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Old 02-13-2008, 08:59 AM   #1
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hydrochlorot for high systolic pressure

I'm 73 years, 6'2", 200lbs. My blood pressure has been running about 150/72. Doctor said I needed to get it down. From my own research, I asked if I could try an ACE, - (angiotension converting enzyme), which is reputed to not impact my sex life as much as others. He said he'd prefer a diuretic, which would impact my high systolic pressure, leaving my diastolic alone, as it's normal. He started with a small dose of hydrochlorot 12.5 mg. He said an ACE would likely lower my diastolic to a too-low figure. He theorized that my problem may be hardening of the arteries (my Dad had this), which manifests as a high systolic figure. First day on hydrochlorot I urinated more than normal. Succeeding days it did not even have this effect. BP remains the same on my home machine. Does anyone have any experience that would be helpful?

 
Old 02-13-2008, 10:20 PM   #2
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Re: hydrochlorot for high systolic pressure

Hi,

Quote:
high systolic pressure, leaving my diastolic alone, as it's normal. He started with a small dose of hydrochlorot 12.5 mg. He said an ACE would likely lower my diastolic to a too-low figure. He theorized that my problem may be hardening of the arteries (my Dad had this), which manifests as a high systolic figure.
It sounds like you have isolated systolic hypertension, which is defined as systolic blood pressure >140mmHg and diastolic <90mmHg. About 60% of elderly hypertensives have this type of hypertension. Believe it or not, age is most often to blame for this. Our arteries undergo changes as we age. This process starts at a fairly young age and gradually becomes more pronounced. Endothelial function worsens after the age of 50, further affecting the tone and structure of our blood vessels. They become less elastic. The changes in the vessel walls affect compliance, which then decreases. This results in an increase in systolic blood pressure. Thus all of us will have some hardening of the arteries as we age. This process is called atherosclerosis.

Diuretics or calcium channel blockers are the drugs of choice for treatment of isolated systolic hypertension. The goal is to lower the blood pressure to about 140mmHg, to 130mmHg for people with kidney problems and diabetics. The ultimate goal in treating this condition is not so much lowering the blood pressure as preventing complications of elevated blood pressure.

You have to be patient. Most of us will respond to small doses of diuretics over time. It can take 4 weeks or longer before you see a maximum reduction in your blood pressure. In some people on low dose of a diuretic this does not happen for a couple of months. Low doses of 6.5-25mg have been shown to be just as effective as high doses (which are not used much anymore). Your dose seems adequate, according to what I've read.
Some people are resistant to diuretics. This usually happens when they consume too much sodium in their food every day or if their renal function is impaired. NSAIDs can have the same effect and blunt the action of the drug.

The use of diuretics results in frequent trips to the bathroom through the night. Our having to get up to use the bathroom means that the diuretics are working and a fluid overload is being decreased.

Good luck with your therapy.
flowergirl

 
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Old 02-15-2008, 09:49 AM   #3
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Re: hydrochlorot for high systolic pressure

Thank you for the comprehensive response. NSAIDs and ibruprofen are my daily diet, so this may not be the drug for me. I go back to doc in 2 months with BP figures. Also my surfing tells me hydrochorot, an abbreviation, I discovered, for a name I've already forgotten, is the WORST offender for causing ED.

Last edited by moderator2; 02-15-2008 at 10:16 AM. Reason: posted commercial website

 
Old 02-15-2008, 11:30 AM   #4
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Re: hydrochlorot for high systolic pressure

Earl,

Has your doctor discussed diet with you? How about exercise? Smoking? Alcohol? Have you screened yourself for sleep apnea?

Some simple lifestyle changes may be all you need to drop that systolic.

Bethsheba

 
Old 02-15-2008, 05:32 PM   #5
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Re: hydrochlorot for high systolic pressure

Earl,

Quote:
hydrochorot, an abbreviation, I discovered, for a name I've already forgotten, is the WORST offender for causing ED
I'll see if I can dig anything of interest up. I remember reading not so long ago in one of my books that the only blood pressure drug that does not cause ED is the calcium channel blocker. I will check my drug book. One of them has a table comparing the effects of various drugs on sexual function.

Found it. Geez. What a long list. Anyway, here is some information. I mention only the BP drugs - the lists are very long.

Decreased libido:...clonidine, propranolol, spironolactone

Impotence: ACE inhibitors, beta blockers, captopril, clonidine, furosemide, Hctz (ESPECIALLY when combined with a beta blocker), lisinopril, losartan, pravastatin and simvastatin (cholesterol lowering drugs) spironolactone and thiazide diuretics

Impaired ejaculation: clonidine, thiazide diuretics
Decreased testosterone: spironolactone
Impaired fertility: aspirin (chronic use), spironolactone, doses of more than 1g vitamin C
Penile disorders: beta blockers
Gynecomastia(excessive growth of male breast): captopril, clonidine, enalapril, eplenerone, felodipine, fosinopril, ramipril, nifedipine, spironolactone, verapamil.

I hope this helps somehow. You could try a very low dose of an ACE and hope for best. Perhaps your diastolic would not get much lower on an ACE inhibitor. Everyone is different. The calcium channel blocker does not have much impact on male sexuality. However, it is not as effective in lowering BP as an ACE or a diuretic and has very unpleasant side effects, especially the high doses. So perhaps you'd be fine trying a small dose, like 2.5mg or 5mg. You'll have to talk to your doctor about it.

flowergirl

 
Old 02-16-2008, 07:43 AM   #6
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Re: hydrochlorot for high systolic pressure

FG,

Thank you for all of the informative information. I've been following the HCTZ part of the discussion because very early in my treatment of HBP I "asked" the Dr. to prescribe it to me, either as a replacement for part of the CCB/ACE regimen or as an adjunct.

The therapeutic value of HCTZ in treating HBP is indisputable. What has given me some pause since I asked my Dr. about it is some of the info coming to light in these discussions and the conclusions that can be drawn.

For my own part, the potential for ED, elevated glucose, electrolyte changes and frequent urination are issues. Prior to going on any HBP medication and when my weight was about 30 lbs above where it is now, I was up several times during the night to go to the bathroom. That and probably some degree of apnea because of the weight led to chronic tiredness and was probably a factor by itself in HBP.

Getting fluid out of your body means the law of physics comes into play with your BP - less mass = less force required to move it around. My biggest concern there would be what it does to your electrolyte levels and the follow on effects. ED, pardon the analogy, is the canary in the mine shaft for cardiac issues. While there are most certainly emotional components to this part of male life, all things being equal, it is an indication of cardiac health.

The glucose issue also sets me off, because that becomes a battle when our weight is out of line.

Don't get me wrong, I'm not a proponent for one medicine over another except in cases where people experience maximum benefits with minimum side effects. I also recognize that CCB / ACE combos are hardly benign when compared to HCTZ. At some level, they are all a "trick" to get your body to react and change some other circumstance.

A good reason for this discussion!

 
Old 02-16-2008, 09:57 AM   #7
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Re: hydrochlorot for high systolic pressure

Hi,

Quote:
ED, pardon the analogy, is the canary in the mine shaft for cardiac issues
Well put and so true!

Quote:
Don't get me wrong, I'm not a proponent for one medicine over another except in cases where people experience maximum benefits with minimum side effects. I also recognize that CCB / ACE combos are hardly benign when compared to HCTZ. At some level, they are all a "trick" to get your body to react and change some other circumstance
I think one must think of the bottom line here. Unfortunately, antihypertensive medication is the worst of three groups of drugs with these troublesome side effects. Some people don't realize that, besides the drug therapy, aging, existing diseases and a lifestyle might play a significant role in developing these problems. Sometimes the end result is a combination of all factors. I think the bottom line of antihypertensive treatment is to ensure that hypertensives will have a life, though its quality may become somewhat impaired.

There are antihypertensive drugs that are known to affect sexual function to a much lesser degree or not at all. As Earl pointed out, ACE inhibitors are considered the best, along with the CCBs and ARBs (e.g.Valsartan). Most doctors probably are well educated about this aspect of treating hypertension. I think that their main concern is achieving a good blood pressure control in their patients, rather than considering any potential side effects when initiating treatment.

I like the way you see things and agree with you. The drugs are designed to trick our bodies into doing things they otherwise wouldn't. Perceived as either good or bad with only a very thin line between the two classifications, I think.

flowergirl

 
Old 02-21-2008, 09:00 AM   #8
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Re: hydrochlorot for high systolic pressure

Quote:
Originally Posted by bethsheba View Post
Earl,

Has your doctor discussed diet with you? How about exercise? Smoking? Alcohol? Have you screened yourself for sleep apnea?

Some simple lifestyle changes may be all you need to drop that systolic.

Bethsheba
I'm 6'2" 200lbs. In my prime I was 185lbs, if I watched it close. I would really like to get down to 190 but my addiction to feeding face while watching tv is a great challenge. (no joke). My doc doesn't seem to consider my weight much of a problem. He suspects hardening of the arteries, a malady my Dad had.

I am an exercise addict to the limit of my low back, what it will stand. 20 minutes of 80rpm on a stationary bike, 30-40 minutes swim. Ride real bike in summer, but low back objects more and more. No smokes for ~40 years. Very light alcohol consumption.

Now, sleep apnea. Probably, some?, but if you sleep alone how can you test for it yourself? I don't usually 'feel' tired, unless I have trouble GETTING to sleep, though I may get sleepy enough after supper to drop off in front of tv.

 
Old 02-21-2008, 11:20 AM   #9
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Re: hydrochlorot for high systolic pressure

Earl,

You may think you were at your prime when you weighed 185 pounds, but despite the gain in weight, I suspect you are really at your prime right now…because like fine wine, men only improve with age (in my opinion).

If you are supposed to weigh 190 pounds, then your weight is a part of your problem despite what your doctor thinks or says…that’s not to say you have to lose weight, but you may have to watch your diet (the sodium, not the calories) or look at other ways to reduce your pressures if you decide to keep those pounds. We all experience hardening of the arteries to some degree…but not all of us experience hypertension…thus, lifestyle changes (and/or medication).

Quote:
Originally Posted by earl73 View Post
...I am an exercise addict to the limit of my low back, what it will stand. 20 minutes of 80rpm on a stationary bike, 30-40 minutes swim. Ride real bike in summer, but low back objects more and more. No smokes for ~40 years. Very light alcohol consumption...
Excellent!!! You’re way ahead of the game here…just keep up the good work! If your back continues to be a problem, you may want to ask your doctor for a referral to a physical therapist who can teach you how to strengthen those back muscles and reduce/eliminate some the pain.

Quote:
Now, sleep apnea. Probably, some?, but if you sleep alone how can you test for it yourself? I don't usually 'feel' tired, unless I have trouble GETTING to sleep, though I may get sleepy enough after supper to drop off in front of tv.
I sleep alone so I know where you're coming from...but it's relatively easy (and free!) to test yourself. I will do a thread about this shortly for everyone.

And just for your info, dropping off to sleep in front of the tv gives you 3 out of 3 points for a sleep disorder...but that's only one question on the test.

I'll try to work on my "sleep" thread this week...I need to do it for beerzoids, too.

Bethsheba

Last edited by bethsheba; 02-21-2008 at 12:24 PM. Reason: In keeping with thread topic, deleted ps.

 
Old 02-22-2008, 05:21 AM   #10
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Re: hydrochlorot for high systolic pressure

Quote:
Originally Posted by flowergirl2day View Post
...Perceived as either good or bad with only a very thin line between the two classifications, I think. flowergirl
Yes.

Bethsheba

 
Old 02-23-2008, 10:00 AM   #11
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Re: hydrochlorot for high systolic pressure

Quote:
Originally Posted by earl73 View Post
...Now, sleep apnea. Probably, some?, but if you sleep alone how can you test for it yourself?....
Earl, I started the thread on sleep apnea where I've included the government's website that contains the Epworth Sleep Index/Epworth Sleepiness Scale. It's only one sleep quiz of many,...but at least it'll give you an idea of how to "screen" for sleep problems without staying up all night,

Bethsheba

Last edited by bethsheba; 02-23-2008 at 10:01 AM.

 
Old 02-24-2008, 09:18 AM   #12
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Re: hydrochlorot for high systolic pressure

I did read through them. I scored myself on the 'sleepiness test' and according to that I'm getting plenty of rest. Most of my 'sleepiness', when I get it, comes from not being able to fall asleep the night before. I go right to sleep, usually, get up to go bathroom, then can't get back to sleep. It's a mental thing I believe. There should be a technique to 'empty my mind' and put myself in the mood for sleep. I've never found it yet. For instance: If I know I have to arise early, and need to get adequate sleep in, then I never can get to sleep.

 
Old 02-24-2008, 09:40 AM   #13
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Re: hydrochlorot for high systolic pressure

I've been having amazing success with going back to sleep listening to the cd's from the Delta Sleep System by Jeffrey Thompson. Better than all the meds I tried. It seems to keep me from ruminating, my mind just goes quiet and out I go.

 
Old 02-25-2008, 03:15 PM   #14
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Re: hydrochlorot for high systolic pressure

Quote:
Originally Posted by earl73 View Post
I did read through them. I scored myself on the 'sleepiness test' and according to that I'm getting plenty of rest.
Earl,

Great!!! I hope you didn't have any trouble finding the quiz. That particular test measures for "sleepiness" and doesn't necessarily measure whether or not you are getting enough rest! Sleepiness is only one "symptom" of a sleep problem and not everyone experiences that particular symptom (I didn't experience sleepiness until I was on blood pressure meds, ). So although although someone may "pass" the sleepiness test, it doesn't mean that they don't have a sleep problem. It simply means that sleepiness may not be a symptom they experience.

I would encourage you to find other sleep quizzes and sleep assessments. Some of them include questions like “Do you ever have trouble falling asleep?” “Do thoughts ever race through your mind preventing you from sleeping?” “Do you ever wake up during the night and have trouble falling back to sleep?” “Do you ever get up to urinate during the night?” Do you sleep 6 hours a night or less?" etc, etc.

Although I filled out a 9-12 page “quiz” for my first visit with my sleep specialist, he told me at that visit that he suspected I had a sleep disorder based on the medical chart my primary doctor had sent him…my chart had three very red flags…a history of acid reflux, a recent development of getting up to urinate at night, and hypertension!!

So based on my personal experience and based on what my sleep specialist told me, I would encourage you to do a lot more reading…because I think your hypertension may be a result of a sleep condition (sleep disorders can be “inherited” by the way)….they can and do run in families! Mine did.

Bethsheba

 
Old 02-25-2008, 07:21 PM   #15
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Re: hydrochlorot for high systolic pressure

Hi Beth,

Quote:
(I didn't experience sleepiness until I was on blood pressure meds, )
.

Sleeping up to 20 hours a day is hibernation not just mere sleepiness!
I am the exact opposite. I don't sleep much at all. My good sleeping habits went down the drain after starting my treatment. The alpha/beta blocker brought on insomnia while also causing extreme fatigue - the type Fam knows only too well. My current beta blocker does not have this effect and I feel energetic most of the time.

FG

 
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