The Case of Jane Doe

Meet Jane Doe. Jane is a 55 year old teacher living in Jacksonville, Florida. When she isn’t busy planning lessons and activities for her students, Jane is catching up with friends, chasing her dogs around, or relaxing with a good book. Her health is one of her top priorities, so she is mindful of keeping up with her annual doctor appointments. This year, her primary care physician diagnosed her with hypertension after seeing the log of blood pressure readings Jane has kept. Let's review Jane Doe’s case.

Jane Doe has been taking her blood pressure regularly for 3 years at the instruction of her primary care provider when she noticed it rising. 

• In year one, her blood pressure was in the 130s. 
• In year two, her blood pressure was in the 150s.
• In year three, her blood pressure was in the 180s. 

Ms. Doe has never had symptoms of hypertension. Her doctor put her on blood pressure medication and Jane felt terrible, but her readings were now back in the 130s. If her blood pressure is better now, why does Ms. Doe feel so bad?

Her doctor decided to refer her to nephrology since the original medications did not seem to be working. Ms. Doe met with Dr. Munjal who made a small, simple change in her medications. Dr. Munjal decreased her blood pressure medication and now her readings are in the 150s and the uncomfortable symptoms of “low” blood pressure have been minimized. Once these symptoms went away, her regiment was changed again to further lower the readings. The uncomfortable symptoms came back briefly, but soon went away as her body acclimated to having lower blood pressure again. Her new goal is 130-140 for her systolic readings. 

Dr. Munjal explained: “When someone has hypertension, the body can acclimate over time and not experience symptoms of hypertension. This means that when we try to bring the blood pressure back down to a lower range, you may not feel as great as the readings may look. It is important to keep this in mind when working to reach blood pressure goals. When we set a goal, we know that this may take a while to reach since changing blood pressure has to be done in steps. You may feel worse before you feel better.”

Working with blood pressure readings is not a sprint, it is a marathon. We must pace ourselves as we work through the steps needed to safely get the blood pressure down to a manageable range. If you have questions or concerns about your blood pressure, call to schedule an appointment with Dr. Munjal! 

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