Elevated blood pressure

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Mario De'Cristofano

Mario De'Cristofano

Member
Relationship to Diabetes
Type 2
Hi,

I was diagnosed type 2 a while ago, but have that under control (current HBA1C a consistent 43) and despite a healthy well balanced life style, I don't smoke, and alcohol is kept to a minimum I do have a problem with somewhat high blood pressure which I can't seem to reduce.

I was prescribed Ramipril starting off on a maintenance dose of 2.5mg and slowly had increased the dosage to 10mg but my BP hovers anywhere around 140/97 right up to 170/110 when I'm at the GP's (although I factor in some white collar syndrome).

I've lost over 3 stone in weight, due to lose one more to reach my target weight. Despite this and living a healthy lifestyle, what more can I do to reduce high BP?

A quick note on my lifestyle, coffee and any other stimulants are minimal, I get a pretty consistent 7.5 hours rest (decent rest) a night, and I eat really well. I do however have a very stressful career but don't feel I'm a constant emotional wreck although I have gone through the mill recently emotionally for a number of personal reasons inc. career.

I guess I'm not convinced that there's that much of a close correlation between circumstantial lifestyle and direct impact on BP, but I wondered if anyone else had, during their diagnosis of diabetes and commonly associated high blood pressure, had any advice, tips, or could share their stories?
 
Hello Mario and welcome to the forum. Have you factored in any exercise as this will help with blood pressure problems?
 
I run typically between 5-8k four to six times a week if not more. I'm pretty active and walk at minimum 20k steps a day (according to Fitbit). I'm at a loss.
 
I guess we're at an empasse now, me & my GP. We're on that verge of how long can I function with elevated blood pressure without causing fundamental cardiovascular damage, vs the impact of further weight loss may have on reducing it naturally.
 
Hi Mario, welcome to the forum 🙂 Are you sure that this is not just a manifestation of 'white coat syndrome', whereby BP levels are unnaturally elevated when you are having your levels measured by a health professional? It's a very common phenomenon - I suffer from it, my levels are always much higher at the GPs! 😱 My solution was to get a home monitor - they are very cheap, I got an Omron basic monitor which I use to measure my levels every day, and they are actually very good (usually around 110/70 or thereabouts 🙂) I then took my readings to show my GP who agreed that there wasn't really a problem and didn't increase my medication (I'm on a low dose of candesartan, a different type of BP med to ramipril).

Worth a try - you appear to be doing everything right as far as I can see. I was going to suggest exercise, but you sound like you've got that aspect cracked too 🙂 The only other possibility is to ensure there is not too much salt in your diet - recommended no more than 6g per day. I spent a few days recording my salt intake and found I was well below, but it's a useful exercise if you haven't done it as a lot of things contain salt that all add up.

Edit: I see you are aware of white coat syndrome, I should read more carefully! 🙄
 
sorry I completely forgot to add further detail, my bad. I do have a very good quality home blood pressure monitor, and have nurses in the family so have learnt how to accurately & correctly measure my BP. My quoted BP level is a mean average over 5 days with home testing, 3 times a day (same arm) as I'm aware I have some WCS when at the surgery. HELLP!!!! As for salt, I don't really have it in anything, and I'd never consider lo-salt or anything. I only tend to consume salt when it's naturally occurring. I'm a big foodie and cook, so as I say, we tend to eat really well, and keep salt at a minimum. 5-6 days a week, I eat a very macro-nutrient controlled diet, only giving myself the odd Fri/Sat night off which includes a couple of beers (honestly just a couple) and the odd thoughtful home made cheat meal
 
I even add to my diet by having proven things which lower BP such as Green tea (which I really like anyway) and I do take time out to relax, even meditate to some degree (although I don't think I really ever meditate properly) but I do (despite my crazy career) get a reasonable amount of down time and relaxation.
 
I was going to really start drilling down into my diet now, and seeing if anything is spiking it. Maybe I have an intolerance to something, no matter in how small quantities I consume. Could it be beer? Could it be the odd bowl of take away? I don't know.
 
This will sound ridiculous - but a bloke on out motorhome forum swears that drinking pomegranate juice has helped lower his. You just never know - and it's cheap enough.

I'm gobsmacked your GP hasn't thrown extra tablets at you though, Mario.
 
I'll try pomegranate. To be fair, my GP is pretty good and I've made it very clear I'm educated and capable of running my own human body thank you very much. 🙂 She knows the score. It helps I'm one of those awkward know-it-alls although it's taken me showing her all my Strava, Google Healthkit, Digital Scales, Glucose monitoring, Fitbit and other health data for her to actually believe yes, I don't smoke, yes, I don't drink, yes I'm food educated etc etc. I was pretty dejected when I was first diagnosed that the advice given is always to the lowest common denominator and they have to assume you lie about your lifestyle etc because a lot of people do.
 
Has the gp suggested 24 hr monitoring of your bp to see what is happening.
 
I've done that before (although a long time ago), and yes it may be worth me suggesting again. I think we're both confident my measurements are pretty accurate, and I try & measure at key points to get an accurate trend of my body but I guess a 24 hour measurement may be useful. I know the last time I had it, and the resultant ECG and trace, everything came back normal, just raised BP
 
A note on Pomegranate, isn't it massively high in sugar, hardly the thing I want to be consuming as a potential diabetic. Or is 150ml a day not going to hurt much?
 
Mario De'Cristofano said:
Hi,

I was diagnosed type 2 a while ago, but have that under control (current HBA1C a consistent 43) and despite a healthy well balanced life style, I don't smoke, and alcohol is kept to a minimum I do have a problem with somewhat high blood pressure which I can't seem to reduce.

I was prescribed Ramipril starting off on a maintenance dose of 2.5mg and slowly had increased the dosage to 10mg but my BP hovers anywhere around 140/97 right up to 170/110 when I'm at the GP's (although I factor in some white collar syndrome).

I've lost over 3 stone in weight, due to lose one more to reach my target weight. Despite this and living a healthy lifestyle, what more can I do to reduce high BP?

A quick note on my lifestyle, coffee and any other stimulants are minimal, I get a pretty consistent 7.5 hours rest (decent rest) a night, and I eat really well. I do however have a very stressful career but don't feel I'm a constant emotional wreck although I have gone through the mill recently emotionally for a number of personal reasons inc. career.

I guess I'm not convinced that there's that much of a close correlation between circumstantial lifestyle and direct impact on BP, but I wondered if anyone else had, during their diagnosis of diabetes and commonly associated high blood pressure, had any advice, tips, or could share their stories?
Click to expand...
Hi mario .
Warm welcome to the forum .
 
Ah - you're T2. Sorry - yeah, I had to have a jab with it - not that it made any difference to mine.

That sort of level you had at the docs however - is prime 'This chap's likely to have a stroke anytime now' sort of territory, usually - which is why I said I was surprised at the GP not insisting on additional measures.

Do you think, some alternative BP med might suit you better and do more for your BP? I realise that they reckon ACE inhibitors are better to prevent kidney damage - but really with you being so fit otherwise, do they need protecting more than your high BP needs treating? - unless your GP knows more about that side of things than you've indicated.

I also know they reckon just because we have the D word, then we're much more likely to drop dead from a whole medical dictionary full of other things - BUT - really? Are YOU?

I'd just be asking my doc those questions - and asking him what his honest opinion is.
 
Mario De'Cristofano said:
A note on Pomegranate, isn't it massively high in sugar, hardly the thing I want to be consuming as a potential diabetic. Or is 150ml a day not going to hurt much?
Click to expand...
Hi Mario...I doubt Pomegranate will impact or spike your blood sugars.. studies indicate Pomegranate juice can be beneficial in lowering blood glucose levels for type 2's...A 100-gram serving of pomegranate... slightly more than a half-cup contains 83 calories...4 grams of fiber and 13.67 grams of natural sugars...a bit higher in sugar than some other fruits...but the fibre helps slow the digestion and minimize the effect on your BG of the natural sugars it contains...no doubt you are aware...diet is very much an individual trial & error issue with us type 2's...so I suggest you try it...then test...that will be your best indicator of how it affects your levels...as for the Blood Pressure...I started on Ramipril last year in July...2 mgs per day... managed to come off them in January this year...weight loss...controlling my BG...increasing my activity and minimising the stress...all relevant factors in 'ditching' the BP meds...you seem to have everything under good control...so are focusing on your elevated PB...at the risk of getting my head bitten off here...(possibly rightly so)...wondering if that could be relevant?...the readings you give above from my limited knowledge indicate stage 1 hypertension...so every possibility you can bring them down...stress however as much we try to avoid it or convince ourselves it is under control plays a major role (my opinion)...possibly just step back a little...try the 24hr BP monitor...should demonstrate when/where...under what conditions your BP is at its highest...be interested to hear how this progresses...good luck.
 
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