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ignis

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History  any advise please

 

still another 3 weeks till my 3 monthly hospital appointment

last 4 days have a problem between midday to 6 pm .. feel light headed. Spinning dizzy, fussy and fear of falling  blurred almost passing out. BP reading down to 90/40 something.......  Since last Hospital Visit 1st July had 16 sudden BP drops

morning around the same 130/70 something every morning

 

 

At Present Prescription 

Hydraiazine HCl  25 MG  1x mornings  [reduced from 4x day on last visit ]

Lo-Sar-Tan  100 MG  1 x evening meal

Atenolol 25 MG    1 Mornings  [reduced from 50 mg last visit]

Zosin 2 MG  1 x Breakfast + 1 x evening meal [self reduced to 1x mornings end July]

 

found a Prescription dating March 2000

Atenolol 50 MG 1 x day   +  Gliclazide  80 MG 2 x day

had this for many years, 2015 went Government Hospital {Red Cross}... every visit was a different Dr + new Med's [many problems and bad reactions] ended up with same Diabetic   Dr for 3 years all good

BP Med's  Atenolol 25 MG mornings + Lo-Sar-Tan  100 MG  1 x evening meal  >>>> then came Covid 19  no longer felt safe with over 2 hr public transport each way to the overcrowded Hospital

= been using local Hospital 10 mins away..........  again different Dr's + different ideas of what is best

 

Please any advise how to stop these lows.........  Reduce Med's which one ?

 

The only thing I know is  Atenolol 25 MG = heart rate 60 something  but Atenolol 50 MG = heart rate 50 something  

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I used to have to take 3 medicines to control my blood pressure. Now I'm down to none. As you age your heart becomes weaker and therefore provides less pressure, so of course you will require less pills. My drop from 3 medications to none was over 20 or more years.

 

See a doctor for advice, but if your pressure is low all the time I'd bet the doctor would agree and will reduce dosages and maybe even stop some.

 

Good luck.

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Not being a doctor, I will make no recommendations regarding those drugs.  But you should know that blood pressure can be affected by a number of things beyond them.

 

1) Lead.  Lead is a toxin that tends to increase blood pressure.  If you have high levels of lead in your system, you may also have mental affects from it--and you should seek help from a certified toxicologist.

 

2) Salt.  Salt is known to influence blood pressure.  Most people think of it as a negative, i.e. too much salt means high blood pressure.  But salt is important for good blood and good production of stomach acid.  We need a certain amount of it.  Those who get too low in sodium will have a condition called hyponatremia.  Click this link to start learning about it.

 

https://www.mayoclinic.org/diseases-conditions/hyponatremia/symptoms-causes/syc-20373711

 

One thing to be aware of: one should never make sudden changes to dietary salt intake without a doctor's advice, because the body adjusts to the amount of salt that it typically receives.  Make your adjustment gradually, spread over several weeks, if you believe salt is your answer.

 

3) B-vitamins.  Certain B-vitamins have a direct impact on blood pressure, including niacin and B12.

 

4) Alcohol.  Just don't drink any; there's no safe level of this toxin.

 

5) Stress.  Exercise is the best way to counter high levels of stress.

 

6) Water.  Along with point #2, water must be consumed in adequate quantities to prevent the blood pressure from dropping too low.  Many people who have dizzy spells would be helped simply by drinking more water (and perhaps a little more salt intake would increase their thirst so that it would be easier to remember to drink water).

 

There are more, but this will give you some ideas to start with--hope this helps.

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1 hour ago, ignis said:

BP Med's  Atenolol 25 MG mornings + Lo-Sar-Tan  100 MG  1 x evening meal

I am surprised you are being prescribed Atenolol. I have been on hypertension medication for about 40 years. The first 20 or so I was on Atenolol and then my doctor in the UK suddenly changed to Ramapril saying studies had shown Ace Inhibitors to be a better choice than Beta blockers. When I came to Thailand 14 years ago I found Ramapril difficult to source and have been taking Anapril ever since.

A simple cause of low blood pressure is dehydration but you really ought to see a cardiologist. I would suggest you request an Echo, I had one at Bang Saen a couple of years ago, think it was about 5000 baht. Money well spent for some peace of mind.

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As said you should see a doctor and expect he will reduce or stop some medication.  I would not wait for scheduled visit if you are older as falling can be serious and it appears you are at that point and perhaps good idea to make that 2 hour trip.  It really is not good to change/stop without doctor check.  There is also your pulse factor involved.  I have stopped all medications as at home do not need (but have extreme white coat - anxious) readings when go hospital and doctors do feel anxious that other doctors will question them if they do not treat with medications when hospital readings are high - so expect there is a lot of over prescription when consult a new doctor.

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1 hour ago, gargamon said:

As you age your heart becomes weaker and therefore provides less pressure,

In most cases, blood pressure increases with aging, no?

 

On the subject, should BP be fairly consistent? I measure mine every morning and evening, keeping results in a phone app, and can see that they vary, sometimes drastically from day to day. The average is OK for my age. I take Amlodepine, Doxadozine & Bestatin.

Edited by KannikaP
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2 minutes ago, lopburi3 said:

As said you should see a doctor and expect he will reduce or stop some medication.  I would not wait for scheduled visit if you are older as falling can be serious and it appears you are at that point and perhaps good idea to make that 2 hour trip.  It really is not good to change/stop without doctor check.  There is also your pulse factor involved.  I have stopped all medications as at home do not need (but have extreme white coat - anxious) readings when go hospital and doctors do feel anxious that other doctors will question them if they do not treat with medications when hospital readings are high - so expect there is a lot of over prescription when consult a new doctor.

Yes  white coat syndrome is a problem....  always get checked 1st + many times so say high = porter arrives with a bed  wheeled into a ward with loads of others with so say high BP test + often must have 2x BP tablets [no idea what they are white and square]  

 

Alway take a print out of my BS + BP daily tests at home........  was told last April to take the BP Med's before the Hospital Blood work Visits so last visit was not carted off for an hour.

 

Yes 72 years so being unsteady is not good, last year had a fall in the garden 12 stiches to top of head

 

 

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21 minutes ago, sandyf said:

I am surprised you are being prescribed Atenolol. I have been on hypertension medication for about 40 years. The first 20 or so I was on Atenolol and then my doctor in the UK suddenly changed to Ramapril saying studies had shown Ace Inhibitors to be a better choice than Beta blockers. When I came to Thailand 14 years ago I found Ramapril difficult to source and have been taking Anapril ever since.

A simple cause of low blood pressure is dehydration but you really ought to see a cardiologist. I would suggest you request an Echo, I had one at Bang Saen a couple of years ago, think it was about 5000 baht. Money well spent for some peace of mind.

Atenolol appears to be one Med I can take without bad side effects........ Yes Dr say it is a very old Med and new one are better, but get serious side effects [have a list of 8 newer? BP meds cannot take] so end up back on Atenolol

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11 minutes ago, KannikaP said:

In most cases, blood pressure increases with aging, no?

 

On the subject, should BP be fairly consistent? I measure mine every morning and evening, keeping results in a phone app, and can see that they vary, sometimes drastically from day to day. The average is OK for my age. I take Amlodepine, Doxadozine & Bestatin.

Yes, generally speaking BP does increase with age due to a narrowing of the arteries. It can be hereditary and I think I was born with it. First indication of a problem was my RAF discharge medical when I was 30, ended up on tablets by the time I was 35. I think it is a major failing that children's BP is seldom checked.

 

"Drastic" is a bit of an open term. When I go to the hospital my BP can be a bit raised, maybe up to 150, but could be down to my wife's driving. Usually drops back to around 125 fairly quickly but some may see that as drastic.

One time an overweight monk was just behind me to see the doctor and his appointment card was on the desk. I could see his BP was just over 220, that is what I would call drastic. 

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Clearly, it could be a side effect of the medicines. 

 

Hydraiazine. For high or very high blood pressure. 

 

Atenolol is for high blood pressure. 

 

In the morning, it could be from you standing up suddenly from bed (orthostatic hypotension). Also, if you are having a long morning urination, this is a common cause of fainting among the elderly (micturition syncope). 

 

There are many possibilities. It'll take the doctors a long time to figure it out. But there are three possible general causes:

 

1. Decreased cardiac output

2. Decreased volume of blood

3. Increased capacity of blood vessels. 

 

If you feel you are about faint, lie flat. Don't panic; if you do faint, your body will recover within 20 or so seconds. 

 

My guess is it's simply the medicine. Low blood pressure is not an uncommon side effect. 

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7 minutes ago, ignis said:

Atenolol appears to be one Med I can take without bad side effects........ Yes Dr say it is a very old Med and new one are better, but get serious side effects [have a list of 8 newer? BP meds cannot take] so end up back on Atenolol

Yes that can be a problem. My sister in law couldn't take Ace inhibitors, I have been very fortunate in that respect.

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Just now, connda said:

For crying out loud.  Go see a doctor if you have a problem.  There are clinics and hospitals all over Thailand.

Which can be meaningless if you do not see the right doctor - they are not bots and can vary greatly.  

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39 minutes ago, KannikaP said:

In most cases, blood pressure increases with aging, no?

 

On the subject, should BP be fairly consistent? I measure mine every morning and evening, keeping results in a phone app, and can see that they vary, sometimes drastically from day to day. The average is OK for my age. I take Amlodepine, Doxadozine & Bestatin.

Yes also keep a chart, can go back for last 10 years.....   Also Dr wants to see this chart every visit.....

 

Doing a average for the past 12 days of morning readings of this month =  BS 109......... BP  137/71 +  Pulse 70  

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21 minutes ago, connda said:

For crying out loud.  Go see a doctor if you have a problem.  There are clinics and hospitals all over Thailand.

clinics and hospitals all over Thailand yes for sure, problem is most want you in and out as fast as possible, with 3 or more different tablets, so who can you discuss many problems with ?

 

What Dr do you see ? Diabetic Dr, Blood Pressure Dr,  CKD Dr ?

Do all the Med's go together.......   Most Dr appear to understand type 1 or 2 Diabetes and what to prescribe, but having Type Lada [1.5]  = confusion   

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3 hours ago, gargamon said:

As you age your heart becomes weaker

Unless of course it's exercised and strength maintained. My BP and HR has stayed optimal for many years as I've aged and I need no meds at all. 

Edited by BigStar
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1 hour ago, ignis said:

Yes also keep a chart, can go back for last 10 years.....   Also Dr wants to see this chart every visit.....

 

Doing a average for the past 12 days of morning readings of this month =  BS 109......... BP  137/71 +  Pulse 70  

TEN years BP records are unnecessary, one is OK especially when you then quote the past 12 days. 137 for average  systolic seems a bit high. 

 

What does BS 109 mean please? 

 

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2 hours ago, KannikaP said:

In most cases, blood pressure increases with aging, no?

 

On the subject, should BP be fairly consistent? I measure mine every morning and evening, keeping results in a phone app, and can see that they vary, sometimes drastically from day to day. The average is OK for my age. I take Amlodepine, Doxadozine & Bestatin.

No, blood pressure drops with age, all other things equivalent. However, if you have other conditions that raise blood pressure, that may cause the rise. General consensus is that it's better to have a slightly elevated heart rate in the elderly. Bad luck for me with mine dropping.

 

As for consistency of rates, they vary tremendously throughout the day. Best to take yours at the same time daily.

 

For the OP, are you drinking lots of fluids(non alcoholic)? Dehydration can be a cause of low BP.

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44 minutes ago, KannikaP said:

TEN years BP records are unnecessary, one is OK especially when you then quote the past 12 days. 137 for average  systolic seems a bit high. 

 

What does BS 109 mean please? 

 

Blood Sugar + Blood Pressure records plenty of room so why delete just fun sometime to look back over the years

 

as said before 130/70 something has been average for a couple of years.  that is why a sudden drop to 90/40 something is alarming for days on end.

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2 hours ago, ignis said:

Yes also keep a chart, can go back for last 10 years.....   Also Dr wants to see this chart every visit.....

 

Doing a average for the past 12 days of morning readings of this month =  BS 109......... BP  137/71 +  Pulse 70  

Your blood pressure results mean nothing without knowing your age. ????

 

Edited by Chris.B
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Two years ago, having a treatment against high BP, a doctor stopped Atenolol for me, it seems bad with other medecines ( but I don't know if it's the same problem for you  ), and Atenolol had bad effects on my kidneys , I am now on stage 3 ckd because of Atenolol 

Edited by Aforek
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I'd go to a doctor not seek advice here.

 

Sounds like you're on huge amounts of meds. My BP is pretty high due to urban lifestyle and lack of real and proper exercise.

 

I have been taking enalapril 20mg and it does the trick. No side effects, no diuretic problems.

 

I hope you have a boatload of medical conditions because if all you have is high blood pressure it seemed like it could be solved for easier than all that medication.

Edited by BonMot
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5 hours ago, gargamon said:

As for consistency of rates, they vary tremendously throughout the day. Best to take yours at the same time daily.

I take mine at 7.30 and 19.30. EVERY DAY. In the last 6 months my morning has varied from 110/60 to 144/86, and my evening between 121/72 and 142/84.

My average however is 124/74 with a BPM of 53.

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I eliminated my need for blood pressure meds with exercise.

As other posters have said, see a doctor. Staying on a diastole of less than 60 may cause permanent damage.

Be aware taking Viagra or Apcalis can lower BP quite drastically.

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Just a suggestion; the daily GP (they change constantly) at our local Community Hospital completely reviewed my Mother-in-Law's cocktail of medications, tweaking doses, prescribing alternatives and withdrawing others completely. Spent a lot of time with her. We were most impressed with the resultant improvement in her condition. 

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