Managing Blood Pressure Anxiety: Insights from Recent Health Tests

Blood Pressure and Medication (Follow-up Inquiry)

Hello Director He, after following my attending physician's advice to rest for 2 weeks without exercise, I had my blood drawn again for testing.

Blood Test Results:
- "Hemoglobin" increased from 37 to 36.1, which is 0.1 above the normal range.
All other previously elevated items have returned to normal.

Kidney Function:
- All values remain normal, and the "glomerular filtration rate" improved from 76.78 to approximately 108.
Liver Function:
- This time, the "total bilirubin" increased from 1.9 to 2.4; "direct bilirubin" changed from 0.51 to 0.52.
Triglycerides decreased from 207 to 66, and cholesterol dropped from 180 to 162.
Urine Test:
- Urine protein improved from "2+" to "+-".

The blood test results are clearly better than the first time, so I would like to ask Director He a few questions:
1.
My attending physician mentioned that my body is gradually recovering, but the total bilirubin and direct bilirubin are still elevated, mainly because they require a longer time to metabolize.
I would like to ask Director He, aside from avoiding excessive exercise, what dietary restrictions should I consider?
2.
Case 1: Before my physical examination, I measured my blood pressure at home, which was around 150-155, not exceeding 160.
However, at the hospital, my readings were consistently above 220, averaging around 240, while my pulse remained between 50-60.
I am confused about how my pulse can be low while my blood pressure is so high.
Is there an element of anxiety or tension involved? (I was anxious the night before the examination and had trouble sleeping due to my worries about measuring blood pressure, as I had never measured it at a hospital before.)
Case 2: On another occasion, using the same blood pressure machine at home, I measured several times, averaging around 150-155.
However, when someone was nearby, my readings spiked to 210-220.
I genuinely want to ask Director He, while the machine in Case 1 might have been different and possibly inaccurate, in Case 2, the same machine showed a difference of 50-60.
Is it really possible for anxiety and tension to cause such a significant spike in blood pressure?
*I do not have any obvious discomfort, dizziness, or headaches, but my blood pressure can reach over 200, which makes me even more anxious!*
3.
Since measuring a terrifying reading of 220 or higher at the hospital, I seem to have become more anxious about measuring my blood pressure, even at home.
After the examination, my home readings are noticeably 20-25 points higher than before the check-up.
Should I just stop measuring it altogether?
4.
Now, regardless of where I measure my blood pressure, it seems to be consistently distorted.
I asked my attending physician how I can know if my blood pressure is high enough to damage my organs.
The physician suggested regular blood tests.
I would like to ask Director He, is there really no way to obtain more accurate data through blood tests?
I apologize for the lengthy questions, but my attending physician just laughed when I mentioned my readings above 220 and told me to relax.
I genuinely don't know if I am being too anxious, but I am truly afraid of sudden deterioration or complications! Thank you very much for your answers, Director He!

Niming, 20~29 year old female. Ask Date: 2015/02/01

Dr. He Dongjin reply Cardiology

Hello, please stop measuring your blood pressure.
It only creates anxiety and can lead to uncontrolled blood pressure and even complications.
At your age, I have not seen this happen.
We are here to treat people, not numbers.
You know that stress and anxiety cause those numbers to fluctuate, so they are not important.
Let's not measure it for a month and revisit it later.
Changhua Hospital cares about you.

Reply Date: 2015/02/01

More Info

Managing blood pressure anxiety is a common concern, especially for individuals who experience heightened stress or anxiety during medical evaluations. Your situation reflects a complex interplay between physiological responses and psychological factors, which can significantly impact blood pressure readings.

1. Understanding Blood Pressure Readings: Blood pressure is measured in two values: systolic (the pressure when the heart beats) and diastolic (the pressure when the heart rests between beats). A reading of 220/whatever is considered hypertensive crisis, which can be alarming. However, it’s essential to recognize that anxiety can cause temporary spikes in blood pressure. This phenomenon is often referred to as "white coat syndrome," where patients experience elevated blood pressure readings in clinical settings due to anxiety.

2. Factors Influencing Blood Pressure: Your experience of fluctuating blood pressure readings, particularly the significant difference between home measurements and those taken in a clinical setting, suggests that anxiety plays a substantial role. Stress and anxiety can lead to the release of stress hormones like adrenaline, which can increase heart rate and blood pressure. Additionally, the presence of others during measurements can further exacerbate anxiety, leading to even higher readings.

3. Managing Anxiety and Blood Pressure: Given your heightened anxiety surrounding blood pressure measurements, it may be beneficial to take a break from regular monitoring. This can help reduce the cycle of anxiety that arises from worrying about your blood pressure. Instead, focus on relaxation techniques such as deep breathing, meditation, or mindfulness practices before taking any measurements. When you do measure your blood pressure, ensure you are in a calm environment, ideally after resting for at least five minutes.

4. Diet and Lifestyle Considerations: Regarding your concerns about elevated bilirubin levels and dietary restrictions, it’s crucial to maintain a balanced diet low in saturated fats and high in fruits, vegetables, and whole grains. Reducing alcohol intake and avoiding processed foods can also support liver health. Regular, moderate exercise can help manage both blood pressure and cholesterol levels, but it’s essential to follow your physician's advice regarding physical activity, especially after recent health evaluations.

5. Regular Check-ups and Monitoring: While it’s understandable to feel anxious about blood pressure readings, regular check-ups are vital for monitoring your overall health. Your physician's suggestion to focus on blood tests rather than daily blood pressure readings is a reasonable approach. Blood tests can provide insights into your cardiovascular health and help identify any potential issues without the immediate stress of blood pressure monitoring.

6. Seeking Professional Help: If your anxiety continues to interfere with your daily life or health management, consider seeking support from a mental health professional. Cognitive-behavioral therapy (CBT) has been shown to be effective in managing anxiety and can provide you with tools to cope with stress related to health concerns.

In summary, while it’s essential to monitor your health, managing anxiety is equally important. Taking a step back from frequent blood pressure measurements, focusing on relaxation techniques, maintaining a healthy lifestyle, and seeking professional support can help you navigate your concerns more effectively. Remember, your health is a journey, and addressing both physical and mental aspects is crucial for overall well-being.

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