LOW blood pressure: I've written before about my... - PMRGCAuk

PMRGCAuk

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LOW blood pressure

Hindags profile image
9 Replies

I've written before about my afternoon lows with the wobbliness and weakness and occasionally on really bad day, some faint nausea. I usually find that it is worse when I get up from being sedentary. On days when I keep up a steady level of mild physical activity it seems better.

Well yesterday was unusual. No low at the usual time. But then I it was one of those steady mild activity days so I wasn't entirely surprised. Ate an earlier dinner, around 5:45, and went to a 7pm movie.

At around 9, at the end of the movie, I got up and felt all the wobbliness and weakness and faint nausea that I usually get earlier in the evening. When I got home I took my blood pressure, as I have been doing the last few weeks in the evening. It has been running just fine. High teens or low 120s over something in the high 60s or 70's. Normal heart rate, in the 70s as well.

After the 15 minute ride home, most of the worst wobblies had passed. I got my 10 pm snack/tea and meds ready and sat down. I took my blood pressure, as I have been doing the last few weeks in the evening. It has been running just fine. High teens or low 120s over something in the high 60s or 70's. Normal heart rate, in the 70s as well. However, this time it was low. 99/57 hr 80. A few minutes later it was 104/56 hr 77, then 96/49 hr 76. I had no symptoms by this point. Had my snack/tea and took my Pred. Tested my BP two more times : 104/56 hr77, and 109/61 hr85. All these varied readings were sitting in the same chair.....

Stupidly, I took my usual BP med this morning. Not my intention, but just took it in one swallow with the rest of my morning supplements and couldn't undo that. BP so far today has been fine and no wobblies or weakness. Right now BP is 138/81 hr 68. And that is three hours since taking BP meds.

I'm using an Omron wrist BP tester. It has been pretty reliable until now. I called the advice on call nurse and was set up with a phone called with my Internal Med GP on Monday afternoon. I was told to continue monitoring if I feel symptomatic.

Any thoughts? Is this common with Pred tapers? I know Pred can increase blood pressure, but I'm wondering if this could be a sign that given my Pred absorption rate, I might be below adrenal support, or near enough to it, that my adrenals are kicking in and out a bit erratically. Just another of my "theories".

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Hindags profile image
Hindags
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9 Replies
PMRpro profile image
PMRproAmbassador

Dunno - but something similar happened to me the last time I had a big flare. Am just having a minor one and there have been suggestions. But I'm too apathetic to go and find the sphyg!!!!!! However, it has improved a lot since I upped the pred again.

Last time I adjusted the BP meds marginally (1/2 a losartan tablet instead of a whole one) and it seemed to settle. And of course I went back to 15mg from 5mg where it had happened. This time I've gone from 5 to 10mg.

How good is the Omron thing really?

Hindags profile image
Hindags in reply to PMRpro

Thanks for the info. I'm not going to take bp meds tomw. For sure. Can't tell how accurate the omrom wrist thing is. Will dig out the old omrom cuff thing and compare. Found the cuff awkward, too big for me. But will try.

Soraya_PMR profile image
Soraya_PMR

Sounds like postural hypotension to me. When we sit still for a length of time gravity will effect our blood. Standing up too quickly and expecting our bodies to cope like they did when we were in our twenties can be a big ask ;)

Firstly ensure you are well hydrated to naturally prevent depletion of blood volume.

Then be kind to yourself: after sitting, initially do some pointy feet exercises, point, bend, these will work your calf muscles and in turn will get your blood flowing back up your legs. Then stand slowly, hooch yourself to the front of the chair, pause, another couple of leg wiggles. And rise slowly. Pause before walking to acclimatise to the altered altitude!

Some people with severe postural hypotension are prescribed support stockings to prevent blood pooling in lower limbs.

Sounds like your BP meds’ need review/reducing?

Also check any other meds such as amitryptylline, which caused me terrible postural hypoT. And supplements such as olive leaf can and will reduce B.P.

Hindags profile image
Hindags in reply to Soraya_PMR

Thank you so much. I'll definitely work my feet before getting up on them. Though that doesn't explain the prolonged interval of lower blood pressure. Will discuss reducing bp meds.

Hindags profile image
Hindags

Well, I guess I'm not alone. Did a google search and found this from a few years ago on Patient.com. patient.info/forums/discuss...

I also did dig out my old BP cuff and it correlates closely enough with the wrist BP machine.

Ah, this condition certainly keeps on giving/taking. Whichever way you look at it.

Soraya_PMR profile image
Soraya_PMR in reply to Hindags

Interesting. Horses for courses I guess. Different people react different ways to different drugs.

Time to discuss with your GP I think. Bit of a silver lining if you can ditch your B.P. meds 👍🏼

Hindags profile image
Hindags

Funny coincidence today. My cousin called and when she asked me how I am. I said, "OK". I asked her and she said, "OK". Then she said, "Not really, I was just diagnosed with postprandial hypotension."

Well I think this description kinda fits what happened to me this other night:

verywell.com/postprandial-h.... Even though the episode occurred a little over 2.5 hours after eating. I had been pretty sedentary in that movie theater. And I had eaten more than usual at dinner.

ali5son profile image
ali5son

Have been experiencing dizziness over the last week. The week at work was very stressful and was suffering anxiety. Had also started Cambridge diet plan. Also last year before onset of PMR had some dizziness and doctor suspected middle ear infections and gave meds and all ok the next day. Went to chemist and have blood pressure checked and all ok but was only able to get phone appointment with GP and prescribed meds for dizziness said could be combination of all of above. But also now tappering to 8mg pred ? Hope this makes sense.

Hindags profile image
Hindags in reply to ali5son

Dizziness without other symptoms can be caused by many things, and combos of many things. If is continues, need to change one thing at a time to isolate probable cause(s) suppose.

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