Safe BP Drugs?

[HarGreg]

Hello, I was on Lisinopril for 7 years prior to a RP in 2020. After the surgery my BP was normal for 1 1/2 years! and now is on the high side again in the 140s. Yesterday I was at the doctors office and it was 188/90. I really don’t want to go back on medication, but maybe I have no choice? My question, is there one BP medication that is better than the other? or any herbal supplement that actually works? Thanks

[LearnAll]

Sartans like Losartan reported to be a good option. Also, Atenolol is said to slow conversion from Castration resistant cancer cells into NeuroEndocrine Cells.

pubmed.ncbi.nlm.nih.gov/285...

pubmed.ncbi.nlm.nih.gov/323...

Discuss these options with your Doctor.

[HarGreg in reply to LearnAll]

Thank You for the info!

[Benkaymel]

A good plant based diet and plenty of cardiovascular exercise is good for reducing BP. I had high BP and was on amlodipine for 5 years before I was Dx’d with PCa plus BPH. I’m now on tamsulosin to improve my urine flow and that also reduces BP to normal levels so I’ve stopped taking the amlodipine for now.

[HarGreg in reply to Benkaymel]

Hello, The thing is, I do all that you mention! We eat organic food, many fruits, veggies, drank only water and occasional red wine, meat once a week, usually walk 5k every day (weather permitting)! I am 5’ 8.5” 172 lbs. I do have anxieties with the PC Active Surveillance, waiting for test results! I guess many on this site do! I am seeing my GP tomorrow, I want to know what is causing the increase in my BP! Anxieties? Medical? Genetics? This morning it was 140/88 pulse 69. I did well on Lisinopril before, probably will have to go on it again! Thanks 🙏🏻

[London441 in reply to HarGreg]

More vigorous cardiovascular exercise would definitely make a difference. How long does it take for you to walk the 5k?

[HarGreg in reply to London441]

About 50 mins! We walk along at a rapid pace!

[London441 in reply to HarGreg]

That’s good. Twice that much would be better still, but I know there may be a number of reasons you don’t want to do that. But if walking is all the exercise you’re getting it’s still a good idea.

Do you have your own BP kit? I’d be monitoring it more often if I were you.

[Hidden in reply to HarGreg]

I've had higher than normal BP readings at some doctor visits. I think they call it the 'white coat syndrome'.

[HarGreg in reply to Hidden]

Mine is always higher as well!

[Kentucky1]

Lots of choices. Lisinopril is an ACE inhibitor, Losartan a ARB(angiotensin receptor blocker), Amlodipine(calcium channel blocker) are all good choices to start. Many times it takes more than one type of BP med to control hypertension. Make sure to see if your choice interacts with other meds you may be taking for your prostate cancer. Calcium channel blockers tend not to perform well with Xtandi, ACE and ARB's are sometimes helpful controlling potassium levels that Zytiga causes issues with. Keep your diet low in sodium and exercise as much as possible. This decision is an individual one based on other factors of your health such as diabetes or metabolic syndrome. Beta blockers( atenolol, metoprolol) are sometimes helpful but can mask the symptoms of low blood sugar and they do cause fatigue in lots of patients. Diuretics( HCTZ,chlorthalidone) are seldom effective alone and are used as add ons to the other classes of drugs.They are potassium depleters so keep that in mind. Alpha blockers(prasozin, tamulosin) are helpful with BPH, which many of us have if your prostate is intact.These are the most commonly used drugs, but there are more out there. Your doctor should be able to get your BP under control with one or two of these . 188/90 is way to high and puts you in stroke potential territory. I hope you find the best one for you.

[HarGreg in reply to Kentucky1]

Hello, Thank You for the great info!

[Kaliber in reply to HarGreg]

I had enormous problems with my BP for a while, diagnosed with ADT medication induced high blood pressure. Seeing 210/115 ( at rest ) in a clinic wasn’t unusual at first. Freaked a lot of clinicians ( and me ) totally out yayahahahaya. Now my BP is generally in the 123/65 range “ at rest . A combination of HTZ + amlodipine + lisinopril ….. and rosuvastatin ( to prevent heart attacks and strokes ) works perfectly. Strokes run in the family , the rosuvastatin helps with those. Seems like a lot of meds but my BP fought hard trying to run high out of control . Nowadays I never have to think about it ( I do measure it every coupla days ) . I don’t notice any SEs from the BP meds ( possibly my other SEs drown that out ). Just my experience, everyone is different, your cardiac specialist should be the last word .

❤️❤️❤️

[HarGreg in reply to Kaliber]

Thank You for the great info! My wife sent me to the ER to get checked out! All labs, ekg and chest image came back fine 🙏. Will see my GP tomorrow for medication.

[Kaliber in reply to HarGreg]

Sounds like smooth sailing brother. 😁😁😁

[Hidden in reply to Kentucky1]

I was on metoprolol. Not for high blood pressure but for atrial fibrillation. It works by slowing the heart rate down. Too much turns you into a zombie. Now I am blessed not to need any BP or heart medications.

[tango65]

The initial treatment of hypertension usually is a thiazide diuretic plus an ACE inhibitor, or a calcium channel blocker or an angiotensin receptor blocker. Beta blockers are not usually used unless the patients has atrial fibrillation.

A combination could be hydrochlorothiazide or chlortalidone (diuretics), and losartan, or lisinopril or amlodipine.

With your blood pressure you need treatment. Instead of 2 medications it may be possible to use only one depending in your response. They could start with the diuretic and go from there.

[HarGreg in reply to tango65]

Thank You for the info! Lisinopril worked well in the past for me, probably will again.

[HarGreg in reply to tango65]

Started this evening on Lisinopril 10MG. Hopefully it will do the job, if not back to the Doc. Again thank you for the information. Harlow

[tango65 in reply to HarGreg]

It may work and if it were not enough to bring the BP to the 120s to 130 over 70s to 80s they could increase the dose {up to 80 mg) or add HCTZ or chlortalidone.

[HarGreg in reply to tango65]

Just check the BP 123/79 Pulse 62, hopefully this dosage will work! If not they will increase it. Thanks again for the advice. Harlow

[tango65 in reply to HarGreg]

That is great. Best of luck.

[leebeth]

Quinipril is a great ACE inhibitor. It has more tissue activity than lisinopril and is great to reverse endothelial dysfunction. If you did well on lisinopril, I would stay in that class as it is great for your kidneys, but quinipril is more protective. It’s generic and inexpensive.

[HarGreg in reply to leebeth]

Thanks so much for the info!

[Hidden]

Discuss with and listen to your Cardiologist. In my opinion you are headed to strike territory. I wish the best.

GD

[HarGreg in reply to Hidden]

Info appreciated!

[Fash01]

You may want to check out olive leaf extract oil. It’s a bit pricey but used with everything else you are doing you may be pleasantly surprised.

[HarGreg in reply to Fash01]

Thank You, I always prefer natural supplements! but with my numbers, I will start with a prescription and then experiment with supplements. I have some herbal Scullcap coming on Saturday. I understand prolonged high BP can damage arteries!

[Steve507]

Talk to appropriate medical professionals. The information in these posts is.all over the place. My short term Zoladex ADT raised my BP. Switched from Lisiprnil to another. BP is now well controlled.

[HarGreg in reply to Steve507]

Thank you Steve, Info well taken!

[EdBar]

I’ve always had high BP and taken meds for it. Around year 6 of my 8+ years of being on ADT I found the old BP medications weren’t working as well any more. Probably a combination of me getting older and the cumulative effect of ADT drugs. I exercise daily and have a normal BMI and eat a healthy diet. So I got with my GP and a cardiologist and changed some of the meds I’m on. I tried a beta blocker and felt terrible and my heart rate which is normally low went too low so discontinued that and I remember Snuffy Myers saying to stay away from ACE inhibitors because they can interfere with ADT drugs. Now I’m on a combination of drugs that is doing the trick.

BTW do you take your BP at home? Mine is always high at the doctors and they don’t take it correctly for the most part.

Ed

[HarGreg in reply to EdBar]

Hello Ed, Thank You for the input. I do take my BP at home and it’s been a little high! I have a cuff and wrist monitor. My GP said the cuff is more reliable? Have an appointment this morning with him! I am taking no other medications, so maybe back on low dose Lisinopril? Harlow

[EdBar in reply to HarGreg]

GP is right cuff is more reliable. I wouldn’t hesitate to get on BP drugs if you need them, ADT can cause cardiac issues and high BP. Just gotta consider it as part of your overall treatment IMO.

Ed

[HarGreg in reply to EdBar]

Thank you Ed!

[maley2711]

I was scheduled for a dental extraction, but cancelled when BP measured at 195/90-95?

GP immediately suggested I begin BP meds...bought a meter and found my BPs were averaging 130 or lower over low 80s.

What are you averaging over 30 days...assume you have reliable meter. In my case, discovered my home meter read slightly higher than clinic device. Usually high when visiting an mD !! My BP has risen as I've aged, and that is normal. Father time.....not just our outside that ages ???

Try to calm down re your AS protocol and measurements....we have no/very little control? Natural to worry about such things, but shouldn't be of a magnitude to cause sustained high bP IMHO.

[HarGreg in reply to maley2711]

👍👌

[dentaltwin]

Can I assume you're taking your BP at home? Certainly if the reading at your doctor's office is out of the ordinary for you "white coat hypertension" may be at play. Still, numbers like that deserve attention.

I like the rundown Kentucky1 gave. My late wife's oncologist preferred the ARBs, specifically because she said they were more protective of the kidneys (my wife was on a drug that caused both hypertension AND proteinuria).

[HarGreg in reply to dentaltwin]

Thank You for the input! Harlow

[Tony666]

Also possible it is something else (like non-symptomatic covid) and will resolve itself over a few weeks. You may want to test again in a few weeks before moving to BP medicine.

[No_stone_unturned]

I never had bp issues until I got cancer and the SOC treatments that followed. My primary put me on lisinopril at the jump which did the trick. I switched to clonidine because I read that it helped with hot flashes but it did not for me so I went back on lisinopril.

[HarGreg in reply to No_stone_unturned]

Thanks for the input! Well appreciated! Harlow

[jackcop]

Can't remember who said it was white coat syndrome but all I can say is get your own BP monitor and ignore the first few measures... then use measurements over an hour (I know I know) and see if you need help. My doctor wanted me on BP meds but my pressure averaged 126/75. While on the medication my BP was 85-70/60's...too low for me and I always felt faint. Quit the med, and I'm back to regular. The nurses should take into account that we have been dx with prostate cancer... sometimes they don't.

[HarGreg in reply to jackcop]

Hello, Thank You for the info. I do monitor my BP on two different monitors! It seems recently over the last couple of months over 140 and of course when at the doctors office it seem to spike! 185, 177,190. My wife insisted that I go to the ER on Wednesday, EKG and all other test were normal. Saw my GP and started last night around 6pm on Lisinopril 10mg! at 10pm I was 123/79, this morning 110/71, and at 1pm 114/72. Maybe until I figure out this Recurrence PC thing, treat or watchful waiting, I might need a little help with the Lisinopril for the BP. Thanks, Harlow

[Cackalacky_cyclist]

One natural compound you may want to look at is Nattokinase. It can lower BP, and yes, it also is used as a natural blood thinner. Your Dr. May or may not add it to your regimen, but it’s worth a discussion.

[HarGreg in reply to Cackalacky_cyclist]

Thanks for the info. Harlow

[HarGreg]

Good Morning and thanks for all the great info.

[HarGreg]

Hello, I feel the same! I just started with Lisinopril 10 mg and it seems to be working. I was taking Lisinopril for 5 years prior to RP in June of 2020! For almost 2 years post RP my BP was normal with no medication. My PSA was undetectable for 17 months and has started to rise very slowly. I have decided along with 2 doctors to just monitor PSA until treatment is needed. I am sure the anxiety of PSA results elevates my BP. My wife and I eat very well, organic etc., walk 4-5 miles daily. I am 5’ 9” and weigh 170 lbs. and on no other medications! I much prefer taking natural supplements. Thanks, Harlow