Asthma and HBP help

[suki1724]

I am looking for the best med to lower my BP without making my asthma worse. I also have a fast HR (I had an ablation 3 years ago, but still have a fast heart rate at times)

I tried toprol in 2005, I think it was 25mg and it brought my pressure down and slowed my HR beautifully, but after about 2 weeks I was short of breath.

I recently was on cardizem 180 and felt terrible, headaches, dizzy felt that my heart was racing, so I went down to 120mg and still felt crummy.

The last drug I tried was Diovan 80mg and felt extremely anxious and had a pounding heart sensation, I called my Dr. yesterday and he told me to skip it last night and take it in the mornings (I was taking it in the evening and was having trouble sleeping as well) I feel so much better (and was able to sleep) after skipping the Diovan, that I don't really want to take it again.

Also, I'm allergic to sulfa and got a rash when I tried HCZ-something.

With my history, a beta blocker would probably be perfect for me if only I didn't have the darn asthma.

Does anyone know of a better beta-blocker to try? Or any other BP drug that might be better? I also take singulair and a steroid inhaler (q-var 80) for asthma, and zyrtec for allergies as needed.
:
I'm dreading calling my Dr. today.

Susan

[famnd]

I take Labetalol ( apha/beta blocker). I don't have asthma. But Dr. McGowan says in her book that some patients with asthma are able to take this drug because it isn't a pure beta blocker. It's cheap, easier on the tummy than other BB's, & it blunts one's taste buds so helps with over eating. When you first take it, you will probably get some tingly in your head but it goes away in a few wks. I would recommend starting with small amounts to see how you do. Get a very small thin paring knife sold in grocery stores so you can cut it up in 4 pieces. I cut mine pills on wax paper; then I can just wrap up the other pieces. Be glad to answer any other questions. Fam

[suki1724]

Mr. Dr. wants me to try Avapro. I haven't taken the Diovan in two days and I think I'll wait until at least tomorrow to try it. I've been on the Diovan for about 8 days, so I hope it's o.k. to not take anything until tomorrow.

[flowergirl2day]

Suki,

I was on the same boat as you. They say I have asthma. I don't believe I do. I take Advair & Atrovent (half the time).

I was on Labetalol (the same medication mentioned in Fam's post), maximum dosage, for 6 months (as well as other BP meds.) My breathing got so very bad the Labetalol had to be discontinued. As mentioned by Fam, it is a combination of a non-selective beta blocker (beta 2) and an alpha blocker. It affects mostly the peripheral beta2 receptors, causing bronchospasms and cold extremities in people with asthma or COPD. While it is a very effective drug and it had helped me greatly, given your asthma, I would not recommend it for you.
As a non-selective beta blocker, it's used mostly for overactive thyroid issues, migraines and high blood pressure. It works more generally on the body.
The cardioselective (beta 1) beta blockers, such as Atenolol, Bisoprolol, Metoprolol and Acebutolol work mainly on the heart. Cardioselectivity is dose related. Unfortunately, even at low doses there will be some peripheral effect. These beta blockers will cause less impairment of circulation and less bronchospasm than the non-selective types.

I am happy to say I am on Bisoprolol now and have no bronchospasms whatsoever. As a general rule, beta blockers of all types are usually avoided in the presence of asthma or COPD. If there's another condition requiring the use of beta blockers in people with pulmonary obstructive disease, such as cardiological problems, cardioselective beta blockers are a safe drug to use.
I am doing great on a low dose of Bisoprolol. My breathing is almost normal, thanks mostly to another drug I take for GERD. (I saw no improvement in my breathing with the asthma drugs, but a huge one with the PPI's.)

Avapro is a good choice if your doctor is not too concerned with your heart rate. If you must be on beta blockers, I would recommend a low dose of any cardioselective beta blocker, combined with perhaps an ARB (Avapro) for blood pressure control.

flowergirl

[suki1724]

Thanks to Famnd and Flowergirl for the replies,

I feel so much better off the Diovan, and I haven't taken the Avapro yet. My husband and I are going away for the weekend, and I may just not worry about it until next week.

I have the added fun of being on an event monitor right now because of a run of non-sustained v-tach that was caught on a recent holter. Both my EP doc and my internal med doc seemed most concerned about my blood pressure at this point, though. I had a normal echo and they are telling me that isolated non-sustained v-tach in a structurally normal heart is o.k.

I am discouraged that I've felt so bad on everything I've tried so far. I'm a thin, non-smoker, non-drinker, mostly healthy eater. I had a hysterectomy a year ago, and that's when my pressure really got high. I had a reading of 170/110 at my EP doc's office two weeks ago. At home I run more 120s/90s