Blood Pressure Meds Roulette

[HappyHiker]

Has anyone else played this "game" of roulette?? It's rather frustrating trying to work with Doc to find the winning combination of high blood pressure meds to bring the BP to a reasonable level-- and avoiding the worst of the life-changing side effects.

Right now my combo of two meds is doing a wonderful job of keeping my BP in good order, but with side effect of ankle edema and weight gain. I can live with the edema -- it's not terrible -- but the weight gain is kind of depressing.

Doc wants to try a new combo -- but not sure that I want to put my body through yet another trial of new meds.

Wondering if it's better to live and accept current side effects (which are less intolerable than previous side effects with different meds)?

Anyhow, thanks for letting me think out loud here.

I've found that prescribing HBP meds is a very inexact science of trial and error.

And your meds may not work for me. Because each of us is so unique. Grrrr...

How's your roulette going?

[lmerullo]

Sorry you're dealing with this, I bet it sucks!

My mom is on a low dose of something...don't ask what...and doing well. She was on med #1 for a long time, all fine but she had *creeping up of her numbers. Dr changed to med #2, side effects (this one I remember-lichen infection of the lower legs) Med #3, side effects...finally, med #4 - good. Then insurance denied, back on #1. After the creep got her a tad too high, Dr fought for med #4 with insurance and she's good again.

[SteveinMN]

It's tough to find a combination that works. I'm on three BP meds, all low doses to try to avoid significant side effects. My BP has been well in check for a long time now, so, yeah, I'm loathe to mess with what's working well.

One thing that helped me considerably was to time when I took the meds. For quite a while I had trouble remembering to take meds in the morning so I took them at lunch. When I left my career, lunchtimes became quite variable so I ended up taking the meds at night. The diuretic had me up and in the bathroom at least once or twice a night; not good when you have trouble getting back to sleep. So I switched. I take the diuretic in the morning when I wake up and the other two at night before I go to bed.

You might want to try Web-searching best time to take <name of drug> to see if changing when you take a medication increases (or decreases) its effect or its interaction with other medications or supplements you may be taking. You may find some relief there.

[Teacher Terry]

Yes I was on a beta blocker that left me winded just walking short distances when I was power walking 6-8 miles/day. So got off of that. Every 5 years or so my medication stops working and I have to find something new.

[Gardnr]

If you can live with this long-term, stay with it. If you want to try for less side effects, switch. It really depends on you.

DH is on round 3. He periodically thinks about going back to #1 which he stopped because of negative side effect that made him leave it. His BP is 10p higher than on #1.

It's a personal decision.

[CathyA]

Are you on a calcium channel blocker? They can make you have those symptoms. They can also give you headaches.
Supposedly, the other types of BP meds do not cause these symptoms. Fortunately, mine is controlled on a very, very low dose of a beta blocker (Toprol/metoprolol). I would like to go up on it to control some of my anxiety, my I get too spacey on anything higher. If you're not on a calcium channel blocker but having these symptoms, I would suspect something else is causing them.

[Teacher Terry]

Cathy, your medication is the one that left me winded.

[catherine]

I know that Tammy and the other health care providers can answer FAR better than I but from my experience working on blood pressure medications, it seems that there is a logical progression from diuretics, which are easy and pretty benign, and then up the chain through beta blockers or calcium channel blockers (generic and cheap) to more "advanced" products like ACE inhibitors or angiotensin-receptor blockers (ARBs)--some of which are also generic and cheap. And I'm sure there are more beyond that--combinations of drugs. ARBs are very well-tolerated. ACE inhibitors can have a side effect of a cough.

My DH takes a diuretic plus a generic ARB (losartan). It works fine for him. My BP is OK for now.

[Tammy]

I’m certified in psych so I only know the basics about cardiac stuff. But yes - that list of the typical progression of meds rings true to what I remember.

[jp1]

Interesting, I just recently started taking low dose meds for HBP and immediately they put me on a calcium channel blocker and an angiotensin-receptor blocker. I wonder why they didn't start me with a diuretic. But they seem to be helping and I haven't noticed any side effects. I'm not down to completely normal but I'm about 50% of the way there so I assume they'll bump the dosage(s).

[SteveinMN]

Interesting, I just recently started taking low dose meds for HBP and immediately they put me on a calcium channel blocker and an angiotensin-receptor blocker. I wonder why they didn't start me with a diuretic.
I'm on an angiotensin-receptor blocker and a calcium-channel blocker and a diuretic. While all meds have their side effects and contraindications, the first two meds have only minor side effects for me at the doses at which I take them, but I time when I take the diuretic (even at its low dose) because it will require access to a toilet shortly after taking it -- and that's not always easy or even possible. I usually take the diuretic in the mornings when I'm home to manage that side effect, but if I need to get moving as soon as I wake up, I may push taking the diuretic until lunchtime or whenever I'm home from the event. So whoever prescribed it for you may be cognizant of this (IMHO) significant side effect.

[Float On]

I'm on a combo of 4!!! 2 of them I take a.m. and p.m. This has been the only combo that doesn't create headaches. I do cough from one of them. Tomorrow is renewal day so I'll see if he'll let me continue another year. I've wondered if they've been the reason for weight gain....Well a % of it anyway.

[jp1]

SO takes a diuretic. I’m definitely fine with not having that side effect. He has to get up early to take it, allow time for the side effect, and then he can leave for work because his half hour commute is too long to manage it.

[HappyHiker]

Yep, I'm so glad to be off the HCTZ. Those all-too-frequent bathroom trips got very tiresome and sometimes problematic when a loo wasn't in sight... read in some journal article that older folks (that's me) shouldn't take diuretics...forget the reason why...yet they are often the first med prescribed for HBP and then the combo pills start if the diuretic wasn't successful...

[lmerullo]

Darn, Mumsies med (valsartan) was recalled. She's had to change, and we can't remember what to look out for with the new one...