So, I have been struggling with blood pressure problems for a few years now.

A little background, I have always had a steady blood pressure of 135/75 to 138/80, then one day taking my DOT physical, it was 141/80 and I failed my DOT physical, because it has to be 140/80 or under. Soooo I had to see my primary care physician and he put me on 5mg Amlodpine once a day and this "controlled" it for a short time. Then it was 5mg twice a day. Then 10mg once day, then it was that and 10mg hydrochlorothiazide with the Amlodpine once a day, then twice a day, then it was bumped up to 25mg. All this would "control" my BP for a while, then it would go haywire again, be all over the place, feeling like shit and all. Then the last was adding 50mg of Metoprolol on top of the previous, and then upping it to 100mg.

I lost weight, and need to lose more, but no matter what, my BP is "controlled" for a short period of time, then it gets WORSE.

Now, last Thursday I took my DOT physical, and failed, was sent to the ER with a BP of 190/110 and was told to go home, rest, take my meds but to take my Amlodpine twice a day until I can see my PCP which is tomorrow, check my BP four times a day and log it, my best has been 175/75 pulse 59 and everything else between that and 200/101 Pulse 62.

Because of this my medical card has been pulled and now I can't drive a school bus. Now I'm on sick days, until I (1) have to be put on medical leave, (2) or has to take medical disability. I'm getting paid, but I'm losing about 40% of my income, so that's not helping my situation.

Funny thing is, I feel better than I have in a long time.

Before my DOT physical I cut booze completely out, reduced salt of almost nothing, cut caffeine out, and added cinnamon to almost everything.

I'm 55 years old and fairly active, I walk minimum 1 mile twice a day, but more like 5 twice a day, depending upon weather, time and such. I play, ie. run, jump, throw balls with my aussies at least an hour a day, but more most days. I do some other light exercises and was swimming once or twice a week.

Yet, here I am. Blood pressure through the roof, medical card pulled and unable to work until or if I can get this fixed. I have worried about the future since Thursday.

ARman

I’m sorry that you’re going through this. I wish I had something to suggest, but you’re already doing everything that comes to mind (losing weight and consulting your doctor). Wishing you good luck in resolving this quickly and positively!

Are you taking any other over the counter meds of any type?

I take a combination of Amlodipine and Benazepril to control my bp.

I was on stronger dosages in the beginning and was getting dizzy after taking them. Started reducing the dosage and then splitting it up to twice a day. But thats not your problem.

Perhaps something else your taking or eating is driving up your bp. What about salt? How much are you using.

High blood pressure is one of the things that frequently takes some experimentation (for lack of a better word) to find the right medication or combination of meds. My doctor and I went through several iterations of this. My BP would be controlled for a while and then start back up again, so we'd have to adjust the dosage or try a different drug. The med I'm on now has been working for several years now. My current doc (different than the one that originally prescribed it) suggested I take it in the evening instead of morning, and while I don't understand why, it does make a positive difference.

I think HPB is also something that doesn't always have any causal relationship to your overall health.

I've had a similar situation. I was on Lisinopril for 20 years until my new Primary Care Doc said it was responsible for raising my blood potassium so they take me off that and on to Amlodipine and that's when the problems started. The PCP raised the dosage and my BP would get higher. I'm on Metoprolol also. The pharmacy doctors took me off the Amlodipine and put me on a different BP drug (Valsartan) and my problem went away and BP is back to normal.

Just sayin' that the Amlodipine might not be for your metabolism, see if you can see a real pharmaceutical doctor. Change up your meds maybe because something ain't right.

Sorry you're going thru this. I've been on some kind of blood pressure med for 30 years (genetic). They'll get it figured out.

Have you talked with your doctor about switching you from amlodipine to an ACE inhibitor like lisinopril, or an ARB, like losartan? Amlodipine is a good drug, but it is not usually considered the first choice for BP control.
Would you consider asking for a referral to a cardiologist? I'm perhaps biased, but as a cardiologist of many years I frequently got referrals for patients whose BP was not managed with the first or second drug prescribed by a primary care physician.

Probably the most important thing, if you have not already done it, is to buy your own digital BP cuff, like an Omron, and use it to record your blood pressure readings at home. What's important is what your BP is most of the time, not just when at a doctor's office.

Next, once you've established that the BP readings at home are abnormally high, is to find a drug or combination that works FOR YOU.
In our very large medical group, where I was on a task force for cardiovascular disease prevention, we reviewed the medical literature for evidence of benefit and effectiveness of various BP drugs. Bottom line: almost always start with lisinopril, then add a diuretic if needed. Calcium channel blockers such as amlodipine are good, usually well tolerated; but offer no advantage over lisinopril or losartan except for patients who have a contraindication--a medical reason NOT to prescribe them.

quote:

Originally posted by Mustang-PaPa:
Are you taking any other over the counter meds of any type?

I take a combination of Amlodipine and Benazepril to control my bp.

I was on stronger dosages in the beginning and was getting dizzy after taking them. Started reducing the dosage and then splitting it up to twice a day. But thats not your problem.

Perhaps something else your taking or eating is driving up your bp. What about salt? How much are you using.

If you re-read the OP he says he's taking virtually no salt.

At a follow-up with my surgeon, they tested me at 160 over 100. That explains the sensation of wanting to crawl out of my skin head first. They said make an appointment with your primary care right now. 10mg of Lisinopril daily did the trick.

So, in the Search for the cause, it was found that I have developed a 40% blockage in the artery to my left kidney. In three years it hasn't changed. I'm on potassium citrate for kidney stones, and low dose Aspirin. And of course I'm on hyddrocodone-acetaminophen here and there because of chronic kidney stones ( multiple episodes a year).

I try to eat healthy, but until this I usually work between 50 and 70 hours a week, 5 to 6 days a week, and sometimes eating out, fast food IS the only option. Even then, I still try to make the best choices, which is extremely hard.

The thing is, it seems like no matter what I do, nothing helps. This adds stress, because this can lead to me having to lose/leave me job.

ARman

quote:

Originally posted by goose5:
At a follow-up with my surgeon, they tested me at 160 over 100. That explains the sensation of wanting to crawl out of my skin head first. They said make an appointment with your primary care right now. 10mg of Lisinopril daily did the trick.

Like I said, I feel better in the last week than I have felt in a long time.

When I was at the ER, they couldn't believe that I didn't have a headache, which I haven't had in a least two weeks, I have had migraines for years, but lately nothing.

No chest pain, no dizziness, no nose bleeding ( which I have problems with since I broke my nose as a teenager), no ringing in the ear nothing. I feel great. My feeling of anxiety is a little higher, but I have an anxiety disorder caused by something unrelated that is taken care of without medication.


ARman

You may have developed what is called "white coat syndrome" lately. It's what happens when your bp is high in the dr.'s office but not other places. Lots of us have it and it's quite common according to all of my drs. They had me check mine every week for 6 weeks when my physical bp was high. I checked it at the gym weekly with the physical therapy techs there and it was around 125 over 80 or less every check. You may want to find some other place to check yours frequently too. The only places my bp is high is when it's checked at the various doctors' offices I used. My dr said those machines at pharmacies are pretty accurate if you want to give them a try. Hell, it can't hurt to try. BTW, if you are using Prep H or something like that it can also raise your bp.

quote:

Originally posted by sjtill:

Have you talked with your doctor about switching you from amlodipine to an ACE inhibitor like lisinopril, or an ARB, like losartan?

I had been taking Lisinopril for many years. Had a constant cough for all that time, and never made the connection until I read someplace (Can't recall where, maybe WebMD) that the cough was a fairly common side effect of Lisinopril. Sent my Primary Care Doc an email asking about it, he responded immediately, telling me to stop the Lisinopril, and he sent me an Rx for Losartan. The cough that I had had for many years disappeared within couple weeks.

I went hardcore keto, mostly carnivore, for 2 months starting mid April. No bread, rice, potatoes etc. I ate steaks, eggs, bacon, pork chops but few carbs. Dropped 20 lbs and blood glucose went from 170 to 120 bp went from 140/80 on 3 meds to 125/70 w no meds. I'm now eating clean but am eating some carbs. Sugar is the enemy and the food pyramid is big pharma bullshit.

Perhaps see a different Cardiologist. My wife had BP issues but her Cardiologist kept throwing increasingly higher dosages of her meds. Took her to 5he ER when she hit 219/100. We changed Cardiologist in a Heart Hospital, low and behold, her BP now runs aro7ns 125/60.

There are generally 2 categories of hypertension
Primary (also called idiopathic which means there is no identified cause)
And secondary - almost everyone has primary secondary is fairly rare, but significant blood flow disruption to a kidney is an excellent example. It may be worth seeing a renal specialist or urologist to see if any interventions on the renal artery stenosis are possible to reverse the hypertension.

Take sjtill's advice please.

I went to the Dr. last week and my BP was 138/100. The doctor took it 5 minutes later and it was 128/83. Why, because I had to park about 1/2 mile away due to no parking due to construction, was a few minutes late because of it, and after getting to the office all stressed out after walking and going up 3 flights of stairs they took me immediately, sat me down and too my BP.

Best to take your BP at home a couple times a day while relaxed/rested (I think 5 minutes is the standard) and sitting up straight, legs not crossed, and arm at heart level.

Hope you get it sorted out.

I am off meds for BP since I have been doing strength training 3 times a week and a couple days a week on cardio bike for 45 minutes. I have found that at 72 taking some l-citrulline and beet root juice powder twice a day has helped with lowering it by boosting my nitric oxide levels which also give me more stamina/faster recovery when working out. Of course one should check with their MDs before taking supplements. Some research shows taking garlic pills may help too.

You said they found that you have renal artery stenosis (RAS) at 40%. Generally, that's not severe enough to require renal angioplasty and stenting, and meds should do the job. Problem is, during all these years, you have not been treated with the first-line BP med for RAS, namely an ACE inhibitor or an ARB, as doc goodheart suggested above. Sure, the ACE-I has the common side effect of cough, but not all patients will have it, and until you're taking it, you will never know. Even if you develop the cough, ARB will oftentimes not have the same side effect. Got to give those a try. I'm really surprised they have not put you on these meds. And, if all else fail, renal angioplasty and stenting should be the last option.

Also, since the the majority of RAS is due to atherosclerotic disease, if you have hyperlipidemia, you should be on med for that, too.

quote:

Originally posted by captain127:
There are generally 2 categories of hypertension
Primary (also called idiopathic which means there is no identified cause)
And secondary - almost everyone has primary secondary is fairly rare, but significant blood flow disruption to a kidney is an excellent example. It may be worth seeing a renal specialist or urologist to see if any interventions on the renal artery stenosis are possible to reverse the hypertension.

Yeah, I'm seeing a urologist and vascular specialist, as a matter of fact, I just was there two weeks ago for an ultrasound. Still 40% blockage, and they won't do anything until it's 65%, even though I have explained to them that before the blockage I did have this problem, and that this WILL/DOES effect my livelihood.

Yet they don't seem interested in doing anything about this blockage.

ARman

I have a blood pressure cuff, and it's been checked with the doctors and is pretty spot on. I was taking it a few times a week until this now it's four times a day, on both left and right arms, the right are is always lower by a few points, and the lowest it's been since Thursday has been 175/80. Mostly 190/80 to 200/100.

As I said before, besides that I have been feeling better this last week that I have in a long time. No headaches, chest pain, dizziness, nothing.

ARman