Blood pressure

[GatorGal93]

I am a novice when it comes to info on high blood pressure. About a year ago, my gp doctor said I had high blood pressure and put me on meds, although my gyn doctor says my pressure is not high.

Three days ago I stopped taking the meds and have been monitoring my bp very closely (please no comments to see my doctor).

Today, my bp has varied more than the past days I have checked. When is the correct time to take an accurate bp read? Should I just take an average or is that too inaccurate?

Today :
**9:30 am (pre-food, post commute) BP 162/115 YIKES!
**11:00 am (post food, pre-lunch) BP 146/93
**1:30 pm (post lunch) BP 129/98

Thank you for your help,
Julie

P.S. My usual pressure is around 140/90.

[bluesmoke]

I work in the medical field and have experience with BP machines. You've just discovered a little secret about BP numbers, they vary constantly. You need to measure exactly the same way, under the same conditions everytime to know if your numbers are moving. When I am testing a cuff, as I did just today, I can raise my systolic by30+and diastolic 20+ simply by holding my arm parallel to the floor, rather than straight down. I can raise it as much or more by putting the cuff on my forearm, or simply using to wrong size cuff. Always take it sitting, with at least 5 min of sitting quietly first.
Hope this helps. DLB

[Rosebud]

Hi Julie,

I have to ask - why did you stop taking the medication? Were you having side effects?
My next question, what was your BP reading taken by your gynae? And were you taking the meds at the time?

Low carbing does usually lower high blood pressure, but ceasing prescribed meds without consulting with your doctor is never a wise idea.
I know you are keeping track of your BP, but I seriously think that ceasing this medication should only be done under medical supervision.

High blood pressure is not something to be taken lightly. In my many years as an ICU RN, I have seen many, many people with major problems caused by untreated hypertension.

All the best to you.

:rose:Rosebud:rose:

[doreen T]

hi Julie,

bluesmoke brought up a good point about cuff size. If your upper arm is larger than 14" around, you should be using a large cuff, otherwise the readings will be off.

I heartily second Rosebud's admonition, being an old ICU/ Emerg RN meself ... :) What I'd like to know is ... what was the name of the BP med? Reason I ask is that certain meds can cause rebound high blood pressure when stopped abruptly .. with serious consequence.

Doreen

[GatorGal93]

Thank you folks for your responses.

Bluesmoke : Thanks for the info on keeping your arm straight down. We had always measured with the arm at an angle.

My med was "BISOPRL/HCTZ 10/6.2 TAB WATS" , whatever that means.

The reason for me stopping the med is really stupid.
>>I have gained 30 pounds since my doctor has seen me. He had put me on a 1200 calorie diet where I gained some and then I gained an addition 19 pounds when I started Atkins in Feb/Mar. My bp script expires 9/11/2 and I am not going back to the doctor to get a script renewed weighing this much.

Thanks again for your help.

Julie

**BP before food: 160/104

[Oldsalty]

My understanding was that the upper arm had to be parallel to the floor and level with the shoulder, In my case this gave a somewhat lower reading than with the arm hanging straight down. I used to have a prop to support my arm on while I was sitting down. I made sure that the conditions were alway the same for each reading that I took

[Marie_D]

Gator Gal -

Couldn't you go to another doctor? A new doctor would have no way of knowing you had gained weight if you didn't say so! I know how you feel, but health comes before pride I would say.

[GatorGal93]

Very , Very good advice, but this doctor IS kind of a new doctor. I will try and find a new one today. Thank you for the motivation.

Heck, I could always go back to the present doctor AFTER I finally lose some weight.

Thank you,
Julie


EDIT: Forget it. I'll stop being a whimp and bite the bullet. Calling my regular doctor at 2pm for an appointment. Thanks!

[doreen T]

Julie ... I'm so glad you're getting back to the dr right away. Bisoprolol is a beta-blocker, and is one of the meds you should NEVER stop taking abruptly!! It can cause rebound high blood pressure, higher than previous even ... and a BP of 160/104 is not good at all, way too high :( High blood pressure isn't called the Silent Killer for nothing. Stopping a beta blocker suddenly can cause angina and even heart attack.

Doreen

[Voyajer]

Thought someone might find this interesting:


Medical Devices & Surgical Technology Week
Publisher: CW Henderson
Issue: September 1, 2002
Page: 3

Hypertension
FDA clears breakthrough breathing device to lower blood pressure

2002 SEP 1 - (NewsRx.com) -- Millions of Americans with high blood pressure can now benefit from the first nondrug medical device clinically proven to reduce high blood pressure without side effects.

InterCure, Inc., announced that the device, RESPeRATE, has received clearance from the Food and Drug Administration (FDA) for over-the-counter distribution.

The interactive, device-guided breathing technology used in RESPeRATE is based upon the established scientific evidence that certain breathing exercises, when performed routinely, can lower blood pressure. These therapeutic breathing exercises are difficult to perform properly without the interactive, personalized coaching that RESPeRATE provides.

RESPeRATE has been clinically validated to significantly lower blood pressure by an average of 14 mm Hg systolic and 9 mm Hg diastolic after 8 weeks of routine use (15 minutes per day, 3-4 times per week). Average reductions are even greater for older patients and patients with higher baseline blood pressure. These reductions are in addition to reductions achieved with other therapies.

"RESPeRATE offers an important new option, in fact, a whole new therapeutic class for the adjunctive treatment of high blood pressure," said Henry Black, chairman of the Department of Preventive Medicine at Rush-Presbyterian St. Luke's Medical Center in Chicago and member of InterCure's Scientific Advisory Board. "Physicians and patients have long been searching for an additional effective nondrug therapy, and RESPeRATE is a real breakthrough. It will have a major impact on how high blood pressure is treated."

RESPeRATE, about the size of a paperback book, is battery operated and can be used anywhere. Users place an elastic belt with a respiration sensor around their torso, above the clothing, and wear standard headphones. RESPeRATE automatically analyzes the user's breathing rate and pattern and then interactively guides the user through a therapeutic breathing exercise that effortlessly slows the breathing from a normal rate of 14 to 18 breaths per minute to the "therapeutic zone" of less than 10 breaths per minute with prolonged exhalation.

While breathing returns to normal after each session, the beneficial effects on the blood pressure accumulate and a significant and sustained reduction in blood pressure can be achieved with regular use.

"We are thrilled to be announcing FDA clearance to sell RESPeRATE over the counter. Now the tens of millions of people suffering from high blood pressure have easy access to this remarkable therapy," said Paul Sheils, president and CEO of InterCure. "Patients finally have a nondrug, no-side-effects treatment option to lower their blood pressure that's easy and pleasant to use and can be incorporated safely into their existing hypertension therapies."

This article was prepared by Medical Devices & Surgical Technology Week editors from staff and other reports. Copyright 2002, Medical Devices & Surgical Technology Week via NewsRx.com.

[GatorGal93]

Doreen,

I have compiled a list of things I want to chat with the doctor about. Can you critique and/or add some?

Questions for Dr.
1. WEIGHT gain since last visit (Prozac, bp med?). Why?
2. Stopped Prozac, gyn recommended Ativan instead. Thoughts?
3. Stopped your 1200 calorie diet. Continued to gain. On Atkins now since it worked 5 years ago. Thoughts?
4. Still get occasional unknown bruising. Why? High bp?
5. ?
6. ?


Thank you very much in advance for your help. http://216.40.241.68/contrib/ruinkai/smileyb.gif

Julie

[doreen T]

1. WEIGHT gain since last visit (Prozac, bp med?). Why?Hmmm .. well, beta blockers (bisoprolol) are notorious for stalling weight loss, according to Atkins. They increase insulin resistance, and can cause fluid retention. The particular formula you took had a mild diuretic in it though (hydrochlorothiazide, or HCTZ). Prozac on the other hand, IS associated with significant weight gain. A small % of people lose weight, but most gain. 10 yrs ago, I was given Prozac to help my chronic fatigue (it helped all right .. I was bouncing off the ceiling, and insomniac) .. anyhooo, I gained 30+ lbs in less than 3 months. The dr. had the nerve to say the reason was "I was feeling better, therefore eating more" :bash:
2. Stopped Prozac, gyn recommended Ativan instead. Thoughts?Stopping Prozac is a good idea :) Some of the literature I've read shows that it can have effects on carbohydrate metabolism (in the liver) and even cause hypothyroidism. These effects aren't common, but still ...

Ativan (lorazepam) is related to Valium, and most helpful for anxiety. It has more sedative effect than Prozac, that's for sure! Best taken at night. The sedative/drowsy effect lessens after awhile, as your body adjusts. It's not associated with weight gain or fluid retention at all.
3. Stopped your 1200 calorie diet. Continued to gain. On Atkins now since it worked 5 years ago. Thoughts?Atkins should work again, as long as you do it to the letter. Might consider the suggestions about arachidonic acid from Protein Power too (in the fat of red meat and egg yolk). And do be sure to incorporate OWL and increased vegetables as you gradually work up to the higher carb levels. Fiber from vegetables (and low-glycemic fruits like berries and melon) are known to help with blood vessel health and lowered blood pressure. Plus the natural potassium they contain is beneficial. So many people stay below 20g carbs for so long ... which may or may not speed weight loss, but at the same time they're depriving their bodies the benefits of eating the best kinds of carbs.
4. Still get occasional unknown bruising. Why? High bp?We've had previous discussions about bruising, you might want to check 'em out: Bruising (http://forum.lowcarber.org/showthread.php?postid=331484#post331484)

Easy Bruising-Is this happening to anyone else? (http://forum.lowcarber.org/showthread.php?postid=472997#post472997)
Hope this helps :)

Doreen

[GatorGal93]

You were so personalized and thorough! (To be honest, my eyes got a little damp thinking someone I have never met can help me sooooo much.)

I am going to print your post (answers) and bring it with me to the doctor.

I cannot say, "THANK YOU ! " enough! I really appreciate it.

Thanks again,
Julie

:bhug: :bhug: :bhug:

[doreen T]

S'okay Julie. Some day, you'll be able to share what you've learned and help somebody else. That's what support is all about.

http://www.click-smilie.de/sammlung/sehrgrosse/grosse052.gif

Doreen

[GatorGal93]

I RULE!!!

My cholesterol is down . Although, I have no idea what they mean, here are the numbers:

Total cholesterol: 237
Triglycerides: 193
HDL: 75
LDL: 123

Ratio: 1.6

Whoopie!!!

But..........................back on the bp meds. :tears:
50mg HCTZ


Thanks for listening,
Julie

[doreen T]

Originally posted by GatorGal93
[Total cholesterol: 237 ....
Triglycerides: 193
HDL: 75
LDL: 123

Ratio: 1.6:thup: That's great Julie! Especially the HDL ("good" cholesterol) of 75. Anything over 60 is considered protective against heart disease.
But..........................back on the bp meds. :tears:
50mg HCTZ That's not too, too bad. At least you're off the beta blocker. HCTZ (hydrochlorothiazide) is a relatively mild diuretic. Best to take it early in the day, so that you're not running to the bathroom all night :eek: The previous bp med you were taking had a small amount of HCTZ in it, so your body will be used to taking this already. It is a higher dose though, so you want to be aware that it can cause some problems such as orthostatic hypertension. What that means is that you might possibly experience a sudden drop in blood pressure when you stand up suddenly or bend over. This effect is made worse by drinking alcohol.

HCTZ can cause your kidneys to lose potassium in the urine ... talk to your doctor or pharmacist about taking extra potassium :)

It will be good if you can ultimately get off the bp meds altogether; which should happen as you continue to low-carb and progress with the weight loss.

Congrats :)

Doreen

[GatorGal93]

Thank you, "Doctor Doreen." :wave:

I think it was a blessing that my original doctor was out today. It was easier laying all of this stuff on a stranger.

Thanks also for the explanation of the new med. They don't hesitate to write you a script, but forget to tell you what the heck it is.

You quoted my doctor regarding getting off the meds when (not if) the weight gets down. Now, let's see some results!!

:agree: :bhug:
Julie

[GatorGal93]

Doreen,

May I have grapefruit with this med? It has always been a no-no in the past. (Regardless of the fruit limitations allowed on Atkins.)

Thank you,
Julie

[doreen T]

hiya Julie,

Grapefruit doesn't appear to be a problem with thiazide diuretics. The blood pressure meds that it can interfere with are the calcium channel blockers (nifedipine, verapamil, etc).

However, there is a problem taking grapefruit juice with benzodiazepines, which is the class of drugs that Ativan belongs to. It can increase some effects of the drug, especially drowsiness and decreased alertness.

For everything you ever wanted to know about this topic, check out the Grapefruit Juice - Drug Interactions webpage (http://www.powernetdesign.com/grapefruit/interactions/index.htm).

:)

Doreen

[GatorGal93]

Wow! You really pay attention. Here I am rambling about bp meds and you remember my Ativan. You are great.

Thank you for the info and the great grapefruit website.

I have learned a lot from you.

Have a great day,
Julie

Aside : Thank you also for mentioning the side effects of HCTZ. Yesterday was my first day and I just felt a little light headed...until later. When I walked up the three flights of stairs to my apartment with some packages, I felt awful. I thought I was winded from the extra 30 pounds I have put on recently and that made me depressed. I sat on the couch to calm down and think. Good thing. I realized I was just very dizzy (as you mentioned the HCTZ could do). Thanks for wising me up. :read: :bhug:

Julie

[doreen T]

re - feeling dizzy

Have you upped your potassium as I suggested? Aldactazide (HCTZ) will cause you to lose more potassium in the urine than normal. This may be somewhat exaggerated for you .. since the bisoprolol you were on previously caused you to retain potassium. It's a balancing act for sure.

You can take potassium pills, or the least expensive way is to use a potassium salt substitute, such as No Salt or Nu Salt to sprinkle on food.

Talk to your pharmacist or doctor for guidance, but I think this may help. Climibing 3 flights of stairs is an accomplishment but you should feel winded, not ready to pass out :eek:

Doreen

[GatorGal93]

Now I can satisy my salt cravings without sodium. Yippee!!!

I ordered right after I read your post and shipping was free (for me :( ).
http://www.nusalt.com/

I never will be able to thank you enough. Now maybe I can get back to running up those stairs!

Julie

P.S. Also left message with doctor.

[GatorGal93]

I called my doctor to find out if he wanted me to take potassium. He called back and said he did not like the new drug I was on (HCTZ). You see, my doctor was out on Monday due to the Jewish holiday and I got to see a "fill-in" for him.

He also said whatever I lose with the new pill, I will gain once I stop. Yeah? Whatever! It's for bp not weight loss. This is the same man who thinks when my boss gains four pounds (and exercising) it is an issue and when I gain thirty, it's 'oh, well.' Same goes for our nearly the same cholesterol. Mine is great but she may need meds. Is he Jekyl and Hyde? (Although, I do like him.)

Well, I told the doctor that I did like the new med. We had a nice chat. I now have a potassium script (ugh! more drugs).Regardless, I see him in two weeks.

Any input is welcome and ammunition (oops, information) for my next appointment.

Thanks for listening,
Julie (the medically naive)

[GatorGal93]

Will the potassium make me gain any weight or retain? I have gained 30 pounds with the meds this Dr. has prescribed and lost 4 in just the last 2 days from the new HCTZ the other Dr. prescribed (and added water). I really can't handle another setback.

It's POT CHLORIDE 20 MEQ. They look like horse pills!

Thanks,
Julie

[doreen T]

20 mEq is roughly 600 mg. Are they extended release type? The pharmacist would know. If they are, then it would be unwise to break or crush the pill, since they have a protective coating to slow the rate of of absorption in the small intestine.

If you do manage to get 'em down, make sure you also have a full glass of water with it. Potassium can be hard on the stomach. There are liquid forms of pot. chloride, and effervescent tablets that dissolve in water. Perhaps these would be easier to take ... again, check with the pharmacist.

No, potassium won't make you gain weight, and in fact they might help with your efforts, since potassium helps to regulate the sodium salt and water balance in the body, among other important functions.

Doreen

[GatorGal93]

Thank you. No problem with the pills so far.

I can't wait to shock my doctor next Monday with some results.

I appreciate all of your knowledge and advice. It is so great to be so well informed before you go to see an "expert."

Thank you,
Julie

[GatorGal93]

One week after HCTZ:

5 pounds finally gone ,

BP 124/88

Thank you all! Especially Doreen! :wave:

Julie
P.S. I am so happy, I could :tears:

[doreen T]

Wow, Julie, that's awesome!!!!! Be sure to check your blood pressure regularly and keep an eye out so it doesn't get too low. With low-carbing itself, plus the potassium, plus losing weight ... you could be able to wean and eventually get right off the HCTZ altogether. :cool:

Congrats :cheer:

Doreen

[GatorGal93]

If you read through this thread, you will see that I have thanked Doreen (or you) many times. Today, I realize just how important all of this bp info has been.

My perfectly healthy boss' bp just shot up to stroke level (she is 39). When she went to our doctor, he was very concerned. He mentioned a lot of technical terms which my boss looked up on the internet to learn than the doctor was talking about a possible kidney or other tumor. She must go for some testing and an ultrasound.

Do not disregard your high bp as I did recently. Who knows what it could be a sign of.

Counting my blessings and hoping the best for my friend (boss),

Julie

P.S. Doreen, I promise to keep an eye on my bp.

[GatorGal93]

Here we go again. I saw the doctor this a.m. and even though my bp was lower, he said he didn't like the medication I was on (HCTZ). He kept naming meds and I kept saying, "No," because I don't want any more meds hindering my weight loss.

Long story short, he put me on Diovan HCT and off of HCTZ and potassium.

Any inputs on this latest script for Julie? UGH!!!! :mad:

Julie