Hi all,

l had my blood pressure taken Friday before last at my doctors office at it was inexplicably hitting a massive 160 systolic, despite having been 120/75 when l saw the doctor a week prior and being consistenly measured between 110 and 120 by friends during the week (we're medical students so we practice on each other a lot).
This of course sent me into a panic even though my doctor told me the only thing that could make my BP suddenly so high was stress. l monited my BP at home over the past week and it was fluctuating between 135 and 165 systolic, still much higher than it is ever been previously. While practicing with a friend for our clinical exams today it first hit 140/80 and then 150/85 about 10 minutes later.
I am under a fair amount of stress at the moment due to fast-approaching exams and some big career path choices which need to be made over the next couple of months, but l do not feel like I am at my most anxious or stressed compared to periods I've have in the past (though I've never monitored my BP at these times before).
I am really starting to worry that l might have developed hypertension given such consistent high readings over the past couple of weeks. My question is: does anyone think this could be purely stress-related or should l be concerned?
I am an 18 y.o. female, fairly overweight but still quite fit and with a low salt diet in otherwise perfect health.

l think it is purely fat related.

160 systolic is not massive.You r not on any medication & yet during certain periods of the day ur B.P.is a copy book perfect.Being a medical student u can understand that B.P.is secondary to so many factors.Your reading will be high if u r under mental tension & stress,if reading is taken without 10 minutes rest,different instruments can show a variation error of 5 to 7%,B.P.taken on different arms will be different,lying down or sitting posture will give a different reading,reading taken after meals or before meals will vary & so on & so forth.Being over weight is a contributary factor,Heridity can be another .Since u r over weight it will be worth reducing because a reduction of 10kg.in weight lowers the mercury by 5mm.In my openion u r not hypertensive,but u may be having a tendency.So watch ur weight & diet & do regular exercises.

Hi, - Why do u call 160 'massive'.? Millions of 18 yr olds have systolics of 160 & over. It is not ''average'' but so what''? Everyone is different biologically, & physically, & if there was not a range (from low to high) there would not be any ''average'' would there? And what is exactly worrying you? the variations? Well it is the way the system works. If ur BP is did not continuously go up & down (as well as ur pulse rate) then ur brain & nervous control systems would not be doing their job.

What counts is ur 'mean' pressure = (Pd + Pp/3).. Yours seems to be about 100 - 107 which is absolutely fine. -Again not average, but l assure you, completely normal.
You did not say what ur Pd was when ur Ps was 160.? But l will make a stab at guessing, .... about 90-ish?
This would be because u were stressed in some way, & needed a higher cardiac output, which in turn required a raised mean arterial pressure - perhaps about 113? -It is a guess of course, but am l right?

Here is another guess: l think ur pulse rate would have risen also to a level roughly equal to the % rise in ur mean pressure? So if ur relaxed pulse was about 71 bpm, then when ur Ps was 160 ur pulse should have risen to about 80 bpm? *** Note: -If it did not that would be unusual, & be cause for some concern & investigation. For someone ur age the ratio Pp/N (pulse pressure to pulse rate) would be expected to be roughly 0.5 as compared to that of an elderly sclerotic, perhaps 1?

Just two other things u should know:

(1) ''Hypertension'' is largely a myth, & u have my assurance u have not got it, &
(2) The readings u obtain by auscultation at the brachial (or any other downstream) artery r not of course, (-in any sense-) true, That is, while if the readings change over short periods (like those you've cited as examples) these r fairly accurate reflections of the changes in left-ventricular pressures generated, -BUT they themselves r not in any sense accurate measurements of absolute brachial arterial pressures., So, 160 is not really the peak pressure in ur artery, & neither is 140, nor 120 etc. The true arterial pressures r lots lower. (The same applies to diastolic pressure, Pd, of course. the cuff-pressures r simply not ''real''.)

By contrast, the real 'true' pressures on the downstream side of the aortic valve r much HIGHER than the figures u & ur fellow-students r getting with ur monitors or sphygmo's.
''It all goes to show - does not it?

___________________________________________
If you're at all interested l will be happy to post a description of how the cardiovascular system really works, & some interesting observations u can make on yourself & colleagues. Such as, . for instance, '' If u divide ur Mean Arterial Pressure by the product of ur pulse rate & pulse pressure, what is the answer''?. Well, if you're truly relaxed, the answer is always approximately 0.02.. . )
** Here is a Homework question for you,..''Why.?.'' That is, - why should it be?The pulse rate varies throughout the day,, ur mean pressure varies continuously, & ur pulse pressure also goes up & down spectacularly, does not it? .. So, .. WHY does (Pm/ N.Pp).. always come out at 0.02? The answer is incredibly important.

EDIT: The problem with Katrina is answer is that if u really do ''keep ur BP below 135/85'' , as she says, then the numbers simply do not add up .. (and the numbers r the medical profession is , - not mine.) .

For instance, If u have (say) 128/80 then mean arterial pressure is 96.
But if Pm = 96, & the TPR is 0.02 (your figures, again, -not mine) then from Darcy is Law cardiac out put falls short of the 5 litres per minute ur body needs... and, -of course, the lower ur BP is the worse it becomes, -the shortfall becomes greater & greater..

P.S. If l were a doctor, then I'd say so. And If l were an imposter, then I'd still say l was a doctor, would not l ?.. But l am neither, - l am a Physicist, & very proud of my record. l specialise in the Physics of Cardiovascular Physiology. That is why l get paid so much; it is what l do, & l do it well. I've no need to pretend l am a doctor.

You say ur diet is ''low salt but it would have be near zero to be helpful in lowering ur blood pressure. The body only needs 200 ms of salt a day but even the American Heart Association recommended amount is 10 times that amount. And most Americans consume twice that, or 4000 mg a day. So, what u think of as ''low'' is probably not low enough.

Salt comes into our diets no just as table salt. Many foods--processed meats, snacks, even bread--has salt in it, so u r probably getting more than u know.

To lower ur blood pressure, avoid foods that raise ur blood pressure (salty foods) & eat foods that lower ur blood pressure (those high in potassium).

l feel stressed just reading some of the other ! Mr Physicist is not a medical doctor. l worked for a cardiologist & if is difficult to look at blood pressure the way that he is doing.

We find more disease processes every day that blood pressure directly effects. It is now recommended that u try to maintain a pressure less than 135/85.

As for causes, Yes, stress can directly contribute to ur blood pressure, as u know. If u were able to drop a little weight, it will likely go down as well.

The question that l ask all young people with BP issues is, ''Do u use energy drinks, like Red Bull?'' Caffeine is a powerful constrictor. Energy drinks r packed with caffeine and/or guaranine (worse than caffeine).

Your blood pressure is perfectly normal, it happens to most patients during a physical check up, l can assure you it will be between 120/80 mm Hg normally.
Got luck and stop worrying.