How low can you go ? Blood pressure GP policy and general guidance

[Richard9999]

Hi

I have had high blood pressure for over 20 years. At some point in my late 20s (I am now 51), a GP decided I met the criteria for high blood pressure and prescribed medication.

For most of the next 20 years I had an annual or semi annual check at the surgery and a blood test every year. They would tell me all was good and send me on my way. I am not sure of my exact readings but in the region of 150/90 springs to mind. I didn't take my readings at home or have any side effects ( I didn't actually think about the possibility of side effects).

Well in the post pandemic landscape I have had my meds changed 3 times in a short space of time (about 18 months). My initial dose of Losartan 50mg was increased to 100mg. After a couple of episodes of higher readings it was increased to Losartan 50mg + Amplodipine 5mg at which point my readings averaged 125/87 (at home). I had a hypertensive urgency episode (reading was over +200/+100) although this came down over 12 hours. As such they decided to increase my dose further to Losartan 100mg + Amlodipione 10mg.

My average reading over a month is now 117/75 and slowly dropping. My question is how low is too low? If it gets to say 110/70 should the meds be reduced? Some of my readings have been as low as 105/60.

I am now having side effects - dizziness/lightheaded and nausea from the amlodipine.

I am a non smoker, weight is now in target range having lost loads this year, cholesterol levels fine at latest blood test and not a big drinker. Has anyone reduced the amount of meds they are taking because they believe their blood pressure is becoming too low?

I read that for controlled hypertension, average readings in the region of 130/85 are actually fine and there is no need to reduce further if your other risk factors are in check.

In summary, I can't see the benefit of getting the reading as low as possible if it means you suffer daily side effects. I am not sure GPs see it his way, or mine doesn't! If people have experience of this I would like to hear your thoughts on what you did or didn't do and what your GP advised.

Thanks

[Madlegs1]

If you check out the Sprint research ,it may help you .

Basically it says that 120 BP, may be ideal and should be aimed for.

But - if the side effects of attaining this number are too great, then figures up to 140 or so are acceptable, providing no other issues.

So-- as you can see , it's very much a question of balancing benefits and risks.

Generally, just increasing one medication is not as safe as varying meds, keeping all at a lower dose to avoid more severe side effects. Hope that is helpful.

All the best.

[Hidden]

As I said in the answer to an previous post, my father lived for a long time with the BP 90/60, having no problems. I remember having seen in people's posts lower values, such as 75/40, but in these cases people were blue-lighted to hospital.

I would not like to scare you, but keeping the BP low at the cost of reduced blood flow-rate (poor blood circulation) may be dangerous for your health. Lightheadedness, from time to time, is a good sign that you are at the lower limit value of blood supply to your brain. Personally (71 of age), I live with a high BP, experimenting where the truth is. I measure pretty high values (when it is 160/90, I am happy, it's usually higher) and feel perfectly well. It is not BP what matters, it is blood flow-rate. "They" either do not know it, or neglect it for the purpose of selling medications.

[Happyrosie]

certainly Richard my medication was reduced when I got my pressures down, I think to about 110/70 ish.

I gather from your post that your take your pressure at home. In your position I would take your pressure (throw away the first then take the average of the next three) at the same time approx each day for a week. Ensure you sit down for ten minutes beforehand with the cuff on, relaxing, and don’t talk while the machine is doing it’s stuff.

Then present your doc with these readings.

In the meantime, go to the website of Blood Pressure UK the specialist charity and see what you can get out of it.

[peter999999999]

keep to 100 plus your age and under 100dis and you wont go far wrong, you need more blood to your brain as you age stops you falling over and a lot more ,

[Eviedog12]

Hi there, I'm wondering if your low readings are causing the dizziness etc, not the medication. A trip to the GP might be an idea to discuss.

[Katreg]

 doc put me on Amplodipine 10mg my side effects were extreme anxiety came off on my own started exercising and changed my diet my BP is down to 120/80 .