Hello doctor,I am a 38-year-old female with a history of SVT, cardiac ablation. Smoker of 25 years, 5’4”, 175 pounds. Yesterday I experienced pain in my jaw and left shoulder, took my blood pressure it was 150/105. This went on for about three hours. And went to the ER. They ran a CBC and one Toronto pen test, came back negative. EKG was negative. Blood pressure seems to stabilize on laying down but upon standing the diastolic number continue to be in the 90s and 100s. I was sent home with a diagnosis of anxiety. All day today my blood pressure seems fine until about two hours ago when once again I got jaw pain and pain in my left shoulder. I took my blood pressure and the systolic was 138 but the diastolic was 99. Diastolic remains high over the course of the last two hours. I am not experiencing anxiety. I have no history of high blood pressure and do not take medications. Is this acceptable for the diastolic number to be this high? Currently, I am taking Nexium 40 mg.
Hello. It is elevated. Our target is to keep it below 90. However, it is acceptable to have if systolic remains well controlled as there is no definitive and excessive proven risk from it. But, we try to target it below 90. Now, the possible reasons in you, firstly, do you still smoke? Do you snore at night, is there any history of uninterrupted sleep at night, morning headaches, etc? Is there any history of gastritis or chest burning, nausea, etc? This is for the possibility of gastroesophageal reflux causing the symptoms. Here, the possibilities I am keeping, first is of being overweight will raise diastolic BP. So, a healthy lifestyle and regular exercises, weight loss will help to bring it down. Also, low salt diet will help. You should keep on monitoring it thrice a day for a week (resting BP) and if it continues to remain high then better to have low dose angiotensin receptor blockers. Next, there is also a possibility of obstructive sleep apnea due to being overweight and it can raise the sympathetic tone and diastolic BP. For more information consult a cardiologist online -->