High Blood Pressure and AF - problems with finding suitable medication

[Travelwatchdog]

I’m 82 years of age and new here, despite having had a problem with high blood pressure for three years. Despite trying Ramopril, Amlodopine and Losartan reinforced by Doxazosin, I’ve never settled to an acceptable BP reading for other than a couple of months.

In March I became concerned because my BP monitor was showing an irregular heartbeat, frequently dropping to 28bpm. I managed to get to see a consultant and had the tests. The bpm was not as bad as 28 bpm because there are evidently beats that monitors fail to pick up. Just over 40 bpm was the low resting point. My Apple Watch confirms that for the past couple of months.

I was prescribed Apixaban to go with 100 Mg Losartan and 2 Mg Doxazosin (now raised to 3 Mg) at the behest of the consultant who emphasised that it was essential to control the BP problem.

Since my BP problem first emerged, no medication has consistently brought down my BP on a continuous basis. At present, over the past six weeks it’s risen from an average 145/70 to a good day returning 174/75.

I have spoken to my GP, telephone only of course, on four occasions and he raised the Doxazosin, but he seem to believe that a reading of around 174/70 is ‘not too bad’. As someone who lived with normal blood pressure for 79 years, I find the GPs opinion worrying and would welcome comments particularly on that point.

Like many at this time, I hesitate to continuously bother the GP with the same problem. I also realise that compared with many, my problem may not be too serious, but I’m sure there are others who have experienced a similar path to where I am now. How they resolved the problem would be great to hear.

[Cliff_G]

If your GP is having difficulty getting your BP under control, a couple of options to consider.:

1. Ask for a referral to a hypertension clinic. The folk in these are used to difficult BPs and can usually help.

2. Consider asking for Spironolactone (or the similar drug Epleronone). This is known to help BP in some people who have high BP due to high aldosterone. It is an aldosterone inhibitor, and is even used for short periods of a few weeks to diagnose aldosterone issues - they put a patient on it, and if their blood pressure comes down rapidly, bingo, that's the diagnosis.

I had resistant BP for many years and only after my aortic dissection did I find out that the Spironolactone I was put on post-op was the key to my own BP. I had to change to Epleronone due to side effects, though they weren't bad.

Hope that helps

[Travelwatchdog in reply to Cliff_G]

Thank you for your advice, its really appreciated. I'll ask the GP about it.

[seasider18]

At our age they are more concerned about us being over medicated and having dizzy turns than the effect of high BP. How often do you take your BP ?

[Travelwatchdog in reply to seasider18]

Hi,thank you for your reply.

I take my BP about once a week, but have done so more frequently in the past month as it started to rise again. My concern is that when I have had my meds changed/adjusted, it settles for a week or so, then starts to rise again. Almost as if its learning how to overcome the obstacle!

One of the problems I'm sure is the COVID limitation of consultations to phone calls.

[seasider18 in reply to Travelwatchdog]

That's the problem we all tend to have taken it more often when we feel it is high as we are concerned about it. Better to take it regularly at the same time with three readings over a ten minute period. You will find that the first one tends to be higher. BP clinic consultant told me if two of them are close to believe them but if quite different not to.

[Travelwatchdog in reply to seasider18]

Thanks. I'm beginning to learn the nuances. Probably the sort of things doctors talked about before they became a call centre.

[seasider18 in reply to Travelwatchdog]

My call centre is not returning calls :-)Fill in an online questionnaire and it says you will get a call back in two to four hours but it seldom happens.