BP meds

How difficult is it to get on effective blood pressure meds?

Its been a couple of years that I have been trying and numerous appointments.
I’m not running super high (130’s/85, or so), but they want it down.
But, they don’t compare the pre-med BP with the post med BP (which tends to be identical).

They seem happy if I’m on a BP med. But, not super interested in the effect of the medication.

Is it harder than I thought to find an effective BP med? Is it a process that takes years?
I guess I didn’t think it would be this hard. Everything is so hard.

Are you testing it yourself, or just getting numbers when you go in for your appointment?

Asking because my BP is always elevated when I go in, because they always test it after they ask for my pump and meter to download, and I tell them “No! You can’t have it, or download it!”

Anyway, a common thing is higher BP when testing in the doctor’s office. If you have not been testing it at home, you should do that too.

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I do monitor at home. I need to get another machine today because mine broke. The replacement I bought was highly inaccurate because the cuff was 2 sizes too large, at least.

They don’t want to check BP in the clinic. They don’t want people coming in for that, now, so they are completely reliant on my data. But, I dont think that they ever had very reliable data on their own - too few data points, even though I came in sporadically for them to collect some extra data points.

There’s not really anyway for me to give them a full data set. I need to hand them something that they can look at. Otherwise, they don’t think about the data and don’t make any effort to. They are making decisions off of no data. Even in the best of times, its a bit of a fight to get them to look at numbers. If they have to dig through the medical record to find it, then there is no hope.

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I had one problem at the outset. I had a dry cough with the most common meds (ACE inhibitors) . I was moved to an angiotensin receptor blocker and all is well.

Yep - I was on that one. My endo swapped my med without telling me at an office visit. That’s a really common side effect. Everybody in my family has been on that med and had that darn cough. I don’t know why they put everybody on it. It must be cheap.

He swapped my BP med right before covid hit. That cough really scared the ■■■■ outta my coworkers, lol. If I would have known he was gonna do that, I would have told him not to. He was very ‘cloak and dagger’ about it. I had to show that provider the door.

ACE inhibitors are known to have beneficial effects on your kidneys on top of helping with BP, that’s why they like them so much. Its to bad that a lot of people get that darn cough which prevents them from taking it.

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Ahhh, that makes sense. My dad has kidney disease. I wish that one worked.

I was put on ace inhibitors ,vasotec at 26. I was very healthy and fit, and my blood pressure was normal. So I took it but I didn’t get a cough, I felt like I was choking and I got hiccups that lasted hours. I switched to a ace blocker, it was better but I had low blood pressure. I tried a beta blocker and again I had low pressure. I finally stopped taking it and decided there is no point, even though every doctor tells me a diabetic should be on it even with normal pressures.
I did a 25 hour monitor, and finally my doctor stopped harassing me about it.
And now I’m 54 and I have chronic low blood pressure esp when I stand fast. I run around 115/80 but can drop into 110/60 at times. And I don’t take any meds.
So I don’t know why.
But I think meds are tolerated differently and for some like me, I am far better off without any.
So far I have no issues like kidney failure or eye bleeds so I’m grateful for that.

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Raises her hand as to having had a horrible cough from an ace inhibitor!

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I take angiotensin Losartan Could not tolerate the cough until I switched manufactors of the drug.

Thats odd. Why do you think that the manufacturer made a difference?
I would never think of something like that.

ACE inhibitors are a class of drugs that are not all the same chemical compound or formulation. It’s not unlike grouping “insulin” into a single drug class. I tried three formulations but all gave me a cough. That’s why I was moved to an angiotensin receptor blocker.

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@mohe0001
Many drugs have additives, fillers or liquid bases that are used to composed the drug. Different drug manufacturers may use different fillers to compose the same drug. Although these drugs are chemically equivalent hence do the same thing their actual make up may be different.

In my case I was doing great on Losartan, then all of the sudden I could not stop coughing. I thought it was a brand vs generic thing but I did not remember the pill being different. Also the pharmacist said there was no change in the pills and they were both generic. I could only tolerate half of what i should take. Then CVS switched suppliers again and it went back to my preferred manufacturer and I have mild to none issues. I always check pill color and shape. I do not know how I missed the first switch.

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If the BP med includes an ACE/ARB inhibitor there’s an excellent chance it is helping you in multiple ways even if it’s not obviously lowering your bg.

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Results from three landmark studies of almost 4,000 diabetic patients suggest that a specific class of blood pressure drugs called angiotensin receptor blockers, or ARBs, can protect kidneys and reduce the need for kidney dialysis or transplant.

Irbesarten aka Avapro is one of the most commonly prescribed ARBs. There are versions of the drug that are available with a diuretic (combination irbesartan / hydrochlorothiazide).

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Medicine is equal parts art. Unfortunately, it’s often difficult to find those elegant practitioners who can guide you to the medicines that work for you.

But, yes, it can take a very long time to find that combination of medications that work for you in terms of BP control and limited to no side effects. Many doctors follow the JNC8 algorithm

The link from the Joint Commission may not reflect the recent upgraded guidelines that recommended stricter control starting at over 120/80 (I think it is the older one - but it at least gives you an idea). I’m sure you know by now, that for accurate measurement your arm should be at heart level, your feet flat on the floor, no talking, and you should have been calm the previous five minutes. If you want your doctor’s office to measure your BP, they really should.

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Have you ever counted sodium like you do carbs? I found out this spring that my left kidney was damaged and is now dead from cancer surgery. My eGfr had just dipped below the normal range which started the detailed analysis of my kidney function. I had already been on Lisinopril for years for BP without any appearant side effects. With one kidney now shot, my kidney doc advised no more than 1700 mg Na/day. That was an eye opener. There is an enormous amount of salt in processed foods, breads, salad dressings, ketchup, bread, on and on. Once I figured out how to stick to a low salt diet by chucking part of my pantry and cooking more within a month he cut my Lisinopril dose in half because my BP was trending too low. I stay in the 110-120/70-80 range now. Since your BP isn’t terrible, looking hard at the sodium in your diet might be insightful. Stay safe!

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I may need to, @obxdiva.

Shoot, I have too many empty medicine bottles around.

Which one is the 'coughy ’ one again? Is tha the Losartan or the simvastin?

Losartan makes u cough and simvastin gives u diarrhea. I’m not sure of those are the therapeutic reasons to take them or the side effects.

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I thought that was the case. They filled the wrong med. Gosh darn it. Thanks for the double check.

I’ve been out of meds for so long I can’t remember which ones are correct.

I think its the simvastiatin (BP) and Lisinopril (cholesterol).