Thank you for writing in tonight. I want to provide you with the best possible information, so I do have a few questions. I hope you understand.
What is it about the blood pressure that makes you unconfortable? Do you recall how/why you came about this anxiety with blood pressure? Have you had a bad experience? You mention that you take your blood pressure. Do you do it differently? How do you check your blood pressure? Do you have any blood pressure issues, such as high blood pressure? Do you have anxiety about other things as well?
Please let me know.
I hate that the readings are always much higher than when I take it at home. They tell me that I have high blood pressure and need medications for it. It is sometimes high at home but only after a very stressful day. I have been taking atenolol for several years and it is low in the mornings. Sometimes in the upper 90's over 50's with pluse in the upper 40's, which I know is to low. Everytime I get it taken at the doctors office it is usually 160/95 or 160/100. I have had anxiety at times during my life but nothing bad. I guess it is just embarassing that a man gets nervous over getting blood pressure taken but can watch anyone stick me with a needle. My doctor tells me that even if I get nervous my blood pressure should not be that high if I am on my medicine which I do take. Maybe I am afraid that I have some really wrong. I am 5'8'', 170-175 do not drink or smoke and exercise when i can. Hope this sheds some light.
Thank you for responding.
First of all, it is not uncommon for people to become anxious at the doctor's office. It's also not uncommon to have some higher readings at the office compared to those taken at your home while you are relaxed. The issue is that they are too high. I would have to agree with your doctor. Even if anxious, your pressures are too high at the doctor's office. Also, you admit to a few high blood pressures at home. At this point, you do likely need to add a medication to your current blood pressure regimen. Two medications for blood pressure actually can promote better blood pressure control.
In your case, a systolic pressure in the 90s and diastolic in the 50s in the morning is not too concerning, if you are not symptomatic. As for the pulse in the 40s, this is a bit low, but it is a side effect of your atenolol. Now, with this being said, you may want to talk about the atenolol usage and dose with your provider. He/she may advise you to stay on the atenolol, because it has some other benefits, such as cardioprotective and anxiety related. However, your provider may be able to adjust your dose a bit and add another blood pressure agent from a different class. This may reduce some of the side effect, such as lowered heart rate. Also, younger (middle-age) men frequently have some fatigue and sexual dysfunction from atenolol; therefore, please discuss this with your provider if these are also an issue.
As for your anxiety with the blood pressure, you can't let it defer you from going for your medical care. I suspect, once your provider adds a blood pressure medication to your regimen, you will likely have lower to normal blood pressure readings, even when anxious at the doctor's office. Once your blood pressure is better controlled and your readings are more within a normal range when taken at the office, your anxiety related to blood pressures will likely diminish.
Finally, you mention your stats, such as height, weight, and lifestyle. All very good. Therefore, you may not be able to control your blood pressure via lifestyle change alone. In fact lifestyle changes usually only create a very small reduction in blood pressure. This is why medication management is so important with high blood pressure. Also, consider your family history. Hypertension correlates strongly with family history. I suspect some of your family members may have required more than one agent to control his/her blood pressure.
I hope this helps. If you have any additional questions, concerns, or need clarification, please let me know. Also, please feel free to let me know what you think.