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Professional opinion needed, please


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I am not real sure where to post this topic so Ill try here. If this isnt the right place I apologize.

My question is this: I am an EMT student and 3 weeks ago in class we learned about "vital signs", learning the normal blood pressure for adults and children. I was a little concerned when my blood pressure was consistently >180/100. I recorded two weeks of morning, noon, and nite vitals and made an appointment to see my doctor. I was seen by the physicians assistant and when presented with the recorded trend she looked back through my file and commented that my blood pressure had been that high every visit since 1999, comprised of approx. 20 visits. She asked," why havent you done anything about this yet"? My reply was, "good question"! My question is, is this acceptable? Should they have been more observant and treated this earlier? What do you think about this situation? Thanks for your reply.

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Yeah, I would say your BP is pretty high for any age, but especially at 30. I would also say that your doc should have been at least talking about lifestyle changes that could help lower it, if not outright treating it pharmacologically. Both systolic and diastolic are high, which is an even greater concern. The systolic at 180 is quite high pressure inside your arteries when your heart is in systole (or pumping). But the diastolic (heart at rest) at 100 means your arteries are under constant high pressure, with little to no break. BP alone usually doesn't mean a whole lot acutely, but chronically for 7 years this is a problem. Chronic hypertension predisposes to artherosclerosis, heart disease, stroke, kidney disease and probably other less devastating disease.

I don't say any of this to frighten you, but to motivate to get this under control. At 30, I would venture to say (but don't take it as fact) that if controlled now, you quite possibly will avoid serious damage. If it were me, I'd be having a serious talk with my doc or finding another. This is just my opinion based on limited information, though. Are there any factors that could have contributed to elevated BP at all the times it was taken? For instance, after physical exertion? Any meds? Hungover? Just finished smoking? Look at the variables. The good news is that hypertension is quite controllable. Good luck - let us know how it goes.

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Thanks becksdad. Yes,the p.a. prescribed two meds and it is making a considerable difference. I am just curious if doctors normally need to see several years worth of trending to treat since I was so young or if he was simply negligent. I also read that hypertension in adults aged 18-47 results in reduced cognitive function. Hmmmm, maybe thats why I so sllllloooowwww, lol.

Thanks again Becksdad.

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Lucky, your doc should have addressed this a long long time ago. 7 years is way too long to have it just sit there.

I'd be asking some serious questions to this doctor about why he let this go on for so long.

Good luck and I am glad that you got the meds you need.

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Yea. They typically don't need years to start trying to control this thing. If you were hypertensive back in 1999, they should have told you then and there to start trying to control it through lifestyle changes. (mainly exercise and diet) and scheduling a followup. Not for years later, but months later. If you showed no improvement with exercise and diet they would probably try pharacological interventions. Speaking of, the typical drugs you get are dieuretics, angiotensin converting enzyme (ACE) inhibitors, and beta-blocking agents. You're probably on at least one of these three types of medications now. Good luck with this.

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If you were hypertensive back in 1999, they should have told you then and there to start trying to control it through lifestyle changes. (mainly exercise and diet) and scheduling a followup. Not for years later, but months later.

Not even for months later. Days later. A week at the most, unless there was some compelling primary cause for the HTN that was otherwise being addressed. Stage II hypertension is not something that a competent practitioner blows off in any patient as being "normal," regardless of the presence or absence of symptomology. Sounds like this guy has lost his touch, or is simply too busy to pay attention to details. I'd switch docs, without a doubt.

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Not that you haven't heard it, but yes, 7 years is far, far too long for a doctor to have taken action. Unfortunately, things such as this are becoming far to common in the modern health care world as HMO's squeeze more and more patients into less and less doctors.

One day, the system will either collapse or wake up and see that medicine is not McDonald's, you can't streamline or make diagnosis faster without compromising quality.

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