Is there a way to lower both the systolic and distolic pressure independently? - High & Low Blood Pressure Message Board

strong_one · 11-09-2004, 05:54 PM

I was wondering if this can be done with different meds. My systolic seems to be doing much better in the 120-140ish range. My diastolic however ranges from the 90's - 100's. Does Lisinopril 20mg bring down just the systolic? My doctor seemed to be fine with 128/98 at my last visit. I wasn't too thrilled about the 98 diastolic. And why wouldn't she be quite concerned about that number?

I don't understand docs. Some are so proactive at trying to get your numbers below 120-75 and there are some that are happy with it in the 130/90 range.

JJ · 11-09-2004, 07:10 PM

I'm very surprised your dr. was happy with a dystolic of 98. Your right, the systolic is fine, but the bottom number is a tad high. To answer your question, I don't believe there is any med. that will lower one without the other, as usually meds. reduce both. Next visit I would ask her about it.

Your right, most dr.s are getting very aggressive about keeping the numbers very low, sometimes I think a lil too low. Just my opinion, but I still see nothing wrong with a BP reading of 130/80. That was mine basically for 58 yrs, and all my drs. thought it was fine. Still think alot of these number games are to put more and more folks on meds. JMHO

Good luck, and hope the bottom number comes down for ya...

Catalina_FLA · 11-10-2004, 06:39 AM

I had a similar situation. I was on 10 mg of enalapril, and even though the diastolic was never below 90+ at the dr office, he didn't seem concerned. He brought another doctor into his practice, and I ended up seeing her one day. She took one look at the history, and said that 90+ was just too high, and doubled my dose to 20 mg per day. I have been on it for a few months. Last time I saw the dr my BP was 114/72, the lowest since I developed HBP. I still get readings during the day with the diastolic in the high 80s, but the systolic stays low and my diastolic rarely creeps into the 90s now. I've been on a low sodium diet most of my life, since HBP runs in the family, usually coming on us in our late 30s, so my parents started the good habits early. (made no difference as you can tell). I was never sodium sensitive. We tried a formal low sodium diet before the meds. My DH's BP (which is not really high) went way down, mine didn't budge. I have noticed since I am on the enalapril though that I seem to be sodium sensitive now. I think I'll try really monitoring my intake again and see if I can keep the diastolic lower.

Random2 · 11-10-2004, 07:04 AM

Your right, most dr.s are getting very aggressive about keeping the numbers very low, sometimes I think a lil too low

I agree. In my last visit, my b/p ws 120/78 & he wouldn't wean me off of Atenolol & Lotrel. He said it wasn't low enough. Well yesterday I had a nice reading of 106/64 away from the doc. Is that low enough??? I'm 34, so I am young as well, thin, active & have a low sodium diet with no alcohol. *** do I have HBP? I feel better when my B/P is in the 130/80 range then when it is in the 108-116/64 range.

Palamedes · 11-10-2004, 08:14 AM

Quote:

Originally Posted by Catalina_FLA

I have noticed since I am on the enalapril though that I seem to be sodium sensitive now.

Yep, I think this is true for pretty much anyone on an ACE inhibitor or ARB. I noticed the same thing on Benicar. I normally eat relatively low sodium (not totally millitant about it, though). Before drugs, I tried cutting out sodium to lower my BP to avoid drugs. Nothing, nada, zip change in BP. When I started Benicar, I was still eating low-sodium. Wow, Benicar is working awesome. I guess I can eat tons of sodium now. WRONG! If I eat out at certain places my BP will almost return to where it was before the meds for about 2-3 days. Then, I started researching about this. And, it all makes sense now.

I think it all comes down to volume. When we lower our sodium intake, we have a feedback mechanism that causes our blood vessels to constrict to compensate. So, it is impossible for most of us to lower our BP with a low sodium diet. However, the ACE/ARB blocks this feedback and makes us "salt-sensitive" so we can lower our BP by reducing sodium.

Again, I still find the 1978 experiment on dogs to be the most interesting article on this subject. Here is the URL: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=372606 . It's interesting for several reasons. First, it was done in 1978. We knew about this before these drugs were even available. Second, we keep reading about all this worthless salt nonsesense all over the place with no mention of renin-angiotensin feedback system that comes into play. I remember reading in some other studies how sodium restriction seemed to only make a difference in the hypertensive population. Well, duh, many of those hypertensive people are taking ACEI and ARBs.

Oh well, enough about this. I've stated this before in many threads.

Pal