Blood pressure and anxiety, obesity and one kidney

[peljbl]

Hi - I am a 54 yr old obese female.  I was dx'd with hypertension 10 yrs ago and over the years I have been on many BP meds, unable to take most of them due to allergies or severe side effects.  I have suffered from anxiety and panic attacks for almost 20 yrs and five yrs ago, mu right kidney was removed due to renal cell carcinoma (contained - no further treatment necessary).  Of course that has added to my anxious state - always worrying about return of CA.  I am exercising - treadmill 30 minutes a day and hopefully soon some additional weight training and watching my diet.  Currently my BP runs an average of 140/86, I am on Cardura 1 mg and Amiloride 5 mg daily, Xanax .25 qd, synthroid .125 qd, .81 mg aspirin qd, multivitamin, CoQ10 30 mg qd, folic acid 400 mcg qd.  My BP spikes to 160/95 sometimes during anxious times and then I have been instructed to take clonidine 1 mg on those days also.  My nephrologist seems happy with these readings and what I am doing.  Stress test 2 yrs ago was normal and so are EKGs, no immediate family history of heart problems - two paternal uncles with heart attacks in late 40's (they were smokers - I have never smoked).  I am concerned that the BP is too high, especially since I only have one kidney but all my drs seem fine with it.  What do you think?

[CCF-M.D.-MJM]

Hello peljbl,

I can understand your frustration.  The blood pressure guidelines state that high blood pressure is greater than 140/90 that does not respond to therapeutic life style changes.  The goal is to keep your blood pressure below this range.  I am not a big fan of taking medications as needed for blood pressure control.  This tells me that they must have had a difficult time titrating your medications.  The first option I would consider is increasing the dose of norvasc.  The next question is what is your medication allergy?  There are lots of other hypertension meds -- you should be able to find several you are not allergic to.  Another option is to see a hypertension specialist -- this is probably your next step.

I hope this helps.  Good luck.

[peljbl]

Thanks for your answer but I think maybe you mistook Cardura for Norvasc.  If you meant Cardura - my nephrologist has increased the dose but due to water retention and therefore not helping the BP decrease, has decided to keep it at 1 mg and added the Amiloride 1 mg.  I am seeing the nephrologist as a hypertension specialist - is there someone else I should see - the cardiologist that did the stress test and ekgs said to let the nephrologist take care of the hypertension since I only have one kidney and no heart problems.  Is there someone you recommend at the CCF?  I live about 1 1/2 hrs away so I could go there if necessary.

[cristabelle]

Hi there.  Just a quick comment, I echo the Dr. response about trying different meds for high BP.  I also have another medical condition and my Dr. and I went through about five different trys on high BP meds.  But when we found it wow what a difference.  Just wanted to encouraage you in that.
Sincerely,
Crista

[Ingrid223]

I didnt understand much about blood pressure only until I had by daughter and developed pre-eclampsia which was new to me too.  I havnt really worried about it since then and for the last 9 years my blood pressure has remained high ever since having my daughter.  

I have been today to have it checked and the reading was 110/96 which was pretty high for a 34 year old I think.  My previous readings have been 120/82, 115/84.  I was wondering if this is due to them using these new electronic machines nowadays.  I have always had mine checked with the old pump style bp gadgets and it has always been low but ever since they have used the new electronic machines on me it always gives a high reading of 110/96 and over and it has also been up to 120/103 which is mind blowing.

I am a healthy woman of 34, I weigh 9st 4 and never smoked, eat healthly and have occasional drink at weekends. I do regular excercise everyday.  I dont understand why it is so low.

I have a twin sister whos bp is normal 120/83 and she has the same lifestyle as me.  My doctor has told me to come and get it checked every 3 months, but I've been doing this for years!

Can anyone out there reassure me I'm not going to have a stroke any day now!!!!  I may be overeacting there!

[tickertock]

New Guidelines for Blood Pressure are.

Systolic   Diastolic
< 120        < 80     optimal
120-129       80-84   normal
130-139       84-89   high normal , note systolic 120-139 and diastolic 80-89 are also considered prehypertensive , a reading of 115/75 are now considered optimal or the new normal.

Mild hypertension = 140-159 systolic 90-99 diastolic
Moderate hypertension= 160-179 systolic 100-109 diastolic
Severe hypertension= 180 and above systolic 110 and above diastolic.

If you are concerned with your readings consult with your doctor. As I understand it for mild hypertension weight loss, diet and exercise are usually the first measures taken, if that doesn't work then usually drug treatment is started. I am not a doctor but I understand treatment is usually recommended now if your B/P is consistently above 135/85.

[luvweezy]

For the past month I have been having symptoms of Panic attacks.  Well, yesterday I went into a minute clinic at a Target Store in MN just to see if I was getting a sinus infection.  No infection just a cold and at the end of my appt the NP said,"Let's take your Blood pressure."  So, I wasn't nervous about going in and so I know I was calm.  She took it and then re-checked and then proceed to tell my it was 130/98.  I almost flipped I have never had a BP so high in mylife.  Well good thing that she took my BP.  So, all of the high BP symptoms fit like a T to the symptoms that I have been having for the past months.  SO, I made an appt today to see a MD and she told me thinks my HBP is related to more towards panic attacks.  I could see where she is coming from, but again my BP that was taken in her office today was still high 149/90.  So, do to the fact that I am bi-polr II she assumes my HBP could be more panicky then HBP.  So then she prescribed Xanax to help me calm down.  It definitely help with my anxiety, but it didn't make my HBP go away.  I know this sounds silly but I took the xanax then my husband and I went to Target today and during our stay I checked my BP to see again where my BP was at after taking the meds well needless to say it didn't change much but got worse.  My BP was now at 168/102 100 beat per min and then a few mins later I took it and it went down to 149/98 100 beats per min than after walking around for a few more mins and the med really kicked and checked and it went down to 135/92 85 beats per min.  What I am asking is do you think I have HPB?  Do you think those symptoms could just be mimicking more of a panic disorder state or maybe a combo of both HBP and panic disorder.  I know my BP is still in the range of 140-130/98-90 BP and really this is the highiest it's ever be in my life.  History of my parents are on BP meds and my dad had a mild stroke at the age of 49.  I am concerned!!  Do you think I should Be?  Sorry my short story was much longer than I expected.  Thanks for any advice.

Beth