Blood pressure - how do I get this down

[RAE]

OK, I'm sure this topic has been discussed before, but here's my situation. Age 54 (almost), not overweight (5'11", 168 lbs); never have smoked; get a moderate amount of exercise (walk 4-5 days per week, 60 minutes at a fast pace, plus other exercise); eat a pretty healthy diet, lots of veggies and some fish, with moderate amounts of red meat (no salt at all from the shaker, read labels on canned/boxed foods and avoid those that are too high in sodium); consume about 2 alcoholic drinks per day (mostly red wine with dinner). Despite all that, my BP has been creeping up over the last couple years, and is now pretty consistently around 140/90. No matter what I do, I can't get it much lower than that. I really, really don't want to go on BP medication, and am afraid that is what is going to happen if I go to the doc and have this checked out. Yeah, I know that hypertension is nothing to mess around with, and I need to get it under control, but is there any other lifestyle approach I can take before I have to go on meds? (Rich - any advice?). One of the nurses that my wife works with knows my situation pretty well, and seems to think that some folks (maybe I am one) are genetically predisposed to hypertension, and no amount of lifestyle changes are going to bring it down, without meds. Any truth to that? How safe is HCTZ, the diuretic that is most commonly prescribed for BP? I am reading about some of the possible side effects......dizziness, headache, fatigue, muscle cramps.....doesn't sound like much fun! Any advice from those who have been in a similar situation would be much appreciated, thanks.

[REWahoo]

Quote:

Originally Posted by RAE OK, I'm sure this topic has been discussed before...

http://www.early-retirement.org/foru...rgh-42217.html
http://www.early-retirement.org/foru...ure-38531.html
http://www.early-retirement.org/foru...ire-34207.html
And don't miss this one: http://www.early-retirement.org/foru...ure-40023.html

[harley]

There may be a few things left to try, but it sounds like you are one of the ones that will probably end up on meds. You've done everything right, but genetics trump environment. I'm like you, I'll move heaven and earth to avoid prescription meds. But in the end I'd rather take them than shuffle off earlier than I need to. Good luck, and let me know if you find the magic.

[Rich_by_the_Bay]

I re-read the old posts about blood pressure, and I would stick by my remarks.

Hydrochlorothiazide at low doses is a very benign and effective drug, if it comes to that. In your place I'd cut out the wine altogether (you can re-introduce it once this is sorted out). BP is most worrisome to me not for its heart effects but more for the stroke risk. If your pressure is up despite salt, weight control and alcohol reduction, I'd take something gentle for it. Definitely more benefit than risk - most don't even know they're taking it.

[Bestwifeever]

DH's BP came down to normal when he was diagnosed with and treated for low thyroid--have you had your thyroid levels checked lately? This article discusses it.

Thyroid Hormone Effect on Hypertension, Aortic Stiffness - September 1, 2002 - American Family Physician

[Khan]

My BP went down (along with stress and weight) after I retired. I don't know if you are still employed, but I have had several people tell me that their BP (and need for meds) went down after they retired.

My advice*: take some first level meds suggested by MD.

*I do not even pretend to be a doctor

[Sue J]

HCTZ was the first BP med my dr. tried and I had a reaction to it. My eyes got all swollen and my eyelids looked purple and I had dark purple circles under my eyes. Other than that I was fine and it worked well on the BP.

Next we tried Lisinopril, but that one gave me a tickling/gagging/annoying cough. I had a feeling that I had been bumped in the throat all the time.

Now I'm on Atacand which seems to be just fine and my BP is very good. Too bad there's no generic. If I had to pay for it it's $2.30 a day. Luckily we have a good prescription plan so I pay $10 for a 90 day supply.

[aaronc879]

I would say cut out the alcohol completely. Other than that it seems your doing all you can. Get a BP monitor and use it daily. If your consistently at 140/90 or higher then you'll probably have no choice but to go on meds.

[CuppaJoe]

You didn’t say anything about job and inter-personal stresses. That was my game. As far as meds. go, IIRC, some of them had really bad side effects the first day or so, so if I had it to do over again, I wouldn’t start them on a work day. I found Mindfulness Meditation with yoga useful. In hindsight, I would stick with the beta blocker and skip the water pills, and hear my doctor's hints about taking a statin.

[RAE]

Thanks for the advice, everyone. I am still employed (for about one more year or so), so there probably is some job stress involved. I do have the blood pressure monitor and have been using it regularly lately. I may try to give up the wine as Rich suggests and see what happens (that would be rather difficult, though, as I really do enjoy it, plus my wife and I make wine as a hobby).
If nothing seems to work, I guess I'll go and talk to the doc and see if a low dose med is warranted.

[kaneohe]

Quote:

Originally Posted by Sue J HCTZ was the first BP med my dr. tried and I had a reaction to it. My eyes got all swollen and my eyelids looked purple and I had dark purple circles under my eyes. Other than that I was fine and it worked well on the BP. Next we tried Lisinopril, but that one gave me a tickling/gagging/annoying cough. I had a feeling that I had been bumped in the throat all the time.

Also remember, if you do go on meds, that reactions can also
(at least in the short term) have no symptoms. My doc, initially had reservations about putting me on meds. Several yrs later when I got put on the lowest dose of what he thought would be
ok, I remembered fortunately and negotiated periodic blood test monitoring to check. The first test was 2 wks after starting and a day later, I got a urgent call from him to stop taking the
meds. Apparently that kind of reaction is relatively rare but it happens. Switching to another class of meds has been ok.

Also re: job stress vs BP........mine also went down after I retired , but a yr or so later it gradually seemed to have worked its' way back. Doc didn't seem surprised......like he had seen it before.

[OAG]

Quote:

Originally Posted by RAE OK, I'm sure this topic has been discussed before, but here's my situation. Age 54 (almost), not overweight (5'11", 168 lbs); never have smoked; get a moderate amount of exercise (walk 4-5 days per week, 60 minutes at a fast pace, plus other exercise); eat a pretty healthy diet, lots of veggies and some fish, with moderate amounts of red meat (no salt at all from the shaker, read labels on canned/boxed foods and avoid those that are too high in sodium); consume about 2 alcoholic drinks per day (mostly red wine with dinner). Despite all that, my BP has been creeping up over the last couple years, and is now pretty consistently around 140/90. No matter what I do, I can't get it much lower than that. I really, really don't want to go on BP medication, and am afraid that is what is going to happen if I go to the doc and have this checked out. Yeah, I know that hypertension is nothing to mess around with, and I need to get it under control, but is there any other lifestyle approach I can take before I have to go on meds? (Rich - any advice?). One of the nurses that my wife works with knows my situation pretty well, and seems to think that some folks (maybe I am one) are genetically predisposed to hypertension, and no amount of lifestyle changes are going to bring it down, without meds. Any truth to that? How safe is HCTZ, the diuretic that is most commonly prescribed for BP? I am reading about some of the possible side effects......dizziness, headache, fatigue, muscle cramps.....doesn't sound like much fun! Any advice from those who have been in a similar situation would be much appreciated, thanks.

When I retired from the military (1979) my BP was 160/100 on the final physical (still VA disabled for high BP and a couple of other things). I have never been able to get it down to "acceptable levels". Several years after that I was put on HCTZ - which I am on currently (I take it along with a "baby" asprin fist thing in the morning - only medication I take). BP is still pretty high (140/90 or so). My Doctor seems to be comfortable with it after reading my history. I get exercise (walking 4 miles a day 7 days a week), eat decently, very little liquor, have not smoked in over 35 years, but all to no avail. I guess some people are predisposed to HBP (and after 35 years without a stroke or heart attack maybe that last statement is true (at least for me)). You seem to be doing all of the "right" things and maybe HCTZ is the answer for you (they are cheap and reasonably mundane as far as side effects go - remember many (like me) suffer none of those side effects).

[socca]

December 2003: my blood pressure was 140/90 - insurance company demanded that I go on medication or risk higher premiums or losing my coverage. I was 180 lbs (6'2"), which is a BMI of 23, smack dab in the middle of the BMI range the CDC considers 'healthy' (18.5 to 25).

I was curious what life would be like at the very lowest end of the 'healthy' BMI range, so I lost 30 lbs over the next 26 weeks, ending up at 150 lbs (BMI = 19). The difference was (and is) remarkable. My new BP was (and is) 115/80, my average sleep time reduced to 6 hours from 8+ hours, and I was (and am) bursting with energy. I've stayed at 150 lbs since 2004, and haven't regretted it for a second.

The only disadvantage of living inside my new body is that women have complained that I'm too scrawny (I prefer the word 'lean', myself ). However, I'm willing to put up with whiny women in exchange for the (apparent) health benefits available to a 46 year old guy in a teenager's body.

[Alan]

RAE

FWIW I would try a couple of things before going onto meds since you are so young and the bp is only a little high.

1. a low dose aspirin a day
2. stop all alcohol (I have 1-2 drinks a day myself so know how hard that will be)
3. increase the intensity of your exercise - need to get the heart rate elevated 2 or 3 times a week into the aerobic zone - but check with Doc and/or build up slowly.
4. Although you are a healthy weight you could try either losing more weight or adding more muscle by including weight training as part of your exercise regime if you don't already.

Good luck.

[Koolau]

RAE,

I use HCTZ and a beta blocker. Together, they are very effective for BP control. DO BE careful to monitor potassium (or else take supplements, eat bananas, etc.) I had a real problem w/potassium until I took supplements. Doc. didn't even suggest checking potassium until I had A-fib "attack".

Good luck. Trust your Doc. - but be your own advocate! Make him/her earn the money!

[Jay_Gatsby]

If you don't take salmon oil capsules, you may want to give them a try.

[Zoocat]

Quote:

Originally Posted by Alan RAE FWIW I would try a couple of things before going onto meds since you are so young and the bp is only a little high. 1. a low dose aspirin a day 2. stop all alcohol (I have 1-2 drinks a day myself so know how hard that will be) 3. increase the intensity of your exercise - need to get the heart rate elevated 2 or 3 times a week into the aerobic zone - but check with Doc and/or build up slowly. 4. Although you are a healthy weight you could try either losing more weight or adding more muscle by including weight training as part of your exercise regime if you don't already. Good luck.

Numbers 2 and 3 work for me. My BP seems to be very sensitive to alcohol and I really have to watch the intake. I exercise 5 days a week. Even though I'm overweight, my BP is usually 120/75 or thereabouts.

[Zubini]

Let me tell you my little BP story. At age 43 having never smoked, never drink with a BMI of 18.5 and a former marathon runner I was diagnosed with elevated BP 140/90. For 3 years I tried every medication combo under the sun and none of them lowered by BP. I tried exercising more, meditation, etc. and no movement. I had no family history of hypertension. After 3 years started feeling really lousy and went on a mission to find out what it was. Had my aldosterone, renin and potassium tested and lo and behold they were way off. Turns out I had an aldosterone producing tumor on one of my adrenal glands. Dr. never considered it even though I *knew* I didn't have primary hypertension and that something else was causing it. Had the tumor and adrenal gland removed and now after surgery in January (sort of brutal) back to 100/65. Adrenal tumors are more prevalent than once thought. Have your aldosterone, renin and potassium checked just to be sure. They are quick blood tests and it's worth ruling out the adrenals as the culprit.

[Rich_by_the_Bay]

That's a good reminder. About 5% of hypertension turns out to be due to things like you described, or a kidney problem, over-active thyroid, or other hormone-secreting tumors. While we usually don't go hunting for them in every patient, they are worth considering in patients who do not respond well to usual therapy, in those who are young, or have very high or very sudden hypertension.

[tmm99]

I would get the thyroid checked as some of the people have mentioned.