Just how arm's length and offhand can GPs get?

To be fair Autumnrose, when my own hypertension was diagnosed years ago, one of the first things the GP did was test my thyroid function. I've had my TSH and T4 tested a few times - I can see the results in my Patient Record.

As a routine thing much better to do a weeks worth of morning and evening measurements and send them in than a one off taking an appointment for someone who may need one more urgently
It was discovered that I had high BP and medication helped bring it down, it's not the only thing you can do is it. I am asked as a routine a couple of times as part of the medication review, I also have an annual blood test.
It is sensible to do some wellbeing checks once you reach a certain age, much as it's sensible to do regular checks on babies and children.
My daughter has to submit readings a couple of times a year, she just borrows my monitor.
I can't imagine that anyone would be so daft as to make up figures, what would be the point of that

I don't see a problem with this request. The local pharmacy will take your DD's blood pressure for free.

I’ve not felt very well for a couple of days and this morning I had totally lost my voice, I panicked and I was frightened.
After 2 mugs of tea I could croak a little so phoned my doctors surgery forgetting it was Thursday and they don’t open.
My call went through to the emergency service and a lovely young lady got my name and date of birth somehow and straight away said she would arrange for an emergency doctor to call sometime before seven.
He did arrive just after five but as I had been asleep most of the day time had flown.
I want to tell you he was wonderful, kind, understanding and in no rush. He examined me thoroughly my temperature was up a bit, oxygen levels were fine, my chest was a bit rattly but my throat was a bit inflamed. He suggested I could go to the hospital but he felt I had a Viral Infection and I would feel better in a couple of days. His advice was to drink plenty, eat if I could, just small meals, and try not to talk 🤭
I still feel unwell but am reassured and I thanked him and said how I appreciated his visit just like the old days. He patted my hand and said if only he had more time.
He even bought my Amazon parcel in off the step, now that is service above and beyond.

Based on my own experience, there is a vast difference in approach between those GPs of our generation and the younger ones in practice today. There are no longer ‘family doctors’ who know you as an individual and can take a holistic approach. I might refer to ‘my GP’ but in reality that is shorthand for a succession of different doctors who see the symptoms in isolation rather than the whole person.

Absolutely!

Well said.

My late husband was a diligent and conscientious GP. In my opinion for what it’s worth … they’re damned if they do and damned if they don’t. 😢

It’s all very well measuring blood pressure, but it seems to me that the automatic response to elevated readings is to dish out medication without establishing the cause of high blood pressure. This happened to me in my late 40s. I had no lifestyle factors that could have been the cause and no further attempts were made to establish it. If I had known then what I know now at the age of 78 I would not have meekly accepted medication without further investigation. For the next 20 or so years I reported many symptoms to my GP including insomnia, brain fog, feeling exhausted and cold all the time and weight gain for no obvious reason. To say I was fobbed off is putting it mildly - I was even offered antidepressants. Two years ago as a result of a visit to A&E I was diagnosed with an underactive thyroid and put on replacement hormone treatment. Guess what? An underactive thyroid is one of the causes of high blood pressure. In the last two years my blood pressure has started to come down but because I took medication for so long, it is unlikely that it will return to completely normal levels. I’m sharing this to emphasise that high blood pressure is a symptom and that the underlying cause should be investigated. This failure to join the dots by my GP has led not only to years of unnecessary medication but also to sub optimal quality of life.

Aveline I also have a blood pressure monitor at home, easy to use and not expensive. Are they not available over there?

Earlier this year I was referred by the gp to neurologists as I had a numb foot and changing sensations on my right leg. I was told to use the bp machine in the surgery for readings. The first time I used it there were alot of questions about life style that you had to put a number by. I must have misread the question about alcohol intake. Meant to put 5 units per week but managed to put 50 per day. The next day I had a phone call from the surgery to discuss my alcohol addiction. I explained I made an error and my records were changed.
However there wasn't such a quick response about the numbness on my right side. I finally managed to have another appointment with gp.as my right arm was weak and I couldn't walk properly. I was told that you are on the waiting list to see a neurologist but it could take a year. He shrugged his shoulders and said there was nothing he could do.
I went to casualty,was an inpatient for a week, seen by neurosurgeon as they found on mri swelling at base of brain. Unfortunately it is not treatable due to position.
Best to be an alcoholic to see a gp rather than have a brain condition !!

Artols it's not so easy to see a GP here.

I live in the States, and BP is always taken at any doctor visit. It is considered routine here. High blood pressure can lead to strokes, among other things, I myself had a mini stroke a few years ago. My blood pressure is always closely monitored, and I take medication also. Why would anyone object to having their blood pressure checked? Seems like common sense to me.

I was found to have high BP in February gp referred me to heart clinic. After 36 weeks saw cardiologist who put me on waiting list for bypass op current wait is 10 months.

A man I know was given one of these wiz watches which do everything.
He was over 70 and was inform by the watch to see his doctor asp because he had a defective heart. News to him but it turned out he did. He had the operation to put things in order and will now live even longer.

My DD has one as does her DH, each device informs the other, if there is a health problem.
Maybe it’s the way to go.

Lizzie44

I remember a flurry of activity with blood pressure checks when I was in my 50s/60s, but nothing much recently. I think that once you get past 80 you are of less interest, though to be fair I am usually given a place at at the front of the queue for Covid/flu jabs.

I don't think it's because you are of less interest. This is what the QOF guidance has to say:

"The NICE guideline for hypertension19 recommends that patients aged 80 years and over with hypertension should be treated to a target blood pressure below 150/90 mmHg. It also recommends that this group of patients should be
offered the same antihypertensive drug treatment as people aged 55-80 years, taking into account any co-morbidities.

Where people have had a lower treatment target before the age of 80 years their treatment should continue and not be adjusted or down titrated. There is an important distinction between continuing long term and well tolerated
treatment in people aged 80 years and older, and starting blood pressure lowering therapy at this age."

www.england.nhs.uk/wp-content/uploads/2024/03/PRN01104-Quality-and-outcomes-framework-guidance-for-2024-25.pdf

There are a couple of important points. Firstly, the target blood pressure is higher for people over 80. That's because the damage from high BP is long-term. If somebody of 50 has high BP, it could cause damage well before pension age. If people over 80 have high BP, the chances are that something else will kill them anyway.

The guidance says that BP medication should be continued, but recommends caution with starting new medication over the age of 80. That's because it's not always well-tolerated and the side effects might not be worth it for the benefits it gives.

If you've had high BP in the past, you'll probably already be on medication. If you haven't, you're not that likely to develop it suddenly. BP tends to increase slightly with age anyway and isn't anything to worry about much. The theory is (I think) that you should enjoy your remaining years without the side effects of BP medication.

In other words, the greatest benefit comes from identifying younger people, for whom high BP is more likely to affect life expectancy. Prevention of problems (eg kidney and coronary) is preferable to dealing with the results.

Hope that makes sense!

Lizzie44 . you are so right I am well past 80 had goodhealth, recently.. bp, I think could be due to change of bp medication, but can I get a docs appt to discuss this? they !!! whoever they are seem to prefer I keep going to urgent care...

How is it offhand? GP requesting a BP reading and you say you own a monitor she sometimes borrows . They also said in email how to obtain a monitor ?
She wants an invitation to attend? It’s not a wedding invite OP , I think we all need to be mindful of the limited resources available and do what we can to help ourselves. Would you prefer them overlooking potential health conditions?

I remember a flurry of activity with blood pressure checks when I was in my 50s/60s, but nothing much recently. I think that once you get past 80 you are of less interest, though to be fair I am usually given a place at at the front of the queue for Covid/flu jabs.

Just ask for mot by the practice nurse

DH did thr BP readings over 7 days at home. I entered them on the in line document. Some readings were v high and some v low. The algorithm ...or whatever it is called... averaged the readings so the final figure was OK!!! Ridiculous as no note was taken of why were some v high and some v low. A box ticking exercise obviously. He heard no more. He actually had heart problems and a mini stroke not long after for which he was hospitalised. And that was another horrific story for another day.

OP if this had happened to me, I would have emailed back to my GP and asked why in heaven's name he wanted to know my blood pressure as there is nothing wrong with me? (After all, if I didn't feel fit, two years would not have elsapsed since he had last seen me.) Iwould certainly not have run out and bought a sphyg myself, but then, I grew up in a doctor's household and was firmly taught that medical examinations should only be carried out by a professional who is trained to do them properly and interpret the result correctly!

That said, elevated or low blood pressure are both signs that there is something wrong, which may explain why busy doctors and nurses are asking for them to be done.

I very much doubt the BMA would approve of a doctor asking for any form of examination to be done just so that he or she could receive "freebies" from a pharmaceutical company. The ethical standards ( both those of the BMA, the drug companies and doctors and nurses) must certainly have
been lowered drastically if such practices are even possible!

Use the monitor in the surgery and then hand it in to the receptionist. if you can’t be bothered to do it yourself.

I get requests twice a year for a monitoring reading, a similar letter. I am pleased they are bothering to check it, and would much prefer to send my own reading than to drive to the surgery and get a reading there which would be sky high due to my white coat syndrome. It's always low at home.

‘Seems fine by me. Obviously the GP surgery is wanting to start monitoring her as she's now over 50. It's in her interests to make this tiny effort on her own behalf. It would be useful for her medical notes to have a baseline BP for future reference. Not sure why you are so cross about it.’

I agree with this, it’s just a simple request, she doesn’t have to do it.