High blood pressure and aortic valve defects

[South Sound Sailor]

I have posted info on my situation in other threads but basically, I have aortic valve stenosis with an aortic valve opening of .82 cm. Most other info from my echo reads normal. I have been experiencing the classic symptoms of fatigue and marked decrease in ability to exercise.

My blood pressure continues to concern me. 2 months ago my doctor put me on prazosin, an alpha-blocker that dilates blood vessels. Prazosin also addresses benign prostate problems (just in case anyone is wondering why the doc didn't put me on another BP medicine). I'm up to 4 mgs a day, a dose that's just slightly below what might be considered average. My BP is averaging 136/87... I know that's hardly anything to get too nervous about but I do see spikes in the range of 140 to 150/90 to 100 and that's with me taking the meds.

My question... is high blood pressure a problem that's commonly seen with aortic valve stenosis and narrowing aortic opening? What about after surgery? Do others with high blood pressure prior to AVR surgery experience any changes with BP after surgery (good or bad)?

I do think one problem I'm having is now that I am not getting a good dose of daily aerobic exercise, I'm going to continue to see an increase in my BP. Like everyone on VR.com, my hope is to minimize the number of meds I need to take so I'm really looking forward to post-surgery and the ability to return to daily exercising.

Thanks for any info or insight anyone can provide!

SSS

 

[Phyllis]

This thread might help answer some of your questions: http://valvereplacement.com/forums/showthread.php?t=20269&highlight=high+blood+pressure

 

[aussigal]

Weekends can be pretty quiet around here sometimes, especially at this time of year.

I have taken meds for high BP for about 8 years now and in the last 3 or so have owned a home monitor. I have also witnessed spikes in my BP , some of which were very alarming. Mine had previously risen to dangerous levels of 200/140. I wonder if the time you measured these spikes were stressful moments or immediately after moving around...both of which can cause raised BP. I was told to sit quietly for 5-10 minutes before I take my BP. Monitor yourself a few times throughout the day and write it down to show your Doc. Let them decide if its casue for concern or if you need a change in meds.

Blood pressure is quite variable throughout the day and little spikes are pretty normal...as long as the resting BP is good most of us are OK. You dont say you have an aneurysm which would cause concern with the spikes.

Its good that you are keeping an eye on your BP...many out there in the big wide world have no idea what their BP is.

 

[epstns]

SSS -- I don't know if there is a cause/effect connection at all. I have aortic stenosis, with valve opening only a bit larger than yours. At age 60 (really? Yeah. . .) I still jog 5 days a week, although I have slowed down over the years. I have always had high blood pressure. Not all that high when I was younger (maybe 130/86), but rising as I got older. I am now taking Avalide for hypertension. Works fine, no side effects, etc., but I believe that the elevated blood pressure was present way before the valve opening began to diminish.

 

[Marguerite53]

I think the heart needs a slower blood pressure when it is in such distress as with having deteriorating stenosis. I was told to keep my BP to 120/80 max prior to surgery. Post surgery she wants it more in the 110's so as not to "wear out the new valve" and I know I'm not there, but I'm being stubborn about trying to get it down with exercise and just a slightly increased BP dose. I take Diovan. I was also on beta blockers for palpitations (benign PVC's) prior to and after surgery. I negotiated with my cardio p ) to up the Diovan and drop the beta blocker at about 1 year post op. Feel SO much better now and have not had any episodes of PVC (knock on wood).

Whether or not she was teasing about wearing out the new valve or not, as long as your bp is lower, and not affecting your day to day, it seems like it would have to be better!

I'm concerned with your bp numbers. Please call your cardio and have a nurse explain everything to you. Many of us do not use the cardio's office to their benefit. I got the name of a very helpful nurse. I just call, leave her a message, and when she has time and has consulted with the cardio, she calls me back and we have very helpful discussions.

Call today!

Marguerite

 

[Susan BAV]

Ahoy - Hope this is helpful.

Ahoy - Hope this is helpful.

I think it's fairly common.

I think I recall reading you have a bicuspid? The doctors like bp to be lower than yours... but, with meds, yours is where mine was pre-op, and for many years when I had no other reason for it except the bicuspid condition. Mine would easily spike up very high also. I think that is called labile hypertension?

Post-op, I was completely off bp medications for about nine or ten months. My bp was even a bit on the low side. My family doctor told me that I would probably need bp meds again, months following OHS, and turns out he was correct. He said he'd seen it before.

I take one bp med now called Micardis which was described to me as a next-generation med somewhat like an ACE inhibitor. There are many different kinds of bp meds, some with annoying side effects and some that just don't work as well for some people as others, or with certain hypertension causes. This one I take works really well for me and I have no side effects with it. I'm about 110/70 and pretty stable I think. Excellent.

For what it's worth and for anyone else who might read this, one thing I researched once also is that post-op A-fib is often seen among those with pre-op beta blocker use--you could find that information on a Betapace/Sotalol RX warning--the connection was anesthesia. I took some beta blockers pre-op and had some A-fib/A-flutter post-op. Connection? I can't be sure. But all the doctors and surgeons I saw insisted I needed to take a beta blocker as my valve became worse and I was having some arrhythmia issues. I would do it again if they said I needed it, so I'm definitely not saying don't take it.

The med Marguerite described is one I took fairly successfully pre-op for quite awhile and I believe it is an ACE inhibitor also. I had no side effects with it either.