DEAR DR. GOTT: My doctor has indicated that he wants a 24-hour blood-pressure reading on me. I just returned from my ophthalmologist’s office for a routine visit and asked him about this. I am uninformed but was surprised a specialist would not have heard of it, either. Can you fill in the blanks?
DEAR READER: The use of ambulatory blood-pressure monitoring (ABPM) for 24 hours has gained greater acceptance for several reasons. A situation known as white-coat hypertension occurs in up to 32 percent of patients, and this particular testing unit can monitor the condition. It can also delineate circadian variations in readings and pick up on drug-induced orthostatic hypotension and episodic primary hypertension. There are instances where high-blood-pressure readings appear to have no known cause; however, with the capability of 24-hour monitoring, it stands a better chance of identification.
Primary hypertension, as indicated above, is defined as that which occurs with no known cause. It occurs in up to 95 percent of people with high blood pressure. Secondary hypertension with a known cause occurs in up to 15 percent of people with high blood pressure. and may result from a kidney or hormonal disorder, the use of specific drugs, hyperthyroidism and other conditions.
Blood pressures vary and increase with age. Systolic pressure (the first number) increase until about the age of 80. Diastolic (the second number) increases until the age of 55 or 60. Then these levels stabilize or perhaps decrease. Smoking, a sedentary lifestyle, stress, eating too much salt, obesity and numerous other conditions can aggravate the condition.
My guess is that your physician is attempting to zero in on whether you have white-coat syndrome, whether your readings are consistently lower at home, or whether extenuating undefined circumstances cause the problem. The monitoring device is harmless and should provide the answers the doctor is seeking. Go with it, and get to the bottom of the problem.
To provide related information, I am sending you a copy of my Health Report “Hypertension.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 4409-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
