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Heart Disease (Expert Forum)
Hypotension to Hypertension
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Hypotension to Hypertension
by MistyEve, Oct 24, 2002 12:00AM
Thank you so much for answering my questions.I'm a 48 year old female.
Along with the hypothyroid problem -I take metformin (500mg with meals)for insulin resistance. I was told it was
'borderline type II Diabetes'. So, would that be the problem then? If so how would I handle that?
I've also had a diagnosis of Fibromyalgia -though a lot of the symptoms have eased (if not abated yet),since starting thyroid med.
The only BP that I take is HCTZ diuretic(hydrochlorothiazide) 25mgs in the morning. Would you consider that aggressive enough treatment?
I was prescribed Inderal initially, along with the diuretic. But it caused a problem with worsening hypothyroid symptoms,(blocks conversion of T4-T3)- so I was put on the Ace Inhibitor Altace (with HCTZ). After 2 weeks I was tested and showed a marked problem with creatinine levels.
I wonder -if I'm only able to tolerate a diuretic (as it would appear) - whether a change to a stronger one like Lasix (Furosemide) might do some good in dropping the extreme BP spikes?
Its good to know hypothyroid doesn't cause the BP problem.
I'm wondering if levels of thyroid MEDICATION might - even though levels are presently optimized?
BP readings done on multiple days.
Thanks so much
little0ne
Doctor's Answer
by CCF-M.D.-KE, Oct 24, 2002 12:00AM
Dear littleOne,
You have a medical history of diabetes, fibromyalgia and hypothyroidism. Peole with diabetes need very aggressive blood pressure control in an effort to prevent the complications from diabetes. Blood pressure greater than 140/90 is considered high, but in people with diabetes the blood pressure should be lowered even further (120/80). An ACE inhibitor is the drug of choice in people with diabetes, but you are unable to tolerate this class of medications. I would then suggest an ARB along with your diuretic (HCTZ) and possibly a different beta blocker than inderal. The most effective regimen would be the one which lowers your blood pressure and has the fewest side effects.
There are blood tests which monitor the thyroid gland. You should ask your doctor how well you are adjusted to your current dose of thyroid replacement hormone. Hope this helps.
Thanks for your question,
CCF-MD-KE
You have a medical history of diabetes, fibromyalgia and hypothyroidism. Peole with diabetes need very aggressive blood pressure control in an effort to prevent the complications from diabetes. Blood pressure greater than 140/90 is considered high, but in people with diabetes the blood pressure should be lowered even further (120/80). An ACE inhibitor is the drug of choice in people with diabetes, but you are unable to tolerate this class of medications. I would then suggest an ARB along with your diuretic (HCTZ) and possibly a different beta blocker than inderal. The most effective regimen would be the one which lowers your blood pressure and has the fewest side effects.
There are blood tests which monitor the thyroid gland. You should ask your doctor how well you are adjusted to your current dose of thyroid replacement hormone. Hope this helps.
Thanks for your question,
CCF-MD-KE
