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Mother has a Dr. She once told me to take Mother to the emergency room if her blood pressure goes above ??? SYS and above 100 DIA. Taken today her SYS has been 172/118, yesterday 169/98, day before, 2 readings 180/83 and earlier that same day, 158/133. I called when it was 158/133 and the Dr. told me to check it in a few hours to see if it improved and if improved, to just continue with 10 mg Lisiniprol in the am and 20 mg Lisiniprol in the evening. Mothers diet is scrambled eggs in the am with white toast and olive oil w a little butter and jelly. Mother is at a facility where they do not have special diets. Their cooking is low in salt. Mom does not add salt. She skips bacon and hotdogs, and foods w nitrates. The food at the Senior Facility is not bad but includes a lot of gravy, french fries, white bread. Mom does not eat pork or ham. I make her healthier foods or we go out to eat when she does not like the menu. Mother enjoys the deserts here. I have held back from discouraging her from deserts as she is not diabetic. I have asked for the last results of her blood tests to be sent to me. Mother does not like to exercise but we go out to places she can walk into restaurants or we go to my home where she can walk up 1/2 flight of stairs. In her apartment, she walks about 24 feet each way to get to the bathroom. In any ones experience, how much Lisiniprol is given for high blood pressure. Is that the answer or is anything else given? Is it dangerous to take Mom out to the Dermatologists when her blood pressure is so high. What has been successful in your experience. We have an appointment for a second opinion coming up in 2 weeks. Mother only drinks 2 cups of water a day along with 6 oz orange juice and 3 cups of decaf with 2 oz of low fat milk or ensure.

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daughterlu, sometimes we can do everything from diet to meds, but if high blood pressure or hypertension is in Mom's DNA, we can only do as much as we can. I inherited hypertension from both of my parents. Blood pressure pills do the trick, plus I have a really super Cardiologist.

I know my Mom went overboard with salt-free food for her and my Dad. Ever taste salt-free soup? Might as well be eating water with some veggies floating around in it. There were no salt shakers on the kitchen table. My Dad loved to eat, so once Dad moved into Independent Living facility, after my Mom had passed, his favorite times of the day were breakfast, lunch, and dinner. He was finally having food that he could actually taste. Ok, it might have shorten his life a tad, but he was really enjoying his meals. Dad was in his 90's.

Personally, I feel if someone lives to an old age and wants ice cream for breakfast, let them have it. They deserved it :)
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My mom's under treated high blood pressure lead to the eye bleed that stole the vision in one eye and I am convinced it contributed to the multiple mini strokes that have destroyed her brain. Is she being treated by a specialist?
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Take in a cat or dog. Pets are calming. :) Seriously.

Good luck
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Salt is generally considered the culprit with hypertension. There is so much hidden salt in processed food as well as resturant food. Even raw chicken you cook at home is often loaded with salt check the packaging carefully. Fast food is also loaded with salt.
You’ve listed all the solutions I’ve studied that can help. Exercise. Salt free food, hydration. You didnt mention elimination which is very important.
A plant based diet is what I’d like for my aunt to have but we haven’t tackled that one yet.
But I agree with FF’s dad. In your 90s you should be able to enjoy your food.
Most people with hypertension take three prescription meds. The reason given is that each do something different to lower the pressure. For instance my aunt (91) takes Lisinopril, metoprolol and amlodipine. One of them is a ER. She takes all in the morning. Her BP usually hangs around 126/76 until recently.
She has been having issues lately because she has to skip the metoprolol and replace it with a second amlodipine when her pulse falls below 60. The metoprolol causes the pulse to lower.
She’s been taking all three for years. And now that she can’t take the metoprolol everyday her bp is up around 138/80 -143/82. Still not too bad all things considered.
She eats entirely too much salt as she loves cheese.
She has therapy several times a week. OT and PT and although she uses a cane she gets around very well.
The BP meds are dehydrating. But she does drink a lot of decaf. Not too much water or juice. I wish she drank more.
But your mom’s bp is what I thought was stroke range and can also contribute to Congestive Heart Failure. I think I’d be asking for some help to get it lower. I don’t think her diet is likely to change enough to assist her soon.
About taking her out with the high bp. I just don’t know. On one hand you would be closer to the ER if something happened. On the other she would be exerting herself more.
My niece is going through this right now with her husband. He’s an avid bike rider. They are waiting for blood work from his last appt. They told him not to ride for now. Unless she has a bad problem with the dermatologist I might just reschedule.
Are your mom’s feet or ankles swollen? If they are have her elevate them when she sits. Probably good to do that swollen or not. It makes it easier for the blood to circulate back to her heart and it doesnt have to work so hard.
In his book How Not To Die, Dr M Greger says that high BP is an illness of choice because we cause it by our diet and lifestyle. That may be true but you and I are just trying to manage what we can. He is the one wanting us to eat a plant based died. Fruits and Veggies.
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Daughterlu; My mom's doctor had her on a regimin of several meds, along with instructions to take X if bp was above Y /Z and skip X if bp was below Y/z. Along with his cell phone number to call if she was concerned.

You might want to see if you can get this kind of arrangement with your mom's doc.

My mom's bp issues were caused by a combo of anxiety (treated with antianxiety meds) and heart issues (she had some structural issues that apparently caused her bp to go out of control with little we could do about it).

At 90, we were in a holding pattern, waiting for a stroke. There really wasn't anything we could do to prevent it; we held it off as long as possible.
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I would check your BP meter to make sure it's accurate. I have one at home and I have compared it to several medical offices and the pharmacy to ensure it's pretty close.

I might get a second opinion from a geriatric doctor. I might inquire about meds to help. From what I have heard, it's really very difficult to control hypertension with diet. So much has sodium. And sodium free is tasteless. It's quite daunting and for a senior. I would think that a senior would want to be relaxing and enjoying their days, not stressing over a stringent diet.

Why can't they control hers with meds? My mom takes her meds daily and it stays in a great range. And, she doesn't even avoid sodium. If she didn't take it, it would be quite high.

I hope you can find some answers to help your mom.
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She may need additional blood pressure medication. Lisinopril may not be enough. If she has a cardiologist, have her evaluated. Bring your log of her blood pressure readings and take the reading one hour after she takes her med.
As mentioned above make sure the blood pressure cuff you use is calibrated correctly as well as that you are using the proper size cuff for the size of her arm.
Make sure you are taking the reading when she is relaxed, legs uncrossed and has not done any exercise ( walking or even bathing).

Try to be consistent with the time you take her BP as well.
A diastolic of 133 is very high. Per your doctor, retake her BP in about an hour and try not to make your mom nervous by telling her that her BP read high. Just tell her you want to recheck it for accuracy. Her anxiety will cause her BP to rise.

I would also add more water to her diet, she could be dehydrated  and the body’s result would be to secrete a hormone that will raise her blood pressure to meet her body’s need for perfusion. She should drink at least 32- 48 oz per day. Her intake is nowhere near that. Dehydration can cause  her kidney function test (creatinine) to have a false elevation as well.

I wouldn’t take her out if her BP was too high.  
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If we just concentrate on the instructions you were given by your mother's doctor:

"She once told me to take Mother to the emergency room if her blood pressure goes above ??? SYS and above 100 DIA. Taken today her SYS has been 172/118, yesterday 169/98, day before, 2 readings 180/83 and earlier that same day, 158/133. I called when it was 158/133 and the Dr. told me to check it in a few hours to see if it improved and if improved, to just continue with 10 mg Lisiniprol in the am and 20 mg Lisiniprol in the evening."

Well. Having improved the day before yesterday, your mother's diastolic reading is now back over 100. And the systolic, though also better than the day before yesterday, does seem to be trending upwards. Which we don't want.

I should put in another call reminding your mother's doctor of the instructions she herself gave you and asking if there is any reason why you *shouldn't* take your mother to the ER, then.

There may be very good reasons not to, I wouldn't know. But the instructions don't seem ambiguous, do they?
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"She once told you....". How long ago was that?

I agree with CM, call the doctor today and read her your results. 172 over 118 is quite worrisome.
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If she's in a facility they should also be monitoring this? They have nurses and Dr's on staff? So the general trend is suppose to be that they contact her Dr. when things are not right and that Dr. adjusts her meds to control her BP. Or the facility Dr. should also be aware that her meds are not controlling her BP and also adjusting them as needed to make sure her BP is not that high.
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Thank u all for the answers. I want to answer all your questions. Mom is 100. She has a good appetite. I am on a stringent diet, she is not. Mother's dad had a stroke in his old age. I worry about that. Mom's Dr. is the Dr.who sees Assisted Living and Memory residents. Mom is in Independent Living.  She sees the same Dr. everyone here sees except she is her private patient. It is a problem for Mom going to her office as it is too long a trip for her. Mom doesn't see any specialists. What is advice on type of specialist do you go to for high blood pressure or possibly for her memory? I have many specialists. Are there B.P. specialists? Just took Mom's BP. It is 142/75 this am.  That is a lot better.  The Dr. bumped her Lisiniprol to 40 mg per day. Think the monitor we have is accurate. Have been testing my BP along with hers, mine remained normal through her spikes. Both myself and our cat stay with Mom 24 x 7 at her facility.  Kitty and mom and I hold hands at night.  Being upset over Brother's actions upset Mom recently.  We need to do something about him butting in, trying to direct the show, when he lives out of state, doesn't have a relationship with Mom, no calls, visits 1/2 hr a year now when he is back home to socialize and visit his friends.  It was a tragedy at a rogue facility  how he and cousin intervened to get me out and Mother into their Personal Care hellhole.  She almost died.  We got Mom out of there to this new facility.  It has been a Godsend. He was quiet for a while but now there are issues to deal with, later now becaise of the effect it has had on her BP spiking.    Re: elimination. We are on top of that. Mom takes Polyethylene Glycol, 1/2 cupful every other day but if constipated she gets a full cup and some prune juice. I watch all three of us "Golden Girls", every day: me, Kitty and Mom. Time to get am meds ready. Got half way through answers . . will get back to this. Thank you everyone. You are like a good family to turn to here.
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I was thinking of a cardiologist since high BP usually = heart and stroke problems, but at 100 years old I wouldn't worry about that anymore. I was thinking that she might need additional BP meds or an adjustment of what she is already on (my mom was on several) and it looks like her doctor is on top of that. I think it is wonderful she is doing so well at her age!!
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It's a balancing act. If given too much blood pressure type meds, the blood pressure could drop any time that person stands up from a sitting position, thus cause that person to feel extremely lightheaded to a point of falling.

I remember reading for many years the upper pressure reading should be in the 130's, but not long ago that was changed to 140's for seniors. Who knows, that could have changed back. Also, don't take your blood pressure right after climbing a flight of stairs, it has to be a "resting" blood pressure test.

Oh my gosh, the sodium/potassium in processed food is sky high. For years sig other had to watch his sodium intake. Now he found out he also should be watching the potassium amounts as apparently that is more of an issue then sodium. What's next?

Both sig other and I love pot pies, but all the well known brands have crazy high sodium levels. Finally I found a brand with mega low sodium levels by comparison, the company is Blake's, and their pot pies are pretty good :)
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. . . continuing here on answers to questions in the Answers given. We will look into metroprolol, and amlodipine and research how much is too much Lisiniprol online. Mom's feet and ankles do not get swollen. I buy diabetic socks for myself and now use them for Mother as she gets a little line mark from her socks but not w diabetic socks. Will keep a daily log, take BP every day at the same time. Also really like the idea of checking Mom's monitor at the Supermarket Pharmacy's BP machine on myself. We have added sliced apples with a little bit of peanut butter for snack in her apartment. The Nursing Staff is available to us when we need them however, they are so busy, to take Mom's BP and call the Dr. is much faster  if I take her BP and call the Dr.  There is a human error factor the more people that get involved.  Mom's Dr. is very attentive.  It is up to me to ask the right questions.  I feel more fully equipped now and will do other research on the internet.  We are getting a second opinion with a Geriatric Dr.  whose Office is much closer. I thank everyone for their input.
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Daughterlu
I remember some of your previous posts. Your mom’s 100th bd party and the problems with the facility and your brother. And stress does cause high BP and of course brother is good at causing that. Look up loving kindness meditation and see if it is something you and your mom would enjoy. If you can do even 5 or 10 min of meditation daily you will be able to reduce the stress.
I had the same question as you about which dr to see for BP. I did try a cardiologist for my aunt. Her primary took her off of one of her pills (because of low potassium) and her BP went sky high.
I had already taken her to the ER and they prescribed a tablet that brought the BP down immediately and then it would go right back up. So I took her to a cardiologist she had seen before. He ran every test he could think of. Several days of testing. He ended up not being able to bring it under control. He had me checking the BP all day long and adjusting the meds. Then he said that there was a phenomenon where when one did something called “chasing” the BP that the constant checking makes it high. So he basically sent us home with no solution. I took her back to the dr who took her off the one bp med and asked him if he could put her back on it now that her potassium had returned to normal. He did and her bp settled down.
Your mom’s bp sounded good this morning. Some believe that as we age and our vessels stiffen and narrow that we actually need a stronger pressure to circulate the blood. I would be very cautious about adding another medication at 100. Try ground flaxseed on your mom’s food or in applesauce. This is supposed to lower bp and it’s a healthy food.
Take good care of yourself daughterlu and know that you are doing a good job.
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MANY people see the blood pressure cuff come out and the BP shoots up. Called white coat syndrome (for the drs). Mine is ALWAYS 90/60 (genetics, the same ones that give me insanely high cholesterol readings!!). But at the drs., I am always like 128/75, which, for some reason ticks me off b/c I am so proud of the ONE THING that is "good" in my health profile. BMI is too high, cholesterol is insane--I'm kind of crazy...etc.

I take my hubby's as he has anxiety issues and when he is having a panic attack, we kind of use that as a way to consciously lower his BP. 3 readings within an hour can be hugely different. I'll have my Drs nurse take my BP at the start of the visit, and the end. It's always back to normal by the time I've seen the dr.

NOW--of my mom was 100 and having these readings--I wouldn't bat an eye. But that's just me. Your mom has already lived a longer life that the "average" and you know it. Of course you should be in touch with the dr, but at 100, she's living on extra time! Bless her heart!!

When my grandmothers passed, both into their 90's, drs asked me what they died from. I believe the best answer was "being 95".

Daughterlu--you are doing amazing work and you enjoy your time with mom, what a great blessing to both of you. I would not stress out the numbers game too much.
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I added magnesium citrate to my dad's regiment daily 200mg, doctors loved the idea, why they don't prescribe is a mystery, but it does a few things, it is the mineral our nerves need, so we saw a stabilizing of dad's BP, it is a natural relaxant so he sleeps better, it also is an important electrolyte so it hydrates the bowels, so we were able to stop giving him laxatives.

I tell everyone because my research has shown that 80% of Americans are magnesium deficient and that leads to a whole host of medical problems, I started taking it for migraines and it started working the 1st day, I sleep better and feel better overall. Look it up on Google, it still amazes me that it is such a huge problem and doctors never prescribe it, I guess sick people are big money, especially when it's chronic, which magnesium deficiencies do create chronic issues. My friend, who is a huge skeptic and nay sayer just fell out of her chair when she had to go to the ER and the 1st thing they did was put her on IV mag drip. She asked the nurse and was told that it is standard procedure to give mag drip in ER, hmmmm.

I pray that you have your loving mom with you as long as possible and that her son and nephew take a hike. I believe that if you have POA you can say no contact. I know I can refuse to let certain people have contact with my dad, no need to yet, but good to know I have the ability if it started impacting his life negatively.
God bless you golden girls!
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Why is mom on Amlodopine? That is a very nasty drug with horrible side effects. Does she have atrial fibrillation?
I have had high blood pressure and taken medication for many years.
I would check my B/P fairly regularly and one day it was ridiculously high so i began taking it like every half hour and it just got higher and higher till it was in the critical range so I went to the ER and they gave me some pills which I don't remember. Didn't do an EKG or anything. After a few hours it had dropped a bit but was still far too high. So the Dr said "You can go home and stop taking your blood pressure so often.
I agree with everyone else not to worry too much about it at 100. Don't be stupid about it but let her eat what she wants and be thankful she has a good appetite. At such an advanced age something is going to take her so try not to pile on the medications. A visit to a cardiologist would certainly be a good idea.
i understand why you are concerned because she and the cat are all you have but just try and keep her life as happy and comfortable as possible and if she wants to do something let her.
Sweet dreams you golden girls.
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I didn’t realize your mom was 100! Goodness!
I don’t know if I would get her up and out to any more specialists. I agree with many above - maintain your status quo. Taking her out of her home can open her up to respiratory infections or the flu.
You’ve been a great caregiver for your mother!
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Oh what stress can cause. Your mum sounds remarkably. The brother unfortunately must be a challenge. Hopefully the second opinion doctor will be helpful. Especially at 100 they will be monitoring her BP and careful not overprescribe meds. She is blessed to have such a loving daughter. (((((hugs)))))
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