Your mother’s situation does sound worrisome, as you are describing falls and also some concerns with thinking. Her age of 96 is pretty old, so clinical research studies don’t provide much guidance on what is optimal blood pressure. Unless she has compelling medical reasons to aim for a SBP of 120, most geriatricians would probably reduce her BP meds and try to aim for a SBP in the 130s or 140s. So you may want to ask your mother’s doctor to discuss with you what is a suitable BP goal for her, and whether a reduction in BP meds might be reasonable.
It sounds to me like the cardiologist is in the process of trying to figure out what is the right dose of BP meds for her at this time, given the current state of her heart. Re the nurse’s recommendation, you may want to call back and make sure they realize that your mother’s SBP is only around 110, even off all BP meds. Ask them what they think her goal BP should be.
A SBP above 140 is not “alarming” per se, but historically this has been the cutoff separating “high” blood pressure from normal or “bordeline” blood pressure. Many doctors do still believe that older adults should be encouraged to get their SBP below 140, and in the SPRINT blood pressure trial, one group of participants actually aimed to get their SBP below 120.
Clinicians do sometimes prescribe still higher doses of a BP medication, especially if adding another agent doesn’t seem to be a good option. However, the BP may not improve much in response, although the risk of side-effects (such as electrolyte disturbances) usually does go up. You can ask your usual healthcare provider or a pharmacist to review potential side-effects with you, so that you’ll know what to monitor for.
High blood pressure, or hypertension, is the leading risk factor for heart disease and stroke. Damage to your blood vessels occurs every time your pressure is elevated, and the new guidelines are meant to help people become more aware earlier. And through earlier awareness, it may help prevent the damage that would occur if you waited for a later diagnosis.
I would not recommend changing BP medications every 3-4 months just to prevent the onset of potential side-effects, but it certainly makes sense to reassess how you are doing on a BP med after a certain interval (usually after a few weeks, and then every few months or more often if the dose still needs to be refined or if there is concern about potential side-effects).
I totally agree with you that we should not rely on medication for high blood pressure. End of the day, high blood pressure is a symptom that our body requires immediate attention. The kidneys work extremely hard to send out the “signal” to us and what we did is to pop a high blood pressure pill to suppress the signal. With this medication, our body has to work even harder to send us another signal. No wonder over the long run people who are suffering from high blood pressure needs an additional pill for deteriorating kidneys. Our body is fully capable of healing itself without us realizing it. I strongly encourage high blood pressure sufferers to listen to this and say goodbye to high blood pressure once and for all:
Arteries are naturally flexible and smooth, which allows blood to easily move throughout the body. High blood pressure creates extra force against the artery walls, which damages the lining of the arteries. As they become narrower and harder, this restricts blood flow, and when blood flow is lowered, the heart has to work harder to pump it through the body, which only makes the problem worse.
Well, it is common for people’s BP to be higher in the office, but if it’s higher in the evenings at well, you could certainly discuss changing your BP management with your doctor. I would recommend that you discuss further with your doctor. Specifically, you may want to ask your doctor why your BP seems to be higher in the evening, and what your goal should be for your home BP readings. You could also try changing the time of day you take your amlodipine, to see if that changes your daily BP pattern.
While you shouldn't shrug off the change, there's also no need to panic. "Obviously, nothing happened overnight inside a woman's body or to her health with the release of the guidelines," says Dr. Naomi Fisher, director of hypertension service and hypertension innovation at the Brigham and Women's Hospital Division of Endocrinology, Diabetes, and Hypertension, and associate professor of medicine at Harvard Medical School.
Get moving at least a little bit every day, with a standard recommendation of 30-60 minutes a day, 3-5 times a week. Get your heart pumping at a moderate intensity for a few times a week, and mix it up with some strength training. Because life happens, on the days when you can’t fit it in, try to build more activity into your day by parking further away, taking the stairs instead of the elevator, or even just doing a quick sprint or two up and down the block. Every little bit helps.
3) Coconut water. Rich in potassium, electrolytes, and other important nutrients, coconut water has been shown to help significantly lower blood pressure levels in most of the people that drink it. A recent study published in the West Indian Medical Journal found that drinking coconut water helped 71 percent of participants achieve a significant reduction in systolic pressure, and 29 percent of participants achieve a significant reduction in diastolic pressure. The results were even more amplified when participants drank both coconut water and mauby, a tropical drink made from buckthorn tree bark.
A long-term study concluded in 2014 found that people who ate more protein had a lower risk of high blood pressure. For those who ate an average of 100 grams of protein per day, there was a 40 percent lower risk of having high blood pressure than those on a low-protein diet (33). Those who also added regular fiber into their diet saw up to a 60 percent reduction of risk.
In Sweden, blood pressure is often wrongly measured at clinics with the subjects lying down. The differences tend to be small, however: when seated, the systolic blood pressure registers a little lower, and the diastolic a little higher. Trying this on myself, I noted readings of 116/73 averaged over several seated measurements and an average of 119/72 lying down.
A 2013 review on yoga and blood pressure found an average blood pressure decrease of 3.62 mm Hg diastolic and 4.17 mm Hg systolic when compared to those who didn’t exercise. Studies of yoga practices that included breath control, postures, and meditation were nearly twice as effective as yoga practices that didn’t include all three of these elements (24).