Fluctuating high blood pressure at 22 years old!

Heart health and blood vessels
1

I'm a 22 year old female with recently discovered hypertension.

I do not smoke or drink, I have a limited caffeine intake, I have a relatively healthy diet, I excercise regularly, I am under no stress, and I have no family history of hypertension or anything related.

I have a very small renal history of scarring on one kidney from birth, but a recent ultrasound shows no worsening, and my kidney function is and always has been normal.

It was found at a routine contraceptive pill check that my blood pressure was elevated, (in particular, my diastolic - 110/100) so my GP changed my pill to the progesterone only pill. I was sent home with a home monitor and told to take my blood pressure twice a day, am & pm, for 2 weeks. I found fluctuations, from 110/70 to 160/110 and also fluctuations within readings taken minutes apart.

My GP sent me for tests:

Diabetes - no.

Kidney function - normal.

Liver function - normal.

Cholesterol - normal.

FBC - normal.

Infection markers - normal.

I have just completed a 24hour blood pressure tape, which showed my blood pressure fluctuated throughout the day with no particular cause. I had readings such as 130/115, 120/85, 145/95, 190/115!!. With heart rate elevations and dips every half hour also (from 70-105).

Overnight, my blood pressure was low and normal. Averaging 115/65.

My GP wants to refer me to a renal consultant?

Any insight/ideas/thoughts or similar experiences with answers would be so helpful and reassuring please!

What will or should my GP test for next?

2

Get your GP to test for Conn's Syndrome, it is more common than GPs think,  20% of unexplained hypertension is down to Conn's.  Don't let him fob you off either, keep nagging until he agrees, or get him to refer you to an endocrinologist, they are much more knowledgable about it.  Good luck!

3

Hi Samantha

Well I would think one bit of positive news to hang on to would be that your overnight blood pressure is excellent.  I have been told that the overnight readings are very important.

Your GP is doing the right thing in referring you when he doesn't know what is causing the high daytime readings, and it isn't surprising that he should choose a renal consultant owing to your history of scarring on one kidney since birth, and your very young age.  If the renal consultant feels assured that the blame doesn't lie with your kidneys, then at least he will be able to either refer you to a hypertension consultant, or treat you himself with his knowledge.

My thoughts, for what their worth (I'm not from a medical background, just someone with personal experience of kidney problems and hypertension) are that the contraceptive pill may have contributed to the hike in blood pressure.

I do hope you will find some answers soon - meanwhile, although I know it's difficult, do try not to worry as that will have a knock-on effect on your blood pressure.  Just hang on to the thought that those night-time readings are excellent. Also, drink plenty of water, and throw away the salt pot!  If you eat any salty foods such as processed meats of any sort, or any foods with added salt (crisps), either reduce or discontinue those, plus try ditching the coffee completely for a while, or even switch to decaf.  Good luck and do come back and let us know how you get on.

4

How do we know what is normal? if we all did 24 hour monitoring may be we would all have spikes like this, so what did your daily day time bp come out at?  Do you worry about it maybe you tensed up when the cuff inflated  good luck

5

When I was 22 I suffered with hypotension, when I was about 35 my BP was fine, and at 50 I suffered with hypertension which still bugs me today even though at 70 years of age I have less stress in my life than ever before.

You figure it, because I'm sure that I can't.

6

So I had the follow up with my GP and have been left very dissappointed.

She couldn't explain the abnormally high fluctuations and said she hadn't seen it before. However, she said "good news, the average readings aren't 'that' bad (130/85) so we don't need to start medication". I asked about Conn's syndrome and she laughed it off.

I was left with the advice to excercise (no brainer) and come back in a years time.

I can't help but feel very let down. After all the positive steps she was taking to help find out what had suddenly caused my blood pressure to 1) rise so young and with no primary causes and 2) fluctuate quite serverly and quickly, she then dropped everything with no referral and is happy for me to go a year without any readings.

I'll add, she was running an hour late.

7

Thank you MrsO. Better advice than the GP can give me! I'll limit my salt (I'm not a salt on the dinner table person or much of a crisp or processed meat eater), but I'll take extra care to look at ingredients of food and check for salt content. Also, I rarley drink hot drinks but I'll completely ditch the few I do occasionally have.

I really hope it doesn't continue to rise, what with wanting children soon, I work in the Maternity services and know the awful complications having high blood pressure in pregnancy can cause!

Highly dissappointed with my GP.

8

Samantha, perhaps that original diastolic reading of 100 has improved simply as  a result of the recent change in hormone medication?

If you don't feel reassured, then either see a different GP in the practice for a second opinion and/or ask for referral to either a cardiologist or a renal consultant.

Meanwhile, a year is obviously too long to wait before having a re-check, so perhaps you can invest in your own home BP monitor and take your BP once a week - but don't obsess about it as that can lead to stress which in turn can lead to high BP!

As for hoping to start a family soon and  knowing "the complications having high blood pressure in pregnancy can cause", you will be well monitored.  When I was expecting many many years ago now, I was immediately referred to a dietitian due to having just a sole kidney.  Pregnancy is known to place the highest stress on this particular organ.  Her advice was to ditch the salt completely, and watch that my weight gain didn't go overboard.  I followed her advice religiously and gained 1 1/2 stone during the 9 months, and all remained well.  I hated the taste of a boiled egg without salt so thought my first boiled egg with a sprinkling of salt post-pregnancy would be great.  It wasn't!  All I could taste was salt, not the eg  g!   It just goes to prove that when we add salt to our food it takes away the whole natural taste of our food.  I now  often notice the salt content in my food when eating out.  A professor at a London hospital has worked his butt off for years in trying to get the food industry to reduce the massive amount of salt in the food chain - thankfully it is having some positive results now.

Stay well, Samantha, and good luck with your future plans!

9

I am 20 and have the same. My BP can fluctuate widly within minutes and my heart rate is seldom under 100. Im not stressed and I try and live healthily but I have a condition which affects the sympatgetic nerves causing pain and I also have postural teachycardia

I know how hard it can be to get someone to take fluctuations seriously. Everyones fluctuates its just ours does it much more quickly and regularily. Seems everyone is hung up on averages tbh

The way my neuro explained it is that overnight whilst asleep everything resets. My pain goes my dystonias and my bp and hr go back to normal. When awake my sympathetic nervous system gets lots of mixed signals and cannot regulate hence the problems

Not an easy thing to handle or resolve. Hope you get some answers soon

10

Hi Samantha,

I know this is an old forum, but I was wondering if you ever received a correct diagnosis? My daughter is 22 and going through a similar problem with her GP. Last May during a routine Gyno check, her gynecologist told her she had hypertension and took her off the pill completely. Since then we have been monitoring her and her blood pressure fluctuates throughout the day. It ranges from 120/76. - 150/100. Of course whenever she goes to the GP it is within a normal range and he just keep monitoring her. Her doctor recently retired, and we are now starting over with a new doctor. Just wondering if you got answers?