Blood pressure. Medication

[Tinker2015]

Can I ask is it the norm to get issued with more than 1 lot of meds to lower blood pressure. As I will most likely be on them when I get it checked on Thursday morning. My sister in law is at present struggling to get hers down she is on more than two lots which resulted in her having a stroke. Chatting to her last night she went to her doctor last Friday it’s running high still. They have to change meds. Surely this is not the usual with everyone. I know that doctors will add meds rather than increase dosage to ward off side effects. After reading a lot of posts average is two meds.

[MichaelJH Heart Star]

Dual medication is not used because of side effects but because dual therapy has been found to be more effective. Different types of drugs have different actions so the BP is being tackled two ways. The response to a drug is not linear. For instance quadrupling my statin only caused a further 12% reduction on my total cholesterol level.

Before my bypass I was on an ACE inhibitor and CCI (calcium channel inhibitor). Besides lowering BP the CCI also acts as an anti-anginal. After my bypass the CCI was dropped, the ACE inhibitor dose reduced and Bisosoporal, a beta blocker, introduced. Combining BP medications and their doses is specific to the patient and their condition(s). It may take a short while working with your GP to get this right.

Sorry to hear about your sister. Has she been referred to a Hypertension Clinic? This often happens in more stubborn cases.

[Tinker2015 in reply to MichaelJH]

I don’t think so. Thankyou for your comments

[Thecyclist]

Yes it is very normal to be issued more than one med to control BP and everyone reacts differently, so it is not an exact process but a bit of trial and error. When I was diagnosed last year I wrongly thought I would be on one medication but now being far better educated on the subject I now know that it can take some time to find the right combination of meds.

Depending on severity you will usually be put on an ACE inhibitor first, they slow the production of an enzyme which caused high BP the most popular is Ramipril. You may also be put on a Calcium channel blocker that relaxes the blood vessels, an example of this is Amlodipine. In addition they may also give you an Alpha Blocker such as Doxazocin and you could also have a water tablet such as Furosemide which reduces sodium by getting rid of water. You may also have a Beta blocker, these were the go to for high BP many years ago, but do come with more side effects and tend to now be used more to control heart rhythm issues and post HA, they essentially give the heart a rest by slowing it down by stopping the production of adrenaline.

Doctors can and will use any combination of the above and I am sure there are a couple more as well. It really depends on you. Also they do take a couple of weeks to fully "work" so don't worry if your BP is still a little high to start with, they may play around with the dose as well.

I was on four when I started out! Now down to three, with very little side effects and I am on some high dosage's but my BP was very high.

Diet and weight loss can do much more as well, so this also needs to be factored in as well.

[Manhattan1 in reply to Thecyclist]

i’m currently on bendroflumazide and perindopril.. also on tildiem retard 90mg but not sure if that is for bp or angina.. maybe MichaelJH could answer that ine for me lol

[MichaelJH Heart Star in reply to Manhattan1]

The first two drugs you mention are a diuretic (have you had any odema?) and an ACE inhibitor. Diuretics reduce blood pressure by removing both sodium and excess fluid. Tildiem Retard 90mg, also known as Diltiazem, is a slow release CCI. Whilst it reduces blood pressure it is more commonly prescribed as an anti-anginal.

[Tinker2015 in reply to Thecyclist]

A lot of my raised blood pressure is down to severe anxiety which flares up from time to time. It going to take awhile for me to get used to any as one lady suggested in a recent post to start very slowly cut them in half perhaps with the nurses agreement

[Thecyclist in reply to Tinker2015]

Doctor will advise on the starting dose and then see how that worksout. They tend to start small and titrate upwards depending on reaction. What they don't want is a sudden decrease in BP as that will make you feel unwell.

Likewise if the side effects are not good they may swap.

Anxiety is a driver of high BP as you have said so please don't worry unnecessarily. They will find the best combination for you and you will get your BP under control very soon, the sooner the better so you avoid issues that your sister had.

Good luck, I am sure it will be fine. My BP was horrendous and I have been an anxiety sufferer as well, so I know how you feel.

[Tinker2015 in reply to Thecyclist]

Thankyou for your comments I have just been told by my sister in law the one with the blood pressure that my brother has just roughly a month to live what next does life throw at you. Sorry for the gripe still shocked from the news.

[Lezzers in reply to Tinker2015]

So very sorry to hear your sad news.