Blood Pressure Medicines

[Khan]

I maybe should start taking such.
Any suggestions of drugs?
What is the etiquette of suggesting drugs to a doctor?

 

[martyb]

I take Benicar, 20mg once per day. Works well for me. Usually it's the doctor who suggests that the patient should take meds. Has your doctor told you that you have high blood pressure?

 

[Rich_by_the_Bay]

What is the etiquette of suggesting drugs to a doctor?

It's "Please may I have some hydrochlorothiazide, Sir (or Ma'am), if you don't mind and if it's no trouble. Thank you kindly."

 

[6miths]

New guidelines were recently released for diagnosis and management of high blood pressure.

New guidelines published for managing high blood pressure - Harvard Health Publications

Within this article is a link to the actual guidelines that were published February 5th in JAMA.

 

[M Paquette]

Hmmmm....

This weekend I had three straight days of restaurant dinners. BP Monday night was 139/89 for multiple readings.

Then I got back in my routine, hitting 'it' hard. Tonight, BP is 109/71. The magic drug?

Cut out the sodium.

My high BP problem, like many folks, is sodium sensitive. You wouldn't believe how much sodium is packed into the food we are served, or buy off the shelf. Bread is the worst. Oh, cheeses can be bad, but bread is sneaky. 200 mg in a slice of plain old wheat bread. 500 in that tasty bagel. 1,200 in that scone.

So, my 'medicine' is tracking sodium in everything I eat. Weighing portions, reading the damn labels in the store (and at home!). I use tracking software on my iPad that I've entered all the label info into.

Yes, I tried the DASH diets. The amounts of sodium in foods, particularly anything prepared or processed, can vary wildly. Once I started tracking in detail I found the diets could be rendered useless by picking the wrong brand of some things. One specific brand of bread is 10 mg sodium per slice. Most others are 20 times higher. Gah!

After 751 mg of sodium intake yesterday, and 801 mg today, I've managed to get my BP down. Getting to that level is hard, though. I'll probably be at 1200 mg/day the rest of the week. By keeping the right foods around, I've been able to keep sodium intake below 1500 mg a day most days since last November, and my BP numbers definitely show it.

Just a thought.

 

[obgyn65]

Ask for HCTZ. Safe and cheap.

I maybe should start taking such.
Any suggestions of drugs?
What is the etiquette of suggesting drugs to a doctor?

 

[imoldernu]

I don't know that I'd suggest a medicine to a doctor... After the doctor makes a recommendation, I usually look it up online, to check on the extended information for warnings, other drug interactions and side effects, and of course if and what generics are available. The doctor is usually right, but we've had a few side effects like coughing, or tummy upset, that necessitated a change.

I have a suggestion for testing BP... Do it twice... either in the office, or in the mall or drugstore... In my case, the first reading is often higher by 20 points. Not a common occurrence for most, but it happens, so if the first reading is higher than usual... in the doctor's office, ask to have it taken again, in the other arm. One of the doctors that we went to inthe past, said this was because the arteries in the arm constricted and then released during the second testing, but our current doctor doesn't agree. The first BP reading is often 140/85 or higher, but the second reading is always in the 120/70 range... Doesn't happen with DW's test.

Also, not all home BP machines are created equal. We've been very satisfied with the Omron brand. Two other machines gave inconsistent readings.

A recent summer activity weight loss (just 3%) allowed me to go off medication completely but winter slothiness has led to going back to being a druggie. Surprising what a few pounds can mean.

One of the points made in the cited Harvard article was that BP in the elderly may be safer.... 150+ to avoid dizzines... Going to do a little more study on that, as many friends and neighbors, (and us) are in this category... Yes... trust, but verify... This article mentions age 60.
http://www.nbcnews.com/health/heart-health/higher-blood-pressure-threshold-ok-older-adults-f2D11767022

 

[Tailgate]

Thanks for the articles included in this thread.. this is new info to me. My Dr just increased my meds in order to get me into the teens/70's... I'm 62 and my readings have consistently been 130-140/80's or low 90's. Currently on Lisonpril HTCZ 20/12.5 in mornings and Amlodipine Bestylate 10mg in evenings (the new drug).

In any event I was concerned.. perhaps too concerned. I'm eating much better and exercising since ER at end of year. I'm going to stop worrying and be more optimistic knowing that I'm working' on it.

To the OP... I started with Lisonpril HTCZ years ago and had found it to be effective for a long while with no side effects for my. YMMV.

Cheers!

 

[eytonxav]

Hmmmm....

This weekend I had three straight days of restaurant dinners. BP Monday night was 139/89 for multiple readings.

Then I got back in my routine, hitting 'it' hard. Tonight, BP is 109/71. The magic drug?

Cut out the sodium.

My high BP problem, like many folks, is sodium sensitive. You wouldn't believe how much sodium is packed into the food we are served, or buy off the shelf. Bread is the worst. Oh, cheeses can be bad, but bread is sneaky. 200 mg in a slice of plain old wheat bread. 500 in that tasty bagel. 1,200 in that scone.

Thats my nemesis as well. Been eating too much popcorn lately and it has spiked my BP and also added some lbs. Need to cut it out

 

[wrigley]

I maybe should start taking such.
Any suggestions of drugs?
What is the etiquette of suggesting drugs to a doctor?

The doc may have to experiment with you. The drug that is good for my BP may not be good for you. I've had my medication changed 3 times over the past 6 months. Some have bad side effects, some have virtually none. The trick is to find the meds that will control and stabilize your BP with the least amount of impact on your quality of life. Good Luck!

Mike

BTW I am curently on 20mg of Lisinopril along with 5 mg of Amlodipine once a day.

 

[Mulligan]

Hmmmm....

This weekend I had three straight days of restaurant dinners. BP Monday night was 139/89 for multiple readings.

Then I got back in my routine, hitting 'it' hard. Tonight, BP is 109/71. The magic drug?

Cut out the sodium.

My high BP problem, like many folks, is sodium sensitive. You wouldn't believe how much sodium is packed into the food we are served, or buy off the shelf. Bread is the worst. Oh, cheeses can be bad, but bread is sneaky. 200 mg in a slice of plain old wheat bread. 500 in that tasty bagel. 1,200 in that scone.

So, my 'medicine' is tracking sodium in everything I eat. Weighing portions, reading the damn labels in the store (and at home!). I use tracking software on my iPad that I've entered all the label info into.

Yes, I tried the DASH diets. The amounts of sodium in foods, particularly anything prepared or processed, can vary wildly. Once I started tracking in detail I found the diets could be rendered useless by picking the wrong brand of some things. One specific brand of bread is 10 mg sodium per slice. Most others are 20 times higher. Gah!

After 751 mg of sodium intake yesterday, and 801 mg today, I've managed to get my BP down. Getting to that level is hard, though. I'll probably be at 1200 mg/day the rest of the week. By keeping the right foods around, I've been able to keep sodium intake below 1500 mg a day most days since last November, and my BP numbers definitely show it.

Just a thought.

Bread.... I sure do miss my 20s in this regard. Even back then, people were talking about how just looking at it caused weight gain. I just shoveled it down daily in different formats thinking they were also eating pounds of junk food with it. Now in my later years I have succumbed too. I hate restricting my bread intake, but it has to be done to keep my weight where I want it.

 

[wrigley]

Bread.... I sure do miss my 20s in this regard. Even back then, people were talking about how just looking at it caused weight gain. I just shoveled it down daily in different formats thinking they were also eating pounds of junk food with it. Now in my later years I have succumbed too. I hate restricting my bread intake, but it has to be done to keep my weight where I want it.

Anything WHITE my doctor told me to cut out of my diet.

Mike

 

[MRG]

Agree sodium is evil. Exercise and weight can contribute.

Your DR. should make the decision. I had been on atenonal for many years. I wouldn't suggest it, for me taking my dosage late was horrible, thought I was dying. Then 5 years ago I started feeling faint. Actually went to the ER, the smart DRs there thought my heart rate in the ~30 some BPM was not condusive to life. The cause was the atenonal. Lisinopril seems to work fine for me, and I have a normal heart rate. YMMV.
Best wishes,
MRG

 

[InTheSticks]

Good timing on this thread. My BP started going up last fall. I had some bad issues this week. The good news, no blockage according to Angiogram. So, we, wife and I, are really going to work on reducing salt intake. We were already planning on it, this thread just confirmed it.

 

[AllDone]

There are more than 120 available BP drugs, most of which are cheap and generic. A lot of them are pretty interchangeable. Side effects vary, but usually there is some combination of dosage, dosing time and drug that is tolerable. You may or may not have to work with your doc a bit. There is a standard protocol called the "JNC 8" which is used to start these kinds of meds.

Your level of BP is called "pre-hypertension", if you want to be PC. Weight loss (any amount, any method), daily exercise (any type) and diet can help. Sodium excretion in the kidney is assisted by potassium (any fruit or vegetable) and calcium (dairy, dark green cabbage family vegetables, supplements). Calcium absorption is controlled by vitamin D (sun exposure, dairy, supplements) and magnesium (green vegetables and, um, chocolate). You may see a theme there. As long as you are otherwise healthy (talk to your doc), it certainly wouldn't hurt to work on the life style issues. The DASH (Dietary Actions to Stop Hypertension) diet is 1000 mg of calcium and 9-11 servings of fruit and veg daily.

 

[franco45]

Forget the drugs. They ALL have side effects. All drugs are Damage control for people who don't want to make a life style change.

 

[AllDone]

Oh yeah, I forgot to mention OTC pain medications. Advil/Motrin, Aleve, aspirin and their generics can all raise BP. A few people are sensitive to Tylenol, too. Unfortunately, there aren't really any decent alternatives. If you have a lot of pain, talk to your doc. You might benefit from changing sports, improved ergonomics at the computer, physical therapy, etc.

If the choice is an annoying side effect vs. a stroke, I'd be prone to choosing the drug with the side effect. YMMV.

 

[LazyErik]

Hmmm, 60 mile a week vegetarian long distance runner here (BMI 20). I'm on 5 mg of lisinopril per day. The only time it is ever out of whack any more is if I eat out at a restaurant. The sodium amounts in some foods is amazing.
I'm only about 40, and had HBP since I was in my early thirties.
A lot is life style, but sometimes it doesn't matter (don't use this as an excuse to not work on your weight or diet).
Also I noticed years ago that one beer a night is ok, but two will cause higher readings the next day. Just my observations.

 

[franco45]

Better to treat the cause and not just the symptom.

 

[InTheSticks]

Yeah, I'm working on the lifestyle changes. I'm about 20 lbs overweight. I exercise a lot. Frequently 2 times per day. But, salt intake is high.

Until then, I'll take the meds to keep it under control.

 

[AllDone]

Hmmm, 60 mile a week vegetarian long distance runner here (BMI 20). I'm on 5 mg of lisinopril per day. The only time it is ever out of whack any more is if I eat out at a restaurant. The sodium amounts in some foods is amazing.
I'm only about 40, and had HBP since I was in my early thirties.
A lot is life style, but sometimes it doesn't matter (don't use this as an excuse to not work on your weight or diet).
Also I noticed years ago that one beer a night is ok, but two will cause higher readings the next day. Just my observations.

Some people just get "lucky". Thank mom or dad for the "gift".

Alcohol drops BP pretty quickly, but then there is often a rebound rise the next day. Tobacco vasoconstricts and raises BP. Sudafed can be a big problem. Some people are sensitive to salt, but some aren't. Some people even have BP rise with certain BP drugs. Some people do everything right and still have a problem. Unless Franco can come up with a cure for genetics, some people just have to take meds.

 

[imoldernu]

Interesting quote from an short aticle on health, concerning "salt".
It does recognize that the greatest risk is from prepared foods.
DW blood tests indicate low sodium... We wouldn't have guessed that w/o the test.

Salt

Old Wisdom: Salt kills. It raises blood pressures, causes hypertension and increases the risk of premature death.

New Wisdom: Salt is essential to health. Too little salt can actually lead to premature death.

The new wisdom is actually older than the old wisdom. Long before it became the number-one evildoer in the Department of Agriculture's hit list, worse than fats, sugar and booze, salt was considered so valuable to body and soul that it was literally used as currency. Homer called it a "divine substance." Plato described is as dear to the Gods. The Romans considered it the spice of life; a man in love was salax—in a salted state. Only fairly recently, in that oh-so-wise 20th century, did salt become the bad guy at the dinner table.

It turns out that high-sodium processed "food" is the real villain in our diets. Unrefined salt, such as Himalayan salt or raw sea salts, contain 60 or more valuable trace minerals. It supports thyroid function and a faster metabolism and speeds the elimination of cortisol, the stress hormone that causes weight gain. Did you know salt is also a natural antihistamine (a pinch on the tongue may stem an allergic reaction). Finally, unrefined salt is needed for good digestion.

 

[Elbata]

My high BP problem, like many folks, is sodium sensitive.

Always piqued when I read that quote. I would guess most are "salt sensitive" if 90% of the US population is eventually diagnosed with HBP. Wonder if it was a term invented by the salt institute.

We eat too much salt. Up to a month's worth in one day's eating of what our body needs.

Here's a website by a guy who was on a donor list for a new heart in 1997. He never got the heart transplant, but to this day he's still going strong:
low sodium Recipes, Low Sodium Cooking, heart disease, No salt recipes

 

[AllDone]

Interesting quote from an short aticle on health, concerning "salt".
It does recognize that the greatest risk is from prepared foods.
DW blood tests indicate low sodium... We wouldn't have guessed that w/o the test.

The "new wisdom" is a misreading of a recent Cochrane review of low salt diets. The review concluded that it is hard to get people to lower salt intake and that attempts to get people to lower their intake did not result in decreased cardiac events because people failed to lower their intakes, not because lower intake was unhealthy. The "salt is good" theory has been bouncing around the popular press for a couple of years now because of that misunderstanding. Here's a good explanation:

Salt: More confirmation bias for your preferred narrative « Science-Based Medicine

 

[M Paquette]

Always piqued when I read that quote. I would guess most are "salt sensitive" if 90% of the US population is eventually diagnosed with HBP. Wonder if it was a term invented by the salt institute.

It just means that my BP has statistically significant changes in response to sodium intake. (For the pedantic: Everyone's BP changes. Mine shows changes in excess of the statistical daily fluctuations when I alter sodium intake.)

Less other diseases or stuff like nicotine, I suspect that everyone has a salt intake response in blood pressure. The change in sodium concentration directly alters the osmotic pressure across tissue membranes. That means the body tries to hold more water to maintain a sodium ion concentration when you eat more salt.

And yes, there is a lot of sodium in processed foods. My own experience is that if I eat only unprocessed or minimally processed (yes, please roll the oats for me...) foods, I would be taking in less than 400 mg of sodium a day, which would be too little. An honest to gosh Paleolithic diet like Alley Oop ate would probably deliver around 700 mg a day, enough to maintain health.