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Old 12-30-2001, 11:55 PM   #1
D@N D@N is offline
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High Systolic Won't Go Away!

I am 33 and was diagnosed with high BP a year ago averaging 140/100.
I was put on 2.5mg of Zestril and now am up to 10mg.
After going to 10mg my bp went down to 135/90.
I have since been put on a diruetic form of Zestril 10mg, and my bp is 118/90.
The doc says if I keep taking them, the systolic reading will follow on down with Diastolic.
All I know is that reading after reading, I consistently test at 90 on the systolic level.
What is causing this? What role is does the systolic reading play in the reading overall?

 
Old 01-02-2002, 03:20 PM   #2
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Re: High Systolic Won't Go Away!

Hi D@N -
I think you're confusing the systolic and diastolic BP's. The systolic is the first reading, the diastolic is the second reading.

The systolic BP is a measure of the pressure while your heart is pumping and, therefore, changes much more frequently, as your heart will pump faster/harder or slower/softer depending on events such as stress, physical activity, etc. The diastolic, or second half of the reading, is a measure of your pressure when the heart is not beating. This reading relates more to the condition of your arteries, how flexible they are, how much atherosclerosis you may have, whether there is a blockage somewhere, etc.

The fact that your diastolic is still not below 90 is of some concern. You're only 33, and you certainly don't want to have high BP for a lot of years, and especially not high diastolic BP. Did your doctor do any tests regarding your kidneys? Although not the only cause of high BP, the kidneys can be one cause...and not necessarily major kidney disease, but something as simple as an obstructed renal artery, or a kidney infection (although usually an infection would be somewhat painful). At any rate, it might be worth pursuing...an IVP can look at the size/shape of the kidneys, a physical exam by a nephrologist would include listening to the renal arteries.

No matter what the cause, it is very important to control your high BP as it can do damage over the long term to your arteries, to some organs, etc. 118/90 isn't bad, but the 90 is still borderline high for the diastolic.

When are you going for a follow up with your doctor? It's probably no big deal if your diastolic is 90 for a few months, but if it doesn't come down, I would definitely look into the possible causes, and also insist on trying other medications to lower it.

There are so many categories of BP medications, and even within categories, one may work better than another. Sometimes it takes a combination of two different types to achieve good control.

I'm not familiar with Zestril, but the broad categories are beta blockers, calcium channel blockers, ACE inhibitors, diuretics (which reduce excess fluid in your body).

Sounds like you're very close to good control, and the diastolic only needs to come down about 5 points to be in excellent control, so hang in there!

 
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Old 01-02-2002, 03:41 PM   #3
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Re: High Systolic Won't Go Away!

Hi D@N -
I had written a reply to your post, but somehow the reply didn't get posted...so here goes again!

It seems you are confusing the two readings of BP: the first reading is the systolic, the second reading is the diastolic. Systolic measures your pressure while the heart is pumping while the diastolic measures the pressure while your heart is at rest.

It sounds like your systolic pressure is now under good control, but the diastolic is still borderline. Giving it a month or two to come down doesn't sound like a bad idea. However, if it doesn't get any lower than 90, youmight want to ask your doctor to try another medication, or stay on the Zestril and add another type of medication. I don't know what type Zestril is, but there are 3 main types: beta blockers, calcium channel blockers, and ACE inhibitors. Sometimes it takes a combination of 2 to get the BP down.

Have you had your kidneys checked? You're rather young to have "essential hypertension", which is what they call it when there's no cause other than the ageing process. There are some kidney problems that can cause high BP, and it should be checked out. I can give you more info regarding that if you need it, but don't want to make this longer than necessary if that's already been done.

At any rate, sounds like you're on the right track as far as control goes...the diastolic only needs to come down about 5 points, and the systolic is now right in the normal range at 118.

 
Old 01-02-2002, 11:55 PM   #4
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Re: High Systolic Won't Go Away!

Thanks for the reply!
Zestril is an Ace inhibitor but I am now taking Zestoric...which is the ACE combined with a diuretic.
I have had no tests done on my kidneys, and my doctor has never mentioned it. He really doesnt seem too concerned as he sees improvement with each change in medication. Since I started out 140/100 and sometimes peaking at 170/103 he seems quite pleased with the current progress, so that may be why he hasnt gone to the next level.
I have a PPO for insurance so I am sure that explains why they are taking some slow steps and not ordering any tests.
I will go back in next week to have another check. If my reading has not dropped below 90, I will demand some attention to the kidneys as you suggested.
Thanks alot for the insight.
Take care.
D@N

 
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