Blood Pressure

[Andymegv]

Anyone have a drop in blood pressure after starting prednisone (20 mg for first 3 weeks and then tapering to 15 mg and 10 mg) for suspected diagnosis by rheumatologist for PMR? At first, we thought the tiredness was due to the prednisone itself, but then the blood pressure was low, even though on blood pressure pills. Thanks PMR community.

[PMRpro Ambassador]

"but then the blood pressure was low, even though on blood pressure pills"

I don't understand the "even though" - BP pills are used to moderate high BP, not prevent low BP. Often patients end up on tablets because their BP is raised before diagnosis of a vasculitis, Then once they are on pred and the inflammation is cleared up their BP falls as a result - inflammation narrows the arteries and narrow arteries increased the resistance and therefore BP. Once the BP due to that has fallen, you need less medication for the raised BP. It becomes a balance.

[Andymegv in reply to PMRpro]

PMR Pro, let me clarify...the blood pressure would run higher prior to PMR diagnosis and prednisone pills and this was on blood pressure bills: 135/80, but now the blood pressure reading is about 107/65 now on the prednisone pills and still on blood pressure pills. Plan to talk to primary care physician. Thank you for your response!! Interesting. Just was wondering if others had this happen. 😊

[PMRpro Ambassador in reply to Andymegv]

That's what I said - raised BP while the inflammation was rampant, it has fallen with the pred removing the inflammation - you need the BP meds adjusted down a bit ...

It isn't uncommon.

[Andymegv in reply to PMRpro]

Thank you PMRpro!!

[Koalajane in reply to PMRpro]

I had my blood pressure pills reduced due to them going lower

[montebello in reply to PMRpro]

This is interesting. After having been on high doses of PRED for 5 months, my BP slowly soared to 200/100. It's now under control with BP meds. I thought the high BP was due to the high dosages of PRED. Do you think it could have been? Thanks as always

[PMRpro Ambassador in reply to montebello]

In that case - yes and it is a known effect of pred. But there is no single cause of hypertension.

[AshPen9 in reply to PMRpro]

That's really interesting PMRpro. I didn't realise that inflammation potentially causes high BP. I had borderline high BP for a number of years, then I had a TIA four years ago, apparently caused by very high BP. Since then I have been taking Amlodipine. BP did go up for a while after starting Pred but is OK now. You've made me remember that my rheumy commented a while ago that inflammation can start many years before a condition is diagnosed. He said that because a tiny amount of blood is kept from blood donations, researchers had looked at historic samples from blood donors who had gone on to be diagnosed with inflammatory conditions. They had found evidence of inflammation going back as much as 15 years. So maybe my historic high BP and TIA were down to my inflammatory condition? I had never tied the two things together.

[PMRpro Ambassador in reply to AshPen9]

Perfectly possible - especially if the inflammation was affecting your kidneys, They play a massive role in BP.

[AshPen9 in reply to PMRpro]

Fascinating, thanks PMRpro. It makes me realise how little I know about what's going on in my body. In my youth I spent 5 years in the TA, it was a medical unit and I was a corporal. I was also a student radiographer but gave it up as a bad job. Just as well, I would have been a danger to the public!

[PMRpro Ambassador in reply to AshPen9]

Depends how much theoretical training there was I suppose. I did the equivalent of an ordinary degree as day release and then went on to Uni to do honours physiology. Then worked in medical associated field for the rest of my life - learned a lot about a lot of things just doing the background reading for large translation projects!

[AshPen9 in reply to PMRpro]

Must have been really interesting. You must also have very good recall! Re training - I have a certificate to say that I have passed an exam in medicine and surgery but the only real life practical thing I ever did was give an intramuscular injection!

[Andymegv in reply to PMRpro]

So, PMRpro, can inflammation that causes high blood pressure and vasculitis be anywhere in the body? Also, I might note that I am posting under my name for my husband who has been diagnosed with PMR. He has been on BP meds since 1986, but the PMR was diagnosed in February, 2023. I noted you said that the inflammation can go on many, many years before the diagnosis. This site is so helpful!!

[PMRpro Ambassador in reply to Andymegv]

Yes - but it varies. PMR inflammation can be identified using PET-CT and it tends to be in soft tissues around joints above all.

jrheum.org/content/46/12/1552

describes it - might be a bit technical

This has prettier pictures:

ncbi.nlm.nih.gov/pmc/articl...

[Andymegv in reply to PMRpro]

Thank you PMRpro!!

[Andymegv in reply to AshPen9]

Agree with you AshPen9, that is really interesting!

[LBM1953]

Hi. I have had Hypertension for years and it was kept under control by medication. When I started on steroids (30mg) my BP dropped. Not to levels which were a concern though and as I have reduced my steroids (currently 2mg) my hypertension came back and I have had to increase my (hypertension) medication to try and control it. Interestingly, I had developed olecranon bursitis in my leftellbos a couple of week ago and my BP increased significantly. It has dropped as the bursitis has improved.

[Elephants2019]

my blood pressure dropped too after 8 months or so on prednisone. I completely stopped taking bp meds.Now that I am reducing prednisone, I remain hopeful it stays low.

[winfong]

And I'm one of the ones whose blood pressure increased

[Jigsawlass in reply to winfong]

Me too , I'm now on meds to control it