High Blood Pressure in a Young Adult

Q:  Within the past month or so I have been to two different doctors and both times my diastolic and systolic blood pressure have been high, about 150/100 and 160/100. I know both numbers are extremely high, but the bottom number is my main concern. This is all new to me. My last reading was a year ago and it was 129/85.

What is causing me to have such a drastic change? I am very frightened, and would like to know some of the things that could cause such an unusual occurrence.

I am only 24 years old. I don't eat very healthily, but I don't eat fried and greasy foods all the time either. I go to school during the day from 9 to 4 pm, and I wait tables at a night club from 6:00 pm until 3 in the morning. I'm 5'5" and weigh 115 pounds. I don't smoke, but on the weekends I do drink. Since this last reading, I only have a few glasses of wine per week. If you have any insight to my problem, please let me know.

A:  Adults over the age of 18 who have blood pressure (BP) of 140 systolic or 90 diastolic or higher on at least 3 separate measurements meet the criteria for hypertension, so you need at least one more reading to be sure of the diagnosis. Some people have "white coat hypertension," in which their BP is only high when they are at the doctor's office.

Most cases of hypertension (>95%) turn out to be what we call "essential" and are not due to kidney disease, narrowing of arteries, or tumors of the adrenal gland. Sometimes high BP is transient and caused by over-the-counter medications like decongestants or prescription medications, like birth control pills.

Hypertension also can be related to lifestyle factors. Excessive alcohol intake can increase your BP, so it's good that you've cut down. Dietary factors, such as heavy salt intake and low calcium, can raise your BP. Emotional stress may also raise your BP, and it would appear that your life is pretty full. Between school and your job, when do you sleep?

Please get your BP rechecked, along with a good physical exam and some basic blood and urine tests before you keep worrying about it (which will probably raise the BP even more) and consider simplifying your life.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.