WOMENS-HEALTH Messages for November, 1997: Re: ; Essential Hypertension: Attn Dr Marchbein!

Re: ; Essential Hypertension: Attn Dr Marchbein!

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Thu, 27 Nov 1997 13:28:03 -0600 (CST)

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At Thu, 27 Nov 1997, Tammy wrote: >
>Thanks for your reply to my post concerning essential hypertension and
>white coat syndrome.
>
>I had went to a regular appt on Tuesday ( I am 28 wks) prior to that my
>bp was in my normal range of 140/80 (+/- 5).

That's a little high to begin with (marginal HTN (hypertension)). The cut-off is usually accepted as 140/90 but many factors may lower or raise that (including what someone starts out with). An increase of 30 systolic or 15 disatolic is another criteria.

>When I went in my bp was
>like 170/86 he was obviously concerned and as he spoke to me the top
>number went higher and higher to a high of 198 the bottom number went
>lower to a low of 82 then rocketed to a high of 97 with the final being
>198/97.

I'd certainly have some concern about now.

>He recommended going into the ob dept to be monitored which we
>did. Initally there with all the fuss my bp was in the 150s over low
>90's.

Appropriate.

>As we were left alone and I was planning to leave it gradually
>went down to a low of 126/86(on left side monitored every 15 min) then
>the next reading my ob came in andd it was again 155/94!

Remember we spoke about labile HTN?

>So to make a
>long story short, he recommended staying, since my labs all came back
>normal, I recommended leaving.

Hmmmmm. Tough call.

>We were given an altimadum, and stayed
>and started procardia. We had an ltrasound and baby(boy) is about 3
>weeks ahead in development and weights about 3lbs.

Either you dates are wrong (I'm not saying they are. This is just for argument's sake) or this is a good sized kid.

>And protein is
>neg..so if there was any blood pressure problems it is not affecting my
>body or the baby as he is obviously growing well.

The important concept here is *YET*. It may or may not affect things. Usually, marked elevations over a significant period of time cause intrauterine growth reduction.

>Dr thinks I am
>chronic hypertensive, even though my normal is 140/80 when not preg.

As above, that is a little high unless you're overweight and they're using the wrong size BP cuff.

>Now
>on the procardia after walking around and taking a shower it is 122/75 ,
>and when resting ( as I am doing) lower 111/65 and upon waking this morn
>much lower.

Tht's getting a little too low for me. With chronic hypertensives (if you even are) 140/90 is an OK place to be.

>Guess my questions are: does this all sound like a normal scenrio?

Now we'll have to define normal. I've given you a good picture of normal in the answers above.

>Why
>would my home readings be ignored(they are the consistent with office
>monitor)?

Dunno.

>And what effect will the procardia ( 80 mg a day) be on the
>baby and the good growth he is experiencing?

Shouldn't be a problem to either of you.

>How low is to low, even
>when first getting up?

Numbers vary depending upon the person. My wife's BP is normally much lower than mine. If I had her BP, I'd be in trouble and if she had mine, she'd be in trouble.

What does the perinatologist at the hospital say?

>Thanks and Happy Thanksgiving!

You too!

--
Harvey S. Marchbein, M.D. FACOG, FACS
OBGYN.net U.S. Representative, New York
Great Neck, New York
http://www.obgyn.net/states/bios/marchbein.htm
http://www.obgyn.net/women/advisors/harveym.htm

*Note:  Opinions expressed here are for educational purpose only.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options.

**Private emails cannot be entertained due to time constraints,
consequently no private emails will receive a response.
**Thank you for your understanding ;-)

Next message: Harvey S. Marchbein, M.D.: "Re: placenta"
Previous message: Esther: "Should I rush to get mammogram done?"
In reply to: Tammy: "Re; Essential Hypertension: Attn Dr Marchbein!"
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