Sheryl Posted September 13, 2022 Share Posted September 13, 2022 You are on 4 separate medications that each lower BP (though thd Doxazosin is being takenfor different reason) do not surprising that yoh ard having drops in BP. Your meds (and possibly the timd you rske them) need adjudtment snd this is best done in consultation with your doctor. Of thee various meds you are on, thd hydralazine is the most potent and used only for severe hypertension. It is also rapud acting do consistent withthe timingnof uour episodes. so I woild expect thd doctor to discontinue it 1 Link to comment Share on other sites More sharing options...
Sheryl Posted September 13, 2022 Share Posted September 13, 2022 11 hours 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. He may be on the atenolol for reasons other than (or in addition to) hypertendion e.g. heart disease. Link to comment Share on other sites More sharing options...
gargamon Posted September 13, 2022 Share Posted September 13, 2022 One trick a cardiologist told me years ago when I would get dizzy when first standing up is to rock your feet a few times before standing up. This means keeping your feet on the floor, raise your toes a few inches, then lower them. Then do the same with your heels. Cycle those a few times then stand. It actually helps. 1 Link to comment Share on other sites More sharing options...
ignis Posted September 13, 2022 Author Share Posted September 13, 2022 8 hours ago, Sheryl said: You are on 4 separate medications that each lower BP (though thd Doxazosin is being takenfor different reason) do not surprising that yoh ard having drops in BP. Your meds (and possibly the timd you rske them) need adjudtment snd this is best done in consultation with your doctor. Of thee various meds you are on, thd hydralazine is the most potent and used only for severe hypertension. It is also rapud acting do consistent withthe timingnof uour episodes. so I woild expect thd doctor to discontinue it Many thanks Others have also said timing when taking Med's.... evening is easy take Med's + Insulin + meal between 5:30 - 6 pm Morning come down toilet + Blood Sugar + Blood Pressure reading + Insulin + Med's + Breakfast...... what time ? when I wake up, yesterday + today was 4 am, mostly around 6:30.. Going back over my records find something never thought or connected before,, EVERY time I had a drop of BP in afternoons was when I woke up late... The day that it was so low 93/41 [reason for my post] I did not wake up to 9:45 = was after 10 am before Med's taken.. So maybe now have the reason ?? Link to comment Share on other sites More sharing options...
VinnieK Posted September 13, 2022 Share Posted September 13, 2022 (edited) See things holistically. I would recommend a vegetarian or vegan diet...stop smoking if you do ..walk more..way more I would stop taking those ghastly drugs slowly also A BP monitor at home is a must obviously. Also a good idea is to understand the mechanics of HBD I assume high BP ,not low, is the original problem..? Edited September 13, 2022 by VinnieK Link to comment Share on other sites More sharing options...
KannikaP Posted September 14, 2022 Share Posted September 14, 2022 How does a Doctor determine which is the best medication for high BP, or any similar ailment Let's say Ace Inhibitor or Beta Blocker. Will he put you on one (A) for a certain length of time, monitoring BP daily. Then wean you off that one for some time, expecting a rise in BP. Then put you on the other (B) for the same length of time as A and similarly monitor BP. Then wean you off that one as well, in order to make a decision. Link to comment Share on other sites More sharing options...
sandyf Posted September 14, 2022 Share Posted September 14, 2022 Do keep up. Read the thread and avoid superflous posts, the OP had already responded. Link to comment Share on other sites More sharing options...
ignis Posted September 14, 2022 Author Share Posted September 14, 2022 7 hours ago, KannikaP said: How does a Doctor determine which is the best medication for high BP, or any similar ailment Let's say Ace Inhibitor or Beta Blocker. Will he put you on one (A) for a certain length of time, monitoring BP daily. Then wean you off that one for some time, expecting a rise in BP. Then put you on the other (B) for the same length of time as A and similarly monitor BP. Then wean you off that one as well, in order to make a decision. What I found over past 20 years appear to happen here that make difference...... Seen many Drs in Hospitals + Clinics over the years, Many Dr work x amount of time in a Big Private Hospital the other hours in Government Hospitals or Clinics..... = often totally different Med's available Another is the Dr and age group, the older Dr tends to give tried and tested med's. the younger ones are more likely give you new ones,,, a 60 year old Dr has maybe only read about some med's. the 20 something Dr was trained with the newer latest med's Eg: had a problem was taken to the local Hospital 2018 for 4 nights, list of all my daily med's 4 type of med's they did not stock. so given some different ones....... 2015 went with kidney failure to Red Cross for 5 nights, they have all med's....... 2004 Diabetic Dr at a local small private Hospital said goal = 130 reading....... The male older Diabetic Dr at Red Cross, got me to keep my Blood Sugar between 95 - 120 and adjust my Insulin to the reading,,,,,,,,,,, Because of Covid + the long trip to BKK, now use local Government Hospital, the much younger female Dr want me to keep the same units of Insulin each time + set the goal at 150 !!! Crazy every so often my BS will drop, no way with a reading of under 60 would I take take a full amount of Insulin [she was not even born when I was controlling Diabetics] Link to comment Share on other sites More sharing options...
KannikaP Posted September 14, 2022 Share Posted September 14, 2022 7 minutes ago, ignis said: What I found over past 20 years appear to happen here that make difference...... Seen many Drs in Hospitals + Clinics over the years, Many Dr work x amount of time in a Big Private Hospital the other hours in Government Hospitals or Clinics..... = often totally different Med's available Another is the Dr and age group, the older Dr tends to give tried and tested med's. the younger ones are more likely give you new ones,,, a 60 year old Dr has maybe only read about some med's. the 20 something Dr was trained with the newer latest med's Eg: had a problem was taken to the local Hospital 2018 for 4 nights, list of all my daily med's 4 type of med's they did not stock. so given some different ones....... 2015 went with kidney failure to Red Cross for 5 nights, they have all med's....... 2004 Diabetic Dr at a local small private Hospital said goal = 130 reading....... The male older Diabetic Dr at Red Cross, got me to keep my Blood Sugar between 95 - 120 and adjust my Insulin to the reading,,,,,,,,,,, Because of Covid + the long trip to BKK, now use local Government Hospital, the much younger female Dr want me to keep the same units of Insulin each time + set the goal at 150 !!! Crazy every so often my BS will drop, no way with a reading of under 60 would I take take a full amount of Insulin [she was not even born when I was controlling Diabetics] Well that did not answer my question. Link to comment Share on other sites More sharing options...
ignis Posted September 14, 2022 Author Share Posted September 14, 2022 18 minutes ago, KannikaP said: Well that did not answer my question. YES Maybe the Dr will try different med's lisinopril diltiazem amlodipine benazepril 4 of many med's cannot take Myself have had all of these Blood Pressure Med's , had very bad side effects so taken off to try a different one by Doctors. = why I am back on the 53 year old Atenolol Link to comment Share on other sites More sharing options...
KannikaP Posted September 14, 2022 Share Posted September 14, 2022 3 minutes ago, ignis said: YES Maybe the Dr will try different med's lisinopril diltiazem amlodipine benazepril 4 of many med's cannot take Myself have had all of these Blood Pressure Med's , had very bad side effects so taken off to try a different one by Doctors. = why I am back on the 53 year old Atenolol so how long on each med til you found the right one Link to comment Share on other sites More sharing options...
ignis Posted September 14, 2022 Author Share Posted September 14, 2022 27 minutes ago, KannikaP said: so how long on each med til you found the right one at lease 2 years + sent so many other Drs test/scans etc, worst one was amlodipine, feet ankles legs hip so swollen ended up in a wheelchair for months "found the right one" back on the same one I had from 1970 so maybe these still trying to find a newer med for me 1 Link to comment Share on other sites More sharing options...
KannikaP Posted September 14, 2022 Share Posted September 14, 2022 3 minutes ago, ignis said: at lease 2 years + sent so many other Drs test/scans etc, worst one was amlodipine, feet ankles legs hip so swollen ended up in a wheelchair for months "found the right one" back on the same one I had from 1970 so maybe these still trying to find a newer med for me Strange, I have been on amlodipine for 4 years with no problems. but how do I know if there is something better without stopping it, and using another . 1 Link to comment Share on other sites More sharing options...
Sheryl Posted September 14, 2022 Share Posted September 14, 2022 2 hours ago, KannikaP said: Strange, I have been on amlodipine for 4 years with no problems. but how do I know if there is something better without stopping it, and using another . There are a number of different drugs that may be used as first line of treatment for hypertension. Broadly they fall into 3 groups 1. Calcium channel blockers (CCB) 2. Angiotensin Converting Enzyme (ACE) inhibitors (ACE inhibitors) 3. Angiotensin Receptor Blockers (ARBs). ACE inhibitors and ARBs are similar in action. Calcium channel blockers work differently. The choice from among these can be influenced by a variety of factors such as the patient's ethnicity, age/sex, co-morbidities (presence of other conditions like diabetes etc.) and overall cardiovascular status. in some cases it boils down to simple physician preference. Treatment will start with one drug from the above 3 groups. If acceptable results are not obtained with maximum usual dosage of one drug then a second drug is often added; many people take both and ACE inhibitor + a CCB, or an ARB + a CCB. (ACE inhbotrs and ARBS are not usually combined as their action is too similar). And, of course, if intolerable side effects are experienced then a drug of a different class will be used instead. Amlodopine is a Calcium Channel Blocker. While it can cause swelling of the legs and feet in some people, it does not do so in everybody. Since you are experiencing no problems with amlodopine, there is no reason to change. 1 Link to comment Share on other sites More sharing options...
Chris.B Posted September 15, 2022 Share Posted September 15, 2022 (edited) 21 hours ago, KannikaP said: Strange, I have been on amlodipine for 4 years with no problems. but how do I know if there is something better without stopping it, and using another . Me too. 10mg a day. Pay 250 baht for 100 tablets. Edited September 15, 2022 by Chris.B Link to comment Share on other sites More sharing options...
billd766 Posted September 15, 2022 Share Posted September 15, 2022 (edited) On 9/13/2022 at 8:41 AM, 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. I take my BP every morning, twice if I have been cutting the grass and scrub. With at least an hour between the 2 tests. I normally take 5 readings on the trot and use the middle one. I made an Excel program and log them daily. Sys Dia Pulse 126 65 98 124 76 98 127 74 96 121 75 101 123 76 99 122 73 87 120 76 87 122 77 103 113 78 101 120 64 90 117 72 88 124 73 89 127 70 101 115 73 95 126 72 98 121 62 90 123 71 92 123 70 107 121 65 96 116 68 100 These figures are for the first 15 days of this month. I am 78 a bit overweight and borderline diabetic. My meds are Morning Co-Diovan 80/12.5 mg 1/2 tablet Dilatrend 25mg/Caraten 25 mg Caraten is the genetic version 1 tablet Metformin/Glucophage 500 mg 1 tablet Bed time Bestatin 20mg 1 tablet Hydroxim/Atarax 25 mg 1 tablet Orfarin/Morfarin 3mg Blue 1/2 tablet Orfarin/Morfarin 5mg Pink 1 tablet Glucophage 500 mg 1 tablet I have been on most of them since 2006 when I had 2 stents inserted. About 3 weeks ago I screwed up my order and missed about 2 weeks of meds. I had no energy, kept falling asleep and generally felt as rough as old boots. Never again. Edited September 15, 2022 by billd766 Added extra text Link to comment Share on other sites More sharing options...
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