Rising blood pressure

[chickgreen]

So - long version: I'm 8 months in on Abiraterone+Prednisone, 1000mg and 5mg daily.

I also consume 50 mg daily of Losartan (25 mg twice a day) to help control my blood pressure. Losartan is an ARB.

I finished radiation just before Thanksgiving. And perhaps coincidentally, my blood pressure has risen from 120/80 to 140/90, based on a two-week rolling average. (I take my BP twice a day about the same time each day. The device is a wrist cuff, but I verify it against my doctors office regularly.) The increase in BP is fairly rapid, and does not seem to have topped out yet.

The problem: My MO does not think there is any issue here at all. My potassium is on the low end of the spectrum at 3.8 MEQ/L- the range is 3.5 to 5.2.. This is also lower than average for me, over the past 8 months.

Some things that I have read, are that increasing the Prednisone may help, although I do not suffer from Edema. Also perhaps increasing my potassium levels with a supplement. I will be talking to my PCP about the Prednisone, but I would love some advice from this group.

[Tall_Allen]

Discuss raising prednisone to 7.5/day. Discuss eplerenone.

[chickgreen in reply to Tall_Allen]

Thanks - I was going to talk about 10, but less is more I hope!

[tango65]

You could increase prednisone or discuss adding eplerenone (inspra) which inhibits aldosterone a mineralocorticosteroid increased during abiraterone administration.

Aldosterone increases sodium reabsorption, potassium elimination, and causes water retention resulting in hypokalemia, edema and hypertension.

You may have an increase of aldosterone which may be controlled with Inspra or doubling the dose of prednisone if you are taking 5 mg/day.

[chickgreen]

Thanks

[chickgreen]

Sodium has been around 138 (135-145) and Chloride at 106 (99-108). Glucose was strangely low at 57 (normally running ~110)

[d3is4me]

After increasing my prednisone to 7.5 my BP came back to normal

[edgeh]

I was on Losartan 50mg for 12trs, then Amlodipine 5mg for 6yrs. Diagnosed p.c in 2018 started Eligard+Bicalutamide. Sept 2022, psa 0.01 but blood pressure of over 140 constant. Doc put me on Olmetec Tri: blood pressure now 110. Amazing effect.

[chickgreen in reply to edgeh]

I've been on a different BP medication before - maybe it's time to try another

[Gatodd]

Historically, my blood pressure had always been very good and no meds to change it. When I first started zytiga and prednisone, my blood pressure was elevated - but never to dangerous levels. However, after about 8-9 weeks, it returned to my normal level. Has stayed that way for 10 months.

But I would listen to what others are telling you about prednisone changes.

[Texan423]

I had elevated BP before Abiraterone and prednisone. I was able to lower BP without meds, using diet, exercise and meditation especially breathing exercises. I’ve been on the same Abiraterone and predisone as you for over 3 years while continuing the lower BP regimen and BP remains in the normal range. Lots of info available in ways to lower BP. Enjoy the research, find a way that works for you and good luck.

[chickgreen]

Thanks