Exercise and Blood pressure meds

[Dormat27]

I am 51 y/o and was diagnosed with v.high BP in Jan 2024 of 210/130. This stayed high (>198/120) even after a few days and immediately the GP put me on 10mg Amlodipine which reduced my average BP over 3 weeks to approx 155/95. I was then also given 2.5mg Ramipril too (after bloods were fine) and this reduced my BP over a few more weeks to 115-120/ 80-85. It stayed around this region (i measured twice a day (x3 measurements) for 3weeks or so. An ECG revealed an inverted T wave and subsequent Echo showed a mild LVH which was diagnosed as probably due to High BP unsurprisingly.

During this time, i also walked everyday at brisk pace upto 4miles but this was easy from aerobic POV as i have been a keen cyclist for last 10 years. After this i started to cycle more at moderate-vigorous pace at beginning of March 2024 initially on a indoor bike but increasingly outdoors and currently do about 5-7 hrs a week.

I now measure my BP every 3 weeks for 7 days of measurements and my average BP has crept up to currently 137 / 78 even after my ramipril was increased to 5mg and now 7.5mg. My concern is the following.

1. Is it common to have a great reaction initially to amplodipine / ramipril or any BPM which then goes away requiring increasing dosage. i.e. is my body adjusting to the drugs and becoming "immune" to their positive effects? does it happen this quickly normally as well?

2. Am i doing too much exercise. I know this might be counterintuitive to the general advice but can i do moderate-vigorous exercise or is this causing my average BP to creep upwards?

I have only been living with this for a few months so still very concerned about the long term and interested to learn about others in similar boat regarding exercise and BPM or have been living with HBP for longer.

thanks

[Jo198919]

Hi Dormat 27

I had a similar issue about 12 months ago. My BP went to 240/130 and wouldn't go down so ended up in A&E. They doubled my dose of losartan to the maximum and put me on 5mg Amlodipine.

My BP went down to around 120/80 but remained volatile and 4 months later went back to 200/110. They increased my amlodipine to max 10mg and eventually it stabilised. It may have been my body adjusting to the combination of medication which is common I think.

It now averages around 125/75 but occasionally I can still get periods typically of a few days where it creeps up to 140/85ish and then goes back down.

I do not know why this happens, it just does and my GP isn't concerned. The advise from the cardiologist is that my BP is ok if it is below 135/85 on average throughout the day and unless it goes over140/90 for an extended period of time there is no need to add new meds.

Hope this helps

[Dormat27 in reply to Jo198919]

Thank you for the reply. Interesting to note that the body does seem to adapt but that must be scary to go back upto 200/110. I have also been advised that those numbers (135/85) are my target as well.

[AgedCrone]

In my 50’s I had similar problems & high cholesterol….so my GP referred me to a cardiologist ..whose first remark was to congratulate my GP saying it needs a specialist to sort you out!

That specialist prescribed what turned out to be the correct meds for me. I am now 80+ with an average BP reading of around 126/55.

So if you are just seeing your GP…If things don’t soon improve…do ask for a referral.

[Dormat27 in reply to AgedCrone]

Thanks for the information. I thankfully have good HDL / LDL levels so thats not a major concern. Good advice about the referral though and will follow that.

[Thingybob]

Hi , I was diagnosed with hbp at 52. At the time i was a regular runner, half marathons etc, healthy diet, healthy weight etc etc. Started ramipril, now lercanidipine too. Initially my bp dropped to 120 over 80 consistently . But over the years, Im now 64, is now averaging 135/ 140 over 85. Gp is fine with that . I still do mild exercise, walking , yoga, static bike, which i believe may help but 🤷‍♀️

My hbp is likely hereditary as my mothers family all had it, some from An early age and rels on that side all have it, again all otherwise healthy lifestyles.

So maybe look into hereditary causes ? Also maybe get your thyroid function checked ?

All the best

[Dormat27 in reply to Thingybob]

Hello Thingybob, thanks for the reply and the background sounds similar (ish) in terms of exercise and HBP. I am still keen to exercise relatively hard but also want to be careful about the extra strain on my cardio system.

My HBP is definitely hereditary. (Dad diagnosed at 55 and his mother was at 62) but i am also aware that my diet over the last 5 or 6 years has also been rubbish so working on that to.

Never thought about thyroid function but will investigate too. thanks

[Happyrosie]

you might find something that resonates with you on the website of the specialist charity Blood Pressure UK

[Dormat27 in reply to Happyrosie]

Hi Happyrosie, yes i have been to that site and its a good starting point and i was hoping also to get more than just general information which the kind people of this forum are providing.

[lettingoffsteam]

Hi Dormat27, I was diagnosed with high blood pressure in March 2019 at 244/133.Anyway was also told I had mild lvh and put on amlodipine and ramipril.Meanwhile I managed to lose 5 1/2 stone of weight and my medication dose was halved plus propranolol was added for palpitations.I'm still on the same meds and my bp is 105/70 which I'm happy with.

[Dormat27]

hello lettingoffsteam. Wow, 5 1/2 stone is amazing and congrats for the achievement. I am also losing significant weight as i change my diet. Your current BP is amazing and i really hope my journey follows similar pattern in terms of drug dosing. Whilst i dont have any side effects atm, it would be great to know that the non-medical approaches are working too.

BTW, i am assuming you had an Echo in 2019 to confirm the LVH. Did you ever arrange a followup echo over the last 5 years to determine if your LVH had regressed as the BP reduced?