Ideal BP

Quoted message said:

My BP is currently in the 130-115/65-80 range w/o meds. I was told that the new limits for BP are
120/80? Is there empirical research to suggest these new lowered standards?

The lower a person's BP is, the less likely he is to suffer from BP-related cardiovascular disease.
I think the new limits are a bit on the stupid side ... after all, why not just define ideal BP as
"as low as possible without producing symptoms"? Obviously, since the CV system is like a bunch of
pipes, lower pressure means less wear and tear, and less possibility of failure, but that doesn't
mean that BP must be constantly and artificially driven lower and lower.

Your BP sounds fine. But I'm not a doctor and this is not medical advice. Besides, wait a few more
years and someone will probably define new limits at 100/50 or something, after discovering that
people with BP at that level rarely suffer from hemorrhagic strokes (duh!).

Quoted message said:

I try not to be skeptical and think that the lowered standards are more about pharmaceutical
business than health.

I don't think that there are any decent standards. We know what BP we observe in normal, healthy
individuals, but nobody knows what "ideal" BP should be. Maybe everyone could benefit from lowered
BP. Then again, maybe higher BPs aren't as bad as they are made out to be.

I think the problem is that researchers notice that low BP reduces CV disease, and thus incorrectly
assume that an "ideal normal" BP is unrealistically low. People are thus medicated for no reason
just to get their BP as low as possible, in order to reduce their CV risk.

Well, that's like encouraging people to lie in bed all day because it reduces their risk of broken
bones. Sure, it's _safe_ to lie in bed all day, but is it really _ideal_ to behave that way, just to
avoid broken bones?

Quoted message said:

What are the risks associated with untreated BP in the
125/80 range?

Essentially nil. If it gets to 145/92, watch it carefully. If it rises even more, or fails to go
down even after weight loss and exercise, then you might reluctantly consider medication. I don't
know why anyone would worry about 125/80, but then again, I've never been very good at jumping on
bandwagons.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Quoted message said:

I have always had BP in the 115-140/65-75 range (average probably 125/75). A few years ago, I was
placed on Atenolol because of mild high/borderline BP. I have exercised and lost weight in order
to get off the medication b/c of the side effects. My BP is currently in the 130-115/65-80 range
w/o meds. I was told that the new limits for BP are 120/80? Is there empirical research to suggest
these new lowered standards? Do you have the citations? I try not to be skeptical and think that
the lowered standards are more about pharmaceutical business than health. What are the risks
associated with untreated BP in the 125/80 range? Thanks in advance.

Current guidelines are to treat to goal of 115/75 or less.

Risks associated with untreated BP of 125/80 would be increased risk of developing problems
attributed to hypertension.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

Sun, 02 Nov 2003 19:11:32 GMT in article
<[email hidden]> "Dr. Andrew B.

Chung said:

Quoted message said:

I have always had BP in the 115-140/65-75 range (average probably 125/75). A few years ago, I was
placed on Atenolol because of mild high/borderline BP. I have exercised and lost weight in order
to get off the medication b/c of the side effects. My BP is currently in the 130-115/65-80 range
w/o meds. I was told that the new limits for BP are 120/80? Is there empirical research to
suggest these new lowered standards? Do you have the citations? I try not to be skeptical and
think that the lowered standards are more about pharmaceutical business than health. What are the
risks associated with untreated BP in the 125/80 range? Thanks in advance.

Current guidelines are to treat to goal of 115/75 or less.

Based on what?

Quoted message said:

Risks associated with untreated BP of 125/80 would be increased risk of developing problems
attributed to hypertension.

I will believe it, if I see the evidence. Meanwhile, have a look at this study:

Merlo J, Ranstam J, Liedholm H, Hedblad B, Lindberg G, Lindblad U, Isacsson SO, Melander A,
Rastam L. Related Articles, Links Incidence of myocardial infarction in elderly men being treated
with antihypertensive drugs: population based cohort study. BMJ. 1996 Aug 24;313(7055):457-61.
PMID: 8776312 [PubMed - indexed for MEDLINE]
<http://bmj.bmjjournals.com/cgi/content/full/313/7055/457> <ncbi.nlm.nih.govqOpen ↗
uery.fcgi?cmd=Retrieve&db=PubMed&list_uids=8776312&dopt=Abstract>

Abstract:

"OBJECTIVE: To analyse the association between use of antihypertensive treatment, diastolic
blood pressure, and long term incidence of ischaemic cardiac events in elderly men. DESIGN:
Population based cohort study. Baseline examination in 1982-3 and follow up for up to 10 years.
SETTING: Malmo, Sweden. SUBJECTS: 484 randomly selected men born in 1914 and living in Malmo
during 1982. MAIN OUTCOME MEASURES: Observational comparisons of incidence rates and rate and
hazard ratios of ischaemic cardiac events (myocardial infarction or death due to chronic
ischaemic cardiac disease). RESULTS: The crude incidence rate of ischaemic cardiac events was
higher in those subjects who were taking antihypertensive drugs than in those who were not (rate
ratio 2.6 (95% confidence interval 1.7 to 3.9)). After adjustment for potential confounders
(differences in baseline smoking habits, blood pressure, time since diagnosis of hypertension,
ischaemic or other cardiovascular disease, hypercholesterolaemia, hypertriglyceridaemia,
diabetes mellitus, obesity, and raised serum creatinine concentration) this rate was reduced but
still raised (hazard ratio 1.9 (1.0 to 3.7)). In men with diastolic blood pressure > 90 mm Hg,
antihypertensive treatment was associated with a twofold increase in the incidence of ischaemic
cardiac events (rate ratio 2.0 (1.1 to 3.6)), which vanished after adjustment for potential
confounders (hazard ratio 1.1 (0.5 to 2.6)). In those subjects with diastolic blood pressure <
or = 90 mm Hg, antihypertensive treatment was associated with fourfold increase in incidence
(rate ratio 3.9
(2.1 to 7.1)), which remained after adjustment for potential confounders (hazard ratio 3.8 (1.3
to 11.0)). CONCLUSION: Antihypertensive treatment may increase the risk of myocardial
infarction in elderly men with treated diastolic blood pressures < or = 90 mm Hg."

--
Matti Narkia

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

Quoted message said:

I have always had BP in the 115-140/65-75 range (average probably 125/75). A few years ago, I
was placed on Atenolol because of mild high/borderline BP. I have exercised and lost weight in
order to get off the medication b/c of the side effects. My BP is currently in the 130-115/65-80
range w/o meds. I was told that the new limits for BP are 120/80? Is there empirical research to
suggest these new lowered standards? Do you have the citations? I try not to be skeptical and
think that the lowered standards are more about pharmaceutical business than health. What are
the risks associated with untreated BP in the 125/80 range? Thanks in advance.

Current guidelines are to treat to goal of 115/75 or less.

Risks associated with untreated BP of 125/80 would be increased risk of developing problems
attributed to hypertension.

Is this guideline universally accepted? When or during which hour of a day should the BP be
measured? Early in the morning or late in the evening. I think there is a diference in using this
guideline when applied to patients with or without inherited HBP. People with HBP that is of an
inherited nature should be expected to assume a higher number. No? Personally i would feel a bit
uncomfortable and tense when it goes about near 140/90 _before going to bed_ but anything below
135/85 is just fine.

FP

Sun, 02 Nov 2003 20:27:52 GMT in article
<[email hidden]> Matti Narkia

Quoted message said:

Sun, 02 Nov 2003 19:11:32 GMT in article <[email hidden]> "Dr.

Andrew B. Chung said:

Quoted message said:

I have always had BP in the 115-140/65-75 range (average probably 125/75). A few years ago, I
was placed on Atenolol because of mild high/borderline BP. I have exercised and lost weight in
order to get off the medication b/c of the side effects. My BP is currently in the 130-115/65-80
range w/o meds. I was told that the new limits for BP are 120/80? Is there empirical research to
suggest these new lowered standards? Do you have the citations? I try not to be skeptical and
think that the lowered standards are more about pharmaceutical business than health. What are
the risks associated with untreated BP in the 125/80 range? Thanks in advance.

Current guidelines are to treat to goal of 115/75 or less.

Based on what?

Quoted message said:

Risks associated with untreated BP of 125/80 would be increased risk of developing problems
attributed to hypertension.

I will believe it, if I see the evidence. Meanwhile, have a look at this study:

Merlo J, Ranstam J, Liedholm H, Hedblad B, Lindberg G, Lindblad U, Isacsson SO, Melander A,
Rastam L. Related Articles, Links Incidence of myocardial infarction in elderly men being treated
with antihypertensive drugs: population based cohort study. BMJ. 1996 Aug 24;313(7055):457-61.
PMID: 8776312 [PubMed - indexed for MEDLINE]
<http://bmj.bmjjournals.com/cgi/content/full/313/7055/457> <ncbi.nlm.nih.govqOpen ↗
uery.fcgi?cmd=Retrieve&db=PubMed&list_uids=8776312&dopt=Abstract>

The above study was commented in Journal Watch as follows:

MI AND ANTIHYPERTENSIVES: THE J-SHAPED CURVE REVISITED Journal Watch (General), October 1, 1996;
1996(1001): 2 - 2. general-medicine.jwatch.org2Open ↗

"MI AND ANTIHYPERTENSIVES: THE J-SHAPED CURVE REVISITED

This Swedish cohort study adds to the growing body of evidence that it is possible to overtreat
hypertension. The study involved 484 men born in 1914 who were initially examined from 1982 to
1983 and followed for up to 10 years. The outcome of interest was myocardial infarction or
cardiovascular death.

Subjects taking antihypertensive agents were 2.6 times as likely to have an ischemic cardiac
event as those not taking antihypertensives. After adjustment for confounders (smoking habits,
blood pressure, duration of hypertension, diabetes, obesity, and elevated serum creatinine
level), this relation weakened, but did not disappear (hazard ratio, 1.9). In men with diastolic
blood pressure higher than 90 mm Hg, the use of antihypertensives was associated with a two-fold
increase in cardiac risk that disappeared after correction for confounders. In men with a
diastolic blood pressure of 90 mm Hg or lower, the use of antihypertensives was associated with
a 3.9-fold increase in risk that persisted after adjustment for confounders.

Comment: While the number of cardiac events was relatively small, the investigators did a good
job of eliminating other kinds of bias, such as lower blood pressure being a sign of more severe
underlying illness. Thus, these data support a J- shaped relation between treated blood pressure
and cardiac events in men. In other words, lowering blood pressure below a certain level
increases risk. --KI Marton

Published in Journal Watch October 1, 1996"

--
Matti Narkia

francispoon said:

Is this guideline universally accepted?

Nothing is ever universally accepted. It is widely accepted.

Quoted message said:

When or during which hour of a day should the BP be measured? Early in the morning or late in the
evening.

It matters little, as long as you are quietly at rest and you always measure it under the same
circumstances (with an empty bladder, after sitting quietly for a time, on the same arm, with arm in
the same position and cuff level with the heart, etc.).

Quoted message said:

I think there is a diference in using this guideline when applied to patients with or without
inherited HBP. People with HBP that is of an inherited nature should be expected to assume a
higher number. No?

The damage done by hypertension is independent of how it developed, so the guidelines would be the
same for people with or without a given type of hypertension.

Quoted message said:

Personally i would feel a bit uncomfortable and tense when it goes about near 140/90 _before going
to bed_ but anything below 135/85 is just fine.

In theory, the higher it is, the sooner it will cause problems. If it is only very slightly elevated
and you are not still a child, you may die of other causes before the BP causes any problems.
Contrary to what many people seem to wish to believe, there are no sharp cutoff points.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

francispoon said:

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
news:<[email hidden]>...

Quoted message said:

Quoted message said:

I have always had BP in the 115-140/65-75 range (average probably 125/75). A few years ago, I
was placed on Atenolol because of mild high/borderline BP. I have exercised and lost weight in
order to get off the medication b/c of the side effects. My BP is currently in the 130-115/65-
80 range w/o meds. I was told that the new limits for BP are 120/80? Is there empirical
research to suggest these new lowered standards? Do you have the citations? I try not to be
skeptical and think that the lowered standards are more about pharmaceutical business than
health. What are the risks associated with untreated BP in the 125/80 range? Thanks in
advance.

Current guidelines are to treat to goal of 115/75 or less.

Risks associated with untreated BP of 125/80 would be increased risk of developing problems
attributed to hypertension.

Is this guideline universally accepted?

Nationally it is. That's why they call it JNC guidelines. *J*oint *N*ational *C*ommittee.

Quoted message said:

When or during which hour of a day should the BP be measured? Early in the morning or late in the
evening.

Morning is preferred.

Quoted message said:

I think there is a diference in using this guideline when applied to patients with or without
inherited HBP.

The predisposition for HBP seems to be inherited.

Quoted message said:

People with HBP that is of an inherited nature should be expected to assume a higher number. No?

No.

Quoted message said:

Personally i would feel a bit uncomfortable and tense when it goes about near 140/90 _before going
to bed_ but anything below 135/85 is just fine.

FP

Not sure what your question is.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

Sun, 02 Nov 2003 20:40:34 GMT in article
<[email hidden]> Matti Narkia

Quoted message said:

Sun, 02 Nov 2003 20:27:52 GMT in article <[email hidden]> Matti Narkia

Quoted message said:

Sun, 02 Nov 2003 19:11:32 GMT in article <[email hidden]> "Dr.

Andrew B. Chung said:

[email hidden] wrote:

> I have always had BP in the 115-140/65-75 range (average probably 125/75). A few years ago, I
> was placed on Atenolol because of mild high/borderline BP. I have exercised and lost weight in
> order to get off the medication b/c of the side effects. My BP is currently in the 130-115/65-
> 80 range w/o meds. I was told that the new limits for BP are 120/80? Is there empirical
> research to suggest these new lowered standards? Do you have the citations? I try not to be
> skeptical and think that the lowered standards are more about pharmaceutical business than
> health. What are the risks associated with untreated BP in the 125/80 range? Thanks in advance.

Current guidelines are to treat to goal of 115/75 or less.

Based on what?

Quoted message said:

Risks associated with untreated BP of 125/80 would be increased risk of developing problems
attributed to hypertension.

I will believe it, if I see the evidence. Meanwhile, have a look at this study:

Merlo J, Ranstam J, Liedholm H, Hedblad B, Lindberg G, Lindblad U, Isacsson SO, Melander A,
Rastam L. Related Articles, Links Incidence of myocardial infarction in elderly men being treated
with antihypertensive drugs: population based cohort study. BMJ. 1996 Aug 24;313(7055):457-61.
PMID: 8776312 [PubMed - indexed for MEDLINE]
<http://bmj.bmjjournals.com/cgi/content/full/313/7055/457> <ncbi.nlm.nih.govqOpen ↗
uery.fcgi?cmd=Retrieve&db=PubMed&list_uids=8776312&dopt=Abstract>

The above study was commented in Journal Watch as follows:

MI AND ANTIHYPERTENSIVES: THE J-SHAPED CURVE REVISITED Journal Watch (General), October 1, 1996;
1996(1001): 2 - 2. general-medicine.jwatch.org2Open ↗

Here a couple of more articles about the same topic

1: Cruickshank J. The J-curve in Hypertension. Curr Cardiol Rep. 2003 Nov;5(6):441-52. PMID:
14558984 [PubMed - in process] <ncbi.nlm.nih.govquery.fcgiOpen ↗
ubMed&list_uids=14558984&dopt=Abstract>

2: Cruickshank JM. Antihypertensive treatment and the J-curve. Cardiovasc Drugs Ther. 2000 Aug;14(4):373-
9. Review. PMID: 10999643 [PubMed - indexed for MEDLINE] <ncbi.nlm.nih.govquOpen ↗
ery.fcgi?cmd=Retrieve&db=PubMed&list_uids=10999643&dopt=Abstract

--
Matti Narkia

see below

Dr. Andrew B. Chung said:

francispoon said:

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
news:<[email hidden]>...

Quoted message said:

[email hidden] wrote:

> I have always had BP in the 115-140/65-75 range (average probably 125/75). A few years ago,
> I was placed on Atenolol because of mild high/borderline BP. I have exercised and lost
> weight in order to get off the medication b/c of the side effects. My BP is currently in the
> 130-115/65-80 range w/o meds. I was told that the new limits for BP are 120/80? Is there
> empirical research to suggest these new lowered standards? Do you have the citations? I try
> not to be skeptical and think that the lowered standards are more about pharmaceutical
> business than health. What are the risks associated with untreated BP in the 125/80 range?
> Thanks in advance.

Current guidelines are to treat to goal of 115/75 or less.

Risks associated with untreated BP of 125/80 would be increased risk of developing problems
attributed to hypertension.

Is this guideline universally accepted?

Nationally it is. That's why they call it JNC guidelines. *J*oint *N*ational *C*ommittee.

Quoted message said:

When or during which hour of a day should the BP be measured? Early in the morning or late in
the evening.

Morning is preferred.

Quoted message said:

I think there is a diference in using this guideline when applied to patients with or without
inherited HBP.

The predisposition for HBP seems to be inherited.

Quoted message said:

People with HBP that is of an inherited nature should be expected to assume a higher number. No?

No.

Quoted message said:

Personally i would feel a bit uncomfortable and tense when it goes about near 140/90 _before
going to bed_ but anything below 135/85 is just fine.

FP

Not sure what your question is.

--
Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

B-0b1 here...why not less than 135/75 as in 110 max over about 65 average?? It IS attainable..as
I have been in the 180/110+ bracket a good part of my life UNTIL I learned the RULES about
proper eating AND took a regular Vitamin Mineral (balanced) regimine with all AVERAGES taken
into consideration. My OWN products also made it a certainty. Since 1994/5...I have been where I
belong...as in age 63 + I am NOW 71+ and have never been so healthy. I can HELP anyone do the
same thing by giving them a FREE KIT with instructions that take about 2 hrs average week or
less. (Total additive)

You may pay the shipping IF you can hack it...otherwise I'll do it.all I need are ADDY"S. Once
you begin to FEEL the "differences" You'll wonder why you didn't do it years ago?? Simplicity
is the answer to any complex problem...B-0b1 "Dead Doctors do NOT Lie"

Dr. Andrew B. Chung said:

francispoon said:

"Dr. Andrew B. Chung, MD/PhD" <[email hidden]> wrote in message
news:<[email hidden]>...

Quoted message said:

[email hidden] wrote:

> I have always had BP in the 115-140/65-75 range (average probably 125/75). A few years ago,
> I was placed on Atenolol because of mild high/borderline BP. I have exercised and lost
> weight in order to get off the medication b/c of the side effects. My BP is currently in the
> 130-115/65-80 range w/o meds. I was told that the new limits for BP are 120/80? Is there
> empirical research to suggest these new lowered standards? Do you have the citations? I try
> not to be skeptical and think that the lowered standards are more about pharmaceutical
> business than health. What are the risks associated with untreated BP in the 125/80 range?
> Thanks in advance.

Current guidelines are to treat to goal of 115/75 or less.

Risks associated with untreated BP of 125/80 would be increased risk of developing problems
attributed to hypertension.

Is this guideline universally accepted?

Nationally it is. That's why they call it JNC guidelines. *J*oint *N*ational *C*ommittee.

Quoted message said:

When or during which hour of a day should the BP be measured? Early in the morning or late in
the evening.

Morning is preferred.

Quoted message said:

I think there is a diference in using this guideline when applied to patients with or without
inherited HBP.

The predisposition for HBP seems to be inherited.

Quoted message said:

People with HBP that is of an inherited nature should be expected to assume a higher number. No?

No.

Quoted message said:

Personally i would feel a bit uncomfortable and tense when it goes about near 140/90 _before
going to bed_ but anything below 135/85 is just fine.

FP

Not sure what your question is.

--
Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist heartmdphd.comheartmdphd.comOpen ↗

B-Ob1 said:

B-0b1 here...why not less than 135/75 as in 110 max over about 65 average??

Why not 90/50?

Indeed, why allow blood pressure at all? Any non-zero pressure just puts a strain on the heart and
blood vessels.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Mxsmanic said:

B-Ob1 said:

B-0b1 here...why not less than 135/75 as in 110 max over about 65 average??

Why not 90/50?

Indeed, why allow blood pressure at all? Any non-zero pressure just puts a strain on the heart and
blood vessels.

This is a great point. My blood pressure was 135/80 for as long as I can remember. My
cholesterol in medschool was 150 after eggs and bacon! Last year it was slightly over 200
fasting with an LDL of 125.

When I performed my own CIMT, however, I was blown out of the water. A subtle finding of my
particular carotid intima-media complex appeared to be muscular hyperplasia, and the thickness was
worrisome.

This is why I now take lisinopril, 40 mg qhs (among other things), and my blood pressure is 95/60.
Yes, I sometimes feel light headed when I stand quickly, but personally I am willing to put up with
the side effects and hope that it will help reverse the atherosclerosis that has developed. I do not
want to follow the footsteps of my grandfather, whom I never met. He died of a massive coronary in
his early 50's.

--
~~~ Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
familydoctor.orgblanchardOpen ↗

Quoted message said:

My BP is currently in the 130-115/65-80 range w/o meds. I was told that the new limits for BP
are 120/80?

If it helps, my blood pressure usually rests on 120/80, and I am considered healthy.

Russ.

Quoted message said:

Quoted message said:

In this country (UK) doctors do not believe anything and are not encouraged to send patients to
hospitals. You as a Dr can refer yourself, I am surprised that you are allowed to prescribe your
own medications. After

I

Quoted message said:

Quoted message said:

had a negative angiogram two years ago the consultant said "This time we will sort out your B.P.
at the outpatients clinic" When no appointment came through I spoke to my GP about it. He looked
at the letter from the hospital after the angiogram and said he does not say that here. I phoned
the consultants secretary and she said it is not on your notes. Stalemate. Derek.

Derek, would you be willing to send me a copy of the angiogram report? Also, why was the
angiogram performed. Did you have any additional

studies?

Quoted message said:

Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
familydoctor.orgblanchardOpen ↗

This may be a bit jumbled as I have copied bits from various old postings to the N.G. :-)

This is British NHS where they do not willingly give patients their records. At the time of the
angiogram in November 2001 I asked for a copy of the CD they recorded it on but was politely
refused. The initial report to my GP included: ETI + ve echo good LV function, mild
LVH. o mitral/aortic on echo, aortic calcification. Angiography: arteries normal therefore false +
ve ETT. The angiogram was done after I had been sent to the chest pain clinic with similar
symptoms to ones that I had previously had. This time the young doctor who checked the output
from the stress test said that my condition had deteriorated greatly from the previous year. I
offered to bet him a months wages that my angiogram would be OK but he refused the bet. The
year before even with what we now know to be a false positive the consultant was 98%certain
that I did not have a serious problem and but offered to do anangiogram, being a gambler I
turned it down as I would not bet on such an outsider. He also agreed that I did not have
angina. The background is I have suffered from digestive problems for many years and I always
put chest pains down to wind. After a severe attack in 1992 when I was 57 (sweating, chest pain
and pain in left arm and jaw) my doctor panicked and I was admitted to hospital. I was
connected up to the usual monitors. My BP was evidently normal at that time as it was not
mentioned or treated. After a few days they gave me the stress test in a hot little room and I
did it without discomfort but with much sweating. I was told that my heart was not getting
enough oxygen and that I had angina. They prescribed glycerol trinitrate which gave me a
headache and I stopped taking it. Two follow up visits to the hospital and they were satisfied
that I did not need medication but of my own bat I started taking a mini aspirin each day
(probably not helping my stomach) . At least in 1999 I was fortunate to find that my BP was
very high before any harm befell me. Personally I do not understand why it was suddenly so high
as it had been checked on several occasions and been 'normal' except in the previous September
after a prostate biopsy when it was 180/80 which the theatre nurse put down to the stress of
the occasion. In February 1999 I went to my GP to get something for my indigestion. I was
waking up in the morning with acid reflux and retching and choking. I was also having
indigestion type pain/symptoms with sweating and a pain in the left arm and my chest. The Dr
took my BP which was
210/110 and sent me to the Chest Pain Clinic right away. My BP was still about the same level and
they did an ECG and echocardiogram which they said showed LVH. They would not do a stress test
until medication had brought my BP down a few days later. As in 1992 at another hospital I was
told that I had angina. I did not believe that as I do a lot of walking and live in a hilly city
and it was not defiantly not that type of pain. The digestive problems continue and I have been
taking Proton Pump Inhibitors for three years. In fact today I had another Barium X-Ray which
showed that my acid reflux is getting worse but did not show any sign of the duodenal ulcer that
was supposed to be there last year. Derek.

Derek F said:

Quoted message said:

Quoted message said:

In this country (UK) doctors do not believe anything and are not encouraged to send patients to
hospitals. You as a Dr can refer yourself, I am surprised that you are allowed to prescribe
your own medications.

After

I

Quoted message said:

Quoted message said:

had a negative angiogram two years ago the consultant said "This time

we

Quoted message said:

will sort out your B.P. at the outpatients clinic" When no appointment came through I spoke to
my GP about it. He looked

at

Quoted message said:

the letter from the hospital after the angiogram and said he does not say that here. I phoned
the consultants secretary and she said it is not on

your

Quoted message said:

notes. Stalemate. Derek.

Derek, would you be willing to send me a copy of the angiogram report? Also, why was the
angiogram performed. Did you have any additional

studies?

Quoted message said:

Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
familydoctor.orgblanchardOpen ↗

This may be a bit jumbled as I have copied bits from various old postings to the N.G. :-)

This is British NHS where they do not willingly give patients their records. At the time of the
angiogram in November 2001 I asked for a copy of the CD they recorded it on but was politely
refused. The initial report to my GP included: ETI + ve echo good LV function, mild
LVH. o mitral/aortic on echo, aortic calcification. Angiography: arteries normal therefore false +
ve ETT.

fyi, there can be up to 40% stenosis in any coronary artery before the angiogram will show it.

Quoted message said:

The angiogram was done after I had been sent to the chest pain clinic with similar symptoms to
ones that I had previously had. This time the young doctor who checked the output from the stress
test said that my condition had deteriorated greatly from the previous year. I offered to bet him
a months wages that my angiogram would be OK but he refused the bet. The year before even with
what we now know to be a false positive the consultant was 98%certain that I did not have a
serious problem and but offered to do anangiogram, being a gambler I turned it down as I would not
bet on such an outsider. He also agreed that I did not have angina. The background is I have
suffered from digestive problems for many years and I always put chest pains down to wind. After a
severe attack in 1992 when I was 57 (sweating, chest pain and pain in left arm and jaw) my doctor
panicked and I was admitted to hospital. I was connected up to the usual monitors. My BP was
evidently normal at that time as it was not mentioned or treated. After a few days they gave me
the stress test in a hot little room and I did it without discomfort but with much sweating. I was
told that my heart was not getting enough oxygen and that I had angina. They prescribed glycerol
trinitrate which gave me a headache and I stopped taking it. Two follow up visits to the hospital
and they were satisfied that I did not need medication but of my own bat I started taking a mini
aspirin each day (probably not helping my stomach) . At least in 1999 I was fortunate to find that
my BP was very high before any harm befell me. Personally I do not understand why it was suddenly
so high as it had been checked on several occasions and been 'normal' except in the previous
September after a prostate biopsy when it was 180/80 which the theatre nurse put down to the
stress of the occasion.

This could be an indication that your blood vessels are not dilating properly, not uncommon with
advancing atherosclerotic disease.

Quoted message said:

In February 1999 I went to my GP to get something for my indigestion. I was waking up in the
morning with acid reflux and retching and choking. I was also having indigestion type
pain/symptoms with sweating and a pain in the left arm and my chest. The Dr took my BP which was
210/110 and sent me to the Chest Pain Clinic right away. My BP was still about the same level and
they did an ECG and echocardiogram which they said showed LVH.

yes, this does not suprise me.

Quoted message said:

They would not do a stress test until medication had brought my BP down a few days later. As in
1992 at another hospital I was told that I had angina. I did not believe that as I do a lot of
walking and live in a hilly city and it was not defiantly not that type of pain.

perhaps your atypical pattern represents 'acute coronary syndrome', a symptomatic presentation of
unstable plaque.

Quoted message said:

The digestive problems continue and I have been taking Proton Pump Inhibitors for three years. In
fact today I had another Barium X-Ray which showed that my acid reflux is getting worse but did
not show any sign of the duodenal ulcer that was supposed to be there last year. Derek.

Would you mind including your current medication list?

--
~~~ Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
familydoctor.orgblanchardOpen ↗

Patrick Blanchard said:

Derek F said:

Quoted message said:

> In this country (UK) doctors do not believe anything and are not encouraged to send patients
> to hospitals. You as a Dr can refer yourself, I am surprised that you are allowed to
> prescribe your own medications.
After

I

Quoted message said:

> had a negative angiogram two years ago the consultant said "This time
we
> will sort out your B.P. at the outpatients clinic" When no appointment came through I spoke
> to my GP about it. He looked
at
> the letter from the hospital after the angiogram and said he does not say that here. I phoned
> the consultants secretary and she said it is not on
your
> notes. Stalemate. Derek.
>
>
>
Derek, would you be willing to send me a copy of the angiogram report? Also, why was the
angiogram performed. Did you have any additional

studies?

Quoted message said:

Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
familydoctor.orgblanchardOpen ↗

This may be a bit jumbled as I have copied bits from various old postings to the N.G. :-)

This is British NHS where they do not willingly give patients their records. At the time of the
angiogram in November 2001 I asked for a copy of the CD they recorded it on but was politely
refused. The initial report to my GP included: ETI + ve echo good LV function, mild
LVH. o mitral/aortic on echo, aortic calcification. Angiography: arteries normal therefore false
+ ve ETT.

fyi, there can be up to 40% stenosis in any coronary artery before the angiogram will show it.

Sometimes that depends on who is "reading" the angiogram, unfortunately.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
heartmdphd.comheartmdphd.comOpen ↗

"Patrick Blanchard, M.D." <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Derek F said:

Quoted message said:

> In this country (UK) doctors do not believe anything and are not encouraged to send patients
> to hospitals. You as a Dr can refer yourself, I am surprised that you are allowed to
> prescribe your own medications.
After

I

Quoted message said:

> had a negative angiogram two years ago the consultant said "This time
we
> will sort out your B.P. at the outpatients clinic" When no appointment came through I spoke
> to my GP about it. He looked
at
> the letter from the hospital after the angiogram and said he does not say that here. I phoned
> the consultants secretary and she said it is not on
your
> notes. Stalemate. Derek.
>
>
>
Derek, would you be willing to send me a copy of the angiogram report? Also, why was the
angiogram performed. Did you have any additional

studies?

Quoted message said:

Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
familydoctor.orgblanchardOpen ↗

This may be a bit jumbled as I have copied bits from various old

postings

Quoted message said:

Quoted message said:

to the N.G. :-)

This is British NHS where they do not willingly give patients their records. At the time of the
angiogram in November 2001 I asked for a copy of the CD they recorded it on but was politely
refused. The initial report to my GP included: ETI + ve echo good LV function, mild
LVH. o mitral/aortic on echo, aortic calcification. Angiography:

arteries

Quoted message said:

Quoted message said:

normal therefore false + ve ETT.

fyi, there can be up to 40% stenosis in any coronary artery before the angiogram will show it.

Quoted message said:

The angiogram was done after I had been sent to the chest pain clinic with similar symptoms to
ones that I had previously had. This time the young doctor who checked the output from the
stress test said that my

condition

Quoted message said:

Quoted message said:

had deteriorated greatly from the previous year. I offered to bet him a months wages that my
angiogram would be OK but he refused the bet. The year before even with what we now know to be a
false positive the consultant was 98%certain that I did not have a serious problem and but
offered to do anangiogram, being a gambler I turned it down as I would not bet on such an
outsider. He also agreed that I did not have angina. The background is I have suffered from
digestive problems for many years and I always put chest pains down to wind. After a severe
attack in 1992 when I was 57 (sweating, chest pain and pain in left arm and jaw) my doctor
panicked and I was admitted to hospital. I was connected up to the usual monitors. My BP was
evidently normal at that time as it was not mentioned or treated. After a few days they gave me
the stress test in a hot little room and I did it without discomfort but with much sweating. I
was told that my heart was not getting enough oxygen and that I had angina. They prescribed
glycerol trinitrate which gave me a headache and I stopped taking it.

Two

Quoted message said:

Quoted message said:

follow up visits to the hospital and they were satisfied that I did not need medication but of
my own bat I started taking a mini aspirin each day (probably not helping my stomach) . At least
in 1999 I was fortunate to find that my BP was very high before any harm befell me. Personally I
do not understand why it was suddenly so high as it had been checked on several occasions and
been 'normal' except in the previous September after a prostate biopsy when it was 180/80 which
the theatre nurse put down to the stress of the occasion.

This could be an indication that your blood vessels are not dilating properly, not uncommon with
advancing atherosclerotic disease.

Quoted message said:

In February 1999 I went to my GP to get something for my indigestion. I was waking up in the
morning with acid reflux and retching and choking. I was also having indigestion type
pain/symptoms with sweating and a pain in the left arm and my chest. The Dr took my BP

which

Quoted message said:

Quoted message said:

was
210/110 and sent me to the Chest Pain Clinic right away. My BP was still about the same level
and they did an ECG and echocardiogram which they said showed LVH.

yes, this does not suprise me.

Quoted message said:

They would not do a stress test until medication had brought my BP down

a

Quoted message said:

Quoted message said:

few days later. As in 1992 at another hospital I was told that I had angina. I did not believe
that as I do a lot of walking and live in a hilly city and it was not defiantly not that type
of pain.

perhaps your atypical pattern represents 'acute coronary syndrome', a symptomatic presentation of
unstable plaque.

Quoted message said:

The digestive problems continue and I have been taking Proton Pump Inhibitors for three years.
In fact today I had another Barium X-Ray which showed that my acid reflux is getting worse but
did not show any sign of the duodenal ulcer that was supposed to be there last year. Derek.

Would you mind including your current medication list?

--
~~~ Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
familydoctor.orgblanchardOpen ↗

You are a very cheerful Bugger! My medications are: Securon 240 mg Losartan 25 mg. 75 mg aspirin 2 X
20 mg Omeprazole. I had an ECG last month which was "normal" and a 24 hour BP monitor which had an
average of 139/71. The highs (161/80) were when the monitor was attached and taken off, I put that
down to the statuesque nurse:-) Derek.