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Old 09-03-2007, 02:52 AM   #1
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High Systolic, Low Diastolic, Why?

Hi all,

For the past six months I have been taking 5mg Amlor (CCB) and 50/12.5mg losartan/HCTZ to control my essential hypertension. The medication seems to have worked great on my diastolic pressure, but not so on the systolic. The systolic reading is typically between 125 and 145, and the diastolic between 55 and 70 (very rarely above 70). The other day I recorded 138/50. I should add that this is the average of a total of 4 readings (2 on each arm). I am confused as to why my diastolic is so low relative to my systolic. My girlfriend, who does not suffer from HBP, regularly reads 100-50 and to me, 100 seems a perfectly normal systolic for a diastolic of 50. I have asked my doctor if perhaps the medication is only working on the diastolic pressure (if this is possible?) and, if so, why that should be. He tells me just to concentrate on the two numbers in isolation, ie if the SYS is under 140 and DIA under 80 then all is fine. I am 28 years old and of normal weight.

I wonder if the difference between the SYS and DIA may be contributing to my frequent lightheadedness, dizziness and lethargy. Has anybody else experienced anything similar?

Thank you!

 
Old 09-03-2007, 03:06 AM   #2
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Re: High Systolic, Low Diastolic, Why?

Hi Hux,

My diastolic is always in the 50's. This am it is 130/52. I'm on a heavy dose of Lebetalol (apha/beta blocker) & HCTZ. I've been on several meds. It seems they all decrease the diastolic more than the systolic with the exception of Clonidine & Norvasc which have too many side effects. Hctz decreased my systolic some.

I don't get dizzy etc. unless my b/p decreases suddenly.
I think your lightheadness needs to be investigated. Fam

 
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Old 09-03-2007, 07:00 AM   #3
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Re: High Systolic, Low Diastolic, Why?

You may very well have anxiety issues, which tend to affect the systolic more than diastolic. From what I have read, drug treatment often lowers the diastolic drastically, but doesn't entirely control the systolic, which fluctuates widely due to anxiety. I am not on any meds, but my diastolic is between 63-72 typically, while the systolic swings from 112-145 depending on God knows what.

acp

 
Old 09-03-2007, 08:09 AM   #4
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Re: High Systolic, Low Diastolic, Why?

Hux,

I have been getting perfect blood pressure readings, perhaps 114/70, consistently, for about a week. These are highly abnormal for me, as my usual ones are in the 130-150 and 76-95mmHg range.
Unfortunately, they were accompanied by symptoms similar to yours, dizzy spells, nausea etc. I concluded that having a perfect blood pressure was making me sick.
I had to see a doctor yesterday for a related issue and asked her about this. She told me it was normal. Whenever there's a big reduction in blood pressure, your body tries to compensate and adjust. Regardless of the readings, these sudden or substantial changes result in dizziness and lightheadedness. This is how our bodies react to sudden drops. She did not say how long this was going to last, but it will clear up eventually.

I would look towards your medication as a very lilkely cause of your symptoms. Dizziness and lightheadedness are very common side-effects. You should read the drug information sheets that came with your meds, or look up side-effects on the internet. I'll bet dizziness will be mentioned on at least one of them. Why was a calcium channel blocker chosen as a part of your therapy? They don't come without side effects, either. Do you have another medical condition?

flowergirl

 
Old 09-03-2007, 08:25 AM   #5
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Re: High Systolic, Low Diastolic, Why?

I have to agree completely with the previous post. I had low BP until my early 40s and had dizziness and lightheadedness all the time, especially when standing up, weight-lifting, etc. On days when my BP is lower than normal, I always feel a tad lightheaded. So consider such symptoms a good sign!

acp

 
Old 09-03-2007, 12:22 PM   #6
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Re: High Systolic, Low Diastolic, Why?

Hux,

Six months is too long for your symptoms to last. I would have the Dr. check your blood count (hemoglobin & hematocrit). I was only on Cozaar for 13 days when I had a reaction. One of the symptoms was extreme fatigue-my bl. count had dropped suddenly. It took two yrs to get it back up partly because I couldn't take iron tablets. Caution: don't take iron pills without checking with your Dr. -too much can put you at risk for heart problems.

Good thing I insisted that this was not normal or I would have been dismissed . When I told her that this tireness felt like the early pregnancy fatigue she immediately got out her lab slip & started checking away. I agree there is an adjustment period that the body goes through when the b/p is lowered by meds. That's why it is best to slowly introduce meds when possible.

When I started Lebetalol (alpha/beta blocker), my Dr. wanted to start with a heavy dose. I reminded her the the package directions had a definate plan for taking the drug which I wanted to follow. Since this is a heavy duty drug, it could be dangerous to suddenly start with a heavy dose. Also, the drug dose is depended on the consistent amount of food eaten. This is called bioavailibility. So if you eat small meal one day & a larger meal the next day, you will most likely get more of the drug used with the larger meal.
The rest of the drug just goes down the toilet. Fam

 
Old 09-06-2007, 07:23 PM   #7
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Re: High Systolic, Low Diastolic, Why?

Thanks all for the replies.

It's very interesting (and reassuring) to hear that it is usual for medication to work more on the diastolic. My doctor never mentioned this when I questioned him about it.

Fam, I will mention the bloodcount to my doctor next time I see him, although it was checked in January shortly after I started the medication and it was fine. Perhaps this wasn't long enough for them to have taken effect?

Flowergirl, I have no idea why I was put on CCBs. Is it not normal to be prescribed them for essential hypertension? I believe they are also used for people with heart conditions, which I don't have. In your experience, what is the frontline medication for HBP, if not CCBs?

ACP, the oly time I get anxious is when I get a get a high BP reading or unexplained symptoms. Vicious circle!

Thanks again,
Hux

 
Old 09-06-2007, 10:23 PM   #8
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Re: High Systolic, Low Diastolic, Why?

Hux,

Quote:
Flowergirl, I have no idea why I was put on CCBs. Is it not normal to be prescribed them for essential hypertension? I believe they are also used for people with heart conditions, which I don't have. In your experience, what is the frontline medication for HBP, if not CCBs?
you can't go by me as my hypertension is resistant, unpredictable and plain crazy at times. I've been on all of the meds and just very recently had to discontinue the CCB again, for reasons I won't go into. It looks as if I might have to keep taking it though as I am having problems weaning off of it (again). Just make sure you don't go on a higher dose. That's when a lot of people run into problems.

The frontline meds for an uncomplicated hypertension with no or very low cardiovascular risk factors are usually the thiazide diuretics in combination with either an ACE Inhibitor or an ARB. Exactly what you are on. So you are fine there. I am glad to hear the CCB is working for you. You are lucky you've found a combination that works for you.

When deciding which drugs to prescribe, physicians consider many factors. These include previous experiences with drugs, both favorable or unfavorable; effects of the drugs on cardiovascular risk factors in relation to cardiovascular profile of the patient, presence of other diseases, presence of disorders which would limit the use of specific drug classses, possible interactions with other drugs the patient may be on, side effects and cost. One can only hope that most doctors spend a little bit of time going over the patients' situation before writing out that rx.

I hope you'll find a reason for the dizzinness - you are too young to have to put up with it. Change meds if you have to. I think you should be fine with a higher diastolic - 50 is too low in my opinion. Talk to your doctor about a dosage adjustment. Surely, he can figure something out to take care of that dizzinness. The blood test Fam suggested wouldn't hurt.

flowergirl

 
Old 09-07-2007, 03:27 AM   #9
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Re: High Systolic, Low Diastolic, Why?

Hi Hux,

Losartan is Cozaar-the drug that caused me to develop an anemia. When I first started taking hbp meds my Dr. monitored my blood tests at least every 3 months. You are way overdue for tests. My PDR (drug book) says to check for kidney & liver problems & do CBC )complete blood counts.)

I had a major reaction to this drug. The first symptom I had was very painful wrists. Then my joints (knee), ankles feet, hands swelled. My upper arms hurt & shoulders.

My first symptom was dismissed by my Dr. It wasn't until the anemia set in that she would listen & then she gave the wrong diagnosis (Lupus.)

I don't want to scare you because many people take this drug without problems but you must always be aware of possible serious side effects of all these drugs.

I would call my Dr. & request blood tests. I've had to remind my Dr. at times to do blood tests. These are very important.

I agree with FG about the diastolic. In the past, the diastolic wasn't supposed to go below 70. I just read in the Merck manual that having lower diastolics could lead to heart problems. There are two schools of thought on that I guess. I would prefer my diastolic higher but then my systolic goes over 200 so I'm in a catch 22.

BTW I have permanent damage to my knees, hands, & upper arms from Cozaar. My retirement lifestyle has been altered considerably. I have to wear ACE bandages to do any significant walking. I have difficulty doing the things I used to with my hands that I used to do with ease. Fam

PS Grapefruit juice decreases the metabolism of this drug.

Last edited by famnd; 09-07-2007 at 03:31 AM.

 
Old 09-07-2007, 06:03 PM   #10
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Re: High Systolic, Low Diastolic, Why?

Quote:
Originally Posted by famnd View Post
... I was only on Cozaar for 13 days when I had a reaction. One of the symptoms was extreme fatigue-my bl. count had dropped suddenly. It took two yrs to get it back up partly because I couldn't take iron tablets. .... Fam
Hello Fam,

Despite my extensive reading I have yet to learn of a reason for the extreme fatigue I experienced on hct (I would shower when getting up in the morning but was too tired to dry myself off so I would fall into bed and sleep for 1-2 hours---then get up and dress). I don't recall my doctor doing lab tests (and I think I would have the results if he did). Do you suppose I had a similar problem with the iron? I know hct can mess with the electrolytes, but I have no explanation for the extreme exhaustion.

Oh, and by the way, one of the causes of brain fog is an electrolyte imbalance...another is medication...and of course, there are other causes as well.

Bethsheba

 
Old 09-07-2007, 08:33 PM   #11
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Re: High Systolic, Low Diastolic, Why?

Hi Beth,

Were you taking other meds besides HCTZ? My HCTZ pkg. insert does list your symptoms as adverse effects. There are two anemia's also. Were you drinking enough fluid then? Dehydration & electrolyte depletion could have caused your symptoms too.

I learned with the beta blockers, Clonidine etc. to do any bath/shower activities before taking meds. My husband had to pull me out of the tub a few times which is hard since I was pretty much dead weight especially with Clonidine. I still have trouble from time to time-last week I felt very weak after a bath & took my b/p (120/48). And this was in the afternoon-many hrs since I took my meds. Now if I could stay in the tub all day I wouldn't have to take meds I guess .

I tried caffeine again. This time my b/p flew up to 194/61 & I couldn't get to sleep. But boy did I feel good with all that caffeine ( from one coke). Guess I won't go back on the caffeine wagon any time soon.

I'm going to try to cut my HCTZ dose to 12.5mg-less potential side effects especially longterm.

One thing I learned from Dr. D in the newspaper is that most of us on diuretics get cloudy urine because the urates that are excreted in the urine. I kept thinking I must have a UTI but I didn't have it everyday. Knowledge really helps decrease worry.

I just prepared 20 pkg of mushrooms for the freezer last night. They were so delicious & cheap!!! I can't stomach canned mushrooms.

Next week is my Dr's appointment so I have a lot of homework to do. That report about beta blockers is going to take some studying. Hopefully my Dr. has read it. I may need to go to the University for some answers.

How is the job hunting? Have you been able to exercise at all? The humidity really is killing me when I'm outside. I just exercised inside today & felt quilty because I didn't take my dog for a walk. My husband took took her for a short walk & she ran in our huge fenced in yard. Oh, & we have gotten some tomatoes that were good. I'm going to a luncheon in a few wks to hear someone who has written a book on gardening. Better get to bed. Fam

 
Old 09-18-2007, 07:51 PM   #12
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Re: High Systolic, Low Diastolic, Why?

I took Fam's advice and went to see my doctor about a blood test. The CBC and tests for kidney function all came back normal. My poor doctor was scratching his head when I explained to him my constant symptoms of dizziness / lightheadedness! Anyway, he's decided to take me off the diuretic (HCTZ) to see if that makes any difference. I am to monitor regularly for the next month since he is concerned that my BP will shoot back up. I still take losartan (now Cozaar, not Hyzaar) and 5mg Amlor (CCB). That was three days ago and I'm not feeling too different. Do you think it may take time for the effects of the diuretic to wear off or could the other drugs be the cause? On a positive note, my BP hasn't changed a great deal. I'm still SYS 130s and DIA 60s/70s. Just an update for you. Thanks!
Hux

 
Old 09-19-2007, 08:37 AM   #13
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Re: High Systolic, Low Diastolic, Why?

Hux,

I think it's your other meds that are causing your problems.

Bethsheba

 
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