Blood pressure high all of a sudden? Lose weight and take this medication. . . .

SS writes:
I have been overweight since puberty. Right around age 16 my body settled into a size that has stayed pretty consistent over the years, give or take a few pounds. I can’t remember a time since that I’ve been to a doctor without my weight being mentioned, whether or not it was relevant to the visit. Reading the stories here has been both horrifying, because so many of you have had it so much worse than me, and reassuring, because at least I know I’m not alone in this struggle.

I have had a few bad experiences with doctors, but one in particular has stuck with me. About two years ago, at age 26, 5’4″ and about 220 lbs, I had my first ever high blood pressure reading. I was at the obgyn to get a new birth control prescription, and was told that I couldn’t go on the pill until I figured out what was going on. Obviously, this was a disruption in my plans, and I had always had good blood pressure, so I had no idea why it had suddenly become a problem.

I immediately followed up with a new general practitioner. The appointment was terrible from the start. My new doctor took one look at me and immediately started making assumptions about my lifestyle. She asked how much weight I had gained recently. I said I hadn’t gained any, that I had been at a pretty consistent weight for years. She looked skeptical, but let it go. After a few questions about my diet and alcohol consumption, she said that I should lose 10 percent of my weight and that she would put me on medication in the meantime.

At this point I got upset, because she still hadn’t addressed why my blood pressure may have suddenly skyrocketed. I didn’t understand how I could go from being healthy two months ago to suddenly having this problem, with no noticeable changes in my life. Other members of my family have high blood pressure, but none of them had it until their 40s. Wasn’t I too young for this?

She basically ignored those questions and told me again to lose weight. Then the condescension really started. “Just try to walk a little bit,” she said. I was taken aback by the assumption that I move so little that a bit of walking would make the pounds shed away. I replied: “I live in the city. I walk literally every single day, everywhere I go. I would say that I walk a minimum of a couple miles a day.” She didn’t believe me; it was all over her face. “Just try to increase your walking, you’ll be surprised how much it will help. Take the stairs instead of the elevator, little things like that.” I lived in a 5th floor walk-up at the time of this visit.

At that point, I felt utterly deflated. She didn’t want to hear the truth about my lifestyle, she was content to carry on with her assumptions. I left that appointment with no idea why this problem had suddenly come up, and no real plan for addressing it. When I went back to my obgyn, she decided to put me on the Depo shot, which did not have risks associated with blood pressure. Of course, while the shot is great in many ways, it has a major downside: weight gain.

Two years later, I am now at 230 pounds, and my blood pressure continues to be a problem. I’ve switched doctors, and my new doctor is much more empathetic and kind, but he still says the same thing at every visit: lose weight. I’ve been trying, believe me, but I can’t help but think that there must be more to it than that, and that my doctors are doing me a disservice by refusing to look past my weight.

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  1. Get off the depo shot… my friend ended up having tumors and stuff that grew BECAUSE of the depo shot. I’ve also heard of several others that have had huge medical problems because of the depo shot. I pray that you find a doctor that will listen to you.

  2. I hope you make sure that make sure they are using a big enough cuff on your arm. I’ve had numerous high blood pressure readings, but they almost universally came when the nurse was putting a tiny cuff on my big arm and then inflating until I was in pain. It turns out those readings should not hurt, if the reading hurts, it was done improperly. (I think sometimes on larger patients they inflate until they get the high reading they are expecting. But I’m biased obv.)

    My whole family does have an issue with blood pressure, my cousins started blood pressure meds in their late teens. So it can start earlier. I also think they are trying to diagnose it earlier than maybe they did with our parents generation.

  3. I have highish blood pressure, and since I also have type II diabetes, it is a concern. I have NOT been able to find anything that changes blood pressure other than exercise and/or drugs. Weight loss, I don’t know about, but I get encouraged to do that too, but not in a shaming sort of way.

    I have been on three types of blood pressure medication, and all three had bad side effects.

    Unlike you, I don’t walk a couple of miles a day, so I am not sure how much that would help me, but I am trying to work it into my day.

    I wanted to let you know you aren’t the only one frustrated by blood pressure, but in terms of treating it, there are not a lot of options.

    As for YOUR blood pressure, I agree you should try to find out if there are any reasons behind it besides genetics. I hope you get the answers you need.

    FWIW, I am 43 and have been dealing with the diabetes for about 5 years and the blood pressure for about three. You do seem awful young for blood pressure to have suddenly cropped up.

  4. I am absolutely not a specialist of hypertension.

    But your hypertension may not be hypertension at all.
    Your “hypertension” may be instead related on the fact that the two doctors you saw used a too small cuff to take your BP.
    Too small cuff for your arm leads to a falsely high BP. Then, doctors blame everything on your weight (instead of the too small cuff) and berate you to lose weight while giving unnecessary medications.

    These three articles on the blog Well Rounded Mama explains the problem much better than I do and gives you tips on how to deal with it.

    I was not with you, but your story is very common.

    I hope these articles help you.

    Take care

  5. I wish, I wish, I WISH I could make people understand this is a problem. Every time someone mentions this on Jezebel or some other website that’s usually a safe space, people come out of the woodwork to say “It’s your doctor’s job to tell you stuff you don’t want to hear to make you healthy, so suck it up.”

    They refuse to even consider that doctors have an unreasonable bias and can’t see through it, because they’ve decided that fat = unhealthy and, usually, immoral.


  6. Also, buy or borrow a BP monitor (I think they can be found for as little as $20-40 these days) and check your BP at home every day at the same time, for at least a few weeks. Make sure to do it before you drink any caffeinated beverages, sitting in the right position, having been sitting relaxed for at least 5 minutes prior to reading. My BP always reads high when I have it measured at doctors or pharmacies, because I get nervous and anxious at those appointments. Usually I’m 125/80 or something like that, but it easily goes to 145/95 if I have it checked in a public place. Or higher if I just had coffee!

  7. vesta44

     /  May 14, 2013

    I’ve been diagnosed with high BP, for the first time in my entire fat life. It’s not really that high when they take it at the clinic, usually somewhere around 140/80 or so. It’s never that high when I take it at home. I always figured it was the stress and anxiety that I feel every time I have to go in, along with the pain that the BP cuff causes me. They use the thigh cuff, which is more than large enough, but it’s still so painful that I’m swearing (in my head) at them until it’s over – not a calm, peaceful, relaxing thing to do. Is it any wonder my BP is a little high? Doc prescribed lisinopril, and even after having been on it for a month, my
    BP at the clinic was 138/78 (huge drop there. . ./sarcasm). But they said that was good, and to keep on taking the pills, despite the fact that at home, my BP is more like 112/62. I think that’s rather low for me, I sneezed the other night while standing up and got so dizzy, I almost fell down, and felt like I was going to pass out.

  8. I’ve actually had the clinic I go to stop taking my blood pressure completely because they don’t want to believe that it is fine despite my high weight. With some doctors they would rather deliberately give bad care rather then admit a fat person could either be healthy or have something wrong with them that isn’t weight related.

  9. ss2121

     /  May 15, 2013

    Thanks for the advice, everyone! I actually just recently purchased a BP monitor for home, because I strongly suspect my anxiety at the doctor’s office is contributing to some of my high readings. Hopefully I’ll get a better idea of what’s really going on.

  10. Some suggestions for the comments I keep hearing about painful BP cuffs. If your doctor is using a machine, those often go tighter than a person needs to go. I have had patients of all sizes complain of pain when we would use the machine. I also noticed that the machine would sometimes read a bit higher than when I took the BP by hand.

    Secondly, if your doctor or NP is willing to take your BP by hand, it helps if they check your pulse while pumping up the (appropriately sized) cuff until the pulse stops, then pump up another 10-20 lbs/pressure. This generally helps prevent over inflating, which will hurt the arm. It takes a bit more time, but only a few seconds really. Then they would take the BP as normal. I just finished medical school, so older doctors probably did not learn this technique.

    Your doctor should be looking into why your BP is suddenly higher too. There are several body systems that influence blood pressure and should be considered.


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