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What Causes Increase In BP At High Altitudes?
Question: My husband is 76 years old.
In the last year or so, when he goes to our vacation house at lake Tahoe, his BP goes up. Last time, after three days there, he told me when he turned home to San Francisco that it had spiked at 200/100.
Though not a medical professional i find this alarming. I have read that elevations such as Lake Tahoe -- 6,000 - 6,600' should not cause this. Great -but in his case it does
he had a lacunar stroke 18 mos ago. doing well enough now to work p/t doing medical/legal evaluations. he is a retired orthopod and stubborn about following advice re: doing out-pt physical thjerapy.
Both his internist and cardio guy are on vacation, so i am writing you...THANK YOU
In the last year or so, when he goes to our vacation house at lake Tahoe, his BP goes up. Last time, after three days there, he told me when he turned home to San Francisco that it had spiked at 200/100.
Though not a medical professional i find this alarming. I have read that elevations such as Lake Tahoe -- 6,000 - 6,600' should not cause this. Great -but in his case it does
he had a lacunar stroke 18 mos ago. doing well enough now to work p/t doing medical/legal evaluations. he is a retired orthopod and stubborn about following advice re: doing out-pt physical thjerapy.
Both his internist and cardio guy are on vacation, so i am writing you...THANK YOU
Brief Answer:
H needs treatment immediately.
Detailed Answer:
I am so sorry, if you had to write all again. Must be some technical issue.
Now, with history of Lacunar infarct, such high BP requires immediate attention as this can lead to brain stroke again even brain hemorrhage.
Since his BP readings are very high, and your doctors are not available, he should be taken to ER. He would be investigated and examined for any adverse event like cardiac issue or stroke.
If nothing is found, he would be started on anti hypertensive medications.
Once his BP comes to a desired level on the medications, you have to continue his medicines as BP is controlled on the medicines and not spontaneously.
I would advise for him following investigations:
1. Kidney Function tests
2. Thyroid profile
3. Fasting Blood sugar
4. Fasting Lipid Profile
5. ECG.
I would advise you to get him these investigations done. Based on the reports your doctor will start him on medications that would get his BP under control.
Commonly used anti hypertensives are Amlodipine, Metoprolol, Telmisartan, Diuretics.
You may give him a single dose of Amlodipine 5 mg tablet till you get medical help.
If you have any further query, please ask me.
Stay healthy.
H needs treatment immediately.
Detailed Answer:
I am so sorry, if you had to write all again. Must be some technical issue.
Now, with history of Lacunar infarct, such high BP requires immediate attention as this can lead to brain stroke again even brain hemorrhage.
Since his BP readings are very high, and your doctors are not available, he should be taken to ER. He would be investigated and examined for any adverse event like cardiac issue or stroke.
If nothing is found, he would be started on anti hypertensive medications.
Once his BP comes to a desired level on the medications, you have to continue his medicines as BP is controlled on the medicines and not spontaneously.
I would advise for him following investigations:
1. Kidney Function tests
2. Thyroid profile
3. Fasting Blood sugar
4. Fasting Lipid Profile
5. ECG.
I would advise you to get him these investigations done. Based on the reports your doctor will start him on medications that would get his BP under control.
Commonly used anti hypertensives are Amlodipine, Metoprolol, Telmisartan, Diuretics.
You may give him a single dose of Amlodipine 5 mg tablet till you get medical help.
If you have any further query, please ask me.
Stay healthy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Apparently you didn't receive the information I provided re: the fact that he is already on BP meds, and has been - compliantly - since his stroke.
His BP is now fine, as he is back in San Francisco. There is no need to take him to an ER now, given that.
My issue for you - yet once again - is that his BP spiked at 200/100 while at Lake Tahoe at the elevation of 6000 -6600 feet the last time he was there. I have read that this "should not happen" at this elevation. But it does in his case. Period.
Question #1: Would you say that it is safe for him to go there?
Question #2: If he insists on going, could you please suggest some BP reading beyond which he should not remain there, and should come home.
Brief Answer:
Avoidance of high altitude
Detailed Answer:
Hello, I understood your query now. See, high altitude can itself cause transient rise in BP due to hypoxia (reduced oxygen). This can precipitate Acute Pulmonary Edema and can even cause Acute Cardiac event.
So, from my side, it is strict no for him to go on high Altitudes. If this should not happen as per your research and still it is happening, he requires evaluation for hs cardiac status. An ECHO should be done to rule out Pulmonary Artery Hypertension.
Following are your answers:
1. No, he should not go from my point of view.
2. If his BP goes beyond 150-160/90 mm Hg, he may suddenly develop acute hypertension crisis and should be come back home. He should also be given a diuretic at that time that is Furosemide.
I hope i helps.
If you have any further query, please ask me.
Avoidance of high altitude
Detailed Answer:
Hello, I understood your query now. See, high altitude can itself cause transient rise in BP due to hypoxia (reduced oxygen). This can precipitate Acute Pulmonary Edema and can even cause Acute Cardiac event.
So, from my side, it is strict no for him to go on high Altitudes. If this should not happen as per your research and still it is happening, he requires evaluation for hs cardiac status. An ECHO should be done to rule out Pulmonary Artery Hypertension.
Following are your answers:
1. No, he should not go from my point of view.
2. If his BP goes beyond 150-160/90 mm Hg, he may suddenly develop acute hypertension crisis and should be come back home. He should also be given a diuretic at that time that is Furosemide.
I hope i helps.
If you have any further query, please ask me.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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