hydrochlorot for high systolic pressure

[earl73]

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?

[flowergirl2day]

Hi,

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

[earl73]

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.

[bethsheba]

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

[flowergirl2day]

Earl,

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