Range of blood pressure readings can be telling

DEAR DR. ROACH »

My doctor recently retired, my new one is very concerned about my systolic blood pressure, which was

150. I made quarterly visits to my old doctor, who never had a comment about my pressure numbers. My new doctor wants me on medication, and we agreed I would buy a home blood pressure machine to check my pressure.

I recorded it for 21 days, sometimes more than once day. My systolic numbers range from 118 to 150 and average 132. Out of 26 times, it was 150 once. My diastolic numbers are pretty consistent in the mid- to low 80s.

I sat still at my desk for these tests. Is seeing such a range a concern? I am 71 years old, 6 feet tall and weigh 170 pounds. I am very physically active.

— T.H.

DEAR READER » Your average blood pressure is modestly elevated. The range of readings you are asking about is not unusual. Blood pressure always varies throughout the day, and it’s the average blood pressure doctors are most concerned about, unless there are very high spikes in the blood pressure, which you do not have.

Different physicians take different approaches to modestly elevated blood pressure. Given that you are otherwise apparently at low risk (no diabetes, nor heart or vascular disease), I do not think there is a compelling reason to start medication therapy. Your experience does show how important it is to get many blood pressure readings: The reading of 150, had that been the only number your new doctor had, would have been a reason to start medication treatment.

You can help keep blood pressure down by eating a diet that is lower in salt, getting regular exercise and managing stress. A diet that is high in fruits, vegetables, legumes and nuts, and lower in processed foods than most North Americans get, reduces heart disease risk independent of blood pressure.

You can help keep blood pressure down by eating a diet that is lower in salt, getting regular exercise and managing stress.