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Old 12-04-2004, 09:22 AM   #1
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?? about new diagnosis HBP and put on Hydrochlorothiazide

Hi and thank you for your comments...I am a 36 yof with thyroid disease and fibromyalgia diagnosed in the past year and a half.... and I have a VERY STRONG family history of heart disease.

For the past few months my BP has been averaging 150/82 but has been higher on occassion. My doc told me there are new guidelines now used and the top number is actually considered high. Is this true, and what study is he referring to? (Weblink appreciated).

He began me on 25 mg Hydrochlorothiazide each morning. Almost immediately my numbers are showing improvement....127/90, 114/80, 132/85 (today). Is it possible to have results so quickly? I haven't seen the top number that low in almost a year....although the bottom number is still higher than what it was previously. (1 yr ago averaged 120/60).

Are there any negatives to taking a diurectic? Since this seems to be working for me, then will I have to stay on in forever or is it something that I can be eventually taken off?

Thanks for your help. I've gone from a completely healthy, fit woman to a heavy, fatiqued, ill woman in a very short time. It's been frustrating for me and my poor family who care so much but can do nothing to make it better.

In addition to these answers, any other observations that I should know would be appreciated. Thanks so much!

 
Old 12-04-2004, 10:04 AM   #2
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

Hi happy, I too started out five yrs ago very healthy(other than controlled diabetes) and today i am very ill as well. I was dxd with grave disease back in 2000 and had RAI, so now im hypo.

I also have hbp and was prescribed lisinopril, hctz, verapamil and toprol xl. I receintly discovered that my high cholesterol was due to taking hctz. Hctz can cause glucose levels & cholesterol levels to rise. It did controll my bp but added other diseases.
I recently stopped taking hctz (on my own) and my cholesterol dropped about 50 points and my glucose dropped from 10.9 to 7.5.

My cardio prescribed lasix but im afraid to take it bcuz some on this board same it does the same thing. I did a search and saw it can raise cholesterol but i didn't see anything about glucose.

If you were prescribed 25mg (iwas) maybe you could half the dose, but check with your dr first. Good luck.

 
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Old 12-04-2004, 11:23 AM   #3
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

I almost what to ask the question if some of us would be heatlhier living with HBP and dieting and exercising and never touching a med????????????

 
Old 12-04-2004, 12:11 PM   #4
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

Quote:
Originally Posted by dback
I almost what to ask the question if some of us would be heatlhier living with HBP and dieting and exercising and never touching a med????????????


Oh that's scary for me to think about not medicating HBP. I've already outlived my grandpa by two years (he died of a heart attack one day after his 34th birthday) and my mom and her 5 siblings have all had heart-related issues early in life beginning with HBP in their 20's (for some). In addition, my mom's mom has survived four major heart attacks and several lesser ones. I don't think I could just not treat this. I have two young children at home to think of....I also have to worry about kidney disease as my mom is in chronic renal failure now and the biopsy she had done years ago indicated that her condition is hereditary.

jtu.....Thanks for your info...it's interesting to know about the cholesterol problem associated with taking this prescription. I'll make my doc check the bloodwork often. As of now my levels are all normal (total cholesterol, HDL, LDL, Triglycerides, and glucose) and so I'll know for sure if the med starts changing that. Thanks for that info ....doc and pharmacist had overlooked telling me that potential problem.

 
Old 12-04-2004, 12:42 PM   #5
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

Happy-

The new guidelines come from the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC) who recently updated their OWN guidelines and criteria for the prevention and treatment of hypertension.
JNC reports have been published at regular intervals for more than 30 years and this latest report is called JNC 7.


The new guidelines for diagnosing high blood pressure are:

Normal- Below 120/80
Pre-hypertension- 120-139/80/89 (Shiny new category!)
Stage 1 hypertension- 140-159/90-99
Stage 2 hypertension- 160 or higher/ 100 or higher

They've found that found the risk of developing cardiovascular disease doubles every time the diastolic blood pressure (the bottom#) increases by 10 mmHg and/or the systolic blood pressure (top#) increases by 20 mmHg. They postulate that this increased risk starts at 115/75 mmHg.


The guidelines were prepared by a special committee of the NHBPEP, (National High Blood Pressure Education Program) which represents 46 professional, voluntary, and Federal organizations, and reviewed by 33 national hypertension experts and policy leaders. The NHBPEP issues new guidelines when warranted by scientific advances.

The last guidelines were issued in November 1997. (It was simply known as JNC-6).

Those were the guidelines doctors were using until now.

The main reason for updating is the emergence of important new data gleaned from a number of major clinical trials completed within recent years. The most visible of the new studies was the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).
But there were also a number of other key trials including the secondAustralian National Blood Pressure Study (ANBP2), the Losartan Intervention For Endpoint Reduction (LIFE) study, and others... and they all had a major influence.

It was decided that all this new information accumulated since '97 demanded a 7th report.


Link to the JNC-7 Report:
http://www.nhlbi.nih.gov/guidelines/hypertension/index.htm

zuzu xx

 
Old 12-05-2004, 08:34 AM   #6
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

zuzu8- thanks for the info I requested about the updated guidelines. This is exactly what I was looking for.... . Have a great day! Happy

 
Old 12-05-2004, 02:58 PM   #7
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

Zuzu--Guidlines
Stupid question....If your bp is 139/89-you receive no meds. If you are 145/95 they give you meds to get to 120/80, but are not satisfied with 139/89. This makes no sense to me.

 
Old 12-06-2004, 05:56 AM   #8
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

There's some evidence that an unmedicated 139/89 is FAR healthier than a MEDICATED 139/89.
If this is indeed true, the unmistakable indication is that hypertension is an EFFECT of a disease process rather than the root cause and the damage will continue in spite of the medication.
Don't ask me to prove it, but I'm getting whiffs of it...and I more than half believe it!

Just food for thought (and further research.)

 
Old 12-06-2004, 11:13 AM   #9
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

Dback-

Not such a stupid question! You are asking the same thing that even a lot of doctors are asking...

It's a bit of a conundrum. When to treat? How to treat? How aggressive should we be? What if lifestyle changes DON'T get you out of that pre-hypertensive range?


As far as I can make out, this whole new prehypertension category is based on the premise that while it has always been known that increased BP puts us at risk for future cardiovascular events, NOW they are simply saying that the risk seems to begin at lower levels.

You're right, what if the meds "only" bring your BP down to 139/89?

Seems to me that the pre-hypertension designation serves only as an "indicator" that one may be more at risk of progressing later down the pike to actual hypertensive disease than previously thought.

LENIN sounds like he's onto something....risk is..well...risk...not actual disease and depending on the individual person and any other risk factors that are present or ABSENT, in many instances treatment medically may not be HEALTHY. ( god forbid we actually get healthy!! ).

I'm not saying we should all be complacent and ignore the concept of "risk", and obviously it would be ideal to get that BP down to "optimal" range... but regarding treatment for "pre-hypertension" it may often behoove physicians to leave well enough alone.

You're right, once we start "treatment" the docs don't seem to be satisfied with 139/89..Yet the JNC Committee absolutely recommends ONLY lifestyle modification at these #s!!!!

zuzu xxx

Last edited by zuzu8; 12-06-2004 at 11:14 AM.

 
Old 12-06-2004, 12:43 PM   #10
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

If I could average 134/74 without meds. like I did for years, even up to 140/78, I would wean off of my meds. tomorrow. I'm going to try this with a specialist. I haven't felt like myself in 2 years on B/P meds. Although I have reading that average around 116/66 is it really worth it? The "older" people in their 90's look at me like I am crazy to be taking my B/P. I told him that the doc. put me on it & they say that he is crazy "You look like a model". Your B/P is 116/65, why are you on meds..... My answer... I'm trying to get off of the meds.... trust me.

 
Old 12-06-2004, 04:11 PM   #11
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

Im with you Lillian. Meds ruined me and Im not a wimp, I was pretty tough and in great shape. My experiment would not to be to wean all of the way off of meds(with your numbers you could give it a shot), but to take minimal meds and get my pressure to say 138/88 instead of 120/78 124/81 and maybe feel a little better. Lillian do you trust your monitor? BTW ZuZU that weaning off of Inderal is on hold...

 
Old 12-06-2004, 07:53 PM   #12
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

Dback,

Is your Inderal wean on hold because you feel better? Have decided to live with the side effects? Or need more time to gear yourself up psychologically to try it?

After 4 years I sure would understand if it's the latter!

Keep us posted,

zuzu xx

 
Old 12-07-2004, 05:57 AM   #13
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

DBack,

I won't buy a monitor. Not, because of the $'s, but it becomes an obsession to take B/P. I have measurements averaging around 10-15 a month for 21 months. It always stays within the same range of 110-125 over 62-74. I take it at CVS Phamarcy, Eckerds, Publix, Winn Dixie, Albertons. Basically I take it everywhere, so they can't all be wrong.

Every time that I take it, a 90 year old person comes up to me afterwards & asked me why I am taking my B/P. I tell them that my doc. has me on these meds. & I want "off". I am monitoring to support my case. He will say that you look like a teenager, you're in good shape. Your #'s are really good. you shouldn't be on that stuff. White-coat syndrome prevails.

 
Old 12-07-2004, 06:21 AM   #14
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

If I could average 139/89, I will go off my meds. I am VERY close but the only way to find out is to go sereal weeks annually or semiannually to see what steady-state is.
I have to be patient to let the trials run long enough because there is ALWAYS a rebound when I stop and it lasts around a week or slightly more. I presume the body has feedback loops for all processes that work to circumvent any meds we take.

Last edited by Lenin; 12-07-2004 at 07:10 AM.

 
Old 12-07-2004, 03:35 PM   #15
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Re: ?? about new diagnosis HBP and put on Hydrochlorothiazide

No, ZuZu Im just waiting until I see this BP guy this month to see what his oinion is.

 
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