Optimizing my TRT, having some issues at the moment!

[Ghoul]

Wtf am I meant to do with a bp of 140/60?

If I take AHTs I lower my SBP and DBP.

I don’t want isolated systolic hypertension, but if I treat it I get isolated diastolic hypotension.

There's a trial for that...

Choice of Antihypertensive Agent in Isolated Systolic Hypertension and Isolated Diastolic Hypertension: A Secondary Analysis of the ALLHAT Trial - PMC

Despite broad treatment recommendations, there are no published reports comparing efficacy of different antihypertensive agents in patients with isolated systolic hypertension or isolated diastolic hypertension. This study was a secondary analysis ...

pmc.ncbi.nlm.nih.gov

 

[HUGE McBIGLARGE]

There's a trial for that...

Choice of Antihypertensive Agent in Isolated Systolic Hypertension and Isolated Diastolic Hypertension: A Secondary Analysis of the ALLHAT Trial - PMC

Despite broad treatment recommendations, there are no published reports comparing efficacy of different antihypertensive agents in patients with isolated systolic hypertension or isolated diastolic hypertension. This study was a secondary analysis ...

pmc.ncbi.nlm.nih.gov

That’s people with normal DBP.

Mine is on the threshold of normal. Any lower and I’ve got diastolic hypotension.

I dunno if I should use a CCB if it means bringing my DBP even lower.

Is high vascular pressure worse than ischemia?

 

[AlexDavis43]

Wtf am I meant to do with a bp of 140/60?

If I take AHTs I lower my SBP and DBP.

I don’t want isolated systolic hypertension, but if I treat it I get isolated diastolic hypotension.

Dunno but in the meantime, keep cardio up.

If something bad happens, hopefully it will be less bad with more cardiorespiratory fitness. (general policy for maintaining heart/kidney health)

 

[Ghoul]

That’s people with normal DBP.

Mine is on the threshold of normal. Any lower and I’ve got diastolic hypotension.

I dunno if I should use a CCB if it means bringing my DBP even lower.

Is high vascular pressure worse than ischemia?

This is the kind of relatively rare condition I would feel the need to see a specialist for tbh. I'd be seeing the best cardiologist I could find and say "I'm concerned about this and want to proceed in a way that's best for my long term health." I've read enough to know it's high risk and there are several potentially troubling underlying causes that would be better addressed sooner than later.

It's not "pedestrian" hypertension that's a primary care doc / self treat kind of thing imo.

 

[HUGE McBIGLARGE]

Dunno but in the meantime, keep cardio up.

If something bad happens, hopefully it will be less bad with more cardiorespiratory fitness. (general policy for maintaining heart/kidney health)

Lots of cardio. At least, I think my 260 jump squats, 260 push ups, 260 pull ups every morning counts as cardio

This is the kind of relatively rare condition I would feel the need to see a specialist for tbh. I'd be seeing the best cardiologist I could find and say "I'm concerned about this and want to proceed in a way that's best for my long term health." I've read enough to know it's high risk and there are several potentially troubling underlying causes that would be better addressed sooner than later.

It's not "pedestrian" hypertension that's a primary care doc / self treat kind of thing imo.

Got a GP appointment tomorrow. I’ve been there so many times about my blood pressure and they always tell me to fuck off.

This time, I mean business!

 

[Ghoul]

Lots of cardio. At least, I think my 260 jump squats, 260 push ups, 260 pull ups every morning counts as cardio


Got a GP appointment tomorrow. I’ve been there so many times about my blood pressure and they always tell me to fuck off.

This time, I mean business!

Have to be your own advocate with these fuckers.

I find saying something that sounds like it could haunt them and threaten their livelihood if they don't at the least, pass you (and responsibility) on to a specialist,

"I'm not trying to be an internet hypochondriac, but from everything I've read, isolated systolic hypertension, especially at my age, seems like a high risk condition. Perhaps I should see a cardiologist for an evaluation."

Put them on notice.

 

[HUGE McBIGLARGE]

Have to be your own advocate with these fuckers.

I find saying something that sounds like it could haunt them and threaten their livelihood if they don't at the least, pass you (and responsibility) on to a specialist,

"I'm not trying to be an internet hypochondriac, but from everything I've read, isolated systolic hypertension, especially at my age, seems like a high risk condition. Perhaps I should see a cardiologist for an evaluation."

Put them on notice.

I basically got told to fuck off lol.

I said my BP is about 140/65. Said I’m concerned about the SBP being high, and the wide pulse pressure.

She said the NHS doesn’t have any concern with DBP unless it’s causing symptoms, and that there’s no lower threshold for what’s safe. She said PP isn’t ever a concern in the NHS.

I said the literature says a wide PP is more predictive of mortality than SBP or MAP. I said a PP of over 60 is predictive of a 6x higher stroke risk. She questioned my ability to read the literature lol.

She asked if I have symptoms. I said “none related to my BP, no”. She said that’s fine then. I said “but if I get symptoms it’s already too late”

She said they’ll investigate if my SBP is over 135. She asked me to check my BP daily for two weeks, write it down, and send it in.

Guess I’m fucked lol

 

[Ghoul]

I basically got told to fuck off lol.

I said my BP is about 140/65. Said I’m concerned about the SBP being high, and the wide pulse pressure.

She said the NHS doesn’t have any concern with DBP unless it’s causing symptoms, and that there’s no lower threshold for what’s safe. She said PP isn’t ever a concern in the NHS.

I said the literature says a wide PP is more predictive of mortality than SBP or MAP. I said a PP of over 60 is predictive of a 6x higher stroke risk. She questioned my ability to read the literature lol.

She asked if I have symptoms. I said “none related to my BP, no”. She said that’s fine then. I said “but if I get symptoms it’s already too late”

She said they’ll investigate if my SBP is over 135. She asked me to check my BP daily for two weeks, write it down, and send it in.

Guess I’m fucked lol

Depth of NHS crisis is revealed by coroners’ courts reports

Shortages of specialists and ambulance crews, and long waiting times, have contributed to dozens of deaths in England and Wales

www.theguardian.com

 

[DugPrime]

Wtf am I meant to do with a bp of 140/60?

Nothing, you have a good MAP (60-100).

Mean Arterial Pressure (MAP)

The Mean Arterial Pressure (MAP) calculates mean arterial pressure from measured systolic and diastolic blood pressure values.

www.mdcalc.com

 

[Ghoul]

Nothing, you have a good MAP (60-100).

Mean Arterial Pressure (MAP)

The Mean Arterial Pressure (MAP) calculates mean arterial pressure from measured systolic and diastolic blood pressure values.

www.mdcalc.com

Phew , that's a relief.

 

[HUGE McBIGLARGE]

This is what she wrote down.

I never said my SBP was below 135. I recorded the conversation. Listened back to it. I never said that. I said, quote, “it’s on average at about 140 over 65”

The amount of times my GP have lied about what I’ve said. It really pisses me off. I complain about it, show them the recordings, and they give me some bullshit apology and then the same shit happens next time.

 

[DugPrime]

Phew , that's a relief.

View attachment 316182

Using Mean Arterial Pressure in Hypertension Diagnosis versus Using Either Systolic or Diastolic Blood Pressure Measurements

Hypertension is a severe and highly prevalent disease. It is considered a leading contributor to mortality worldwide. Diagnosis guidelines for hypertension use systolic and diastolic blood pressure (BP) together. Mean arterial pressure (MAP), which refers to the average of the arterial blood...

www.mdpi.com

This study investigated the significance of systolic BP versus diastolic BP in defining cerebrovascular sequelae of hypertension and compared that to the significance of using MAP. Preliminary results indicated that systolic BP might be more predictive of hypertensive association with cerebrovascular indices than diastolic blood pressure. However, using MAP values that incorporate information from both systolic and diastolic BP recorded the highest predictability in detecting hypertension-related vascular alteration than using systolic BP or diastolic BP separately. This result emphasizes the pathophysiological significance of MAP and supports prior views that this simple measure may be a superior index for the definition of hypertension and research on hypertension. Future plans include collecting more data over longer periods of time to allow for tracking the changes of the cerebral vascular and their impact on developing hypertension and to test the proposed methodology with more original data to enhance the accuracy and reliability of the results.

 

[HUGE McBIGLARGE]

Using Mean Arterial Pressure in Hypertension Diagnosis versus Using Either Systolic or Diastolic Blood Pressure Measurements

Hypertension is a severe and highly prevalent disease. It is considered a leading contributor to mortality worldwide. Diagnosis guidelines for hypertension use systolic and diastolic blood pressure (BP) together. Mean arterial pressure (MAP), which refers to the average of the arterial blood...

www.mdpi.com

This study investigated the significance of systolic BP versus diastolic BP in defining cerebrovascular sequelae of hypertension and compared that to the significance of using MAP. Preliminary results indicated that systolic BP might be more predictive of hypertensive association with cerebrovascular indices than diastolic blood pressure. However, using MAP values that incorporate information from both systolic and diastolic BP recorded the highest predictability in detecting hypertension-related vascular alteration than using systolic BP or diastolic BP separately. This result emphasizes the pathophysiological significance of MAP and supports prior views that this simple measure may be a superior index for the definition of hypertension and research on hypertension. Future plans include collecting more data over longer periods of time to allow for tracking the changes of the cerebral vascular and their impact on developing hypertension and to test the proposed methodology with more original data to enhance the accuracy and reliability of the results.

Wikipedia lol

Pulse pressure - Wikipedia

en.m.wikipedia.org

“Awareness of the effects of pulse pressure on morbidity and mortality is lacking relative to the awareness of the effects of elevated systolic and diastolic blood pressure. However, pulse pressure has consistently been found to be a stronger independent predictor of cardiovascular events, especially in older populations, than has systolic, diastolic, or mean arterial pressure.<a href="Pulse pressure - Wikipedia"><span>[</span>3<span>]</span></a><a href="Pulse pressure - Wikipedia"><span>[</span>13<span>]</span></a> This increased risk has been observed in both men and women and even when no other cardiovascular risk factors are present. The increased risk also exists even in cases in which high pulse pressure is caused by diastolic pressure decreasing over time while systolic remains steady or even slightly decreases”