A little background first:
I was dx with hyperthyroidism in 2002. My BP was fine & my body weight was 160. I had Radio Iodine done as treatment in Novembe of 2002 & my weight started to creep on as my body shifted to being hypothyroid. Around 200 pounds, my doctor pointed out that my BP was rising (around 130/82 to 135/87). Unfortunately, in July of 2003 I began having panic attacks. With my first one, I was at work and thought I was having a heart attack (I'm 28 btw). At the ER, I presented with a BP of 162/104! I thought I was a goner Anyhow -- a lot of tests were done & everything checked out ok. I have since gotten rid of my panic attacks & anxiety (this became easy once I got my thyroid under conrol). ANYHOW - to the meat of my problem. I've never had a "close to normal" reading since that day. I'm terrified of having my BP taken because I'm afraid it's going to be 162/104 again. My weight got up to 244 & my BP would range from 139/90 - 148/100 (from August of 2003 until today). I talked my doctor into letting me try to lose weight before we started meds. Well, I've lost down to 205 (and will contine to lose!!) but had my BP taken today and it was 145/98. So, he said we need to treat it now b/c it's been too high for too long. He has prescribed me 50mg of Tenoretic along with Potassium. After reading through these boards I'm becoming very afraid to start. I'm afraid the side-effects will cause my anxiety to return as I hate taking new meds. My doctor said he fully expects me to get off the BP meds as I continue to lose weight and begin exercising. I just really need some insight here about my meds and what to expect and if the people on this board feel it's a prudent move at this point to start meds. Any help would be appreciated!
My opinion - keep trying to lose weight & exercising
I am running about what you are now, unmedicated & I am trying everything I can to bring it down naturally, as I have been thru a half dozen meds & they have only made it worse plus there are nasty side effects (dizzyness, weight gain, muscle pain, etc)
162/104 wont kill you if it is when you are under occasional stress, I am actually reading that right now because i threw my back out again & it hurts like heck, but i cant take my darvocet until I get home (its worse than alcohol for driving)
normaly i'm, 145 - 150 / 95-100, & I'm not going back on meds unless it really shoots up
First of all, be aware that the people who come to these boards may not be representative of all people taking the medications. Seems likely to me that those with problems are more likely to come and talk about it. As someone else here said not too long ago, those without side effects or other problems are probably home in front of the TV set. So try to put what you read in perspective.
I know that there are people on this board who have had severe side effects with BP meds. By contrast, I was put on one, had no side effects at all, got effective control after the dosage was increased and now, after five years, it looks like I might be able to go them entirely. (I've been off them about two weeks and seem to be doing fine.) My recommendation is to read up thoroughly on the specific med you've been prescribed, so you know what to look for in possible side effects. If the first one presents problems or doesn't control the pressure, let the doctor know and request a change of dosage or med. Many people have to go through several, just doing a trial and error to find the right one. Some have to take more than one. People react differently to different meds, so that is just to be expected.
Another thing - are you monitoring your BP at home?
If not I would recommend that for at least a couple of months before taking meds, at least every couple hours (when its convenient), if I'm on a business trip for 6 hrs i dont stop to take it
I use the Omron HEM-711 from walmart, I had to order the larger cuff size as my bicep is over 13", from your weight I think you might have to also, Omron also makes the relion brand for walmart, I prefer the arm cuff style, my mother uses the wrist cuff & they arent very accurate on me, I take at least 2 readings a minute apart & sometimes more, occasionally one reading is wacky, but I average the others
I keep track of what i am doing, what I have eaten, how I am feeling, etc
I dont worry about taking the readings resting, unless I already was, I want to see what its doing under normal activity as well as resting (this was one thing I agreed with my doc on)
Even when doing very strenuous excercise or heavy lifting i dont go over low 170's/low 110's, so i'm not real worried
A little background first:
I was dx with hyperthyroidism in 2002. My BP was fine & my body weight was 160. I had Radio Iodine done as treatment in Novembe of 2002 & my weight started to creep on as my body shifted to being hypothyroid. Around 200 pounds, my doctor pointed out that my BP was rising (around 130/82 to 135/87). Unfortunately, in July of 2003 I began having panic attacks. With my first one, I was at work and thought I was having a heart attack (I'm 28 btw). At the ER, I presented with a BP of 162/104! I thought I was a goner Anyhow -- a lot of tests were done & everything checked out ok. I have since gotten rid of my panic attacks & anxiety (this became easy once I got my thyroid under conrol). ANYHOW - to the meat of my problem. I've never had a "close to normal" reading since that day. I'm terrified of having my BP taken because I'm afraid it's going to be 162/104 again. My weight got up to 244 & my BP would range from 139/90 - 148/100 (from August of 2003 until today). I talked my doctor into letting me try to lose weight before we started meds. Well, I've lost down to 205 (and will contine to lose!!) but had my BP taken today and it was 145/98. So, he said we need to treat it now b/c it's been too high for too long. He has prescribed me 50mg of Tenoretic along with Potassium.
Let's see... Tenoretic = Atenolol + Clorthadone... Yuck!!! Atenolol and a diuretic for starters. And, you need the potassium because the diuretic will deplete your potassium. This is a stupid script for starting on. A combo drug for a 145/98? Is this doctor nuts?
After reading through these boards I'm becoming very afraid to start. I'm afraid the side-effects will cause my anxiety to return as I hate taking new meds. My doctor said he fully expects me to get off the BP meds as I continue to lose weight and begin exercising. I just really need some insight here about my meds and what to expect and if the people on this board feel it's a prudent move at this point to start meds. Any help would be appreciated!
I don't see how you will lose weight on that cocktail. And, getting off atenolol won't be easy.
I'd first like echo the advise of others... Check you BP at home. My preference for a BP monitor is the HEM-780REL model from Walmart. The 711 is a little less expensive. But, I think the the extra features of the 780 are worth it. Plus, the included cuff on the 780 will accomodate a large arm. Either model will work well, though.
Secondly, ask your doctor for something else. That is about the WORST combination I can imagine for a 28 year old. I'd strongly recommend that the doctor start you off on ONE drug. My preference would be an ACE Inhibitor or ARB. And, you won't need no stinkin' potassium supplement with that either. A diuretic by itself would be reasonable alternative. Atenolol should only be used as a last resort if you have a very high pulse rate.
Oh yeah, I almost forgot... Tenoretic (like most combos) is not even indicated for initial treatment. From the label:
INDICATIONS AND USAGE
TENORETIC is indicated in the treatment of hypertension. This fixed dose combination drug is not indicated for initial therapy of hypertension. If the fixed dose combination represents the dose appropriate to the individual patientís needs, it may be more convenient than the separate components.
Please note, he is prescribing this med to you "off-label".
I appreciate all of your input. My husband and I have been discussing this all night long and referring to your informative posts. I did not realize this combo was not a normal first treatment. I wonder why he would do that? I don't think I'm going to stick with him to find out. This doctor has been great to me throughout my panic attacks and anxiety but has been sub-par when dealing with my thyroid. I'm very well researched when it comes to my thyroid and he doesn't really appreciate that - in fact we disagree wholeheartedly about my treatment. I'm afraid the blood-pressure issue will be the same old song and dance with him. I HATE changing doctors because it takes so long to develop a relationship, but I think that's what I have to do. I plan on changing my PCP tomorrow and scheduling the earliest possible appointment with a new doctor to address my blood pressure problems as my anxiety is probably as high as my blood pressure I do feel that being hypothyroid and having a history of anxiety and panic attacks do at least play a part in my hypertension - I definately feel my BP will be elevated no matter what, but maybe not to the degree it is were I not hypo w/ anxiety. In the meantime, I plan on starting off with a 30 minute trounce on the treadmill each morning. Wish me luck, THANK YOU ALL again and I'm sure I'll be around more often.
Zekat, I wish you all the luck in the world with your BP issue. Change doctors if you are not comfortable with him, but do not dismiss so quickly what he has said, "your BP has been too high for too long." You prove what I have said many times on this board. That is the fact that some posts actually frighten some people who should be on meds and are not. ("after reading through these posts, I am becoming very afraid to start"). There are no doctors here. I am a stroke surviver and require four meds to keep my BP at a good level. I do experience side effects, but after experimenting with many drugs, I have no alternative but to stick with the meds that work. Perhaps you can bring your BP down with life changes, but in the meantime you may need some help with medication. Give it more thought and best of luck to you. Remember, all people are different and react differently to medications. One person's experience is not necessarily the rule.
What kind of BP numbers were you getting before your unfortunate stroke. Do you have any idea of the levels?
Were you on any BP meds before the vascular accident?
Was your stroke hemorrhagic or occlusive?
(If any of those questions brings you to thoughts you'd prefer forgetting, just ignore them and I'll understand. I know a stroke is everyone's worst nightmare; it sure is mine!)
Atenolol should only be used as a last resort if you have a very high pulse rate.
Then why am I on 100 MGS of Atenolol when I am on 5/20 of Lotrel as well. I was on Toprol 100 MGS before & my 2nd doc. switched me to the Atenolol (because she said that it has much less side-effects.... yeah riiiiiight). My pulse on Atenolol is 52-61. I have had 2 perfect EKGS, perfect blood tests, thyroid check, a perfect chest xray. I don't get it. I was having a panic attack when my 1st doc. 2 years ago put me on Altace & Toprol. Altace was the worst & my B/P increased on it, so he switched it to Lotrel. 2 years later & 2 doctors later I am still on Lotrel 5/20 & Atenolol 100 MGS. I feel like junk on most days, so I am going to a specialist. My stomach feels like junk in the mornings many days, I feel lethargic, spacey, out of it, depressed, fearful, stomach upset, my body temperature has dropped 1 1/2 points on average.... I am averaging 115/66 still. If I drink even 2 beers I feel like junk the next day. This s**ks. I am only 34 & have never had this before the meds.
Thank you for your response. I do agree that my BP has been high for too long and needs to be medicated. I plan on getting into another doctor this week for their opinion on the meds. There are two other reasons I"m a little "iffy" on the script I was given: 1) My husband and I are trying to get pregnant and the warning on the label said it has been shown to cause harm to the fetus. I could be pregnant now and not know it and I did let my doctor know this (that we have been trying to get pg) and 2) I have psoriasis & I've read some litarature that says it could make this condition worse. When I got the script for the BP med from my doctor yesterday he also gave me a script for the outbreak of psoriasis on my scalp. I just think all of this has gotten me to where I'm questioning my doctor and really just want someone else to take a look at me. I'm tired of being herded in and hearded out without being Heard!
Please wish me luck on finding a doctor that makes me feel comfortable with the meds he is treating me with. I'm doing some research today and would like to have an appointment before the week is out.
I, too, wonder how much of my anxiety and panic problems contribute to my elevated BP. I am not naive enough to think my BP would be 120/80 if I didn't freak out about having my BP taken as I am overweight, but I wonder if my #'s would be closer to 135/90 or something. If I could just find a way to take my blood pressure at home without the reading invoking a panic attack OR if I could just get ONE decent reading I woudl be soooo happy.
1) My husband and I are trying to get pregnant and the warning on the label said it has been shown to cause harm to the fetus. I could be pregnant now and not know it and I did let my doctor know this (that we have been trying to get pg) and
NEW INFORMATION....I have now concluded that your doctor is a total complete idiot. I assume he performed a pregnancy test BEFORE he wrote that aweful script? Atenolol is a pregancy category D drug. Therefore, it should not be used. Also, I told you earlier that my first choice would be an ACE or ARB - throw that advice out the window. These are pregnancy catagory D drugs (i.e., last resort) also. Factoring in potential pregnancy... A diuretic now becomes the number one choice. However, if you have high BP during pregnancy, this should not be treated unless it gets too out of hand.
Thank you again for your advice, Pal. My doc did not do a pregnancy test. I did ask him if we should hold off on trying to get pregnant and he said no, but that the meds would have to be adjusted if I did become pregnant.
On the up side, I just changed my PCP and have an appointment w/ a new doc in two days. Hopefully I'll get better advise and a med I feel more comfortable taking.
I just want to say hi and welcome and maybe put out my thoughts on this,
First I do agree with BHarkins on the issue of preventing any complications of HBP but I really do believe there are better meds out there than the ones prescribed you.
I have been on Atenolol for a very long time and for just BP control I wouldn't advise anyone to take it. It doesn't lower BP all that well and I'm sure you have already read about all the nasty side effects. Most docs like to start with one med and add to that as needed. If you get on it and stay on it then it becomes almost impossible to get off and still maintain a regular pulse.
As for the panic attacks, I too have to deal with that. There's no doubt that when you feel anxious your BP raises (mine goes through the roof!) But I disagree that treating the anxiety will handle the BP. I feel that the opposite is true. If you treat the BP THAT will usually handle the anxiety.
If you are an anxious person like myself, then your BP will rise in those situations. When I am not anxious like the majority of the day, my BP is good. With anxiety meds., my B/P dropped like 20 points on the systolic & 11 on the diastolic. B/P meds. like Altace & Toprol did nothing for the anxiety & actually raised my B/P.
Hi Cass and thank you for your response. I have not read about the nasty side-effects of the med I was prescribed, but the warning signs started flashing from the moment my doctor gave me the script with little explanation about what to expect. I am hoping the new doc I am going to meet with on Thursday will take a more cautious route in the script given to me (and now I am armed with a little bit of knowledge).
You are probably right that my anxiety will be better once I get my BP under control. There is no doubt my BP is elevated, but (and maybe am a bit naive), I would feel much more confident in the BP readings I'm getting if I didn't freak out everytime a cuff came near me. It's so bad that I'm afraid to get a home monitor b/c I'm scared that if I see a high reading I'll have a panic attack. I do think I will get one anyway, be armed w/ some xanax and just grin and bear it. I've got to get over this in order to feel confident about my high numbers. On a side note, once I am medicated, I will probably feel better about having my BP taken also because the numbers SHOULD be lower. I'm just a mess
You are so correct,
Even when I feel like my #s are gonna be good 9 times out of 10 they are.
Anxiety and HBP are a vicious cycle! I never had a panic attack untill I was diagnosed. Then I started to fear heart attacks and my active imagination took over. I was only 32 at the time. I used to have one every time my pressure went up but I have had some therapy and learned how to avoid them.
Hope the new Doc is more understanding. As my great doc says "I'll make some suggestions and you make a dicision."