hypertension So What Constitutes Hypertension?

[Snake Eyes]

VA denied hypertension in my most recent claim based on this:

"The evidence does not show an event, disease or injury in service. Your service treatment records do not show a diagnosis of hypertension in service..."

Here are the BP readings in service I used:

140/90 02 December, 1976
120/90 04 March, 1981
154/90 11 January, 1982 (Retention Physical) -- States "Hypertension"
140/84 03 June, 1986
136/84 20 August, 1987
150/88 08 April, 1988
130/90 07 April, 1989
139/82 08 May, 1989
138/82 11 September, 1989
138/82 09 November, 1989
138/82 02 March, 1990
130/84 28 May, 1992 (Periodic Medical Exam)

VA denial also cites DBQ from my cardiologist stating HTN was diagnosed in 2013. My civilian records show I've had it for some time (but since I had the above record in service, it didn't occur to me to submit civilian records).

SO WHAT DOES THE VA CONSIDER "Hypertension"? I'm currently on medication, but even if I weren't, shouldn't the above numbers be worth a "zero" rating?

[Stretch]

http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/hypertension/faq-20058527

from Sheldon G. Sheps, M.D.

Yes. If you have a diastolic number — the bottom number of a blood pressure measurement — less than 90 millimeters of mercury (mm Hg) and a systolic number — the top number of a blood pressure measurement — greater than 140 mm Hg, you have a common type of high blood pressure called isolated systolic hypertension.

Isolated systolic hypertension can be caused by underlying conditions such as artery stiffness, heart valve problems or an overactive thyroid (hyperthyroidism).

For years, doctors focused primarily on diastolic blood pressure. The theory was that the body could tolerate occasional increases in systolic blood pressure, but consistently high diastolic pressure could lead to health problems. However, doctors now know that high systolic pressure is as important as high diastolic pressure — and even more important in people older than age 50.

The recommended goal for systolic pressure for younger people is less than 140 mm Hg. For people who are 60 or older, the recommended treatment goal is less than 150 mm Hg.

In people with isolated systolic hypertension, treatment may lower diastolic pressure too much, potentially increasing the risk of a heart attack or stroke. So if you have isolated systolic hypertension, your doctor may recommend that your diastolic pressure not be reduced to less than 70 mm Hg in trying to reach your target systolic pressure.

Isolated systolic hypertension can lead to serious health problems, such as:

• Stroke
• Heart disease
• Chronic kidney disease

[Snake Eyes]

My diastolic numbers were 110, 105 & 107 at my c&p exam and they still denied my claim for BP....

Guess they were right to deny my claim based on the numbers in my SMR (none over 160 Sys or 100 Dia). However, it should be a "at as likely as not" situation when you look at the progression over time (unfortunately, I didn't submit any civilian readings until the DBQ. The cardiologist listed the diagnosed date as the date he took the last of three measurements -- and he didn't consider my civilian records at all.

Dr. Bash is reviewing my records for another claim purpose, but I wouldn't be surprised if he notices the pattern the VA either missed or didn't have access to.

Since there's no "Zero" rating, it is probably moot.... but if I leave this world with a stroke or heart attack, I'd hate for my wife to miss out on DIC because a doc trying to "help" me filled out a DBQ wrong.

[Snake Eyes]

I am service connected for hypertension (high blood pressure), however at 0% because it is controlled by medicine. I did experience a relatively quick rise in my blood pressure while on active duty and was directed to see a doctor or be unfit for duty. Saw a doc and was put on meds. All in my records when I filed the claim for hypertension. Again, service connected at 0%...

And my blood pressure is great now,, with medication....

Hamslice

I took another poster at face value that there is no "Zero" percent in the rating schedule (thought there was on all conditions). If he was correct, you're an exception. If he was not correct, I might need to consider a NOD.

[NavyWife]

Definitely ask dr bash to take a look at this issue also! Very important to get service connection for hypertension because it can lead to so many other problems...

Maybe he can get it service-connected as secondary to one of your other already service-connected issues.

[Snake Eyes]

Definitely ask dr bash to take a look at this issue also! Very important to get service connection for hypertension because it can lead to so many other problems...

Maybe he can get it service-connected as secondary to one of your other already service-connected issues.

That seems to be the likely route... unless a NOD is necessary (I don't know if you can simply resubmit a claim for something if it was already denied and still within the appeal window. If it were approved in the original claim, it would not have affected the overall rating, so having it approved "later" is not a problem. Much of what I'm working on is for the benefit of those I'll eventually leave behind :-)

[Carl the Engineer]

Also, if you die from a Service Connected problem your spouse can get benefits, etc. And, I believe hypertension can be associated to many medical problems leading to death....

That is why even a 0% for hypertension is a big deal.

I am also Service Connected at 0% for a plantar warts. Doubt if a wart can kill ya, but I do have that going for me just in case....

Hamslice