Sytolic Creep(ISH)

[Cody]

Dear Cleveland Clinic Physicians,
Background: Age 64; Present Daily Medications: Atenonol(50mg), Vasotec(20 mg), Hydrochlorothiazide(25mg), Imdur(30mg), Lipitor(20mg), Aspirin(81mg). Daily exercise:  30 minutes of jogging.  Present lipid levels:  LDL 40, HDL 59, Triglycerides 55, total cholesterol 110.  Stentless angioplasty performed on LAD 7 years ago.  Yearly nuclear stress tests all with similar and normal results.
For the past few days(approximately 3 or 4) I have noticed an increase in my systolic blood pressure to a level about 165; normally the highest level of the systolic had been in the 120-135 range.  Of course the pressure varies throughout the day for example:
Two hours after jogging: 100/65;  two hours later:  135/70; two hours later it may peak at 165/80 then during the late afternoon it will decline to 120/70.  Is the beginning of systolic creep due to aging?  Are there any drugs on the market that target systolic blood pressure and do not effect diastolic pressures?  Can it possibly be a different generic from the pharmacy, if so what of the above drugs would most likely effect the higher systolic pressure?
Thanks - Cody

[CCF-M.D.-MJM]

Hi Cody,

You are on a very good regimen for someone with coronary disease. The basics are:
aspirin
beta blocker
ace inhibitor
statin

You are correct that your blood pressure management is an important part of risk reduction.  3-4 days of elevated pressures is not enough to concern me.  If that trend continues over the next 6-8 weeks, I would consider tweaking your medications.

Are there any drugs on the market that target systolic blood pressure and do not effect diastolic pressures?

We don't worry about a low diastolic pressure as long is it is below 85-90.  A diastolic pressure of 70-80 is just fine.


Can it possibly be a different generic from the pharmacy, if so what of the above drugs would most likely effect the higher systolic pressure?

It is unlikely caused from a bad generic drug.  I recommend generics over most brand name medications.  I would keep following your blood pressure 1-2 x per day for the next 6-8 weeks. If it continues talk to your doctor about changing your regiment.  Keep a log of your pressures and vary the time you check each day (ex.  odd days check when you get up and after dinner, even days after lunch and before bed).

I hope this answers your questions.  thanks for posting.

[mrbh]

I have noticed issues with generic drugs as well.  My alprazolam (generic Xanax) is what I refer to as "sugar pill useless". My panic attacks rage unabated and the meds have no effect.

With the Inderal, the generics seem OK.

My speculation is that, in general, the generics are not good quality meds. Remember the old saying: "The bitterness of poor quality remains long after the sweetness of low price is forgotten".

[Barbarella]

My Cardiologist told me one time "peoples BP especially at middle or past middle age never stays the same during the day even on BP meds, it varies top and bottom numbers, as long as the average is at normal levels don't worry about it, but if it continues to stay at the higher level call me".