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    Old 05-02-2013, 02:28 PM   #1
    maglib
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    renin, high bp, high cholestrol teenager low aldosterone

    Nobody responded on other board so hopefully some kind intelligent souls can help shed some light.

    high renin but normal aldosterone
    hypertension
    Teenager dx hypertension. High renin. Familial high cholesterol. Low D. Slightly high thyroglobulin AB.

    Has had kidney ultrasound and tests by cardio all supposedly fine. His renin levels are considered high but aldosterone is normal.. Everything I read is that renin causes high aldosterone...so we don't understand this.

    Also familial high cholesterol. Slightly low Vit. D.

    Trying to make sure we get everything done correctly.

    Any ideas out there?

    All the other blood work seems fine.
    TSH 1.2 in range
    T4 1 in range
    Thyroglobulin AB 40 (note this is slightly high but the endocrinologist didn't think it was high enough to warrant a visit).
    Aldosterone 18
    Plasma Renin 8
    Metanephrine all in range
    CBC was all fine
    Sodium 140 in range
    potassium 4.3 in range
    glucose 75 in range
    creatine .73 in range
    Vitamin D 17 LOW
    Cholestrol 208 HIGH (HDL 48, LDL 160
    Triglycerides 150 high



    He's cut out salt, increased fluids, cut sugars and carbs. We use ground flaxseed in cooking, fiber supplements, and he's on Norvasc and just recently they added hydrochlorathizide.

    Still bp is erratic and never better than 135/90 and dr. said he wants 115/70.

    His great GF died at 38 of a heart attack and we are very concerned.


    He had an EKG which was fine and a kidney u/s which was fine. Now they are planning a nuclear renal scan.

    Any ideas?
    Thanks.

     
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    Old 05-03-2013, 12:03 PM   #2
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    maglib, I am sorry that your son is faced with health issues. I'm sure it is not only stressful for him, but also for your entire family. If your untiring determination to help him was medication, he would have been cured by now!

    I had difficult to treat, chronically high blood pressure. I also had Heart Failure. As I got progressively worse, and was very sickly, I knew if I did not get my blood pressure down to healthy levels, I would not survive.

    So... I set out to find out why my blood pressure was so high all of the time.

    I'm going to share a bit of my own struggle and success against unhealthy blood pressure just in case you can make use of the information.

    I started taking my blood pressure about seven times per day, in 1998. I now have about 31,000 blood pressure readings stored in my database, where I have been able to do charts by hour, day, week, month and year. I learned enough about the causes of my blood pressure so that I could achieve permanent healthy blood pressure 24 hours per day, year after year.

    Here is a crude chart showing my average diastolic blood pressure from 1998 thru 2010.

    yr _________70________80________90_______10 0

    1998 ____________________________________*
    1999 _______________________________*
    2000 _______________________________*
    2001 _______________________________*
    2002 __________________________________*
    2003 __________________________________*
    2004 ____________________________*
    2005 ________________________*
    2006 ________________*
    2007 ___________*
    2008 _________*
    2009 _________*
    2010 ________*

    So, as you can see, my average diastolic reading for 1998 was close to 100 ALL THE TIME! For 1999 thru 2003, my diastolic was consistently 95 or higher. From 2007 thru current my average diastolic, all day and night long, has been in the lower 70's.

    I'm going to now show my blood pressure ranges, by hour of the day, so you can see how much someone's blood pressure can vary all day long. I don't know if you will be able to make use of any of this information, but I'll post it just in case. If you can't use the information, just ignore it!

    My first set of blood pressure readings are from the year 2003, summarized by hour. Hour 1 represents 1am and hour 24 represents 12 midnight.

    I've listed the hour, the number of blood pressure readings, the average blood pressure for each hour, the minimum blood pressure, and the maximum blood pressure for each hour.

    To read the data, let's look at hour 22, which is 10pm, the 22nd hour of the day. The readings show that for the entire year of 2003, there were 60 blood pressure readings at 10pm and the average blood pressure of all of the 10pm blood pressure readings during 2003 was 163/103, and the minimum blood pressure for all of the 60 blood pressure readings at 10pm during 2003 was 134/83 and the maximum blood pressure that I had during the entire year of 2003, at 10pm was 188/119.

    My average blood pressure for all of 2003 was 151/96. As can been seen, my problem was not with extremely high blood pressure, in the 200s, but with constantly high blood pressure all day long for the entire year. This, by the way, continued until 2006, when I was finally able to get my blood pressure down to much healthier levels. I am extremely lucky that I survived all those years of high blood pressure, heart failure and permanent Atrial Fibrillation!

    In contrast, the close monitoring of my Blood Pressure, and the reduced spending on my health care has resulted in significantly reduced blood pressure and much better health. My Blood Pressure average for all of 2008 was 122/72, based on 2543 readings.

    Average blood pressure readings for 2003: (when too high!)

    Hour (subtract 12 starting with the 13th hour for PM time.)
    1. Readings 3 Average 141/86 Minimum 125/74 Maximum 157/101
    2. Readings 6 Average 144/90 Minimum 133/75 Maximum 154/100
    3. Readings 7 Average 143/93 Minimum 128/84 Maximum 159/101
    4. Readings 7 Average 151/98 Minimum 140/82 Maximum 162/106
    5. Readings 8 Average 150/97 Minimum 117/76 Maximum 177/110
    6. Readings 16 Average 153/100 Minimum 141/88 Maximum 172/108
    7. Readings 54 Average 158/102 Minimum 127/83 Maximum 182/112
    8. Readings 83 Average 147/93 Minimum 109/68 Maximum 180/108
    9. Readings 80 Average 139/88 Minimum 108/70 Maximum 168/106
    10. Readings 88 Average 143/90 Minimum 108/73 Maximum 167/107
    11. Readings 71 Average 147/94 Minimum 128/78 Maximum 184/110
    12. Readings 73 Average 148/95 Minimum 120/71 Maximum 172/119
    13. Readings 39 Average 151/96 Minimum 135/84 Maximum 178/114
    14. Readings 21 Average 148/92 Minimum 130/78 Maximum 175/102
    15. Readings 41 Average 152/94 Minimum 126/83 Maximum 176/111
    16. Readings 59 Average 146/92 Minimum 122/74 Maximum 179/114
    17. Readings 37 Average 147/93 Minimum 130/78 Maximum 164/102
    18. Readings 46 Average 152/95 Minimum 132/76 Maximum 174/110
    19. Readings 64 Average 155/99 Minimum 111/76 Maximum 179/115
    20. Readings 71 Average 162/101 Minimum 128/89 Maximum 185/116
    21. Readings 75 Average 163/102 Minimum 135/81 Maximum 187/118
    22. Readings 60 Average 163/103 Minimum 134/83 Maximum 188/119
    23. Readings 19 Average 156/98 Minimum 135/81 Maximum 179/114
    24. Readings 4 Average 145/97 Minimum 128/87 Maximum 153/103

    All of 2003: Readings=1032; Average=151/96; Minimum=108/68; Maximum=188/119

    .

    .

    Average blood pressure readings for 2008: (when healthy)

    Hour (subtract 12 starting with the 13th hour for PM time.)
    1. Readings 9 Average 131/73 Minimum 110/62 Maximum 141/82
    2. Readings 10 Average 122/73 Minimum 107/63 Maximum 135/80
    3. Readings 12 Average 126/73 Minimum 109/59 Maximum 144/85
    4. Readings 22 Average 125/73 Minimum 101/62 Maximum 148/85
    5. Readings 52 Average 123/71 Minimum 100/56 Maximum 147/81
    6. Readings 171 Average 120/69 Minimum 85/52 Maximum 145/98
    7. Readings 225 Average 112/66 Minimum 89/50 Maximum 145/84
    8. Readings 180 Average 110/65 Minimum 78/45 Maximum 143/84
    9. Readings 157 Average 118/71 Minimum 85/48 Maximum 150/92
    10. Readings 155 Average 118/70 Minimum 86/51 Maximum 159/89
    11. Readings 118 Average 120/71 Minimum 93/51 Maximum 146/91
    12. Readings 150 Average 121/72 Minimum 80/54 Maximum 154/90
    13. Readings 87 Average 125/74 Minimum 105/58 Maximum 149/93
    14. Readings 172 Average 126/75 Minimum 98/52 Maximum 154/88
    15. Readings 75 Average 126/75 Minimum 101/57 Maximum 148/94
    16. Readings 165 Average 128/75 Minimum 99/51 Maximum 150/95
    17. Readings 86 Average 131/78 Minimum 101/52 Maximum 160/98
    18. Readings 185 Average 129/76 Minimum 98/59 Maximum 151/96
    19. Readings 110 Average 129/76 Minimum 105/58 Maximum 152/86
    20. Readings 185 Average 126/74 Minimum 96/56 Maximum 158/88
    21. Readings 114 Average 125/74 Minimum 100/57 Maximum 152/88
    22. Readings 84 Average 125/72 Minimum 103/56 Maximum 148/84
    23. Readings 12 Average 127/72 Minimum 101/54 Maximum 142/85
    24. Readings 7 Average 120/70 Minimum 108/64 Maximum 133/76
    For all of 2008: Readings: 2543 Average: 122/72 Minimum: 78/45 Maximum: 160/98

    The very first breakthru in lowering my blood pressure was after I started on a diet targeting Insulin Resistance, which is a Pre-Diabetes condition. Usually doctors do not test for this condition, even though about 25% of Americans suffer from Insulin Resistance.

    It was only after I went on a diet targeting Insulin Resistance, that I experienced dramatic improvements to my health. Insulin Resistance is a Pre-Diabetes condition, and usually doctors do not test for this condition, even though about 25% of Americans suffer from Insulin Resistance.

    I documented on Healthboards, during the time I first started the diet, in January 2005, on a thread, I called, Does an "Insulin Resistance" diet improve blood pressure? At that time, I did not really know if I would continue to improve, or continue to get worsening heart failure. The link to that thread is:
    http://www.healthboards.com/boards/showthread.php?t=242229
    The bottom line for me is that it took me from 1998 thru 2004, or eight years, of closely monitoring my blood pressure, before I was able to get my blood pressure down to healthier levels.

    Best of luck with your son's health. I hope that something in this post is of some use to you.

    Take care...
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    Last edited by Machaon; 05-03-2013 at 01:49 PM.

     
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    Old 05-03-2013, 07:10 PM   #3
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    Renin is produced by the kidneys in response to reduced blood flow to kidneys. It is a compensatory mechanism to keep BP up in case of shock, like with blood loss. It can be elevated for other reasons, like narrowing in the renal arteries (stenosis). This may be subtle enough to not produce a bruit, a murmur like sound over the renal arteries which is a clue to renal artery stenosis, but enough restriction to blood flow to raise renin levels. It is good his aldosterone is not high, as that would just make things worse. The nuclear scan will be helpful in assessing blood flow to and through the kidneys, to see if blood flow is reduced to one or both. This test should help and if an underlying problem is found, it often can be treated, and the hypertension goes away. He should be on a low cholesterol diet and should have thyroid antibodies checked again in 6 months or so to see if they are going up. This can mean an autoimmune disorder of thyroid that may eventually cause thyroid failure, which in turn causes high cholesterol. That can be treated with replacement thyroid so is not a big worry. I hope this test yields info so that he can be treated, get his BP under control and be a normal teen again!

     
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    Old 05-05-2013, 05:29 PM   #4
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    I used to have high blood pressure, but since I have taken Ground Ginger in my tea over the past 9 months my blood pressure readings are good, my last reading was 110/70 which is probably as good as you can get. So I would advise people who read this to take Ground Ginger 2 or 3 times a day in your tea with 1 teaspoon each time. Just don't take it too late in the evening as it is stimulatory and may stop you getting to sleep.

    Ginger is amazing spice used widely in Indian cooking - it may not taste great in hot drinks but the effects are fantastic for blood pressure as well as other health benefits. It has even lowered my bad cholesterol too even though I still eat a lot of red meat. It's good stuff.

    Last edited by SpiceMan1; 05-05-2013 at 05:33 PM.

     
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    Old 05-05-2013, 07:35 PM   #5
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    I use ginger (the crystallized chunks) in my tea for anti-inflammatory effects. It melts in the hot tea and tastes great, adds a nice sweetness and spice. I'll try using more of it for my high BP.

     
    Old 05-07-2013, 06:22 PM   #6
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    ahhh... I also added ginger to our diet. I started buying ginger root and used it in pasta and when it dried out in tea.... this is something I added to his diet too.

    He was tested for glucose levels / diabetes and all was fine. not sure if that covers the diabetes type issues.

    Additional info. The kidney U/S I actually got a copy of the report and it doesn't look as good as I was under the impression:

    1. he drank about 32 ounces of water prior to the kidney u/s and it says the urinary bladder is only minimally distended (all that water an hour before you would think otherwise)

    2. the kidneys are of mild increased echogenicity. Please correlate clinically regarding medial renal disease. NO CLUE that sounds like they are darker and no reason given...

    OTHER: this is more info that I never prior included. When he was about 4-6 he had issues with bedwetting that seemed to happen when he had growth spurts and they said he was not urinating completely and emptying his bladder. They also said at that time that his kidneys were a bit smaller. Not sure if this is relevant or not to now.

    Thanks for help so far.

    His next test is Thursday.

     
    Old 05-07-2013, 10:27 PM   #7
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    Quote:
    Originally Posted by maglib View Post
    Nobody responded on other board so hopefully some kind intelligent souls can help shed some light.

    high renin but normal aldosterone
    hypertension
    Teenager dx hypertension. High renin. Familial high cholesterol. Low D. Slightly high thyroglobulin AB.

    Has had kidney ultrasound and tests by cardio all supposedly fine. His renin levels are considered high but aldosterone is normal.. Everything I read is that renin causes high aldosterone...so we don't understand this.

    Also familial high cholesterol. Slightly low Vit. D.

    Trying to make sure we get everything done correctly.

    Any ideas out there?

    All the other blood work seems fine.
    TSH 1.2 in range
    T4 1 in range
    Thyroglobulin AB 40 (note this is slightly high but the endocrinologist didn't think it was high enough to warrant a visit).
    Aldosterone 18
    Plasma Renin 8
    Metanephrine all in range
    CBC was all fine
    Sodium 140 in range
    potassium 4.3 in range
    glucose 75 in range
    creatine .73 in range
    Vitamin D 17 LOW
    Cholestrol 208 HIGH (HDL 48, LDL 160
    Triglycerides 150 high



    why hasn't his doc recommended taking vit D. They want the range between 35-65 these days. Low Vit d can cause erratic bp

    He's cut out salt, increased fluids, cut sugars and carbs. We use ground flaxseed in cooking, fiber supplements, and he's on Norvasc and just recently they added hydrochlorathizide.

    Still bp is erratic and never better than 135/90 and dr. said he wants 115/70.

    His great GF died at 38 of a heart attack and we are very concerned.


    He had an EKG which was fine and a kidney u/s which was fine. Now they are planning a nuclear renal scan.

    Any ideas?
    Thanks.

     
    Old 05-08-2013, 09:30 AM   #8
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    Quote:
    Originally Posted by maglib View Post
    ahhh... I also added ginger to our diet. I started buying ginger root and used it in pasta and when it dried out in tea.... this is something I added to his diet too.

    He was tested for glucose levels / diabetes and all was fine. not sure if that covers the diabetes type issues.

    Additional info. The kidney U/S I actually got a copy of the report and it doesn't look as good as I was under the impression:

    1. he drank about 32 ounces of water prior to the kidney u/s and it says the urinary bladder is only minimally distended (all that water an hour before you would think otherwise)

    2. the kidneys are of mild increased echogenicity. Please correlate clinically regarding medial renal disease. NO CLUE that sounds like they are darker and no reason given...

    OTHER: this is more info that I never prior included. When he was about 4-6 he had issues with bedwetting that seemed to happen when he had growth spurts and they said he was not urinating completely and emptying his bladder. They also said at that time that his kidneys were a bit smaller. Not sure if this is relevant or not to now.

    Thanks for help so far.

    His next test is Thursday.
    Apparently Cinnamon is good for people with Diabetes. Ginger is good for blood pressure and reduces LDL Cholesterol but I'm not so sure if Ginger improves Diabetes.

    Last edited by SpiceMan1; 05-08-2013 at 09:32 AM.

     
    Old 05-08-2013, 09:54 AM   #9
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    Just want to say, none of these spice suggestions are going to make a dent in this. I am surprised they are not using an ACE inhibitor like lisinopril or losartan plus an aldosterone blocking diuretic like aldactone to treat him. ACE is an enzyme that participates in the renin-angiotensin-aldosterone process, and blocking it would be very effective. Both that and the aldersterone blocking diuretic would fit right into the mechansims of his high BP. I would research that and talk to his Dr about those.

     
    Old 05-14-2013, 05:27 AM   #10
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    Is he African American? if not, he should be on an ace inhibitor or an ARB first.

    Is he overweight? His BP and lipids are suggestive of some impaired glucose metabolism. If he is overweight then weight loss is the best way to improve his numbers.

     
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    Old 06-17-2013, 09:59 PM   #11
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    he is African American, he is not overweight.

    We ended up having an MRI and all it showed was 2 very small cysts in his spleed located posteriorly. Doctor said not to worry and that wasn't what was causing his issues. he said it has to be arterial even though none of the tests show it.

    a few weeks ago the doctor took him off the amlodopin and switched to Metoprolol.

    We had better success now and his BP is still a little higher than the doctor wants it.

    Dr is taking him off the hydrochloradathiazide and wants to see if the bp stays low.

    I'm still concerned about the 2 small cysts and even though they are in total smaller than 2cm.

    Any ideas or thoughts?


    Thanks everyone

    I'm thinking a 2nd opinion.

     
    Old 06-18-2013, 04:46 PM   #12
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    He is a high renin hypertensive (assuming the blood was collected properly), and thus should be started on agents that inhibit the renin-angiotensin-aldosterone axis; namely ace inhibitors or angiotensin receptor blockers, with aldosterone receptor antagonists (or amiloride) being a late add-on as needed.

    A diuretic may actually raise renin levels to some degree and is likely to be far less effective in a high-renin-hypertensive. The same is true for calcium channel blockers, such as amlodipine. These are the appropriate agents for low-renin hypertension.

    Beta blockers, while not the ideal choice, do lower renin levels to some degree and thus should lower his BP somewhat effectively.

     
    Old 07-10-2013, 05:52 AM   #13
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    Re: renin, high bp, high cholestrol teenager low aldosterone

    ACE inhibitor seems a logical line of defense here. It is a terrific class of drug for high renin hypertension.
    Of course the only determinant is whether or not he develops the endless coughing spasms that can make ACE inhibition intolerable.
    Then ARB's can be a second choice.

    I am a low renin hypertensive so for me, ACE inhibitors and ARB's are useless. AND I get the ACE cough bad.
    Diuretics are my best antihypertensives, and furosemide my drug of choice.

    Last edited by Voxx976; 07-10-2013 at 05:53 AM.

     
    Old 07-28-2013, 02:41 PM   #14
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    not sure where I was but he is not African American.... he is now on metoprol Suc and his BP has come down and been somewhat regular.

     
    Old 12-15-2014, 09:32 AM   #15
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    Re: renin , high bp, high cholestrol teenager low aldosterone

    oops it was supposed to say he is not african american...

     
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