My Blood Pressure Concerns: A Journey Through Diagnosis

My hypertension issue?

Last year during my physical examination, I struggled to pass the blood pressure test, but I barely managed to get through.
Coincidentally, I extended my studies for another year, which led me to visit the hospital (National Defense Medical Center Songshan Hospital) multiple times.
Each time my blood pressure measured at the hospital was around 165-176.
Therefore, I underwent blood tests, urinalysis, and wore a 24-hour ambulatory blood pressure monitor.
The biochemical report and other data indicated that there seemed to be no signs of kidney disease.
The 24-hour blood pressure monitor recorded 76 readings, with only 7 exceeding 140/90, the highest being 158/103 (which occurred shortly after I put on the monitor).
My average systolic and diastolic pressures, as well as heart rate, were within normal ranges, showing no clear evidence of hypertension.
Initially, I hoped that having high blood pressure would exempt me from military service, but that hope was dashed.
However, another question arose: do I actually have hypertension? If not, why is my blood pressure so high? Last week, I went to the emergency room (United Hospital Renai Branch) due to a herniated disc and underwent surgery after an MRI.
After leaving the operating room, the nurse began to regularly monitor my blood pressure and temperature.
Immediately after surgery, my systolic pressure was 122 (as the anesthesia effects had not fully worn off).
The subsequent readings ranged from 122 to 174 for systolic and 78 to 105 for diastolic.
According to the nurse, my heart rate averaged in the 90s.
During my hospital stay, only a few readings fell within the normal range, but the nurse mentioned that my blood pressure was still too high.
Since I should no longer have military service issues, I am currently focusing on recovering (after undergoing laminectomy) and would like to address this blood pressure concern.
Could you please help me understand what might be going on? Thank you.

P.S.
Do you need any additional information or reports to make a determination?

Cheng Hsun, 20~29 year old female. Ask Date: 2005/11/06

Dr. Huang Guosheng reply Cardiology

Blood pressure can be easily influenced by external factors such as stress, anxiety, insomnia, discomfort, smoking, and irregular lifestyle.
Therefore, it is recommended to rest for ten minutes before measuring blood pressure to minimize external disturbances.
If the blood pressure reading shows a systolic pressure of 140 mmHg and a diastolic pressure of 90 mmHg, it indicates hypertension.
It is advisable to monitor your blood pressure over a period of time and keep a record of the readings, then consult a physician for further evaluation.

Reply Date: 2005/11/06

More Info

Understanding your blood pressure concerns is crucial, especially given your recent experiences with fluctuating readings and medical evaluations. Based on the information you've provided, it appears that you are navigating a complex situation involving both your blood pressure and recent surgical interventions.

Firstly, let's address the concept of hypertension. Hypertension, or high blood pressure, is typically diagnosed when blood pressure readings consistently exceed 130/80 mmHg. However, it is essential to consider the context in which these readings are taken. For instance, your readings in the hospital, ranging from 165-176 mmHg, are indeed concerning and suggest hypertension. However, the average readings from your 24-hour blood pressure monitor, which show only a few instances above 140/90 mmHg, indicate that your blood pressure may not be consistently high outside of stressful situations, such as hospital visits or surgical procedures.

The phenomenon of "white coat syndrome," where patients experience elevated blood pressure readings in clinical settings due to anxiety or stress, could explain the higher readings you encountered at the hospital. This is a common occurrence and can lead to misdiagnosis if not properly accounted for. Your average readings from the 24-hour monitor suggest that your blood pressure may be more stable than what is observed during hospital visits.

Additionally, your recent surgery for a herniated disc and the associated stress and pain could also contribute to temporary spikes in blood pressure. Post-operative pain and anxiety can lead to increased sympathetic nervous system activity, resulting in elevated heart rates and blood pressure. The fact that your blood pressure was recorded at 122 mmHg immediately after surgery indicates that your body was responding to the anesthesia and the surgical stress.

Regarding your concerns about kidney function, it's reassuring to note that your biochemical tests did not indicate any renal impairment. This is an important factor since kidney disease can contribute to hypertension. Regular monitoring of kidney function is advisable, especially if you have risk factors such as hypertension or diabetes.

To address your question about whether you have hypertension, it seems that you may not have persistent hypertension based on the 24-hour monitoring results. However, the occasional high readings, especially during stressful situations, should not be ignored. It would be prudent to continue monitoring your blood pressure regularly, ideally in a relaxed setting, to get a more accurate picture of your baseline blood pressure.

In terms of management, lifestyle modifications can play a significant role in controlling blood pressure. These include maintaining a healthy diet low in sodium, engaging in regular physical activity, managing stress through relaxation techniques, and avoiding tobacco and excessive alcohol consumption. Given your recent surgery, it's essential to follow your physician's advice regarding physical activity and rehabilitation.

If your blood pressure continues to fluctuate or if you experience symptoms such as headaches, dizziness, or palpitations, it would be wise to consult with a healthcare provider. They may recommend further evaluation, including possible medication management, to help stabilize your blood pressure.

In conclusion, while your blood pressure readings in the hospital are concerning, the average readings from your 24-hour monitor suggest that you may not have persistent hypertension. Continue to monitor your blood pressure in a relaxed environment, maintain a healthy lifestyle, and consult with your healthcare provider for personalized advice and management strategies.

Similar Q&A

Understanding High Blood Pressure: A Young Adult's Journey to Wellness

I recently graduated from university, and during my college years, my lifestyle was irregular (staying up all night or sleeping late), and my eating habits were inconsistent, often missing meals. However, I maintained a routine of exercising for two hours every day. A few weeks a...

Dr. He Dongjin reply Cardiology
Hello, feeling anxious can affect your blood pressure readings, making them inaccurate. It's uncertain whether you have hypertension or not. Here are three methods for blood pressure management: 1. Medication: You don't need to rush into taking medication right away. ...

Am I Overly Anxious? Understanding Health Anxiety and Blood Pressure Monitoring

Hello Doctor: I am a patient with hypertension. Although I take my blood pressure medication regularly every day and my blood pressure is completely normal, I have become particularly sensitive to my body due to the trauma of my father's stroke, which left him in a vegetativ...

Dr. Wu Enliang reply Psychiatry
Hello: It does sound like there may be symptoms of anxiety disorder. It is recommended to visit a psychiatrist for evaluation and to receive psychotherapy, behavioral therapy, relaxation training, or medication treatment.

Managing High Blood Pressure: Understanding Medication and Heart Health Concerns

Due to issues with benign prostatic hyperplasia, I visited a urologist and discovered my blood pressure was over 180/112. This led me to consult a cardiologist for hypertension. I have been smoking for over 30 years and started feeling anxious at the age of 27 due to family circu...

Dr. Cai Guiqin reply Cardiology
It is recommended that you discuss the above situation with your attending physician to determine if further examinations are necessary. Thank you, and wishing you good health!

Managing White Coat Hypertension: Causes, Effects, and Treatment Options

Since childhood, I have easily felt nervous during exams, and now that I am working, I still experience this. During health check-ups and blood donations, my blood pressure readings are often elevated at 145/92, but after resting, it decreases to 128/88. My height is 177 cm and m...

Dr. Hou Angting reply Family Medicine
Hello, Zongjun: I suggest that you reduce your salt intake in your diet and develop a habit of exercising. If your blood pressure remains elevated after one month, I recommend consulting with a family medicine specialist for evaluation. Wishing you good health.