After 6 months of lifestyle changes and supplements, went to my doctor for follow up. He noted that 80% of my readings are "prehypertensive" with systolic in the 120s-130s, and wants to get below 120s consistently. He used to believe that 140 is the cutoff for meds, but apparently has changed his mind and now argues that prehypertension needs to be treated with meds if lifestyle isn't showing any effects. The reading of 128/80 with him today just clinched his opinion.

He wants to start me in a diuretic, probably diazide.

HOWEVER, he is giving me one last window of opportunity; 2 months to try biofeedback...he is referring me to a specialist in that. So three questions:

1. Does it make sense for him to treat me with meds with numbers like these?

2. Is there a prayer biofeedback will work?

3. How scared do I have to be about diazide?

Thanks all!

tamuprof45

Hi tamuprof,

You owe it to yourself to give the biofeedback a try. It's a useful and often a very successful technique which teaches people how to control involuntary activities, including their blood pressure. I've heard a lot of good things about it from people who've had success with this therapy. Before starting any blood pressure medication, you'll want to know you've exhausted all your options.

I am on two separate diuretics (not combined into one pill). One of them is hydrochlorothiazide, the other a potassium-sparing Spironolactone.
I'd suggest to watch your heart rate when you first start this drug. It can get pretty fast. I think you'll be started on a low dose. That should reduce the side-effects considerably. I don't think your blood pressure warrants medicating at this point. On the other hand, when researching some cardiological issues recently, I came across a mention that even a slightly elevated blood pressure can be a cardiological risk factor. People don't have to have a high blood pressure to be at risk for cardiovascular events.
The diuretics have long been a gold standard in treating hypertension. They are usually used in combination with an ACE inhibitor or an ARB. I am not too sure about pre-hypertension. I did not know that some doctors now treat it. It wasn't until I was prescribed the Hctz in early August to treat a side effect of another drug that I, to my surprise, achieved a good blood pressure control. Prior to my use of Hctz, my bp control was not good. I guess I am trying to say that it is a very effective drug.
Be aware that this combination of drugs may affect certain tests. It may cause you electrolyte imbalances, increase your blood urea nitrogen, result in muscle cramps (very frequent ones at that, where you've never had muscle cramps before). It may affect your creatinine and liver enzymes, and give your urine a bluish tint. For this reason, you should have your electrolytes and BUN tested often. Also, watch out for the GI side effects, which you might not notice at first and write them off as indigestion etc.
Try the biofeedback and get a second opinion about the need for antihypertensive medication.

flowergirl

I agree with FG. Get a 2nd opinion. While in theory your b/p maybe pre-hypertension, that fact must be weighed against the very real possibility of serious short term & long term side effects of any b/p drug you take.

Now is the time to try biofeedback cause after you are on drugs it might not work as well. I really think I could have made it work at least for part of my b/p program. But by the time I tried it I was on a huge dose of Lebatalol which interfered with the feedback. I had 5 babies using Lamaze so I know that a mind/body connection can have a positive influence .

Did you have a sleep study done? Even if you have only mild sleep apnea, the c-pap machine may reduce your systolic at least by 10 points (that's been my experience).

Have you checked your water supply for toxins which increase b/p. I went down the whole list of stuff that increase b/p & I think left no stone unturned. Fam

If you are going on a diuretic you must educate yourself before starting it. Get the package insert & go over it with a fine tooth comb. The details are very important & will keep you out of the ER. For me it is a easy drug to take but I've had a few slip ups with potassium when I was sick & didn' feel like eating. Like a diabetic you have to eat whether you feel like it or not when you are on a diuretic. Fam

Thanks for the replies all. I am very scared and confused because franky I didn't think prehypertension warrented meds as well. BUT my doctor's opinion was "Look you've had 6 months and your readings are pretty much the same." I am still bewildered...my readings are 120s-130s systolic, but he said emphatically "I want your systolic to be ALWAYS in the 120s!"

So I have this 2 month window to try biofeedback, but honestly what should I do??? I told him about the cuff anxiety...that my normal pulse of 60 always goes up to 100+ when I take my BP, but he seemed nonplussed by this.

I am really scared and at a corss-roads. I feel in my gut that my numbers are too low to be medicated, but I also am worried about the data about prehypertension.

tamuprof45

If you are going on a diuretic you must educate yourself before starting it. Get the package insert & go over it with a fine tooth comb. The details are very important & will keep you out of the ER. For me it is a easy drug to take but I've had a few slip ups with potassium when I was sick & didn' feel like eating. Like a diabetic you have to eat whether you feel like it or not when you are on a diuretic. Fam

I specifically asked for a potassium sparing one (when it comes to this). My diet is pretty high in potassium now so I hope things will be ok.

Did you have a sleep study done? Even if you have only mild sleep apnea, the c-pap machine may reduce your systolic at least by 10 points (that's been my experience).

Have you checked your water supply for toxins which increase b/p. I went down the whole list of stuff that increase b/p & I think left no stone unturned. Fam[/QUOTE]


I had a long talk with my doctor about sleep apnea and he rattled off the list of symptoms and said he was pretty sure I didn't have it. I have pretty deep dream-sleep, and no daytime sleepiness (heck I haven't touched caffeine in months and I can make it through the day!).

Our water is bad here, very soft and high in sodium, so I have studiously avoided drinking it for many years.

Our water is bad here, very soft and high in sodium, so I have studiously avoided drinking it for many years

I just wondered if you drink bottled water. You'll want to drink a lot of water and should get your 8 glasses (bottles) a day, as a part of a healthy lifestyle.
I've stopped drinking all other liquids and just drink water, a bit of coffee and some green or black tea. Drinking these basic beverages, instead of carbonated drinks and fruit juices also saves calories.

I just wondered if you drink bottled water. You'll want to drink a lot of water and should get your 8 glasses (bottles) a day, as a part of a healthy lifestyle.
I've stopped drinking all other liquids and just drink water, a bit of coffee and some green or black tea. Drinking these basic beverages, instead of carbonated drinks and fruit juices also saves calories.

Doesn't water raise BP though?

Doesn't water raise BP though?

Not on its own, only when combined with high salt intake. High sodium intake, regardless of the amount of liquids consumed, will result in fluid retension and thus increase blood pressure.

That's new info for me, although confusing. I thought you need MORE water if you consume salt to "flush it out." So if you overdo it on salt (restaurant meal) should you actually drink less water than usual?

I always eat low salt with what I prepare for myself...going to great lengths to find hyper-low soups, breads, tuna, etc. all less than 50 mg sodium a serving!!! BUT every few days I'll eat lunch out and even though I make it "healthy," like a small-size burrito with black beans, light chicken, LOTS of veggies (tomatoes, onions, avocado), and NO rice or cheese, I still know its loaded with salt. I usually mass consume water when I eat something like that. Maybe that's the wrong approach?

tamuprof45

Well today's BP was 121/69...hard to believe my doc wants to put me on meds!!!

That number at least gives me hope, since I felt anxious when I took it. I would dearly love to know what my actual resting BP is without this damn anxiety!!!

tamuprof45

The way our bodies regulate the fluid balance is very complex and several mechanisms are involved. I am not sure how to approach this issue to make the post brief. I'll try to address it tomorrow.

FG