Another Blood Pressure Question

[Mobi]

I have posted before that I was experiencing problems with low blood pressure, and very low heart rate, due – presumably – to me stopping all alcohol, and consequent ‘over medication’.

Well, some 9 months down the line, since I stopped drinking, my twice daily BP readings have now settled into a familiar pattern.

My heart rate ranges from low 40’s to occasional mid 50’s, but rarely drops below 40, which was a common occurrence before.

My systolic BP ranges from mid 50’s to mid 70’s, which I believe is quite satisfactory.

The problem lies with the diastolic.

Previously, soon after I quit drinking , I was getting some very low readings, like under 120, but for the past few months I am getting a majority of morning and night readings ranging from mid 140’s to mid 150’s. During the day it is in the mid 130’s.

Now I am aware that a diastolic in the 140’s would be acceptable to some, but all my diabetic specialists are adamant that I must keep it under 140 if I am to avoid long term heart damage, and as I already have some coronary disease, this is worrying.

My current medication that has a direct or indirect effect on my BP is: Atenolol 50 Mg, Amlodipine 10 Mg, Ramipril 10 Mg, Aspirin (Cardiprin) 100 Mg, Cardura XL 4 Mg, Harnal 0.2 Mg, Bestatin 40 Mg and Niaspan 500Mg.

I live a reasonable lifestyle, eat sensible food, and take daily exercise, commensurate with a man in his 60’s.

I really am concerned about the amount of medication I take (the above list is not all of it!!) and I have no confidence that my doctor will do anything except tinker with my medication, which she has been doing for the past 9 months. She says ‘Titration is the answer” but I have been titrated till I am blue in the face but they can’t seem to get it right.

Any thoughts or suggestions?

Thanks

[Sheryl]

Mobi,

(1) you've got the terms backward, the upper (larger number) is the systolic and the lower (lesser) is the diastolic

(2) the BPs you report, with a low diastolic and slightly high systolic, would be consistent with the effects of stress.

The systolic BP is the pressure in the atrteries during each pulsation of the heart while the diastolic is the pressure "at rest", i.e. between pulsations. The systolic changes very readily in response to any sort of stress (it will temporaily shoot up to ariound 200 if you sneeze or cough!) while the diastolic changes much more slowly and reflects long-term conditions in the blood vessels.

Fior this reason, there is no need to worry about transient increases in systolic BP, look instead at what it usually is.

With a diastolic already as low as yours, there is no medication adjustment I can think of that would work well. The best thing I can advise would be meditation or other stress reduction techniques/bio feedback. I can almost guarantee that if you take uop meditation, your systolic BP will be lower.

Lacking that, the best advise I would give is to accept what you have. Your systolic BP is under 140 much of the time, and your diastolic is ideal.

Good luck --- and RELAX!

[Mobi]

Mobi,

(1) you've got the terms backward, the upper (larger number) is the systolic and the lower (lesser) is the diastolic

(2) the BPs you report, with a low diastolic and slightly high systolic, would be consistent with the effects of stress.

The systolic BP is the pressure in the atrteries during each pulsation of the heart while the diastolic is the pressure "at rest", i.e. between pulsations. The systolic changes very readily in response to any sort of stress (it will temporaily shoot up to ariound 200 if you sneeze or cough!) while the diastolic changes much more slowly and reflects long-term conditions in the blood vessels.

Fior this reason, there is no need to worry about transient increases in systolic BP, look instead at what it usually is.

With a diastolic already as low as yours, there is no medication adjustment I can think of that would work well. The best thing I can advise would be meditation or other stress reduction techniques/bio feedback. I can almost guarantee that if you take uop meditation, your systolic BP will be lower.

Lacking that, the best advise I would give is to accept what you have. Your systolic BP is under 140 much of the time, and your diastolic is ideal.

Good luck --- and RELAX!

Oops, sorry - my mad cow's disease seems, to be progressing nicely

What you say, Sheryl, - as always - makes so much sense. I frequently take several BP readings at the same time because my systolic is always over the place and even higher the first time or two, while the other readings are pretty stable.

It also explains why I can't seem to get the meds right.

Stress eh...? again, it makes sense, but I wonder why the docs didn't suggest this?

looks like I'll have to work on my stress levels....

Hm..needs some thought.

Thanks, yet again, Sheryl.