High BP control

[Mike1]

Hi,
My details are:
Male, 41 years old, 6'4"", 85 KG approx
BP anywhere between 122/75 to 185/113 approx (avg 140/90 approx)
Resting heart rate 33 - 40
Training heart rate : 140-150 approx

Prescribed medication: 2.5 mg Bendrofluazide

Supplements: Garlic/Hawthorn, Fish & sunflower oils, Kali phos tissue salts, Sometimes passion flower

Symptoms: Pressure/numbness/throbbing across top of head with mild dull headaches. Some light headedness and dizziness. Stress symptoms.

Hereditary influences: My father died at 63 of a heart attack (He had his first attack at about 45-50 and suffered with angina - although he was a long term smoker)

Consider myself to be reasonably fit (exercise 4 times a week) however I am unable to get my BP down to a satisfactory level. It does go down a bit after training.
I would prefer not to be taking the diuretics due to side effects.My GP wants me to take ACE 2's but I am reluctant to do this as I have tried ACE1 and Betablockers and these made me feel even worse.

Do you have any suggestions how I might control me BP better ?
Do you think my low Heart rate is a contributory factor to my high BP ?
Are ACE 2's better to take than diuretics ?

[DottyCece]

Does the diuretic effect of lasix also decrease over time?

[hbp702]

Get a full workup for secondary hypertension as soon as possible.

Specifically ask for tests for the following:

Renal artery stenosis
Other kidney disease (get a urinalysis)
Pheochromocytoma
Insulin resistance/Syndrome X/Metabolic syndrome/Dysmetabolic syndrome
Diabetes

Actually a full endocrine and cardiovascular workup would be good.

Also, see if anxiety/panic is an issue.

Add anything else you or your doctor even think might be useful.

You have to demand a full workup to get one.

Had I been a quiet patient, they would have never found out what was wrong with me.

[raildown]

in what settings has you BP been measured ? and under what conditions does it seem to be elevated ?

have you been given a 24 hr Ambulatory BP Monitor test ?

//

[Cleveland Clinic]

mike, thanks for the post.

There are alot of drugs used to control hypertension.

The 2 first line agents I would recommend would be diuretics and ace inhibitors. The diuretic effects of thiazide diuretics tend to decrease over time.

Since this hasn't worked for you I would recommend ace inhibitors. The most common side effect of these are cough.

As for side effects, do not forget about your supplements. They can cause side effects too.

Your heart rate is not contributing to your blood pressure. Instead it probably a reflection of your fitness.

The question about ACE inhibitors and diuretics is a difficult one. My personal belief is they are probably equivalent in all comers, but in a certain subset of patients there are other benefits of ACE inhibitors that would cause me to use them as first line agents. These include patients with coronary disease, diabetes, or congestive heart failure.

You have the right to talk to your physician about your hypertension and explanations on whether there is evidence of a secondary cause. These include paroxsysm of blood pressure, very difficult to control blood pressure, and typical electrolyte abnormalities. There is no indication to test everyone with hypertension for secondary causes, nor is it feasible.

hope this is a start.