ken keith got a ? for you or anyone with info.

[line]

Hi Ken Keith, I remember you from another board and you were always willing to help others. I know you have been through a lot so you certainly have the experience to offer help

First ??  I have is my b/p is high at the drs. but fine at home.  I finally agreed to take 5 mgs of lisinopril, my last visit my b/p was 201/77 came down to 190/70 the 2 nd check, but the dr. wanted me to take 25 mgs of metrolpo before going to bed. We went grocery shopping, came home and put the grocery away, sat down took my b/p, no resting time and it was 118/58, I retook it before going to bed and it was 105/55. this is about normal for me. Needless to say I did not take the metropolo . I was afraid my b/p would drop too low plus i have bradycardia. I realize this b/p at the dr. was high but she really harps about b/p measurements and i am getting paranoid having it taken there. it use to run about 160-170/90 in the office..

I had a c-scan without dye done before having a hysterectomy, the report states atherosclerotic calcification  in the  iliac and aorta, i was not told this I read it on the report. there is no mention of calcium score and my G/P said if it was significant changes the report would say so and this is common finding.  I am a 69 year old female.

Ten months ago I decided it was time to quit smoking and I did but I have gained 20 pounds so  I am walking a mile weather permitting and up a hill, no sob or chest pain and my legs were achy when I first started walking but now are fine

I don't know whether to see a cardio or not with this b/p and the artherosclertic.I had seen a cardio for a check up, a ekg and echo before surgery and he cleared me for the surgery. my b/p was elevated there but he said if it is okay at home don't worry about it. I did have my b/p monitor compared with my drs. and it was fine.


Any advice would be appreciated. Line

[kenkeith]

Thanks for your response.  I have provided two links to give you some insight into  artheriosclorosis illium and aorta vessels, take care,

Ken ,
http://www.medhelp.org/posts/Heart-Disease/Calcification-of-the-aorta-and-iliac and http://www.medhelp.org/posts/Heart-Disease/Aortic-Calcification/show/869387

[line]

My Echo was basically good, a little of this and that but no concerns at all. He does not  think I need any moere testing done at this time. He did have a copy of my c-scan and saw I have arthicoltises (sp) changes in my illium and aorta and is concerned about the leg pain I am getting when I walk, but said this a common finding and the pain maybe  from just starting the walking, and he feels I should have started slower than a mile until my body gets use to iome exercise. the leg pain could be fibro also but if it gets worse or I find I am unable to walk as far to call than he wants a doppler.

I took my b/p readings with me, including the ones after walking and he said that happens to some people their pressure will go down after exercise and may even go below what they normally have, med and the exercise can do this but while exercising your b/p goes up. He did have a copy of my blod work from my g/p and said your thyroid is fine.

Thanks both of you, Linda

[line]

Will post on this thread as to the cardio's findings. BTW,just came back from a walk and my b/p ws 139/78, took it again 15 minuets later and 110/60, pulse was up to 90 and now down to 57.

i just had my thyroid checked, the full panel everything was normal there.

[kenkeith]

I am interested to hear your doctor's response to your concern regarding an ACE inhibitor and a beta blocker that lowers your heart rate below normal and there is an increase in pulse pressure (not pulse rate...which is heartbeat).  There isn't much difference between an ARB and ACE as both prevent angiotensin ll into the system angiotensin constricts blood vessels: ACE inhibitor prevents the production by kidneys, and ARB binds angiotensin to receptors.  ARB is a substitue for ACE inhibitor if one does not tolerate ACE fro treatment of high blood pressure. I am not fully informed on the treating mechanisms of the given medicatiion (ACE, ARB) and its interaction with a beta blocker in terms of a high pulse pressure...there does appear to be evidence of some pathology associated with a high pulse pressure!?  

Normally almost all physical activity increases blood pressure. This is a normal result of increased blood demand from the muscles.  In order to meet the increased blood demand, the heart has to pump faster and harder, passing a larger volume of blood into the fixed capacity (capacity is less with some hardening of the vessels).  If the arteries are rigid with some degree of inelasticiy and the demand for extra supply of blood from increased demand the blood pressure will rise. The greater the damand,  and associated inelasticity, the higher the pressure. So it appears your system is not behaving as normal under the circumstances you provide.  

The problem may be with the thyroid gland or the central nervous system. etc... Let us know.  Thanks for the response,  Take care,

Ken

[line]

I posted too fast, sorry.
I will let you know the results.

Another ? i wanted to ask is after walking a mile I took my b/p it was 94/48 and a pulse of 97, took it again in 3 minuets and it was 103/50 and pulse 79, my b/p kept going up a little higher as my pulse slowed down,waited for 1/2 hour, b/p was 109/56 and plulse 55, which is normal range for me.

Is this normal for your b/p to go down with walking,I know your pulse rate should go up. I do take 5 mgs of lisinopril and am on a anti-anxiety med,


Thanks, Line

[line]

i will have a echo done on Mon. than see the cardio. The echo I had done in July showed mild pulmonary hypertension, my cardio said the numbers do not add up to this and wants another echo done in their office. will let you know what

[line]

i will have a echo done on Mon. than see the cardio. The echo I had done in July showed mild pulmonary hypertension, my cardio said the numbers do not add up to this and wants another echo done in their office. will let you know what

[erijon]

One thing to keep in mind concerning white coat hypertension is that the same stress you feel at the doctor's office that raises your BP is an indication that your BP will increase higher than most people's during the day over seemingly minor stresses. I also have white coat, don't know why as doctors don't bother me at all. I track my BP here and it averages 111/68 the past 90 days but get me at my doctor's office it will be 150/85 minimum. I always take a copy of my tracker from MH with me so he can see the difference. For this reason you may need to be on meds, just a thought.

[line]

In my opinion I need no b/p meds, I have monitored my b/p at home for years due to white coat, it is very and was very seldom over 140/75. i thank you both the advice and am seeing my cardio on mon. for  his opinion.
I don't think  I have edema no noticable swelling of ankels or any where. But in a way maybe  this smoking weight gain I could be a way to get rid of this extra taking a diruetic.


BTW I see no changes in my b/p with quitting smoking.  But did want to mention that I am taking 2 grams fish oil per day, I always had borderline cholestrol, my  HDL went from 32 to 57 sometime during a 8 month period, my LDL came down some but needs more work. KenKeith, I am so glad that you are having some good times, you certainly  deserve it.no major problems here that I am aware of.


Line

[erijon]

You may want to ask your doctor about an ARB, angiotensin II receptor antagonists, such as Benicar. These work to make your arteries more flexible which allows them to absorb the force of each heart beat. It does not affect your resting heart rate and can also be combined with a diuretic as well. It's a very safe and effect drug for BP.

Just a thought, good luck.

Jon

[kenkeith]

Hi,
I see your participation on forums goes back 8 years about the same for me!  It has been good years for me, and I hope your years have provided good health, or at least no events that are serious.

I can't provide any advice as there are so many intervening constitutional variables for each individual's health. You have monitored your blood pressure unit with the doctor's visit to determine accuracy so your home calculations has some validity...that is good.

What seems to be apparent based on your reported BP at the doctor's office is a condition that is called the pulse pressure.  Pulse pressure is the numerical difference between diastole and systole's heart cycle. An mmHg greater than 60 or 80 mmHg can be a likely basis for stiffness of the major arteries, aortic regurgitation (a leak in the aortic valve), arteriovenous malformation (an extra path for blood to travel from a high pressure artery to a low pressure vein without the gradient of a capillary bed), hyperthyroidism or some combination. These medical conditions should be ruled out.

My source indicates there can be drugs for hypertension that have the side effect of increasing resting pulse pressure irreversibly, other hypertension drugs, such as ACE Inhibitors (lisinopril, my med as well)  have been shown to lower pulse pressure. A high resting pulse pressure is harmful and tends to accelerate the normal aging of body organs, particularly the heart, the brain and kidneys. ***High pulse pressure combined with bradycardia and an irregular breathing pattern is associated with increased intracranial pressure and should be reported to a physician immediately.** This is known as the Cushing reflex and can be seen in patients after head trauma related to intracranial hemorrhage or edema....you have made a very  good point that a beta blocker that lowers heart rate (bradycardia) can be problematic.

You may want to get some assurance from your doctor related to the concern you have expressed.  Thanks for your questions, and I hope I have provided a perspective that can help you for a consultation with your doctor.  Take care, and I believe we on the health forum circuit is large family :).  I wish you well going forward.

Ken