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  • Blood pressure flutuations during specific times

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    Old 10-06-2008, 10:07 PM   #1
    lamal3
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    Blood pressure flutuations during specific times

    My blood pressure is fine when I wake up, and even during the afternoon but for some odd reason it rises from 8:25PM to 9:00PM. My readings are around 130-150 sometimes over 65-75. It's very strange. It would be normal most of the times but sometimes it does this. After 9:00pm my blood presure would come down once I fully relax. I take my ramipril around 9:15AM in the morning and 9:15PM at night. I used to take 160mg of diovan once a day but it wasn't as effective as ramipril so my doctor switched it to ramipril. My other medication includes inderal 160mg twice a day, norvasac 10mg once, apo furmosiide 20mg once, spirolatone 100mg once, asprin 325mg once. I'm only 27 years old and I have just had open heart surgery not too long ago. I just would like to know why during this time that it would trigger a sudden increase of bp? Is this a cause of concern? Once I take my medication from 9:15PM my bp is normal from then onwards.

     
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    Old 10-07-2008, 12:10 AM   #2
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    Re: Blood pressure flutuations during specific times

    anybody have any suggestions?

     
    Old 10-07-2008, 10:44 AM   #3
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    Re: Blood pressure flutuations during specific times

    What are you doing at this time? Fam

     
    Old 10-07-2008, 03:34 PM   #4
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    Re: Blood pressure flutuations during specific times

    lamal,

    It's good to know you're recovering nicely from your surgery. I am sure your doctors are monitoring your progress closely. Make sure to mention any concerns, including your blood pressure spikes, during your next visit to the doctor's office.
    I am on similar medication and have experienced similar issues with my blood pressure. I used to take my ramipril twice daily. My evening dose -10mg, taken around 9:30 p.m.- did nothing to lower my blood pressure, which remained elevated through the night. The nightly ACE inhibitor dose was not cutting it.

    My doctor suggested taking all of my Norvasc (10mg) at night instead, and all of my ACE inhibitor -20mg-as one dose with my other medications in the morning. This simple switch in dosing times has worked well for me. My blood pressure is now on the low side in the evenings and at night.
    I realize that your problem is a little bit different from mine - your blood pressure does not remain elevated for long. Be grateful for that. A variety of substances can raise blood pressure. Your brief blood pressure elevation could be due to drug interactions, suboptimal dosing or dosing times, reduced or enhanced response to antihypertensive drugs, or your body responding to a circadian rhythm or some other factor. I think it is most likely related to your medication. It would be interesting to draw a chart with the various half times of the meds in question. Perhaps the answer lies there, or in the changes in plasma concentration of the various drugs and their effect on cardiac output and hemodynamics. When do you take your second beta blocker dose? I took mine at bedtime for a while but suffered insomnia. Sometimes our bodies respond inapropriately to medication. Do you get an increase in heart rate, in addition to an increase in blood pressure?
    I am aware of several interactions between the meds (I have almost the same meds). The aspirin reduces effectiveness of ACE inhibitors greatly. Any dose over 100mg is going to diminish the antihypertensive effect of ACE Is significantly.
    Mention these spikes to your doctor and see what he says. He might suggest changing the times you take your medication - there is always room for an improvement. Sometimes the doctors switch people from short-acting medication to slow (extended) release medication - the dosing frequency can sometimes make a difference. It takes a while to find the types and dosages of medications that work best. Good luck. Let us know how it goes.

    flowergirl

     
    Old 10-08-2008, 12:47 AM   #5
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    Re: Blood pressure flutuations during specific times

    To answer your question famnd I'm either sitting on the couch watching tv or on the computer at home.

     
    Old 10-08-2008, 01:16 AM   #6
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    Re: Blood pressure flutuations during specific times

    flowergirl2day,

    Thanks for your reply. YOu have some interesting ideas about taking the medication. I haven't tried altering my medication time yet. I'll offer some suggestions to my doctor and see what they come up with. Today when I took my blood pressure at around 8:50PM today it was 136/88 which was strange because my lower ( diastolic ) is usually below 70. I had a strange sensation also as well where I could feel my heart beat faster and faster. It was if it went on all by itself. I got that panic feeling but it went away after I walked around for a bit. I took my ramipril at 9:00PM today and after 20-25minutes I took my blood pressure it was 136/67, and so now my diastolic was lower but systolic remined the same. I waited until it was 10:35PM, that's when I take my bedtime medication. At this time I take my norvasc 10mg and inderal 160mg. Then afterwards I measured it came out to 116/57. The inderal didn't give me sleeping problems so I can't say the same. When my blood pressure rises my heart rate is fine, it hovers around 62-75bpm.

    I guess you could be right about the asprin. The asprin is usually consumed in the morning along with the duretics and inderal. So I suppose it can be taken at a later time. What if the ramipril is not taken along side with the asprin, will it make it more effective?

    One other question flowergirl2day did you also have a heart operation as well?

     
    Old 10-08-2008, 10:21 AM   #7
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    Re: Blood pressure flutuations during specific times

    Lam,

    You should keep a log of what exactly you are watching on TV or what you are doing on the computer. For example, Dr. Dean Edell on XM says he had to stop watching football because either his heart rate or pulse or both were going up too high. I believe there are some studies confirming the fact that for some people this happens. Hyper responders is the term I see written for this reactions. Fam

     
    Old 10-08-2008, 03:57 PM   #8
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    Re: Blood pressure flutuations during specific times

    I wonder what your blood pressure is first thing in the morning. Do you measure it then? Is it about the same as when you go to bed the previous evening? What is your blood pressure goal?
    I have truly resistant hypertension. I'd gone through a lot before I finally managed to get my blood pressure under control. I have exceeded my target blood pressure, which is lower than for people whose kidney function is not impaired. I now have the opposite worries from the ones I used to have - how low is too low? My doctor tells me these blood pressure measurements are perfect. I don't agree. I am doing some research, using the most up to date information available (the one my doctor goes by). What I have learned so far is amazing. Having a blood pressure below a certain level can be harmful in certain circumstances and actually make certain conditions worse. It would seem that lower is not always better.
    I am glad you have your blood pressure under control. Getting to that point is often the trickiest part. I hope you have been getting plenty of help with that, as well as advice and guidance from your doctors. It won't be long before you are fully recovered from your surgery. I have not had this type of surgery. I have some cardiac irregularities and decreased function, most as a result of long-standing untreated hypertension. Everyone says the same thing - the most important thing is to keep the blood pressure where it should be.
    I just wanted to mention that the drugs we take can and do cause various cardiac reactions. The same drugs also affect our ECGs. If you experience any heart rhythm or other irregularities, please advise your doctor without delay. It sounds as if your body has adjusted to your medication very well.

    Good luck with the blood pressure control and recovery from your surgery! If you find out what's been causing your blood pressure elevations, please let us know.

    flowergirl

     
    Old 10-08-2008, 08:09 PM   #9
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    Re: Blood pressure flutuations during specific times

    FG,

    I, too have been concerned about having my diastolic so low-in the 50's. I've read that it can be a problem. In the past the guidelines have said to keep it at least 70. One Dr. said he thinks the upper limit should be 85. Fam

     
    Old 10-08-2008, 11:11 PM   #10
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    Re: Blood pressure flutuations during specific times

    I must admit I have been thinking of reducing the amount of my nightly CCB without saying anything to my doctor, just to see how it goes. I'd feel much more comfortable with blood pressure over 90. It was 95/65 last night. I don't know if it dropped any further during the night. It can get lower than that. My diastolic blood pressure gets pretty low, like yours, Fam. It just does not seem right for me to have gone from one extreme to the other.

    flowergirl

     
    Old 10-15-2008, 01:32 PM   #11
    lamal3
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    Re: Blood pressure flutuations during specific times

    Hi Flowergirl,

    My blood pressure in the morning mostly normal. It hovers around 103-120/60-65. It is fairly consistent with my reading before bed time the previous night. I had some readings that were in the 97/60 range as well but just two times I've noticed. My blood pressure seems to the lowest during the night I find. I do wonder as well why my diastolic is usually lower than its supposed to be. I heard that lower is better but I could be wrong. I did however made a switch on the asprin that I was consuming in the morning to later on in the evening. I started doing this for about three days and I noticed that my blood pressure didn't rise as high as before. Blood pressure reading were aroung 133-136/65 with a heart rate of 75-80bpm. Then about a day ago I took my bp during 8:00PM it was 148-151/74. It was also strange since it was high for a brief few minutes and then all of a sudden it starting going back to normal. I wonder why it would be doing this. Could I be anxious or something. Does being cold also raise your bp?


    I am luckly to be alive and to have survived this whole orderal.

    Last edited by mod-anon; 10-15-2008 at 08:22 PM. Reason: removed quote

     
    Old 10-15-2008, 03:03 PM   #12
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    Re: Blood pressure flutuations during specific times

    Yes, being cold does raise one's b/p because it causes blood vessels to constrict. Fam

     
    Old 10-15-2008, 07:42 PM   #13
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    Re: Blood pressure flutuations during specific times

    lamal,

    Quote:
    I am luckly to be alive and to have survived this whole orderal
    this is the bottom line and what really matters. It sounds as if your blood pressure is well controlled for the most part. A friend with well controlled hypertension (Diovan and hctz) has just told me about her experiment. For a while, she took blood pressure measurements after each meal (I didn't ask how long after) to see which foods and beverages tended to raise it. She found that some foods raised her blood pressure by as much as 10-20 mmHg. Her doctor does not believe her. I do. I should probably do the same. It would be interesting to see what the blood pressure does. I get very tired and sleepy not long after I eat. I will start measuring my blood glucose to see how it reacts. I might as well take my blood pressure at the same time.

    Many things-including anxiety- can trigger a sudden rise in blood pressure. When you get a high reading, try measuring the blood pressure in the other arm. Wait a little bit, then do both arms again. I do this and the second set of measurements is usually in the normal range. Sometimes the cuff does not inflate properly, resulting in a falsely high reading. As long as your blood pressure elevations are not regular, considerable and persistent, they probably are not a huge concern. Your doctor will let you know if any action needs to be taken. Good luck with your blood pressure control. You seem to be doing just fine.

    flowergirl

     
    Old 11-03-2008, 12:23 AM   #14
    lamal3
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    Re: Blood pressure flutuations during specific times

    I'm noticing this past week my diastolic has been on the low side of the 50's. What could the reason for this? I know that is very low however I don't feel dizzy or tired which could happen when it is at that level.

     
    Old 11-03-2008, 08:41 PM   #15
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    Re: Blood pressure flutuations during specific times

    Has your heart rate dropped as well? Your low diastolic blood pressure could mean that you have been receiving an excessive dose of a beta blocker and need a dose adjustment, or that another beta blocker with slightly different properties would be more appropriate. The drop in your diastolic blood pressure could be a consequence of an additive antihypertensive effect of the drugs in your drug regimen. If that is the case, some fine-tuning of your medications might be needed. Beta blockers decrease the workload of the heart, causing it to require less oxygen and blood to do its job. Given your recent heart surgery, this might be what's needed to help you in your recovery. If you are not having any hypotensive symptoms, your doctor might decide not to make any changes to your medications just yet. In any case, I hope that your progress and response to medication are being closely monitored. Please make sure to discuss your concerns with your doctor.

    flowergirl

     
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