Is my doc a quack? - High & Low Blood Pressure Message Board

pfk505 · 08-27-2004, 11:35 AM

The rest of my BP saga can be read in this thread:

http://healthboards.com/boards/showthread.php?t=169774

So about 5 weeks ago, my doctor put me on my first BP drug (chlorthalidone/25mg) against my better hopes, and was quite insistant that I start (this was after a 175/90 reading in the office). Others on the board here had suggested that because of my age (23) and lack of family history of hypertension, that I pressure my doctor to get me all sorts of tests done, of which he obliged me on 2 (fasting glucose , urinalysis (creat/acr)) . So out of those 2 tests, the blood sugar was fine, while the urine test showed a hair of protein in the urine (0.01 off normal level).

So in any case I went back the other day, took 2 readings, 152/70 and 140/70. Of course my heart was racing as usual, my pulse was up around 120. So my doctor leaves the room and comes back with his stethoscope again and starts listening to my heart.. He listens in about 5 places and then proclaims "I think I hear a heart murmur".. Nevermind that he didnt hear this heart murmur during my physical last month, when he spent even more time listening to it. After all this he says to himself that "maybe we'll get you on a beta blocker, propanolol". Now seriously.. He doesnt want me to increase my diuretic dose which is miniscule (25mg/d) but he wants to break out the beta blockers? Because of one high pulse? My pulse is normal at other times, I check it regularly. During excersize its perfect.. at rest its 60-90 bpm.

I just wanted to know what this sounds like to you folks.. I have been tempted since the very beginning with this doc to get rid of him.. I wait 30-45 minutes every visit past my appointment time.. He is a nice guy but im really starting to question his whole outlook..

Thanks once again, for everything.. you people are saints

-B

Random2 · 08-27-2004, 01:28 PM

It could be anxiety related. He should do a full CBC & check your thyroid as well before putting you on the meds.

I'm 33, but on Lotrel & Atenolol & I can tell you it s**ks. Try to work from 3:30 to 6 & see how you feel. You are supposed to avoid caffeine, but when my pulse gets in the 53-58 area on these meds & my b/p gets in the 106/62 range I feel out of it. I had to have a cup of coffee this afternoon just because the meds. knock me out in the afternoon when I take them in the morning. I have tried everything. Work out for a month & monitor your b/p on your own for that month away from the doc. Log your measurements. When the 1st# is high & the 2nd is normal, I believe that a lot of it has to do with anxiety. Do anything to avoid the meds. at any cost.

pfk505 · 08-28-2004, 01:42 PM

It is partially anxiety related but as I stated in my older thread there, I have suffered from anxiety and depression for at least 6 or 7 years now. My question to you all now is whether or not my doctor is doing the right thing by me. He did do a couple of the tests but insists the others are "too expensive to merit doing right now" (thank you, Canadian healthcare system). But in any case, it just seems to me his whole approach is skewed.

And also, I've been on chlorthalidone over a month now with zero side effects.. Im just not too keen on taking a beta-blocker, which on this board anyway have been notoriously bad for side effects. His whole reason for this was the high pulse.

zip2play · 08-29-2004, 05:26 AM

Gee, hope I can post without asterisks like I got all over the place yesterday!

pfk,

What your doctor is doing is VERY standard. The 25 mg chlorthalidone is NOT a particularly small dose- it's a POTENT diuretic (eat lots of potassium food).
This is considered good practice:

Quote:

Chlorthalidone is usually given at a dose of 25 mg daily; the usual initial dose of atenolol is 50 mg daily. Therefore, the initial dose should be one atenolol and chlorthalidone tablet 50 mg/25 mg given once a day. If an optimal response is not achieved, the dosage should be increased to one atenolol and chlorthalidone tablet 100 mg/25 mg given once a day.

So look for a gradual upping of your atenolol dosage (too much chlorthalidone can throw you for a LOOP- I know first hand; it's way too strong for me.)

If you were in the states you'd be started on Norvasc or Cozaar or something even MORE expensive and get poor results...with a $150 a month drug bill...Be thankful.

(I'll withhold judgement on whether your doctor is a web-footed aquatic bird!

)

pfk505 · 08-29-2004, 10:34 AM

I figured it was a small dose because I think I read on some page that it was given in doses of 25mg / 50mg / 100mg / 125mg but I guess I was wrong. I sure hate cutting the damn pills in half though.. Thanks for your input zip2play, Im not on the beta blocker yet so here's to hoping the BP goes down even more in the next few weeks before I go back to the doctor. He mentioned propanolol, so Im guessing a non-cardioselective beta blocker. Its a good thing I drop to part time work in a couple months I guess.