/70-85. My pcp at the time put me on Lisinopril, which worked well, but felt it necessary to take me off the meds as my BP seemed to be in control.

My reading yesterday was 159/85, having a pretty bad headache. Tonight I decided to give it a test run and I'm scared. I've never seen my BP this low.

I initially read 117/68 with a pulse of 59 on my right arm. Seeing my systolic so low (comparatively speaking) spooked me, so I decided to take my BP on the left arm. The reading there was even lower! It was 96/59 with a pulse rate of 57. Seeing that number confused me as well, and being somewhat freaked out, decided to take it again on my right arm. It is showing 115/70.

I understand that these are great numbers and most doctors would be applauding them, but seeing as how my "normal" is never anywhere near that low, I'm highly concerned. I'm without insurance, as I was laid off my job... the clinic that I go to offers free/reduced cost service, but they can't see me for another week.

I'm worried about this and need some advice. Do I need to go to the emergency department? I'm afraid that a doctor wouldnh look at these readings and tell me that I had no business coming in, seeing as how they are "textbook normal". Not to mention that a hospital bill would kind of stink. I'll pay it gladly if it's necessary for me to go.

Any advice/help/experience is very appreciated.

Thanks,

James

P.S.- out of my last 14 readings, my lowest systolic was 134. I've never seen it lower than that.

90/60 and lower is considered hypotension at which point you will feel tired, lethargic. So at 96/59 is bordeline hypotension (low blood pressure). I always take BP on the heart side as I feel it is more accurate.

I would say keep testing, and if you go lower then 90/60 I would at least head for your clinic.

Tick

Thanks Tick.

I had just taken my anti-anxiety about 30-40 minutes prior and was relaxing sprawled out on the couch. I was super duper tired (as is to be expected with my meds) and now that I'm back amongst the living, my BP is gradually rising again. I tested on my heart side, as you suggested, and received a reading of 122/79 with a pulse of 56.

I have an appointment set for my clinic in another week. I'll discuss this with my doctor at that point. I just cannot understand the fluxuations for the life of me. It's frustrating... at least when I was doing tobacco and alcohol my blood pressure was CONSISTENT. Now it's all over the place, depending on the situation. One morning I woke up feeling odd, took my BP and found it to be 180/118. After a trip to the ER, I was told that it was anxiety. (It dropped to 150/90 before I left).

I cannot understand how my pressure can fluxuate so wildly being that I have a "perfectly healthy" heart. I've even undergone the tilt table test and stress test. These were a couple years back, but given my age and the fact that not much has changed, I must assume that the tests would still be valid and I would still be considered a healthy individual.

Is there any reason that you can think of that I could be seeing these fluxuations? Would you attribute it to anxiety? I do take xanax twice a day due to some serious panic episodes that have landed me in the back of more than one ambulance. My therapist and I are working through that and I've never felt as relaxed in my life as I did this week after my therapist visit.

Thanks for your prompt response earlier and I look forward to hearing your thoughts.

-James

As you probably realize, we can't diagnose or recommend here on AMHD but considering the meds you are on, could be a contributing factor in your fluctuations, or you are just being under medicated as I was for such a long time (my retiring doctor admitted that tome years ago). Have since found an excellent doctor who took me out of the stroke range and my blood pressure has never varied now from l20/60. She is apparently quite happy with that.

Good luck and get that BP straightened; as you may know, they say high blood pressure is the silent killer, meaning you have no warning, unless you test frequently, of any problems. Low pressure can be just as bad, as blood has to get to all extremities at a good rate.

Tick

Thanks for taking the time to address my concerns Tick. It's much appreciated, as I am able to relax now.

I'm going to drag my rear into bed and forget about it for the moment. I'll keep a record of my tests for the week and present them to my clinic on the 15th (my scheduled appointment).

All the best and thanks again,

James

I lost everything I typed, so I'm going to try again.

As your aware, we cannot diagnose ailments over the internet.

Blood pressure will increase with anxiety and will increase by drinking fluids. The latter is important when dealing with a hypotension episode.

The normal BP is 120/80 with a pulse of 80. A low pulse below 80 is actually better proving BP isn't low. It's important to lower BP in the range of 170 like yours.

To take your BP, use the left arm while sitting up. Do at least a short walk 20' or so before taking your BP. Take it at the heart level using the left arm. Some electronic BP meters have trouble figuring out what the blood pressure is, so make sure the sensor is placed over top a vein in the arm just above the elbow. Using a stethoscope, even in combination with an electronic monitor will potentially yield better results.

The timing of medications are important. I would recommend taking Lisinopril after 8:00 pm+. This gives the body a time to wind down and lowers the BP prior to sleep.

Lisinopril blocks the conversion of Angeotestin I to Angeotestin II and may not be the right drug for you.

Benicar is an Angeotestin II antagonist and thus directly acts on the what cause the arteries and veins to constrict. Lisinopril limits the amount available.

Benicar is a MUCH MORE EXPENSIVE drug and IT MIGHT be a more beneficial drug for you to use. Psysicians will likely try the least expensive drugs first which is not a bad policy. The drug that they select may not be the BEST for you.

The anxiety issues that your dealing with, whatever they are, need to be addressed. Your using drugs such as Xanax. Long term daily use is BAD. If you have any issues with Xanax, there are other alternatives such as Ativan. Remember to use the least amout that's therapeutic and only use it when you need it. That, in itself, should prevent abuse and addiction issues.

Your anxiety issues are even spilling over to the blood pressure problem. This isn't good. You probably should have split the bill and increased the dose over time. Shocks to the bodies system are not good especially if the BP has been high for some time. If it's an acute issue then lowering it quickly makes the most sense.

I'm glad your getting therapy and addressing your anxiety issues. Your welcome to discuss it here. Because we are such a diverse group, you may get some answers that are more beneficial to you..