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My moms BP is 182/60, what does it mean ?

I took it first thing in the a.m. Mom is 86. Is the first # too high, or the second # too low? I heard that there should not be a difference of more than 40 between the two. She says she feels fine, but was shaking and sleepy. I covered her with a blanket and the shaking stopped, so perhaps she was just cold, but seems weak, although coherent and talking just fine. I will take it again in a little while, but this # has me worried. Mom was at the Dr. on monday for check up and was fine, no need to alter meds doc said. It seems to fluctuate from very low to almost normal to high. She had just awakened and was dizzy while walking down the hall, I had to help her the rest of the way. That s when I took it. I gave her a glass of orange juice to drink and is sitting up now watching Dr. Phil and seems better. 4 weeks ago she had a stroke, and a pacemaker implanted 2 weeks ago, She has been taking Simvastatin, Micardis, Plavix, Isosorbide mononitrate, and Dilitiazem for years now. She has Nitroglycerine spray, but how do I know when she needs to use it? Thank you all so much for your advice.
Thu, 10 Dec 2009
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  User's Response
This is isolated systolic hypertension, quite common in elderly. The higher value is called systolic pressure and occurs when the heart contracts and the lower value is called diastolic pressure and occurs when the heart relaxes. The difference is known as pulse pressure. As you mentioned, the usual pulse pressure is around, when the BP is typically 120/80. Wide pulse pressure and high systolic pressure is common in elderly and is due to the stiffness of the arteries (blood vessel carrying oxygenated blood). Since she was shaking, that means she was feeling cold or excited. This will stimulate the sympathetic nervous system and cause elevation of systolic pressure. Most probably it will come down when you check it after she has settled down. There is also a waking up surge in sympathetic activity, which can raise the systolic pressure. Rarely diseases like a leaky aortic valve can also cause a wide pulse pressure.
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