Need help in lowering systolic blood pressure

[llmom]

I am a 59 year old female, weight 135, height 5'2" who has had hypertension for about 15 yrs.  I have also had PACs off and on over the past few years. I get a moderate amt of exercise. I was on Toprol XL 50mg for 2 yrs and very gradually my pressure was a little higher, 140-150/78. My doctor (a GP) added a diaretic, hydrochlorothiazide, but it didn’t do much.  He then put me on Zestoretic, 20mg, and I had PACs nearly all day for several days.  They felt strong and gave me a very “anxious” feeling.  He then changed me to Coreg, 6.25mg twice a day.  Still my BP wasn’t good, 146-150/80, although the PACs were less than on Zestoretic.  I tried Atenolol 25mg and still no change in BP.  My dr put me back on the Toprol XL 50mg since it controlled the PACs best but it doesn’t help the BP much.  Then he added Norvasc 5mg to Toprol.  BP stayed pretty much the same 140’s/78.  I then went to Norvasc 10mg which put the BP in the 125-130/78 range but my ankles got quite swollen. I was not comfortable with this so dr put me back on Norvasc 5mg and added Spironolactone 25mg.  After several days, the ankle swelling has gone down and the BP is around 128/75 now. Are there any other suggestions for medication rather than taking 3 pills a day for the BP?  Are there are there any things besides the medication I can do to lower systolic number?  I usually take my BP just before I go to bed.  Would it be higher then than if I took it in the middle of the day?  I certainly appreciate this forum.

[CCF-M.D.-RCJ]

llmom,

Thanks for the post, and we certainly appreciate you as well.

Q1:"Are there any other suggestions for medication rather than taking 3 pills a day for the BP?"

Most hypertension patients require more than 1 medicine to control the blood pressure.  Your relative intolerance to several medications makes treating you more difficult.

Q2:"Are there are there any things besides the medication I can do to lower systolic number?"

Lifestyle changes can often drop the blood pressure another 5 points or so.  Things like weight loss, exercise, and avoidance of alcohol and stimulants is a good start.  Eating a high-potassium diet helps in some people as well.

Q3:"Would it be higher then than if I took it in the middle of the day?"

There's an easy way to find out...take your blood pressure during the day.  Try in the morning upon awakening, and then again midday.

Treating high blood pressure requires a partnership with your doctor, and potentially a willingness to tolerate some side effects.  The effort put in now pays dividends later by not having strokes and other complications.

Best of luck.