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how long before meds regulate high blood pressure?
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how long before meds regulate high blood pressure?

My blood pressure has been quite high for the last 3 months but it was not until last week that my doctor finally put me on Tiazac XC 180mg once daily.  The only thing that the cardiologist has found out so far is that I have excercise induced LBBB.  I go for an echo on the 19th and they are also testing for pheochromocytoma (tumor in the adrenal glands).

My blood pressure changes drastically, I could be sitting on the couch at 139/89, I get up to get something from the fridge I sit again and check and now my BP is at 158/106.  

Now that I'm on this medication, the heart rate has decreased a bit, I was at rest at 104 now it's at 90 at night it goes to 77, and the chest pressure I was feeling that is gone.

My question is, how long would it takebefore the meds control my blood pressure?  In the mornings I take it before I even get up and it is quite low 119/77 pulse at 76, I sit on the edge of the bed, retake my BP and it is already 142/88 pulse at 85, go to the batroom return and retake BP is now 154/102 pulse at 98, I had breakfast sat for about 20 min retake BP is now 148/104 pulse at 107.  Shouldn't these pills be regulating it more? or is this normal?

I go see my Dr. on December 23rd for a follow up and results of the pheochromocytoma test but I'm not sure if I should be contacting her earlier if this medication was suppossed to be doing more already or not.

Any advice will be appreciated.
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592969_tn?1248329005
This is not normal. Usually blood pressure medicine works within a week.  Call your doctor and let the doctor know what your blood pressure is and has been.  Your doctor may change your medicine for you over the phone.  Rest and take it easy until your appointment.  
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367994_tn?1304957193
The problem could be hyperthyroidism, and that is an overfunctioning of the thyroid gland. This overfunctioning results in the production of too much thyroid hormone. Because the thyroid hormone controls many bodily functions, this increase in the thyroid hormone level causes these bodily functions, such as heartrate, or in some cases blood pressure, to increase, sometimes to very dangerous levels.
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690060_tn?1247845341
that's possible. But still, with hyperTh you'd expect isolated systolic HTN - and you might also expect to hear a complaint of pervasive jitters or anxiety, etc

(As an interesting aside, being hypoTh can also paradoxically cause HTN - mainly diastolic as the condition increases arterial stiffness while reducing heart rate, and so the body compensates with increased BP)

As far as a pheo goes, you'd expect the rises to be paroxysmal, and also usually (though not necessarily) of an even greater magnitude

with the OP's case, to me the interesting feature is that the rise in BP and HR occurs after physical exertion, even slight exertion. There have been a few of us who showed up here being fit, not MS etc but had a virus cold that coincided with sudden onset HTN. My theory is that the virus causes mild vasculitis, which does two main things: 1) impedes oxygen perfusion to tissue because the endothelium is inflamed, and 2) impairs vasodilation, because of the same endothelial inflammation but also because of all the superoxide that is being generated by the immune response to blast the pathogen (and as you know, superoxide is also the free radical which is the main consumer of nitric oxide)

So what happens? On any exertion, the muscles want O2 but don't get enough so the CV system goes naturally and inevitably into overdrive. The arteries would ordinarily dilate but don't, because of the infection. You get shortness of breath, with elevated BP and HR.

Mild cerebral vasculitis might also account for my occasional dizziness, headaches etc

(I keep saying mild because some forms of vasculitis are deadly.)

Anyway, I believe the OP had posted previously and I responded with a pointer to a thread discussing this. She didn't reply so I didn't relate the things I'd done to bring my BP down from a high of 145/101 to my average of 130/90 or so over the past 2 weeks. That was without meds. However, I want to get back to my pre-virus usual of 115/75. My one blocked ear finally cleared up yesterday after two months. Today I was 120/80 seated. Then I just did some squats without much problem and am at 123/88 while I recover. I think I'm over the hump but not out of the woods :)  Not quite yet, I still have that diastolic floor that I rarely get below, though I've hit 72 at times.

Here's a twist. I mention it in case you (or anybody) has an observation on it: I had orthostatic hypotension along with my hypertension. When my BP was 137/92 I would so some deadlifts and get dizzy right after I did the last one and stood up without the barbell. That again makes me think of vasculitis. (Ortho hypo with htn, though, can be a feature of a pheo, too.)

If anybody has any insights or outright guesses, I'm all ears. As I had said on this condition/topic previously, if we have a rare condition then we're mostly on our own - since docs mainly have to treat the average and expected.



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690060_tn?1247845341
whew, that post of mine turned out to be long :)  But it gave me a chance to coalesce my thinking and maybe somebody who has the same condition will find it in the future. (If you do then write a reply or a private msg and we can compare notes.)
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Avatar_f_tn
Sorry I hadn't reply to your post, I did read the thread of those that all of a sudden had the high blood pressure after a virus, but I couldn't figure out how to reply to a post, so that's why I just posted a new one.

I'm trying this and hopefully it appears as a reply to your post and not as a new one!

I just came back from my echocardiogram, they had a cancellation so I got called.

Since they can't give you results right there, I asked her if I should be worried, all the tech said was "I don't think your Dr. will see anything interesting here, but do you know if you have any liver problems?"  I'm not sure why she asked this and I didn't clue in to ask her why she had asked that, all I said was no, that I didn't know if I had any liver problems although I have had my gallbladder removed about a year ago, not sure if this has anything to do with that???

I'm going to have to re-read your post as there is a lot of terminology I do not understand!

But I am like you and hoping that I can go back to my excercise routine without getting the heart rate or blood pressure thru the roof!

Let me know if you think of anything else as I'm like you too in the sense of having my BP and HR rise after very slight exertion.
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Avatar_f_tn
Thank you for your input.

I had my thyroid checked and that showed normal.  The only other thing that the blood work showed was that I'm anemic so I'm on iron pills, 300mg 3X day.

I called my Dr. to ask about the meds and how long they would take to work and she told me they can take up to a month before they stabilize my blood pressure.  Today it is actually not too bad 138/86, much better than I have had it in the past.

Hopefully something will start to make sense soon!


  



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690060_tn?1247845341
karinosa:

I have tons of things to say about this :)  I actually also did do many experiments on myself, having had access to various drugs. So here's just a very few observations:

Yes, docs will say that it takes 4-6 weeks to see an effect - but there are counters to that argument, especially with vasodilating drugs like CCBs. E.g., my father had USH and saw a big improvement in two days on a CCB (that I had talked the PCP into giving him instead of a BB). But my father had typical HTN. I do not, and a CCB did nothing for me. (Though your doc is apparently giving the CCB for rhythm control, rate control and also BP control.)  

Let me stress that I do no longer get spiked from slight exertion. I ran a mile uphill last week, e.g.

If you want to exercise again (and exercise is known to improve endothelial function), then I'd suggest this: get some Imdur 20 mg, take half a tab. Observe your BP that day, I bet you'd be near normal for 24 hrs or so. I did that and that's what I found. Then take a day off (because nitrates build tolerance). Then take a half tab, and exercise and observe your BP.

If you do that (you need a script or else order offshore), and it works out then you have a BIG clue. IOW, the Imdur contributes Nitric Oxide directly, bypassing the normal endogenous production - and that creates vasodilation.

Yes, there a lots of terms in there but that's what discussion groups are best at: providing sign posts to research. You are unfortunately discovering that your case is not one of "see a doc and get a pill". There can also be, btw, bad side effects to CCBs, such as edema.

Also, the more you demonstrate to a doc that you thoroughly know things, the more they are generally amenable to what you want - like getting Imdur, e.g.

Thanks for the clue on the liver showing something on your echo. Though that might be as you intuit that it has to do with the gall bladder rather than this hypertensive episode.

Oh, and for me pesonally, repleting minerals seemed to play a big part in reducing BP. That was especially magnesium, which is hard to get from diet and even from supplements. I'd had a headache for three weeks (and I never get headaches)  but it was gone in one day after starting Mg. Note that Mg is also necessary for synthesizing NO, which is the main endogenous vasodilator (and HTN fighter).

If you do try Imdur, kindly let me know how that worked. I've also had active results from the amino acid arginine (which NO is made out of), from niacin (which IIRC NADPH is made out of, and that relates to making NO) and nitroglycerin tabs.


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Avatar_f_tn
hmm.... not sure if I'm ready to treat myself yet, so I think I will wait and see what the full medical reports say first, but thanks for your advice.

Glad to see that you are able to excercise again.

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