Some context.. 32 years old, male, slightly overweight.

Got a physical done about three months ago and found out my blood pressure was quite high. Bloodwork revealed my glucose was high as well and it was the first time it's come back high.

For reference- it was 152/105 at the doc office. He prescribed me Antenolol (25mg) and wanted me to start taking it immediately and also advised that I go on a diet to see if my glucose goes down.

I've been a lazy ass for the past few years and I really don't want to get on beta blockers at my age so I decided to get in the gym and start eating better and see what that does to my BP.

Well, it's trending down which is good news. The weird thing is that the diastolic (bottom number) is still really high but the top number is just fine.

After my first week in the gym and dieting it was reading around 145/97 on average. After my second week, it was around 135/90. It's been three weeks now and this morning it was 117/91.

Has anyone had "isolated diastolic hypertension" before? And does anyone know what could cause this?

I still have the Antenolol that I could start taking but I really wanted to see if lifestyle changes would get things on track first.

I'm in my mid 50s. I was diagnosed with HBP at age 25. Dad and paternal grandfather had it as well. My diastolic number has always been the worst. I've been on lisinopril and hydrochlorothiazide pretty much exclusively for all that time. Tried some other meds but those didn't work as well.

When I've been in great shape (running more than ten miles a week/biking long distance, BMI in low 20s) my BP has been "normal" or close to it - still a little high. It may be normal for a few readings, then is too high. So I just stay on the meds. Diastolic has always been the problem, but I've been told that is the one to worry more about.

When I'm out of shape (which is now, unfortunately), it gets high. One of the things I've noticed is alcohol makes it worse. Stress does too, but I have a stressful job.

One cardiologist mentioned that I should get my kidneys checked out, but I never had that done. Apparently vascular problems with your kidneys can cause HBP. (I'm not a doc).

I have a computerized wrist cuff at home and at work. I don't take readings every day, but several times a week. By all means, get in shape and lose weight, but I'd take meds if your BP is high.

Thanks for the info. Does diastolic take longer to bring down?

Automated blood pressure cuffs calculate both numbers based off your mean arterial pressure and a proprietary formula. They aren't the most accurate for individual numbers, but do well for tracking overall MAP.

I was 154/100 for about a year. Heavy drinker and not working out.

I stopped drinking completely and on Losartan and work out a lot.

BP is 128/78 now and going down.

I feel so much better

Late 60's here. I've been on meds since my late 50's. Lisinopril made me cough so switched to irbersartan. Added hydrochlorothiazide 2 years ago.

My BP generally runs 130/80 or below. If I don't workout, gain a little weight and make poor eating choices it'll bump to 140-150/90.

Issue I've run into lately is the home BP devices. My old on had an arrow on the cuff along with the tubing that you pointed down the center of your arm. Had to replace it because the Velcro wore out.

The new one says to point the artery mark and tube down the inside of your arm pointing at your pinky finger. Readings have been all over the place.

I have a similar situation. The diastolic number is also the one that won't come down for me. My glucose was also rising. I would advise reading "Deep Nutrition" by Shanahan. Also check out Dr. Jamnadas on YouTube. Great info for you there.

Also,

Have you done a sleep study?

If I don't wear my CPAP, it's very noticeable

Atenolol is an odd choice for a patient not already on multiple other BP meds.

Dr. Not Yet Dr. Ag said:

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Atenolol is an odd choice for a patient not already on multiple other BP meds.

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Yeah, agreed. Didn't want to call out another doc, especially one in primary care (which I am not), but as far as I know beta blockers have not been first line in a long time.

bigtruckguy3500 said:

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Dr. Not Yet Dr. Ag said:

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Atenolol is an odd choice for a patient not already on multiple other BP meds.

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Yeah, agreed. Didn't want to call out another doc, especially one in primary care (which I am not), but as far as I know beta blockers have not been first line in a long time.

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Yikes. Good thing I haven't started taking it. I'll try finding a new PCP soon.

I agree with the folks above. I am not a doc, but have done much research since I got diagnosed with a coronary artery blockage. I thought beta blockers were the "adder" med when you are already on another BP medication that isn't working well. In fact, they just added metaprolol to my enalapril. Have been on only enalapril for 20 years.

Haha yeah. I didn't know that. I'm not going to take the meds and I'm looking for a new doc as we speak

texasaggie2015 said:

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Thanks for the info. Does diastolic take longer to bring down?

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Yes.

Diastolic BP requires actual improvements in vascular function which takes longer.

From a health & fitness perspective, do more steady-state cardio (Zone 2), reduce your stress, and try to get better sleep.

Cool. I've been doing those things (it's only been three weeks) and will continue to do so. It's gone down some, so hopefully it continues to trend that way.

Nutritionally, monitor your caffeine, water, sodium, potassium, and magnesium intake. Eat nitrate-rich foods like beets, spinach, arugula, and dark chocolate.

I think that's it.

Aggie Therapist said:

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Also,

Have you done a sleep study?

If I don't wear my CPAP, it's very noticeable

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I did. I have apnea and a CPAP. I haven't been paying attention to CPAP usage and sleep affect on BP, but I will start. Good point. Thanks.

Aggie Therapist said:

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Also,

Have you done a sleep study?

If I don't wear my CPAP, it's very noticeable

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Somehow missed this. My doc wanted me to get one, but my insurance was a pain in the ass and wouldn't cover it. It was going to run me a couple grand so I've been putting it off.

texasaggie2015 said:

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Thanks for the info. Does diastolic take longer to bring down?

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I haven't noticed that. They both come down at the same time, but I pay the most attention to diastolic. As long as I'm around or below 130/90, I'm fine with that. If systolic is high, diastolic is high too.

texasaggie2015 said:

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Aggie Therapist said:

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Also,

Have you done a sleep study?

If I don't wear my CPAP, it's very noticeable

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Somehow missed this. My doc wanted me to get one, but my insurance was a pain in the ass and wouldn't cover it. It was going to run me a couple grand so I've been putting it off.

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I did the at-home one. I don't recall the price, but I don't think it was anywhere near that expense. Again, my GF has been telling me for years that I probably had apnea. She's a NP (but pediatrics). But she videoed me, and I would stop breathing for long periods. Also snored loudly at times. So I really already knew.

The at-home test confirmed it. It's just a simple thing you put on your finger. Upload to an app and send it off electronically for a doc to review. I had 78 events per hour and a total of 531 for the night. No bueno. Got a CPAP prescription.

Last night I wore the mask for about 5:30 hours and only had 0.3 events per hour. I had 7:30 hr. total sleep.

Worth the cost, IMHO.

Edit: I looked it up. I got the sleep study through Lofta - about $190

https://lofta.com/products/sleep-apnea-test?msclkid=0cc1df02de461deab4cfb89fcc256e61&utm_source=bing&utm_medium=cpc&utm_campaign=US-Home%20Sleep%20Test-GSN-SRCH&utm_term=lofta%20sleep%20study&utm_content=Lofta%20Sleep%20Study

texasaggie2015 said:

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Aggie Therapist said:

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Also,

Have you done a sleep study?

If I don't wear my CPAP, it's very noticeable

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Somehow missed this. My doc wanted me to get one, but my insurance was a pain in the ass and wouldn't cover it. It was going to run me a couple grand so I've been putting it off.

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Where are you located? I have a couple resources that maybe able to do it for free.

I did one in a sleep lab ran by Texas State University in Round Rock. It was state of the art. I honestly had a higher level of care than the one I did through the Army. I have a contact there that might be able to get you in!

I'm in Houston but my folks are in Burnet so I'm up there occasionally

Just to add….After putting it off for years I finally took the home sleep test and got on a CPAP machine. It has been a game changer for me in the way I feel and for my blood pressure.

My girlfriend says I snore but she's never heard it to the point where it sounded like I stopped breathing or anything like that. Granted, she doesn't hear me every night.

texasaggie2015 said:

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Three straight days of being right around 121/84.

Really questioning the doctor who just threw those meds at me and didn't even mention getting active to see if that changes anything. One month of moderate exercise has brought it down tremendously. Kinda glad I didn't start those meds.

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One month of moderate exercise? You are now in like the top 10% of people. Docs don't recommend exercise because most people won't do that.

Good for you in deciding to first attack it by eating better and going to the gym. Not saying medications aren't helpful, but they should be the last resort when everything else is in order.

As for the BP and glucose, all that jazz. Great that its trending down, that means you have a decent shot at getting this under control with just diet and exercise.

BUT

You haven't really done this long enough to see anything but marginal change. How about lose 20 pounds in 3-5 months, and then see where you are? You have to look at broad trend lines over months...not daily data. That's not how this stuff works.

(you say you are slightly overweight, but my bet is that you don't have alot of muscle mass and are still carrying quite a bit of fat...You probably don't look too terrible and don't feel huge, but that contributes to your high BP/Glocose).

I'm aware. I'm working on it.

I've only had a month to work with. I'm doing my best. I know I need to lose weight.

You're saying going down a waist size and going from BP readings that of 150/100 to consecutive days of 120/80 is just marginal? That's disappointing. I thought I had made progress.

texasaggie2015 said:

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Three straight days of being right around 121/84.

Really questioning the doctor who just threw those meds at me and didn't even mention getting active to see if that changes anything. One month of moderate exercise has brought it down tremendously. Kinda glad I didn't start those meds.

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Dude. Those general doctors are effing quacks. Flat out.

I went on a bulk and went from 164 pounds up to 240 over the course of almost two years. I was lifting heavy, and putting weights on the bar.

I went to see a doc, and yeah, my cholesterol, glucose, BP were all high. Immediately, she went..."we need to think about a statin and some other medication...yada yada).

First I went....well, before we do that...lets do a calcium heart scan to see if I actually have any build up. (My idea, not hers, it came back zero). Second, I said, Give me 3 months to cut. This was all by design to put on some muscle mass.

Dropped from 240 to 207 in 4 months. (Now Im down to 196 and look awesome and can still lift okay...not super heavy). I walked into the doc, got my blook work done...ALL markers back within normal range.

I fired that doctor. The medical system (at least the low end, I have alot of respect for the high end specialists) can get effed.

Long way of saying. Right on man! You have the right idea.

Its great progress! (I just meant with a bit more time and long term trends, you are going to see some great results is all....I was more encouraging you to be patient with it and trying not to micro manage it....though we all do).

Definitely not how I read that lol

Have any more of those long term TRENds?

LOL. If you saw my physique, you would laugh at even the suggestion of that.

Add me on GRINDR and let me take a look.


All jokes aside good on you for taking your health into your own hands