I posted this in the Kidney forum but wanted to get the Heart folks opinions too. I have been taking blood pressure medication for many years and after lots of experimentation by doctors I believed it was finally under control. I went to my nephrologist a month ago and the reading was 118/76. I was doing the happy dance but my doctor took a look at my ankles and said he wanted to change my medication because my ankles were swollen. I was taking 10MG of Amlodipine and 75MG of Metoprolol. So he tells me to stop the Amlodipine, keep the 75 MG of Metoprolol and take 50MG of Losartan. This lasts for a week and my readings were in the 170-180s. I call him and he says to add another 50MG of Losartan. Nada...my pressure is still in the 170s. I call again, he changes me from Losartan to Valsartan and now I am taking 100MG of Metoprolol and 320MG of Valsartan (It comes in 160MG pills). Still no joy - abnormally high readings continue. So I call again and now I am taking 150MG of Metoprolol and 320MG of Valsartan. This is all within a month's time and unfortunately my primary care doctor is on vacation for a month. I have only been taking this super dose for two days but I feel just awful. I am ready to keel over my keyboard from the sleepiness I feel from taking these drugs and I am really not okay with this kind of prescribing. So here's the question - I don't have a cardiologist - does this sound like something a cardiologist should be handling? Any opinions would be appreciated.
Blood Pressure Disaster: I posted this... - British Heart Fou...
Blood Pressure Disaster
Because of the swelling in ankles and blood pressure issues even on that amount of medication definitely get on to any gp you can get in contact with and ask for a referral to a cardiologist?? X
I don't even need a referral. I can go to any cardiologist who takes my insurance (and most of them do). But that I think is what is bothering me....if I go to a cardiologist without letting them know I feel like I am "cheating" on my doctors. What if the cardiologist decides to change all my medication - then how do I deal with the nephrologist and primary care doctor?
I just wanted to add that the ankle swelling was because of the Amlodipine and now that is totally gone since I stopped taking it (so I guess some good came of it - all my shoes fit again).
Right ok yeah that is a possibility, glad the swelling has gone! I still would go to a cardiologist just to be safe x
you will not be cheating on the gp! This is your body and your issue-see a cardiologist and try and get things sorted out!
In the UK there are always detailed leaflets in the medication box that details possible side effects. I would certainly have a read through of this.
You are certainly on large doses of unfamiliar medicines and they are likely to have an effect. They may settle down but I would certainly contact a GP after reading the leaflets
I am a big fan of reading leaflets and did research on both of these drugs. I have actually taken these drugs in the past but was taken off Valsartan several years ago because I think my doctor was worried it was affecting my kidneys (this was before I acquired a nephrologist). In fact the doctor switched out Valsartan for Metoprolol. There is so much irony in all of this - I am on the two drugs that I had problems with in the past.
I have had stage 3 kidney disease for about ten years now and what I have noticed is that my blood pressure medication Ramapril being increased this year had definitely affected my kidney function in as it's got worse.I'm supposed to take 2.5mg of Ramapril of a morning them another 2.5 in the evening I have had to stop the evening dose because I felt so tired and had bad kidney pain with it and was sleeping alot.
I was supposed to have my yearly CHD check this week but my GP had to cancel for 2 weeks as I want to discuss this with them. I'm going to start monitoring my blood pressure from today and see if there are any changes due to my stopping one of the Ramapril.
I would definitely speak to your GP and ask for a referral to a cardiologist.
Hope everything goes well.
Just so you know, I am stage 3 also and when I stopped the Amlodipine my right kidney ached for 2 weeks (kind of like a lower backache on my right side). There is definitely a relationship between these drugs and kidneys. Hope your BP remains low even after reducing your dose - that would be great.
I was prescribed Candesartan in January this year and had the same high BP readings as PecanSandie, my highest was 236/104. I would never again take any med that ended with "sartan".
I've now been changed to Doxazosin and although my BP has settled down, the side effects are many and unpleasant and I have them all still, after 6 weeks. I'm going to ask to go back on Felodopine which suited me and was only changed at my Dental Hygienist's request.
How in the world would your dental hygienist have any say whatsoever in what blood pressure medication you are taking! But your story is why I have hesitated going to a cardiologist......I dread the thought of another person telling me what to take. It's bad enough with two of them...I can't imagine three of them giving me orders. 😂😂😂
PecanSandie, My previous BP med (Felodopine) was adversely affecting my gums apparently.
Hi, PecanSandie,
I love your username; it sounds like a lovely cookie!
I honestly do not know what to suggest in terms of your seeing a cardiologist, but I do know this. You have one life—you are in charge of it—you are responsible for that life—and no one will more honestly care about the outcome more than you! You mentioned that you feel guilty, or like you would be cheating on your doctor, by seeing a cardiologist. It simply is not being dubious, or cheating, by getting a second opinion or additional information about your medical situation. You do need to find out what is going on with your health and get those meds sorted.
I currently take 75 mg of metoprolol daily plus 40mg lisinopril for my blood pressure. For a long time period, I also took 25 mg HCTZ ( a diuretic) daily. In April 2023, my GP found that the HCTZ was having a bad effect on my kidneys. We finally agreed to try 40mg of Lisinopril daily—but take the 25mg of HCTZ every other day to see if that helped my kidneys. I had had swelling in my ankles and feet before so I was fearful of stopping, or cutting back, on the HCTZ.
Turns out that I seemed to do okay on cutting back on the HCTZ. My hands and feet were not swelling, or retaining fluid, so I got to where I might go 3 or 4 days without taking the HCTZ. I have not seen my GP since this, and I have not had additional blood tests or urinalysis to check on my kidney functioning. I do need to do this.
Last Friday, November 3rd, I saw my cardiologist to have him review the results of my echocardiogram (completed August 17, 2023). In his office, my blood pressure was sky high—199/123, etc. it was taken at least three times and all were high. That scared me to death because I have been worrying about my blood pressure anyway. So, I was there to learn about test results, but everything got to be about my blood pressure.
He wants me to take the HCTZ daily again, but I worry about my kidneys too. By the way, I had the echocardiogram originally to find out why I was having so much difficulty breathing. I asked him point blank what was causing all of that difficulty. He looked at me and said, “I don’t know.”
Turns out that the echocardiogram and seeing the cardiologist was no help at all in figuring out my problem. Plus, he now has me confused about the HCTZ.
Long, long story short, because of my anxiety disorder, I have been burying my head in the sand about this. I need to see my GP again and make some decisions about the HCTZ and BP.
I honestly wish you the best in getting your meds sorted. It just sometimes gets more confusing by involving more doctors—or, at least, it seems that way sometimes. ❤️
Your experience with your cardiologist is exactly what I am afraid of. If you come in and say you are having trouble breathing, you would hope your cardiologist would at lease try to figure it out! Did he say it could be caused by the Metoprolol? I think I read somewhere that difficulty breathing could be a side effect. About the HCTZ, I used to take Valsartan HCTZ and when my eGFR starting dropping I begged my primary care doctor to take me off it which she did. For some people, HCTZ really affects the kidneys and I was really paranoid about it. Then a year later my nephrologist puts me on furosemide (a different diuretic) 3 times a week. I took it for awhile but then stopped because it really wasn't doing anything for me. I always wondered which of the drugs I was taking worked. Now I know it was the Amlodipine because the others don't seem to be controlling my BP very well at all. I honestly didn't mind the puffy ankles that much but apparently my nephrologist HATED them.
it’s possible that Blood Pressure UK, the specialist charity, might give you some insight into the medication. Also, many doctors surgeries now have a dedicated pharmacist working for them so ring your surgery and ask. Pharmacists know far about medication and their side effects and interactions than doctors do. Many high street pharmacists do stints in hospitals and the hospital doctors ask them for advice.
I’ve just replied to you but didn’t realise you were in the US, so my remark on pharmacists does not apply.
Actually, it's a good idea. My pharmacist is always cautioning about interactions and the like so I think they are a good source for information.
my experience on another part of Health Unlocked has warned me that US pharmacists say ‘you must see a doc’! So yours is a bit more sensible!!!
Blood pressure monitor
24 HR blood pressure monitor 
Varying Blood Pressure Readings
High blood pressure 
