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    Old 08-30-2006, 11:34 AM   #1
    Des1141
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    Question Low Potassium and Hypertension


    I'm new to this board, but not new to high BP. But, I am new to taking Hydrochlorothiazide (along with Lopressor). I've only been on HCTZ for about two weeks and have already landed in the ER due to low potassium. Thought I was having a stroke. Yesterday I had another (mild) episode which left me totally exhauted, weak and in pain. Wondering if any of you are dealing with low potassium with connection to high BP?
    Actually, I believe I have been having bouts of undetected low potassium for the past 8 years following gallbladder surgery, because that is when my problem with high BP started along with these horrible weak episodes that land me in the ER, usually in the middle of the night. They are very scary.
    My doctor has me on 20mg of potassium. After my last ER adventure I was having a good recovery until yesterday afternoon when one minute I was feeling okay followed by a complete meltdown.
    If anyone has anything to share about BP and low potassium, please share, because I find this all very frightening.
    A new friend, Des

     
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    Old 08-30-2006, 09:16 PM   #2
    rigel434
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    Re: Low Potassium and Hypertension

    Studies show most people with low potassium also have low magnesium which is often undetected because blood magnesium levels may be normal yet body magnesium stores may be deficient. So be sure you take both magnesium and potassium supplements. Actually, potassium rich foods are better than supplements.

     
    Old 08-31-2006, 05:19 AM   #3
    Lenin
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    Re: Low Potassium and Hypertension

    Des,

    I too take the 20 Meq (800 mg.) potassium supplement...one a day. It covers my potassium needs with Lasix. You might need 2 a day.
    But better, why not try getting off the thiazide diuretic?

    Are all your bouts of weakness traced to a blood test showing low serum potassium? What does your serum SODIUM look like at these times? Do you ever test NORMAL for potassium?

    Many conditions have weakness as a main component. In fact, with a beta-blocker, weakness is a VERY common complaint.

    For the long haul you might want to consider switching to either an ACE inhibitor or an ARB for blood pressure control because both of them are potassium sparing/retaining. Are you on the beta-blocker (metoprolol) for any reason besides high blood pressure?

    Last edited by Lenin; 08-31-2006 at 05:21 AM.

     
    Old 08-31-2006, 12:04 PM   #4
    Tamsin
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    Unhappy Re: Low Potassium and Hypertension

    The same thing happened to me. I was so K+ depleted that I had arrythmia. It was very scary. I then tried supplementation, but I couldnt seem to get it right.

    So I gave up all HCTZ and went on straight Cozaar. Yet I still felt incredibly fatigued. And the edema was in full glory. AND my BP crept up to a lovely 180/120!!!

    Now I'm on Benicar, because I refuse to be on a beta-blocker. BP is still high (150/95), but it's only been a couple of days. I'm tempted to try some level of HCTZ again, but I'm afraid to do that. But actually I think something else is wrong with me, so I'll be seeing an endocrinologist in a couple of weeks.

    I'm so tired of this....

    Good luck!

    Last edited by Tamsin; 08-31-2006 at 12:06 PM.

     
    Old 08-31-2006, 12:49 PM   #5
    rck213
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    Re: Low Potassium and Hypertension

    I have been recently diagnosed with Conn's Syndrome after being diagnosed with hypertension 13 years ago and reacting unfavorably to every class of medication out there, many of them caused an increase in my bp

    Two years ago I started having low potassium levels on my labwork and I wasn't on any meds. Through bad medicine and the rule of my HMO my primary kept making me try different meds and even a diuretic again along with oral potassium. I had done everything I could including giving up sugar, alcohol, never smoked, lost 27 lbs and walked, did yoga and pilates for exercise.
    I wanted a nephrology referral and it took over two months to get it while my muscle weakness and pain increased so much I had to give up my job and basically sit around the house.

    Within one month the nephrologist was able to find the adrenal tumor, refer me to an endocrinologist and then to a surgeon. The surgery has a chance of curing the hypertension although due to the number of years I have not been controlled damage may have already been done.

    Conn's is the cause of hypertension and hypokalemia in 1-2% of hypertensives but they are beginning to believe it is more like 15%, it is just that the doctors don't look for it.

    No one on a good diet should be low in potassium.

     
    Old 09-01-2006, 05:43 AM   #6
    Lenin
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    Re: Low Potassium and Hypertension

    Tamsin,

    It sounds like you too are a salt-sensitive hypertensive like me. The first clue is the complete uselessness of ARB's in controlling our BP. Maybe Benicar will be better than the Cozaar...it usually is. If not, maybe my regimen of Cozaar-Lasix-KCl will be for you. It hasn't caused me any problems and would be just Lasix-KCl but for the fact that I have a large Cozaar backlog from pill splitting, samples, etc....but when it's gone, it's gone.


    rk,
    Aha so now it has a name...back when I was first diagnosed hypertensive they first looked for 2 tumors, one called a pheochromocytoma and the other "an adrenal tumor" . The test was to collect a gallon of urine and measure vanillymenadelic acid (for the pheo) and 5-HIAA for the "other tumor."
    Is that "other tumor" Conn's Syndrome?

    Have you HAD the surgery? If not, are you taking spironolactone?

    Anyhoo, I agree that:
    Quote:
    No one on a good diet should be low in potassium!
    BUT lots of people on diuretics, especially loop diuretics can go low in potassium despite the best of diets.

    Last edited by Lenin; 09-01-2006 at 05:47 AM.

     
    Old 09-01-2006, 06:08 AM   #7
    Tamsin
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    Re: Low Potassium and Hypertension

    Lenin,

    "Salt-sensitive" is right! My date with Orville Redenbacher led to that 180/120 horror a few days ago. I forgot that I was no longer on HCTZ. I just can't eat like that anymore.

    My best bet is on Benicar, HCT and some supplement but like I mentioned, in the past I was not able to supplement without feeling the effects of low potassium (dizziness, fatigue, near-fainting) UNLESS those effects were due to something else. That's why the endo was called in. There was at least one "caught on tape" episode when I was experiencing a "wipe-out" where my potassium actually measured "normal", so who knows.

    To confound matters, since I'm getting wiped-out so often, I haven't been able to exercise, which does nothing to improve my BP, and I've gained about 6 pounds, which does nothing to improve my BP and so on and so on...There's also the matter of my hypothyroidism, just to keep things interesting.

    I've long since resigned myself to being on medication forever; I just need to find something that works.

    Last edited by Tamsin; 09-01-2006 at 06:11 AM.

     
    Old 09-01-2006, 11:36 AM   #8
    Des1141
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    Re: Low Potassium and Hypertension

    Quote:
    Originally Posted by Lenin
    Des,

    I too take the 20 Meq (800 mg.) potassium supplement...one a day. It covers my potassium needs with Lasix. You might need 2 a day.
    But better, why not try getting off the thiazide diuretic?

    Are all your bouts of weakness traced to a blood test showing low serum potassium? What does your serum SODIUM look like at these times? Do you ever test NORMAL for potassium?

    Many conditions have weakness as a main component. In fact, with a beta-blocker, weakness is a VERY common complaint.

    For the long haul you might want to consider switching to either an ACE inhibitor or an ARB for blood pressure control because both of them are potassium sparing/retaining. Are you on the beta-blocker (metoprolol) for any reason besides high blood pressure?
    As far as I know this is the first time my potassium has been low when I was at the ER. Mostly the other times I was in the ER was because of rapid heart beat, chest pain and weakness. I had only been on HCTZ for two days when I landed in the ER two weeks ago, and that is when the potassium supplement was added plus additional Lopressor. I was put on Lopressor to control my rapid heart beat. I also have Fibromyalgia and OA....when my pain is intense it causes my anxiety level to increase which causes me to urinate more than usual which I guess lowers my potassium. The diuretic just added to the urine output which evidently lowered my potassium more than usual causing terrible pain, weakness and elevated BP. I am very sensitive to prescription medication so my doctor refuses to give me anything for pain. The only thing I take for pain is Tylenol which really doesn't help much. My energy level rises and falls all day....eating does relieve some fatigue. I try to eat six small meals a day; stay away from sugar as much as possible, and now I think coffee will be the next to go This morning I didn't take the diuretic nor the potassium. Instead I drank more and added a banana to my usual foods which seems to have helped. At least I am not running to the bathroom as often. I really need to get another doctor; this guy wouldn't even return my phone calls for help yesterday. Guess he figured if I was as bad as I claimed I should have just gone to the ER (again)....he's not paying the bills.
    Des

     
    Old 09-01-2006, 12:03 PM   #9
    rck213
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    Re: Low Potassium and Hypertension

    [QUOTE=Lenin]

    rk,
    Aha so now it has a name...back when I was first diagnosed hypertensive they first looked for 2 tumors, one called a pheochromocytoma and the other "an adrenal tumor" . The test was to collect a gallon of urine and measure vanillymenadelic acid (for the pheo) and 5-HIAA for the "other tumor."
    Is that "other tumor" Conn's Syndrome?

    Have you HAD the surgery? If not, are you taking spironolactone?

    Lenin
    I am waiting for the surgery to be scheduled and no, I am not on spironolactone, that was one of the meds my primary doc made me try just because I had terrible reactions to everything else.

    After two weeks on only 25 mg daily my potassium rose from 3.0 to 4.3 BUT after 3 weeks on it I was so nauseated, dizzy and had stomach and intestinal cramping that made me discontinue it's use.

    It also cause increased general body edema AND raised my BP to 220/119! I stopped for a few days, all syptoms relieved and BP to 180/100, took it one day and had return of symptoms and and increase in BP.

    I react badly to any medication I take, since 1988 have only used an occ 325 mg of Tylenol for pain and tried every class of BP meds with no improvement in BP or intolerable side effects or hives or angioedema.

    Conn's syndrome is from an aldosterone producing adrenal adenoma and an adrenalectomy can cure hypertension if caught soon enough.

    A simple serum aldosterone/cortisol/renin blood test can point to it, then the more extensive tests are done. For 13 years no one thought to do the bloodwork and no one would refer me to a specialist. The specialist diagnosed it in three weeks.

     
    Old 09-02-2006, 06:50 AM   #10
    Lenin
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    Re: Low Potassium and Hypertension

    For anyone in regular pain, I think Tylenol should be given a wide berth...it is just too hard on the liver expecially for people taking other drugs that must be metabolized in the liver...LOTS of them.

    I have found generic naproxin-sodium (Alleve or Naprosyn?) to be a far better analgesic for the many aches and pains I suffer...back, shoulder, knees.

    rck,
    I always denigrated my old doctor but thinking back on it, the FIRST thing he did when he got hypertensive numbers from me, before prescribing even my first drug, he ordered the urine test for pheochromocytroma and aldosterone producing adenoma...both negative, so my diagnosis was "primary hypertension." This was back in the late '70's.
    So you REALLY liked that spironolactone, eh?

    des,

    I find that an EXCESS of water hurts my joints and that a diuretic relieves the pressure and pain. If I skip my diurteic, the next morning I awaken with a feel of puffiness and achey hands. For me my diuretic is the best friend I have against OA.

    Last edited by Lenin; 09-02-2006 at 07:06 AM.

     
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