I've recently been changed from 2.50 mg [Ramipril due to the dreadful cough] onto 50mg Losartan which I think is the equivalent dose.

This is for hypertension: I started on meds in early May with a 1.25mg dose of Ramipril raised in June to 2.50mg. the bp went down nicely until I returned from a lovely holiday in Provence just over 2 weeks ago and the bp had risen quite a bit, specifically the diastolic numbers and specifically first thing in the morning. Is this normal?

[Hidden]

Further to my query above - initially the doctor told me that I had 2 problems, systolic and diastolic. I think diastolic shouldn't vary as much as systolic but how much should it vary between early morning and bedtime? Mine seems to vary between the high 80s and 90s early in the day down to the high 60s and mid 70s at bedtime - is this normal?

[florence5]

Higher readings early in the morning are an indicator for cardiovascular risk. Blood pressure readings rise and fall throughout the day but GPs like them to be under 130/80 at all times, especially if you have other risk factors. The Cardiology departments use sphygmomanometers to get accurate readings and use 24/48hr ambulatory readings to get an accurate measurement over time. I don't think many GPs have this equipment available. A diastolic reading over 90 at any time of day is considered high.

[Hidden]

Thanks for your reply, you have confirmed what I thought about the diastolic readings and I don't know what to do about it. I've been told the dr wants the BP below 135/80, or was it 85? I don't go back to the dr for a month and am afraid she might add another pill to the Losartan which I really don't want. I was diagnosed with high blood pressure [163/96]in February and didn't start meds until early May. They gave me all the relevant blood tests ecg etc and all is fine. However I am very concerned about those early morning readings. A month later I had a 24hr ambulatory monitor and that merely confirmed the earlier reading. I'm 5'7" and weigh 9stone 3lbs, so feel quite upset at my blood pressure. I have my own monitor which the dr is happy about and take the pressure 3 times a day. During July and August it averaged at 119/70 then when I returned from holiday and the weather was very cold it was 140/80. More recently it has dropped back to 129/85, but that diastolic number is still too high I think

[florence5]

Hi again,

The following information is copied from the eMC website on the Losartan page. You may find this helpful.

Hypertension:

The usual starting and maintenance dose is 50 mg once daily for most patients. The maximal anti-hypertensive effect is attained 3 - 6 weeks after initiation of therapy. Some patients may receive an additional benefit by increasing the dose to 100 mg once daily (in the morning). Losartan potassium may be administered with other antihypertensive agents, especially with diuretics (e.g. hydrochlorothiazide).

[Hidden in reply to florence5]

I've only been on it for just over a week so perhaps I should be more patient. thanks anyway.

[Floozie]

You don't say whether you are male or female or how old you are & these facts are relevant. Also relevant is your family history. You are certainly not overweight & I presume you don't smoke. These are the risk factors addressed. From what you say, everything has been done correctly. It can take some time to stabilise hypertension, trying out different drugs in order to achieve a satisfactory result for that particular individual. Blood pressure drops in the night when we are asleep & should be at its lowest during the early hours after midnight (around 4 am). Did you wear the blood pressure monitor in bed? During the daytime blood pressure also varies, depending on what we are doing. It is pointless to take your BP three times daily. I can't see what this will achieve, except to make you worry & stress will only make the situation worse. Whether your diastolic pressure is 85 or 80 doesn't matter. I would restrict yourself to measuring your BP no more than once per week & this is still probably too frequently. Do take your doctor's advice & try not to fixate on the situation.

[Hidden in reply to Floozie]

Hi Floozie, thanks for the reply.I'm a fit and well female aged 70 who was shocked and appalled to be told I'd got high blood pressure last Feb at one of the NHS health checks. 'Silent Killer' etc scared the life out of me. The nurse who did the check told me I'd had 70 good years and now it was time to take more care etc, she was the one who first mentioned 'silent killer'. I was livid, felt she'd almost got me nailed down in a box and 6 feet under!! Apart from flu I've never been ill and resented the feeling that the NHS had me in their sights, also I had the feeling it was a stigma but think/hope I was wrong on that. I don't smoke and drink alcohol only occasionally. I have absolutely NO family history of high blood pressure or heart disease.

I've been on an initially small dose of medication since early May. Ramipril [an Ace inhibitor] is not supposed to be a first line med for my age group, I think calcium channel blockers are preferred. I asked not to be put on those as I'm partial to grapefruit for breakfast and they are a no-no with grapefruit. However the Ramipril seemed to work a little and then the doc raised the dose and that was even better. I wonder whether it was the warm summer that made the readings good, I believe that is the case. It was when the weather became colder and I was unable to keep warm that it rose, especially in the morning. Because of the cough I've just been put on Losartan which I think works in much the same way? Don't want a diuretic, at my age I run to the loo in the night quite enough without making it worse! In fact I don't want medication at all but realise I've no option if I don't want a stroke or worse. Maybe what scared me a lot was that my son in law's brother aged just 44 - a healthy and fit non smoker and moderate drinker - collapsed and died of just that around the time I was diagnosed.

Perhaps you are right and I'm becoming paranoid about the issue. I do have to go to the doc at the end of the month armed with a week's readings. She tells me to take it twice and record the lowest number 2 or 3 times a day, then get the average. The systolic is always much higher the first time I take it, often 20 points up, the diastolic is more stable., but is high first thing in the morning. The only time I wore the cuff in bed was when the surgery fitted me with a 24 hr monitor last March, just to confirm the diagnosis.

[suki65 in reply to Hidden]

watch this please and do further research thank heavens for the internet

B12awareness.org you tube the 51 minute one please pass it on