Blood pressure medication and certain foods

[MountainGoat52]

This evening I took my blood pressure and found that it was slightly raised - 134 / 77, okay nothing special about that (my norm is around 125 / 75), but what was unusual was that my pulse was down at 45. I usually record a rate of between 55 and 60, so I decided to find out what was happening.

My current BP medication is 1.25mg Bisoprolol (Beta Blocker), 25mg Losartan (ARB) and 75mg Aspirin. What I found was that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) have the tendency to increase potassium retention by the body. An elevated potassium concentration in the blood apparent increases the risk for developing an irregular heartbeat. This wasn't happening in my case and I didn't feel unwell, but my low pulse rate was of some concern.

The recommendation is that people taking ACE inhibitors or ARBs should limit their intake of high-potassium foods like bananas, oranges, avocados, tomatoes, white and sweet potatoes and dried fruits — especially apricots. Guess what I had just eaten - yes, dried apricots! It would have been good to know this. It has most likely happened before as I have been on Losartan since 2011.

[Wmh79]

That’s very interesting, I am on bisoprolol and other meds and I have been having heart palpitations or irregular heartbeat and I was thinking could it be my diet cause it seemed to be the same time after foods , maybe writing a little diary might help

[MountainGoat52 in reply to Wmh79]

It appears the issue I had was down to the Losartan. The Bisoprolol keeps my heart rate down and the extra potassium lowered it further. I will know to avoid dried apricots in future.

I was originally prescribed 3.75mg of Bisoprolol in hospital after a heart attack, but when I sat down and relaxed, a feeling of dread and that that everything was coming to a stop overcame me. I got my GP to lower the amount of Bisoprolol to 2.5mg which got rid of that feeling, but I still had hypotension and was dizzy more or less every time I stood up. I still get it on 1.25mg, but it is nowhere near as bad.

Keeping a diary is a very good idea. I am a firm believer of keeping health records. The more information you have, the better equipped you are to determine what works for you and "fight your corner" when getting the right medication.

I hope you soon find the cause of your palpitations and irregular heart beat.

[Qualipop]

I was put on Candesartan and from Feb to July developed horrific tachycardia; bouts of fluttering that lasted 90 minutes. After a Holter monitor showed ventricular tachycardia my GP took me off them but failed to give me anything else. I did ask him about potassium but he didn't seem to know anything and refused to check it. It is one of the big warnings on Candesartan. Trouble is I misread it as lowering levels and ate bananas like there was no tomorrow. It's taken 3 months for the tachycardia to almost settle down but now my BP is very high and I have to wait for an appointment with the GP. Last night it was 156/86 which scared me half to death. Up to 3 weeks ago it was usually around 118.68. I wish doctors realised how much damage these tablets can do to us. It's left me wondering whether the two blockages they wouldn't stent have now got worse and of course the anxiety is putting my BP up even further.

[Lizzie20]

I believe with all meds the pharmacist will check what interacts with what and give you advice, you are only have to ask. Hope this helps. X

[jimmyq]

I always read the leaflets that come with drugs. They tell you this sort of information. I used to take one where I couldn't have grapefruit, one of my favourite fruits.

[MountainGoat52 in reply to jimmyq]

So do I, but in respect of Losartan, there is nothing whatsoever about food on the leaflet.

[Lezzers]

Can I ask where the recommendation came from?

[MountainGoat52 in reply to Lezzers]

Amongst other sites, medshadow.org/4-foods-can-m...

[Lezzers in reply to MountainGoat52]

Thank you. My husband takes candesartan and his potassium levels are high but within normal range. It does occasionally go above normal range, so things like banana are a no no for him. However, I know of a number of people who take Ace/Arbs who have no problems with potassium levels so they obviously affect people differently. I would think that unless potassium is an issue there's no reason for most people to avoid any foods unless there's a dietary reason.

[MountainGoat52 in reply to Lezzers]

Yes, I agree. The advice for those prescribing Losartan on the NICE site is that blood potassium levels should be monitored where patients are elderly or have renal impairment. So for the majority of those taking the drug, the foods listed on that website should be okay. I had a banana at breakfast and dried apricots in the evening which a bit of a potassium overload. All was back to normal this morning with my pulse sat at a very nice 57 bpm. I shall be more careful in the future.

[Lezzers in reply to MountainGoat52]

Do you know what your usual potassium level is? My husband has his potassium level checked at least every 6 months, always has done since his heart attack for over 20 years ago, he was only 42. The first time his potassium level went too high was in 2008.

[MountainGoat52 in reply to Lezzers]

No, to my knowledge I have never had it checked. It certainly hasn't been mentioned at any stage. I have had a series of blood tests and everything has been within normal parameters with the exception of my homocysteine level which was too high. This was the apparent cause of me having a blood clot two years ago. Thankfully a daily vitamin B complete tablet has sorted this out.

[Lezzers]

I would think that within your usual blood tests your potassium would have also been measured, maybe its never been an issue. We get copies of all blood tests results so we're aware of any potential issues, maybe ask your GP for copies for your own records. I'm not sure your low HR was due to high potassium, my understanding is high potassium causes an irregular/erratic HR rather then low HR but maybe ask your medical team, I would be interested in what they say if you do ask them.

[MountainGoat52 in reply to Lezzers]

Well, a temporary low pulse rate could be how my body reacts to high potassium as I often have unusual reactions. There was certainly nothing else I could point to as being the cause. I wouldn't have picked up on it had it not been a day when I was checking my BP. As for getting my blood test results, well I don't currently have a reason to make a request, but at some stage I will be asked to have more tests, so maybe that will be the appropriate time.

[Auiron]

This link covers the whole article: medshadow.org/4-foods-can-m...

List of Ace Inhibitors and Arbs: medicinenet.com/ace_inhibit...

[Hidden]

Thank you for sharing this information.

Problem is how to know what is responsible for the horrible feelings that appear when you take particularly heart medicines

[plantsperson]

I used to take cardesartan and had a banana every day but never knew that they could have an adverse effect. There is no mention of any food to be avoided in the lengthy leaflet so how do people know?

[MountainGoat52 in reply to plantsperson]

Indeed, there is no way of knowing. Then again, the effects that I experienced may not apply to everyone. I am quite sensitive to potassium and need a reasonably high level, but I had evidently overdone it on the occasion I referred to. Since then I have taken great care when eating dried apricots and limited my tendency to snack by putting a few on a plate and putting the packet back in the cupboard.

I would say that the effect of too much potassium was far far less severe than not having enough.... witness my experience with loop and thiazide diuretics which stripped out my potassium and left me depleted and feeling absolutely dreadful.

[Lezzers in reply to plantsperson]

If you're taking an an Ace or Arb medication you would/should be having (at least annual) blood tests. These tests will always include checking your potassium level and if it's too high or too low you would have repeat bloods within a week or 2. If your level remains outside guidelines your medical team/GP will advise what action to be taken. However, potassium levels are affected if you clench your hand into a fist when bloods are being taken, transport of the bloods to the lab for testing, the sample being left too long before being tested, all of which give a false high level hence the re-test. A one off high potassium isn't likely to cause any problems, it's when it's massively high and/or consistently high that it becomes a problem. Low potassium is as dangerous as high potassium as both can cause serious heart issues. Strangely enough all the healthy heart foods, leafy green veg, legumes, bananas, tomatoes, beans, prunes, dates, etc, even liquorice are all high in potassium. It makes it very difficult to find a healthy balanced diet if high potassium is an ongoing issue as it is with my husband.Ps: spironolactone is also very guilty of increasing your potassium level!