Drugs & Blood Pressure

[Eric]

Yep, an age old topic but I would like your opinions. What blood pressure level have your docs been trying to keep you around?

I never had high bp until after my surgery 6+ months ago and now I'm on 240mg of Diovan, 75mg of Tenormin and (just recently) 10mg of Norvasc. My bp hovers between 115-125 even with all the meds. Is that normal? Dr. Raissi would like my Sys bp to be lower - around 110.

My resting HR is about 55 and I've been very physically active - beach volleyball, swim and light weight lifting.

Thanks for your thoughts inadvance...

 

[Debster]

Hi Eric! My mom's (mitral valve replaced last year at age 64) doctor has her on Coreg and and an Ace inhibitor to get her blood pressure down to where it averages now to 95-105 over about 55-60. That is as low as it has ever been for her. I was kind of freaked out for it to be that low but the drs are thrilled with it. Good luck to you! Deb

 

[Rush20]

I have had similar challenges since my surgery close to 2.5 years ago. I was always within normal range prior to AVR, however now my BP averages 130/95. Not crazy high, however enough for me to notice.

However, my next cardio appointment is in April and I will be interested to see what their equipment shows. I purchased a home eletronic unit that gives me higher readings than my original manual unit. I replaced the arm cuff with a larger one and other family members who have used the electronic monitor also noticed their readings were higher. I'm hoping it's the machine.

I was on low dosage Toprol XL after surgery and even with the low dosage, I did not like the side effects. I would rather try and manage this with diet and lifestyle, however my cardio informed me I might have "reactionary BP" that tends to elevate based on life stress; i.e. long commute, Corporate America, etc.

My original GP informed me that many valve patients tend to have higher BP after surgery do to the strengthened heart now more forcefully pumping blood. Not sure if I buy that...

 

[Eric]

Deb and Allen, Thanks for your thoughts!

 

[aussigal]

ahaaa...
trying to get an appropriately low BP...my favourite topic!

My BP has always been very sensitive to my emotions and exercise levels and even whilst just out walking round the shops and not stressed it had been known to be close to 200/120 ...

of course once I realised this I raced off to get it sorted, some 6-8 months later I am now heading off for my Bentalls procedure and will face a whole new ball-game soon ...

anyways...my Cardio was fairly happy with my Bp @ 120/80 but I wasnt and kept nagging until I was prescribed more BP pills and could get it down to around 105/70 at rest with a heart-rate around 60, which gives me around 30-40 points breathing-space before it gets to the highish range...mind you it still managed to climb to 150/115 the first-time I met my surgeon. This was heaps better than what it would have done 6 months ago on my original 2.5mg of Enalapril...

I am now on 100mg of Metoprolol twice a day, 4mg of Perindopril once a day and 4, 1.25 of Perindopril and Indapamide once a day...apparently this is quite a substantial ammount of BP meds...they like to use a triple combination of beta-blocker and ace-inhibitor and diuretic to try control a Bicuspids BP and I have one of those ascending aortic aneurysms as well...

I know you are a prety active guy...I am not and have always gotten quite dizzy and faint if my heart-rate goes up...so the benefit of the meds to me is peace of mind with my BP...even a walk around my neighborhood which is all the exercise I can tolerate wont send my BP or HR up to those dangerous levels anymore this is a good thing!...

It does get down under 100/50 when I have been sedated for a procedure and my nightime HR is around 50 but I dont have any trouble with it at all...I was titrated UP to this ammount of metoprolol and perindopril, I think it might cause dizzies if you went straight onto this ammount.

I have heard that my AVR possibly wont make any difference to my BP troubles but at least I wont have my annie right there waiting to blow!

I even have the girls at my chemist asking me about my BP experiences now ...

Good Luck and let us know how you go...

I would suggest you see how stable your BP is on the meds you are on whilst you do all your usual activites ,..before you go asking for a change.

 

[Ross]

BP meds are alot like Coumadin, whatever it takes to keep you in an acceptable range is the right amount.

 

[Mb]

You pose an interesting question.

My husband has dual mechanical valves, implanted 10/01. He has chronic a-fib, as well.

At his post surgery visit, the surgeon (Gus Vlahakis at Mass General), told him that he wanted both his heart rate and blood pressure kept under the normal range. The reasoning he gave was that the artificial valve did not open and close quite as efficiently as a tissue valve, or damaged valve does, so the ventricle needs a more adequate time to "fill" with blood to be pumped out into the system.

There have been a few times when his heart rate/blood pressure have gone WAY out of control, and I can tell you, he does not tolerate it well over any period of time. He was in fact hospitalized in October, as his blood pressure was like 160/90 for around 6 hours. He was SO sick, caused angina, worsening CHF, etc. They IV'd him another beta blocker, and gave him nitro. Took them a couple of hours to get it down, and frankly I think the ativan did the job, and not the other meds.

He takes digoxin, atenenol, lasix, etc. - Ph, he also does (feels) best when his BP is under 110, but above 90. Small range

I hope this input helps.

Marybeth

 

[Rush20]

You pose an interesting question.

My husband has dual mechanical valves, implanted 10/01. He has chronic a-fib, as well.

At his post surgery visit, the surgeon (Gus Vlahakis at Mass General), told him that he wanted both his heart rate and blood pressure kept under the normal range. The reasoning he gave was that the artificial valve did not open and close quite as efficiently as a tissue valve, or damaged valve does, so the ventricle needs a more adequate time to "fill" with blood to be pumped out into the system.

There have been a few times when his heart rate/blood pressure have gone WAY out of control, and I can tell you, he does not tolerate it well over any period of time. He was in fact hospitalized in October, as his blood pressure was like 160/90 for around 6 hours. He was SO sick, caused angina, worsening CHF, etc. They IV'd him another beta blocker, and gave him nitro. Took them a couple of hours to get it down, and frankly I think the ativan did the job, and not the other meds.

He takes digoxin, atenenol, lasix, etc. - Ph, he also does (feels) best when his BP is under 110, but above 90. Small range

I hope this input helps.

Marybeth

That's an interesting analysis by the surgeon considering exericise raises your BP during activity only to help keep it lower and normal/resting conditions and your overall conditioning improves. My cardio never mentioned my artificial aortic valve not closing as efficiently.