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Heart Disease (Expert Forum)
Misc
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
Misc
by kate38, Feb 15, 2004 12:00AM
Hello,
Thanks for taking my questions,
History: Hypertension,High cholesterol,Asthma,Hypothyroid,and recently diagnosed with diabetes.
I recently had my cholesterol levels checked, the tri's went from 365 to 745, total cholesterol 320 to 274, HDL 53 to 48 LDL could not be calculate.I have been on cholesterol meds since about October,currently on crestor 10mg (since December).
Also,as you know from previous post,I take numerous B/P meds.An attempt to stop the minoxidil in Jan did'nt work,so I'm back on it. The dosages of most of the meds are pretty much divided up between morning(6am)and ngt(10pm),clonidine is taken m/n/ngt,minoxidil and triam/hctz are taken in the morning only.The problem I'm having is in the afternoon the blood pressure climbs to (180's/110-up)severe headaches and dizziness. Once night meds are taken it comes down. clonidine was increased to .2mg at noon,it still goes up,but a little later than before.
Q:I was told raising the dosage of crestor would most likely have no addtional benifits,is this true?
Q: Do statins lowerer all lipid levels or just certain ones?
Q: how long do statins take to work?
Q: Why can't LDL levels be calculated if tri's are to high?
Q: Do beta blockers and diuretics really increase lipid levels?
Q: Could you please provide your thoughts as to what could be increasing B/P in the afternoon?
Q:Can the B/P meds I currently take be moved around
to cover the afternoon incease?
Q:Can elevated blood sugar levels increase B/P?
Q:What causes platelet counts to be elevated?
Thanks
Doctor's Answer
by CCF-M.D.-RCJ, Feb 15, 2004 12:00AM
kate38,
Thanks for the post.
Q1:"I was told raising the dosage of crestor would most likely have no addtional benifits,is this true?"
The maximum daily dose of crestor is 40 mg. Taking more crestor may well lower your total cholesterol another 15-20%, but the real issue is your sky-high triglycerides, which will not be significantly lowered by taking more crestor.
Q2:"Do statins lowerer all lipid levels or just certain ones?"
They primarily lower LDL cholesterol, with a slight increase in HDL and a slight decrease in triglycerides.
Q3:"how long do statins take to work?"
Depends on the statin, but usually a significant effect should be seen within 2-4 weeks.
Q4:"Why can't LDL levels be calculated if tri's are to high?"
The Friedewald equation:([LDL-chol] = [Total chol] - [HDL-chol] - ([TG]/5)) breaks down at Triglyceride levels over 400 due to the assumptions made in developing the equation.
Q5:"Do beta blockers and diuretics really increase lipid levels?"
Yes, minimally so.
Q6:"Could you please provide your thoughts as to what could be increasing B/P in the afternoon?"
Your situation is complex, and you have left out details. I would highly recommend seeing an endocrinologist both for your lipid disorder and hypertension.
Q7:"Can the B/P meds I currently take be moved around to cover the afternoon incease?"
Perhaps; the only way to know is with a trial and error approach as guided by your doctor.
Q8:"Can elevated blood sugar levels increase B/P?"
Not directly, but both diabetes and hypertension are part of the metabolic syndrome, and so may have a common origin.
Q9:"What causes platelet counts to be elevated?"
Many, many things. The most common reason is inflammation, which may also be a source for hypertension and diabetes.
Thanks for the post.
Q1:"I was told raising the dosage of crestor would most likely have no addtional benifits,is this true?"
The maximum daily dose of crestor is 40 mg. Taking more crestor may well lower your total cholesterol another 15-20%, but the real issue is your sky-high triglycerides, which will not be significantly lowered by taking more crestor.
Q2:"Do statins lowerer all lipid levels or just certain ones?"
They primarily lower LDL cholesterol, with a slight increase in HDL and a slight decrease in triglycerides.
Q3:"how long do statins take to work?"
Depends on the statin, but usually a significant effect should be seen within 2-4 weeks.
Q4:"Why can't LDL levels be calculated if tri's are to high?"
The Friedewald equation:([LDL-chol] = [Total chol] - [HDL-chol] - ([TG]/5)) breaks down at Triglyceride levels over 400 due to the assumptions made in developing the equation.
Q5:"Do beta blockers and diuretics really increase lipid levels?"
Yes, minimally so.
Q6:"Could you please provide your thoughts as to what could be increasing B/P in the afternoon?"
Your situation is complex, and you have left out details. I would highly recommend seeing an endocrinologist both for your lipid disorder and hypertension.
Q7:"Can the B/P meds I currently take be moved around to cover the afternoon incease?"
Perhaps; the only way to know is with a trial and error approach as guided by your doctor.
Q8:"Can elevated blood sugar levels increase B/P?"
Not directly, but both diabetes and hypertension are part of the metabolic syndrome, and so may have a common origin.
Q9:"What causes platelet counts to be elevated?"
Many, many things. The most common reason is inflammation, which may also be a source for hypertension and diabetes.
I'm sorry for the lenghthy post.
I appreciate you answering my question.I see it in your writing as I here it in the cardiologist tone when he speaks to me. to complicated(get lost)or you need to go to this specialist.
Again,thanks for answering my questions.
Have a wonderful day!!!!
K