Re: Measuring BP and JNC-8

September 20, 2011

Hmm! been saying thus for about 40 years now. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

When I was looking at JNC-8 I noticed quite a bit about not being able to accomplish everything necessary in a 20 min. appt., the necessity of taking BP properly and more than once and incorporating the PTN as part of the team and more use of home BP measurement! Probably not the first time they have been told, wonder how many will listen!

- 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP(last week ave): 122/73

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2. and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > > > > > >

> > > > > > > > > > > > Hi,

> > > > > > > > > > > >

> > > > > > > > > > > > My problems did not start during pregnancy but

> > they

> > > > > > started about 2 weeks after my son was born. 10 years on and

> > still

> > > > > > trying to get sorted!

> > > > > > > > > > > >

> > > > > > > > > > > > ________________________________

> > > > > > > > > > > >

> > > > > > > > > > > > From: hyperaldosteronism on

> > behalf of

> > > > > > Stump

> > > > > > > > > > > > Sent: Tue 20/09/2011 13:13

> > > > > > > > > > > > To: hyperaldosteronism

> > > > > > > > > > > > Subject: PA and pregnancy

> > > > > > > > > > > >

> > > > > > > > > > > > I have searched the board and found a few people

> > who

> > > > had

> > > > > > this show up during pregnancy... Is it common for pregnancy to

> > > > cause

> > > > > > PA? Have been told by several doctors "Your blood pressure

> > > > problems

> > > > > > will go away in 6 weeks" That was well over a year ago, and it

> > > > keeps

> > > > > > getting worse! Just curious to hear stories of women who's

> > > > symptoms

> > > > > > started while pregnant.

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

September 20, 2011

Guess y they used my estimate that to do BP properly it takes 20 min. But this does not count as Dr time. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

When I was looking at JNC-8 I noticed quite a bit about not being able to accomplish everything necessary in a 20 min. appt., the necessity of taking BP properly and more than once and incorporating the PTN as part of the team and more use of home BP measurement! Probably not the first time they have been told, wonder how many will listen!

- 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP(last week ave): 122/73

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2. and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > > > > > >

> > > > > > > > > > > > Hi,

> > > > > > > > > > > >

> > > > > > > > > > > > My problems did not start during pregnancy but

> > they

> > > > > > started about 2 weeks after my son was born. 10 years on and

> > still

> > > > > > trying to get sorted!

> > > > > > > > > > > >

> > > > > > > > > > > > ________________________________

> > > > > > > > > > > >

> > > > > > > > > > > > From: hyperaldosteronism on

> > behalf of

> > > > > > Stump

> > > > > > > > > > > > Sent: Tue 20/09/2011 13:13

> > > > > > > > > > > > To: hyperaldosteronism

> > > > > > > > > > > > Subject: PA and pregnancy

> > > > > > > > > > > >

> > > > > > > > > > > > I have searched the board and found a few people

> > who

> > > > had

> > > > > > this show up during pregnancy... Is it common for pregnancy to

> > > > cause

> > > > > > PA? Have been told by several doctors "Your blood pressure

> > > > problems

> > > > > > will go away in 6 weeks" That was well over a year ago, and it

> > > > keeps

> > > > > > getting worse! Just curious to hear stories of women who's

> > > > symptoms

> > > > > > started while pregnant.

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

September 20, 2011

I know this is in line with what you have been professing but thought the other

600 or so here might like to know that something as important as JNC-8 thought

it important enough to publish. I also thought some might use it to get better

and more complete care. I know when I told my PCP that I would only allow the

use of my BP readings unless and until they started taking readings according to

DOD and VA procedures which was confirmed by my Hypertension Primer, that part

of the conversation was over!

And if my Neprologhist ever " pisses and moans " about over running an appt by 50

minutes I'll refer him to JNC-8 and let him know that I didn't schedule a 20

minute FIRST appt! How did he plan to get everything starting with a HX

accomplished in the time he allotted!

While I think it is important when we start with, " Dr. Grim says... " , it just

might have more impact if we start with, " JNC-8 says... " !

- 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank &

testicle pain. I have decided against an adrenalectomy at this time since

Meds. are working so well. Current BP(last week ave): 122/73

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2. and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > Hi,

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > My problems did not start during pregnancy but

> > > > they

> > > > > > > > started about 2 weeks after my son was born. 10 years on and

> > > > still

> > > > > > > > trying to get sorted!

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > ________________________________

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > From: hyperaldosteronism on

> > > > behalf of

> > > > > > > > Stump

> > > > > > > > > > > > > > Sent: Tue 20/09/2011 13:13

> > > > > > > > > > > > > > To: hyperaldosteronism

> > > > > > > > > > > > > > Subject: PA and pregnancy

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > I have searched the board and found a few people

> > > > who

> > > > > > had

> > > > > > > > this show up during pregnancy... Is it common for pregnancy to

> > > > > > cause

> > > > > > > > PA? Have been told by several doctors " Your blood pressure

> > > > > > problems

> > > > > > > > will go away in 6 weeks " That was well over a year ago, and it

> > > > > > keeps

> > > > > > > > getting worse! Just curious to hear stories of women who's

> > > > > > symptoms

> > > > > > > > started while pregnant.

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

September 20, 2011

Can't find JNC 8 think it is not out yet?Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

I know this is in line with what you have been professing but thought the other 600 or so here might like to know that something as important as JNC-8 thought it important enough to publish. I also thought some might use it to get better and more complete care. I know when I told my PCP that I would only allow the use of my BP readings unless and until they started taking readings according to DOD and VA procedures which was confirmed by my Hypertension Primer, that part of the conversation was over!

And if my Neprologhist ever "pisses and moans" about over running an appt by 50 minutes I'll refer him to JNC-8 and let him know that I didn't schedule a 20 minute FIRST appt! How did he plan to get everything starting with a HX accomplished in the time he allotted!

While I think it is important when we start with, "Dr. Grim says...", it just might have more impact if we start with, "JNC-8 says..."!

- 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP(last week ave): 122/73

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2. and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > Hi,

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > My problems did not start during pregnancy but

> > > > they

> > > > > > > > started about 2 weeks after my son was born. 10 years on and

> > > > still

> > > > > > > > trying to get sorted!

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > ________________________________

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > From: hyperaldosteronism on

> > > > behalf of

> > > > > > > > Stump

> > > > > > > > > > > > > > Sent: Tue 20/09/2011 13:13

> > > > > > > > > > > > > > To: hyperaldosteronism

> > > > > > > > > > > > > > Subject: PA and pregnancy

> > > > > > > > > > > > > >

> > > > > > > > > > > > > > I have searched the board and found a few people

> > > > who

> > > > > > had

> > > > > > > > this show up during pregnancy... Is it common for pregnancy to

> > > > > > cause

> > > > > > > > PA? Have been told by several doctors "Your blood pressure

> > > > > > problems

> > > > > > > > will go away in 6 weeks" That was well over a year ago, and it

> > > > > > keeps

> > > > > > > > getting worse! Just curious to hear stories of women who's

> > > > > > symptoms

> > > > > > > > started while pregnant.

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

September 20, 2011

You are right, JNC-8 is not officially out yet, due 1Q2012. I simply googled

JNC 8 and was looking into the sites that are leading up to the changes. It

appears thr formulation of where they are going is quite well progressed and

there is " early warning signs " if you will. (As one would expect if it is going

to be out in a few months.)

One of the sites I spent some time on was hosted by a PCP, t Kottak

Mavromatis, whose husband is a cardiologist. (www.drdialogue.com) One of her

posts was entitled, " What's new in Hypertension with JNC 8 on the horizon? " She

had been to a talk by Dr. Ferdinand, a card. who has served on previous

NHLBI JNC committees.

One point of particular interest to me was the results of the ACCORD trial that

he said found no advantage for a lower BP std for DM2 PTNs. Since I am talking

with my PCP and setting goals in October I figure we should look to where they

are going and not where they have been for the last 8 years, especially if less

is not better! (There is also a lot of talk about newer meds and class of meds

that you might be interested in if you aren't already. I noticed quite a few

names that I have seen you mention off and on.)

- 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank &

testicle pain. I have decided against an adrenalectomy at this time since

Meds. are working so well. Current BP(last week ave): 122/73

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2. and PTSD.

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 50 MG.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > Hi,

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > My problems did not start during pregnancy but

> > > > > > they

> > > > > > > > > > started about 2 weeks after my son was born. 10 years on and

> > > > > > still

> > > > > > > > > > trying to get sorted!

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > ________________________________

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > From: hyperaldosteronism on

> > > > > > behalf of

> > > > > > > > > > Stump

> > > > > > > > > > > > > > > > Sent: Tue 20/09/2011 13:13

> > > > > > > > > > > > > > > > To: hyperaldosteronism

> > > > > > > > > > > > > > > > Subject: PA and pregnancy

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > I have searched the board and found a few people

> > > > > > who

> > > > > > > > had

> > > > > > > > > > this show up during pregnancy... Is it common for pregnancy

to

> > > > > > > > cause

> > > > > > > > > > PA? Have been told by several doctors " Your blood pressure

> > > > > > > > problems

> > > > > > > > > > will go away in 6 weeks " That was well over a year ago, and

it

> > > > > > > > keeps

> > > > > > > > > > getting worse! Just curious to hear stories of women who's

> > > > > > > > symptoms

> > > > > > > > > > started while pregnant.

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

September 20, 2011

I know well.Most of us call it JNC Late now.CE Grim MD You are right, JNC-8 is not officially out yet, due 1Q2012. I simply googled JNC 8 and was looking into the sites that are leading up to the changes. It appears thr formulation of where they are going is quite well progressed and there is "early warning signs" if you will. (As one would expect if it is going to be out in a few months.) One of the sites I spent some time on was hosted by a PCP, t Kottak Mavromatis, whose husband is a cardiologist. (www.drdialogue.com) One of her posts was entitled, "What's new in Hypertension with JNC 8 on the horizon?" She had been to a talk by Dr. Ferdinand, a card. who has served on previous NHLBI JNC committees. One point of particular interest to me was the results of the ACCORD trial that he said found no advantage for a lower BP std for DM2 PTNs. Since I am talking with my PCP and setting goals in October I figure we should look to where they are going and not where they have been for the last 8 years, especially if less is not better! (There is also a lot of talk about newer meds and class of meds that you might be interested in if you aren't already. I noticed quite a few names that I have seen you mention off and on.) - 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank & testicle pain. I have decided against an adrenalectomy at this time since Meds. are working so well. Current BP(last week ave): 122/73 Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2. and PTSD. Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Hi, > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > My problems did not start during pregnancy but > > > > > > they > > > > > > > > > > started about 2 weeks after my son was born. 10 years on and > > > > > > still > > > > > > > > > > trying to get sorted! > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ________________________________ > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > From: hyperaldosteronism on > > > > > > behalf of > > > > > > > > > > Stump > > > > > > > > > > > > > > > > Sent: Tue 20/09/2011 13:13 > > > > > > > > > > > > > > > > To: hyperaldosteronism > > > > > > > > > > > > > > > > Subject: PA and pregnancy > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > I have searched the board and found a few people > > > > > > who > > > > > > > > had > > > > > > > > > > this show up during pregnancy... Is it common for pregnancy to > > > > > > > > cause > > > > > > > > > > PA? Have been told by several doctors "Your blood pressure > > > > > > > > problems > > > > > > > > > > will go away in 6 weeks" That was well over a year ago, and it > > > > > > > > keeps > > > > > > > > > > getting worse! Just curious to hear stories of women who's > > > > > > > > symptoms > > > > > > > > > > started while pregnant. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >

September 20, 2011

Thought you might, she seemed to put alot of stock in what he had to say.

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > Hi,

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > My problems did not start during

> > pregnancy but

> > > > > > > > they

> > > > > > > > > > > > started about 2 weeks after my son was born. 10

> > years on and

> > > > > > > > still

> > > > > > > > > > > > trying to get sorted!

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > ________________________________

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > From: hyperaldosteronism

> > on

> > > > > > > > behalf of

> > > > > > > > > > > > Stump

> > > > > > > > > > > > > > > > > > Sent: Tue 20/09/2011 13:13

> > > > > > > > > > > > > > > > > > To: hyperaldosteronism

> > > > > > > > > > > > > > > > > > Subject: PA and

> > pregnancy

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > > > I have searched the board and found

> > a few people

> > > > > > > > who

> > > > > > > > > > had

> > > > > > > > > > > > this show up during pregnancy... Is it common

> > for pregnancy to

> > > > > > > > > > cause

> > > > > > > > > > > > PA? Have been told by several doctors " Your

> > blood pressure

> > > > > > > > > > problems

> > > > > > > > > > > > will go away in 6 weeks " That was well over a

> > year ago, and it

> > > > > > > > > > keeps

> > > > > > > > > > > > getting worse! Just curious to hear stories of

> > women who's

> > > > > > > > > > symptoms

> > > > > > > > > > > > started while pregnant.

> > > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > > >

> > > > > > > > > > > > > > >

> > > > > > > > > > > > > >

> > > > > > > > > > > > >

> > > > > > > > > > > >

> > > > > > > > > > >

> > > > > > > > > >

> > > > > > > > >

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

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Re: Measuring BP and JNC-8

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