DEAR DR. GOTT:
I enjoy your column in my local paper and have learned much from it that I practice on a daily basis.

I’m in my late 50s, a type A personality, and have been overweight my entire life. I lead an active lifestyle with weight training and walking. I’ve been practicing some deep breathing to calm down before going to bed because I tend to be on the go physically and mentally throughout the day and it is hard to sleep.

My blood pressure had always been around 120/80. Starting last summer, it was in the 130s and 140s. My doctor put me on atenolol that gave me pressure in my chest. My doctor indicated the possibility of this side effect, so I was somewhat prepared. The good news was that my blood pressure dropped to the 90s and low 100s while I remained on the atenolol. Because of the pressure, however, I had a stress test done and everything was normal. So, my doctor took me off the medication.

Now my blood pressure is usually around 110-120/ over the 80s. After exercise, it rises to the 150s or 160s and stays there for several hours. My pulse rate is in the 90s.

Is there always such variation in a person’s blood pressure and at what point should I go back on the hypertensive medication? Is there another drug that could be taken without giving chest pressure?

DEAR READER:
Your blood pressure varies a good deal. This is normal, especially after physical exercise. In order for a blood pressure to cause health problems, it has to be in an abnormal range consistently. A normal pressure preferred for adults is 120/80.

I recommend you stay away from medication unless your blood pressure consistently rises above the preferred limit. Should that occur, speak with your physician regarding another drug in the same category as atenolol that doesn’t carry such an unpleasant side effect profile. Physicians often receive a variety of medication samples. It might be appropriate for your doctor to give you enough samples to last a week or two as a trial. In this way, you won’t feel committed to purchasing a month’s supply of medication that could be inappropriate for you.