Blood Pressure

[Sheryl]

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 

 

[Sheryl]

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.

[gargamon]

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.

[ignis]

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  ??

[VinnieK]

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

[KannikaP]

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.

[sandyf]

Do keep up.

Read the thread and avoid superflous posts, the OP had already responded.

 

[ignis]

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] 

[KannikaP]

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.

[ignis]

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

[KannikaP]

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

[ignis]

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

[KannikaP]

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 .

[Sheryl]

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.

 

 

 

[Chris.B]

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

[billd766]

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