Blood pressure - how do I get this down

RAE

RAE

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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.
 
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.
 
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.
 
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
 
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.
 
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.
 
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.
 
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.
 
Sue J said:
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.
Click to expand...

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.
 
RAE said:
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.
Click to expand...

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).
 
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 :LOL:). 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. :greetings10:
 
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.
 
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!
 
If you don't take salmon oil capsules, you may want to give them a try.
 
Alan said:
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.
Click to expand...

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.
 
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.
 
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.
 
I would get the thyroid checked as some of the people have mentioned.
 
Rich_in_Tampa said:
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.
Click to expand...

The is a book, "Healing Hypertension" by Samuel Mann, MD, he works at Columbia Presb in NYC at the HTN clinic.

He believes that if pressure comes on young, intense, hard to control, that there is a good chance it is caused by emotions that are not recognized by the patient seated deeply within usually caused by unresolved conflicts, thus the possible secretion of HTN causing hormones.

This is apprently my own case, at a young age, late teens, my pressure went up a lot, but I was also suffering from severe anxiety that made me very dizzy. No one addressed my state of mind at the time and I did not recognize that I was under much stress from events in my life that I did not understand. Docs did all sorts of tests and put me on tons of meds.

I walked around for years very dizzy and the only drug that made me feel any better was when they finally gave me valium, it stopped my head from spinning. It gave me relief. I was finally DX with severe depression/anxiety after having a severe breakdown, almost 20 years after DX of HTN.

I finally found a doctor who examined me as a person as well as a patient and stuck with him for 25 years. He reduced my meds and put me at ease. He understood me, he spoke to me. Pressure was ok with him.

When I moved, the new doc said my pressure was going up, even though I told him when I take it at about 5 drug store machines and have my own home monitors that all measured it within normal liimits. He said, "well I guess there is white coat hypertension" "Well no kidding" I told him.

So those out there with stubborn pressure, try to examine your inner selves, you may well be struggling with something very disturbing in your psyche that is causing you anger, anxiety, and whatever, that you don't fully recognize but sort of suspect is there. The mind is very powerful and I believe is the root of much illness along with diet and smoking.
jug:flowers:
 
Regular bodywork such as massage, reflexology, and reiki are great for hypertension. Our conscious and unconscious stressors take a heavy toll on our bodies....definitely check into the alternative streams.
 
RAE - I'm not a doc, but I like to keep my eye on BP, cholesterol, and ways to keep them under control, since my mom has waaay high cholesterol and my dad has trouble with his BP (both from their late 40s...I'm nearly there, but not a problem yet).

I've read in several places that omega-3s, particularly alpha-linoleic acid, found in flax, helps keep the BP in check. Another source is walnuts. You can sprinkle some ground flax seed on your cereal, eat a small handful of walnuts, or take a flaxseed oil capsule a couple times a day.

Someone mentioned fish oil capsules as well, also a good choice.

Other helpers are berries, tomatoes, and low-fat dairy.

Here is a link I found that may be of interest: The Blood-Pressure-Friendly Breakfast - RealAge Tip of the Day

Good luck.

R
 
To add to what Rambler said...


My understanding is that ALA (vegetable sourced) needs to be converted to EPA to be used by our body, and fish oil is full of EPA.

I switched to canola oil a couple of years ago (I still use olive oil for low heat cooking, salads, etc) for higher heat cooking like stir frys, etc (although I use very little oil to start with.). Canola oil is high in Omega-3 (ALA) compared to other vegetable oils and is considered heart healthy. Canola oil is more heat stable than olive oil or flaxseed oil.

you cannot heat flaxseed oil at all. Even for salad and such, flaxseed oil and the grounds oxidize very very quickly. (That is why you see flaxseeds grounds sold in vacuum packs and the oil/grounds are often in the refrigerated secion, and if they are not, they should be.) I used to (I am too lazy now and not so health conscious) grind flax seeds in a coffee grinder along with walnuts/sunflower seeds and put the mixture in ziploc bags in the freezer, and took out a portion for salads, yogurt, etc, as needed.

I take omegabrite Omega-3 fish oils, ordered through omegabrite.com. I tried other fish oil capsules from different companies, but they all gave me heart burns and nasty fishy burps afterwards. Omegabrite doesn't give me hearburns or nasty smelly burps. Omegabrite is also more concentrated (higher EPA content per capsule than any other brands I've seen.). The side benefit of taking omegabrite for me is it really smoothes out my moods caused by hormone fluctionations. (you can read the benefits, etc on their website.)
 
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