Does any of you experience BP readings higher in the morning like 205/81,145/82,181/154?
I am on Casodex 50 mg,Lupron 7.5 mg,Zytiga 1000mg and Prednisone 5mg.Zytiga was added at the end of September and mid November after I had COVID I start having BP fluctuation from high to normal in the course of the same day .I exercise 5-6 times a week.
Thank you.
Others might chip in, but I am wondering why you are on BOTH Casodex AND Zytiga at the same time?? My understanding is they both do the same thing and it is normally an either/or.
I had severe blood pressure fluctuation when I was on Zytiga (Abiraterone) I stopped Zytiga one year ago and now, I have been on Casodex(bicalutamide) 50 mg/day. My blood pressure is back to steady, .....not much fluctuation anymore.
Both adt and bg meds will mess with your blood pressure , sometimes dramatically. And of course, bp can increase overnights , esp if you take your meds the morning the day before. The long time interval allowing your meds to wear off considerably. If you are taking metformin or glimepride or similar , they impact your bp as well. Metformin lowers your bp substantially. If you change your metformin dose, you may have to recalibrate your bp meds to suit. Also variations of when you take your bp and bg meds could change the daily lowering and rising of your bp measurements. Adt causes my bp to regulate poorly. Very little exertion can cause my bp to skyrocket .....vary much more than before I started adt. Just walking around the house briefly will cause my bp to read 215/110. As with everything here, always consult with your medical care team and see what your GP wants you to do with your bp.
You may not be getting enough prednisone to replace what Zytiga is taking away. How are your potassium levels? Any edema?
No,potassium is good.No edema.
Vios: how was your BP before ADT? Before Zytiga/Lupron mine was 110/70, after five months it was as high as 165/100. I dropped Zytiga, and it settled out about 135/85. Now three months after my last Lupron shot it’s dropped back to about 125/80. I would consider asking your Dr about a lower dose of Zytiga and a low-level BP medicine.
One complication of zytiga could be the development of mineralocorticoid syndrome due to an increase in aldosterone with water retention, and sodium reabsorption leading to edema and loss of potassium resulting in hypokalemia (hypertension, edema, hypokalemia). This situation may resolve by taking 10 mg of prednisone or by adding eplerenone an aldosterone receptor blocker.
Your blood pressure is too high, you need to consult with your primary physician. They have many drugs to normalize your BP, calcium channel blockers, ACE inhibitors, ARBs, eplerenone, hydralazine, HCTZ, etc etc.
Some people have misconception that systolic BP is not that important..but that's not true. Like what Nalakrats said above...if systolic BP goes above 200, your risk of having a hemorrhagic stroke/intracranial bleed goes way up .Losartan is a ARB type BP med which in some studie have said to have beneficial effect on prostate cancer situation. Probably works thru anti platelet route.. Atenolol also has anticancer property.
Zytiga scares me...Not only that I had higher BP..first time in my life.I developed Diabetes..My HbA1C went up to 6.3. I stopped Zytiga a year ago and am on Bicalutamide now. My HbA1c came down to 5.4 last week.
It is MY understanding and experience that MY BP numbers are higher in the morning than the afternoon in general.2Dee
@Sleep Apnea will also affect your blood pressure reading after you get up.
I had ridiculously high BP similar to yours and I also workout 5 times a day. I wasn't taking my Prednisone because I had bad side effects in the past. After my oncologist yelled at me I started taking it and BP is perfect
It could be as simple as your morning coffee consumption which will effect your BP reading. On the other hand it could be the combination of of prednisone and your adt meds. I’ve had BP issues all my life and I’ve had to adjust my BP meds over time due to Xtandi, Lupron etc. Blood pressure fluctuates during the day and from moment to moment, take your BP at different times of the day and keep track of it, there are smart phone apps that make this pretty easy to do.I also started seeing a cardiologist and added her to my team of docs. She helped me adjust my meds and understands how adt meds affect BP. I’m currently taking an ARB and a calcium channel blocker. Avoid taking ACE inhibitors which could affect adt meds, and beta blockers which can add to fatigue.
Back when I was seeing Snuffy Myers he recommended that I add potassium citrate, a supplement to my regimen, it helps relax blood vessels. My cardiologist concurs.
Ed
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Good Luck, Good Health and Good Humor.
j-o-h-n Thursday 12/03/2020 5:25 PM EST
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