High altitude high blood pressure

[gweibl]

My husband had been on three different medications for high blood pressure.  It has been difficult to control. He was always going back for  medication adjustments  We had been living in the Denver ,Co. area at 6000ft.  Since we moved to North Carolina near the ocean my husband no longer needs any medication to keep his blood pressure down. He is 62 years old and not over weight. We may have to move back to the Denver area. How do we keep his blood pressure in check if we move back? Or should we stay here to keep it at normal levels?
Worried Wife

[denver Male HBP]

I live in Denver and @ 53 my MD has me on 3 HBP Drugs : ACE;ARB &CCB.....I am very athletic  (Run 25 miles a week and bike, hike and ski) and do not particuarly care for the Drug's side effects.... Low BP ; Tiredness;

I travel almost 100k miles a year on business and my ankles do swell from 4 hour + flights....

Two questions :

1. What is the potential benefit for living @ Sea Level vs 5800 ft?

2. What is the value of some of the non drug therapies available ?

[Cleveland Clinic]

As you know Denver has a considerably lower oxygen tension in the air.  There is evidence now that low oxygen tension stimulates the sympathetic tone (adrenalin) leading to increased vascular tension and increased fluid absorption from the kidney.  Some patients who live in high altitudes develop high blood pressure accompanied by lower extremity swelling.  Obviously not everyone who lives there develop hypertension, however, some people are more susceptible than others.  Your husband must be one of them.  Certainly limiting salt and fluid intake may help some with controlling the blood pressure.  Make sure that he does not smoke, keeps in best possible shape and that his lung function is normal.  Being obese also predisposes patients to higher sympathetic tone and resulting high blood pressure.  Medications such as diuretics, beta blockers, alpha blockers  or clonidine may be more effective than calcium channel blockers but the only way to know is to try them first.  Keep in mind that they work on the effect of the problem, not the cause, which is the lower oxygen tension.  Also, low oxygen tension may lead to increased pressures in the lung vasculature, which we unfortunately have no way of measuring without taking patients to the catheterization laboratory.  We actually began to realize this when we learned from the vets that cows, for example, can't graze at high elevations because they develop pulmonary hypertension.  Thankfully humans are not as sensitive to high elevations as cows are.  Is your husband the type that would get some swelling in his legs after a cross country flight?  Of course if you HAVE to move back to Denver than this shouldn't really stop you because there is always a way to control blood pressure.  Again, fluid and salt reduction, exercise, weight loss, good lung function by limiting smoking exposure (first and second hand smoking) in conjunction with medications are all going to be very helpful .  

[gweibl]

Thank you for your medical opinion. My husband does not smoke and he worked as a FEDEX courier while in Colorado.This gave him plenty of excersise. Moving back would only put him back on medications that continuously needed adjustments. These adjustment take months to work before results begin to help. High blood pressure is a serious condition that can lead to numerous other health and life threating problems. To help keep my husband as healthy as I can a move back to Colorado is not a good idea. Living at sea level, from what you said, is the answer for him.