High and Low

[Nectarine461]

My systolic is 215 and pulse 57.  Dialstolic usually 60-64 gets up to 80 when systolic is over 200.  Exercise has, until this week, greatly reduced readings to round 138/60. This is usually around midday. (5km walk or bike ride)

This week the exercise success is not working out -- today it actually increased from 177 to 184.

Drugs are Zan Extra and Noten plus aspsirin. By bedtime systolic is high again (196, 204, 199, 214 etc) and continues all night and is much the same on waking.  (Don't drink or smoke, am not overweight, cholesterol checked OK, kidneys checked OK).

[Nectarine461]

Doctor wishes me to double medications but I demurred. Will however take a full Noten tablet rather than the half one of past 3 or 4 years. I halved it when pulse fell to 46 -- it's now usually 55-60 -- will keep an eye on the expected fall.  I'm in a national health group that  monitors older patients (cheaper to keep us out of hospital) and today was my follow up. The nurse was astonished at my high systolics but does know of another similar case, a fellow of 85. She says that there seems nothing to do other than follow doctor's advice. Re Novask, the doctor says it's already included in Mycardis that he's prescribed. This seems to be it for the moment.  I skipped exercise today for the first time in perhaps a year (after yesterday's angina scare) but will resume tomororw.  

[NTB]

Hello again. I'm sure you must be aware that those are very dangerous periods, not only for stroke but also for organ damage (eyes, kidneys, etc)

Weren't you ever on a diuretic?

Just some thoughts:

How well did the nitro work? (Did you know it's not good to drop the BP too quickly?)

I'd maybe ask for isosorbide mononitrate, which works something like nitro but less powerfully and over a longer time. It might work as a preventative. But you can get a tolerance to it, so you can't use it every night. Vit C might reduce the tolerance effect.

If your BP mostly goes high at night, you can switch the time that you take your meds to be at greatest levels at night.

Norvasc is a CCB, which generally is good for Isolated Systolic Hypertension in elderly.

If you ever get visuals distortions, get to the ER right away. It's not just the numbers on your BP readings, but the symptoms you have.

Have you looked at pages on hypertensive crisis, like so:
http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/nephrology/hypertensive-crises/

Good luck, I hope you get it under control soon. One good thing you have going anyway is that your diastolic isn't getting up - but then a high pulse pressure isn't good either.

[Nectarine461]

Well, this morning I was 217/77 and later in the day I had angina (a rare event) and to cut a long story short my wife insisted I go to hospital emergency. They checked me at 228/77 (true!) and got to work with drip, ECG, blood tests, oxygen mask, urine test, nerve system responses, respiratory field etc ---- everything was negative or clear. I reduced to 173 while on oxygen, after that I rose to 205 again so they applied a nitro patch and gave me a norvask tablet -- kept me there for 6 hours till systolic slowly reduced to 161 . I see my doctor tomorrow. Hospital says it's for the doctor, not them, to stabilize BP as it often takes a long time (years!).  I usually check at bedtime but at the moment don't know whether to or not -- maybe better not to know.  The hospitall was very good, efficient -- but whether there's any real benefit I can't say.  

[ColleenC71]

Thanks so much! I didn't know it worked that way.

Have a great day.

[NTB]

hi, Colleen. If you pass your mouse pointer over his name, you'll see he's from Australia - and 80.

High pulse pressure can be a particular problem in that age group.

[ColleenC71]

Just wondering where your located?

[NTB]

hi. is your potassium low? In other words, were you checked for hyperaldosteronism?

since your hypertension is resistant to the meds you're already on (calcium channel blocker, ACE inhibitor and beta blocker), I'd think that's what would normally be looked for

when you say your kidneys are okay, do you mean as regards Renal Artery Stenosis?


or maybe you're just really sensitive to salt. What happened when you were on a diuretic?

on your own, you can try the DASH diet, or if you're really disciplined you can try the radical "rice diet".

[mammo]

I lost a son and grandson because (doctors didn't know what to do).  Get another opinion, this isn't normal, and they also need to try you on different meds, obviously these are not doing the job.

[Nectarine461]

Thanks for comment.  Yes, are for HBP. Not hereditary (parents lived to 90s) . Doctor doesn't know what to do.
Cardiologist neither --- sums it up as "we're not all the same"  Plus 200 readings are usually accompanied by 100 plus diastolics but not in my case --- mine are nearly always normal, as is pulse.

[mammo]

I'm not familiar with the drugs you're on, are they for HBP?  Your BP is dangerously high and you need to see your doctor.  Keep in mind that HBP can also be hereditary, but regardless, see your doctor.