Incresed doses Of medication and LOW BP

[Pippilongstock]

Hello everyone in here!

Im a little worried. My husband GOT his medication increased but his BP is so so low.. he is dizzy whenever he gets up too fast and Im so worried his BP Will not rise again.. because he is not yet on his Max dose Of medication ...:((... How long does it take for BP to rise/adjust new doses Of medication? he is on attacand, Will be moved on to entresto later on I believe.. ( I hope)

Thank you for your replies - this page and your Kind replies has helped me enormously in the past!!

[MichaelJH Heart Star]

You really need to give your GP/cardiologist a call to discuss. They may want to take BP lying down, standing and immediately after standing up. Medication often needs fine tuning as everyone of us is different. It is ways best to ask the professionals. You could also give the BHF nurses a call.

[Calliope153]

Obviously do what Michael says but I don;t know if this is of any help in the meantime: when I was in hospital and my bp dropped the nurses asked me to keep properly hydrated and kept insisting I drank water. Michael will know why this works but it helped me with the dizziness on rising.... just a thought.

[MichaelJH Heart Star in reply to Calliope153]

Drinking water when things are in equilibrium actually tends to decrease BP if the water is replacing other drinks and thus reducing alcohol, caffeine and sugar intake. However, it increases it when there is a degree of dehydration which may be caused by the person not drinking enough (often to reduce trips to the toilet), the dehydrating effect of caffeine and other natural diuretics, and the effects of medication in particular diuretics which are often used in treating heart conditions. So make sure he is drinking enough but also call the GP and, maybe, the BHF nurses.

[Fortepiano]

My husband had this with his DCM - we persevered as it's so important to get the medications up to target levels in heart failure. He was told always to get up slowly and to sit on the bed and march his feet up and down before he got up.

As the heart meds go up sometimes the diuretics are too high and can be lowered.

In the same way, once he starts on entresto some of the other drugs can be lowered if he has hypotension.

All the best

[Lezzers]

Fortepiano is correct with the dizzy issues on rising. You don't say what his blood pressure readings are, the guidelines for Entresto is BP must be consistently over 100. My husbands heart nurse has said she would not be able to prescribe this for him as his BP is too low. She was surprised that his cardiologist was considering prescribing it though she did say Drs can work outside NICE guidelines but nurses can't. Like everyone says, please inform your husbands medical team so they can tweek his meds. In addition to drinking water (be careful if he's on fluid restriction) elevating his legs also helps raise BP.

[Fortepiano in reply to Lezzers]

Interesting: my husband's bp was never over 90/60 (the lower limit for normal bp) and his cardiologists were fine with that when titrating drugs. I think it's true that nurses and GPs are often more cautious than the specialists.

[Lezzers in reply to Fortepiano]

At the moment, at the request of the GP, we're monitoring my husbands BP at random times for 2 weeks & have got to give an average. His reading at the surgery was 80/50 so bisoprolol was reduced to 1.25, he'd only been on 2.5 for 9 days. We're desperatly hoping they'll let him stay on this, unfortunately he's very intolerant to most of the medication they give for heart failure. I believe the only way they'll get his BP up enough for Entresto will be by reducing his isobard monitrate but he takes that for unstable angina, so that carries risks!

[Fortepiano in reply to Lezzers]

My goodness he is sensitive to medications. I do hope he can find an equilibrium.