Hello and thank you for your question.
You are asking an excellent question. I will try to explain the best I can.
You do have high blood pressure. It is not horribly high to the point where it puts you at a risk for an immediate stroke, however, it is border line high. Medical guidelines and recommendations have changed over the last few years. If before acceptable blood pressure was 140/90 and below, now recommended blood pressure is 120/80 and below. The reason for this is because high blood pressure is called "a silent killer". It causes small changes to your heart arteries, kidney arteries, brain arteries, without you feeling anything, until its too late. High blood pressure can lead to heart failure, heart attack, kidney damage, and stroke.
Since you are only 54 years old and, sounds like, you've had this blood pressure for a couple of years, it would be recommended to lower it. Initially we recommend dietary changes. Not consuming salt is definitely the first step to take. There is also a great diet, which you can learn about, called DASH diet (stands for Dietary Approach to Stop Hypertension). It involves eating chicken, fish, fruits, vegetables, nuts, and other healthy foods.
Since I practice internal medicine and internal medicine is a preventative medicine, I would recommend treatment for your numbers. You would require a very small dose of medication to achieve better numbers. Along with the medication you can continue low salt intake and exercise. This will help to keep your blood pressure medication at a low dose.
I hope you find this information helpful. If you need any clarification or have any additional questions, please let me know and I will be glad to assist you further.
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Just for clarity if I go sit for 30 min it goes down to 135
Just for Clarity...I am very tall and the chart that I find (for a 17year old male in the 99% tall ness group) showes 147/97 to be normal...how do we account for that? I am in the 99% group of tall people and not overweight...(yes I am kind of fighting here) height does matter.
My cholostorel is pretty high at 255 but the other is 175 (good?) making ratio 4.8 does this have anything to do with it?
I stopped salt but am dying to kill a salted pretzel! thanks....also during the day my BP will often hit 150...but I am active...?
Yes, I read you are 6'7" - that is very tall, however, it should not make a difference in your blood pressure.
New guidelines say that in order to prevent complications from elevated blood pressure (heart failure, kidney failure, heart attacks, strokes, etc), the recommended blood pressure should be 130/80 and below independant of the height/weight. When your blood pressure is in the 130s, that is ok, but unfortunately quite frequently, it goes up into the 150s (and maybe even higher if you are nervous or stressed out).
If you were my family member I would tell you that you should treat your blood pressure. Honestly, you cannot imagine how many patients I see in their 70s and 80s who have complications after having years of elevated blood pressure that went untreated. I am not a pill pusher and always recommend dietary changes first, however, often we see that dietary changes jus dont work (see, even you are dying for a salty pretzel). People often relapse. If your blood pressure is well controlled on medications, then you can afford to have a salty pretzel once in a while :)
In terms of your cholesterol...255 total cholesterol is high. 175 sounds like LDL - "bad cholesterol". LDL should be below 130, so 175 is quite high. Total cholesterol of 255 is also high. Since you are not overweight and are active, it is most likely that your cholesterol is genetically high. You can try low-fat, low-cholesterol diets (no red meat, low fat dairy, no fried foods, olive or grape seed oil only) to see if your cholesterol improves. You did not write down what your "good cholesterol" - HDL is. We want that number to be above 40, the higher the better. I dont really go by the ratio, I look more at the bad vs good cholesterol. At this point there is no urgency in treating cholesterol. You can try DASH diet and no red meat/no fried foods/low-fat diet to see if cholesterol improve. If it does not, then treatment should be considered.
Let me know if you have any other questions. I am here to help.
Is there anything else I can answer for you at all? Any other questions?
As I've mentioned above, your total cholesterol of 255 is high and so is the LDL of 174. What outweighs the fact that the total and that bad cholesterols are high is the fact that your "good" cholesterol (HDL) is good. We want HDL to be above 40, so 55 is an excellent number.
I do not necessarily look at the ratios of the cholesterol numbers, rather treat the numbers themselves (in our hospital ratios are not even calculated). At this point, I do not feel that your cholesterol needs to be treated immediately. It is something that you can try to improve with dietary changes which I have outlined in my previous answer. If, after 6 months, you cholesterol has not significantly changed, then treatment can be considered. You may have higher cholesterol not because of your eating habits but more because of your genetical make up. Your body produces cholesterol independent of the cholesterol you eat.
Your HDL "good" cholesterol is very good so it outweights the fact that your "bad" cholesterol is bad and that is why your ratio is within normal ranges.
Hope this clears it up. Let me know if you have other questions.