bp medicine for a bp of 130/86? - High & Low Blood Pressure Message Board

pinkpixies · 10-21-2008, 03:14 PM

I'm 23 years old and over weight but I eat very healthy and keep my sodium intake under 2000 mg a day (usually a lot under, actually. I'm paranoid about water weight gain LOL) My blood pressure isn't always high but I have pretty bad anxiety and when I'm anxious, my bp goes up quite a bit.

I saw a nephrologist back in June for trace amounts of protein in my urine (which scared me to death...was an hours drive and I'm agoraphobic) and my bp was 140/100...but I was shaking and everything...felt like I was going to puke. But anyways, he suggested I start taking an ace inhibitor for the "high blood pressure" but I had normal readings at all my doctors appointments after that...usually around 100/60 and then a few weeks ago, I went to my primary physican and she read what the kidney doctor wrote and took my bp and it was 130/86 (I was anxious again...she always tells me to lose weight, which upsets me b/c I'm trying so hard

) and she put me on Lisinopril. Is that normal? I mean, two high blood pressure readings over the course of several months with normal bp inbetween? I worry so much about taking meds and their long term side effects and stuff. I take too much crap already.

flowergirl2day · 10-21-2008, 05:55 PM

pinkpixies,

According to the 7th report of JNC treatment guidelines, blood pressure of 120-139/80-89 is pre-hypertension and should be treated with lifestyle modifications. The European guidelines recommend pharmacological treatment at 140/90mmHg in all hypertensive patients. The threshold for drug treatment is lower in people who have a higher cardiovascular risk, such as diabetics, post-stroke, MI, people with renal dysfunction and protenuria.
Because of you are leaking protein, your nephrologist wants you on the ACE inhibitor. This drug will reduce or eliminate the protein leakage, depending on the cause. Besides helping protect your kidneys, it will also lower your blood pressure. I'd suggest taking blood pressure readings using a home monitor for several days, then reviewing the results with your physician. If your blood pressure is 100/60 without medication, you should not need any blood pressure lowering medication. Watch for excessive reductions in blood pressure if you are already taking this drug.

If your blood pressure becomes too low on the medication, demand a dose adjustment. I hope your doctor will closely monitor your progress and your blood pressure. You should ask your doctor what your treatment goal is. I know you have been eating healthy food and watching your salt intake. That's great.

The lifestyle measures that are recommended for preventing or improving hypertension are: losing weight -5-20mmHg per 10kg weight loss, DASH diet -8-14mmHg, dietary salt restriction -2-8mmHg, exercise -30min 4-5times a week- 4-9mmHg, and reducing alcohol intake to 1-2 drinks a day -2-4mmHg. I can understand your anxiety when the doctors start talking about losing weight, which seems to be the "recipe" to better health, no matter what the problem is. I'd be really annoyed if my doctor kept reminding me to lose weight. Most of us need to increase our calorie output, since we already eat a very healthy diet. It's pretty basic..easier said than done.

flowergirl

pinkpixies · 10-21-2008, 06:09 PM

My weight is a major issue for me b/c I'm bulimic (have been for over 12 years now.) and I'm trying to recover and everytime she tells me to try harder to lose weight...it's like <huh?>...she knows I was in the hospital late last year b/c of it and I'm still in outpatient treatment for it. My treatment team says I'm doing great and are actually trying to get me to eat MORE...I'm afraid of eating anything I consider "bad" and still usually end up purging them.

*sighs* my primary physican just sees a fat girl...she probably thinks I'm a drama queen or something. Which is why I try not to see her much...go to other doctors instead. It took her two years to test my thyroid when I was gaining weight very quickly...she waited until after I gained 170 pounds in two years to check my thyroid and find out that I had hypothyroidism...I kept going in and I would have gained 30-40 pounds since my last appointment and she would tell me to eat less...when I was already fasting most of the damn time.

flowergirl2day · 10-21-2008, 09:01 PM

pixies,

It is hard to believe that, given the circumstances, your doctor should be on your case so much. I think that her comments are rather counterproductive. The problem is she seems focused on the bottom line, which is your need to lose weight, without acknowledging your efforts to date. I am sure she means well. If her attitude doesn't change, you might have to consider changing doctors.

How great to hear you are on your way to recovery. The support and guidance of a team of health professionals to help you achieve your goals is invaluable. Are you getting counselling for your agarophobia? It would help to be able to get out and get some walking done.

How scary that it took so long to diagnose your thyroid dysfunction. Doctors should always question sudden weight gain (and loss) and run the appropriate tests. Has your thyroid function improved with medication? I hope so. Good luck with your treatments.

flowergirl

pinkpixies · 10-21-2008, 11:46 PM

I'm doing a lot better with my agoraphobia...I can actually make myself go farther away now than I used to be able to. I still don't like it, but if it needs to be done, I can. I used to not be able to go more than 4 miles away from home but now, every week, I go 20 miles away from home for my nutritionist appointment.

My thyroid is doing a lot better now. My levels have been normal on recent blood tests. I still have a lot of the symptoms of hypothyroidism, but at least I'm not gaining weight LOL I had my metabolic rate tested last year, and I was only burning 500 calories a day! Should have been around 2100 calories a day b/c I was 300 pounds. (no wonder I was gaining weight.)