low blood pressure

[pmac22]

I have GCA and I have been tapering prednisone for 3 years. I am on my second attempt at tapering prednisone and just got to 4mg. Last year I actually got down to 3 mg but suffered a 4th and acute diverticulitis attack which was too much for my sputtering adrenals. While in the ER the PA didn’t take my adrenal insufficiency seriously (I was not wearing a bracelet (medical ID) and was at different hospital. Finally the ER Doctor listened but I was already in crisis. It was pretty scary.

I now have a medical alert tag and carry an emergency hydrocortisone injection kit. I have a good endocrinologist now and will again go through the cortisol testing at 3 mg.

my question is has anyone else had low blood pressure while tapering.

I have had to cut down my Losartan as I had high blood pressure. It has been pretty steady until I got down to 4 1/2 mg of prednisone. Now I’m getting readings of 102/52 in the evening. During the day it seems to be more in the normal range.

thank you all for being so supportive.

Peggy

[DorsetLady PMRGCAuk volunteer]

Does your own doctor monitor your BP levels? Think you probably need to discuss with them… do you feel any effects when it’s low? Mine goes quite low some evenings, but I’ve never felt unwell - and like you during the day is within normal range.

I do however send readings to GP every 3 months…

[pmac22 in reply to DorsetLady]

Thank you. I just feel really drained and quite breathless while evening walk. I am going to send my readings to endo and see what she says. I am afraid to lower BPMeds anymore as my readings during the day are good. I never really had blood pressure issues until I had a bad case of Covid and pneumonia in June of 2020. My blood pressure was quite high and very difficult to control even on 3 meds! After GCA diagnosis and high dose of prednisone it actually decreased and was controlled with just one medication. Thank you again.

Peggy

[Frewen1 in reply to pmac22]

I too am tapering with GCA, third time, at 15mg Pred at the moment. Everything’s high or low to the extent that i confuse them … but in fact it’s BP high, cortisol low ( I think ) but also having fortnightly blood tests for liver because of newly introduced Leflunomide. It’s a circus, isn’t it? Good luck

[Pixix]

Yes, but I don’t really associate mine with my PMR at all, tbh, & haven’t noticed if it’s worse when I taper. I was having breathlessness and dizziness, especially when I got up from ground or chair. I did a lot of BP readings at different times, f some when I’d been sitting relaxing, then immediately on standing. I’ve had high blood pressure since I took on a European directo role at work & charged round europe, running for planes & working over 60 hours a week! I was put on a small dose of bp medication, which worked. But now I’ve been diagnosed with orthostatic hypotension, & everything is working against each other..highs & lows. I haven’t seen other posts about orthostatic hypotension here, but I haven’t looked, tbh. When I get up from ground, if not careful, I get dizzy, lose balance, fall over. I’m not used to the situation & Dr & I discuss it regularly, & adapt medication. Good luck!

[Nightingales]

I have an interesting thing going on with my bp. It had become too high to ignore. I was already on 3 bp tabs but it was hitting the 200 systolic and diastolic was much higher than usual. Doc put me on Indapamide 2.5 a diuretic I believe. Within three days I felt terrible, nauseous and weak.But my bp dropped to normal. I stopped it and took potassium and felt better. Since then my bp seems to be getting lower and lower, average 115/55. I have never seen these numbers before! I am tapering to 9.5 mg. I wonder could this be coincidence, or an adrenal problem. Did they say your low bp was caused by the neglect of your pred needs in ER?

[pmac22 in reply to Nightingales]

I did not go to ER just messaged cardiologist and endocrinologist , waiting for a reply. Good luck with your taper.

[PMRpro Ambassador]

Low blood pressure is common in adrenal insufficiency - when it gets extreme it becomes a crisis.

I had similar levels to that up to a few months ago - probably due to the atrial fibrillation meaning the heart wasn't pumping effectively and so my BP fell. I felt OK, just tired. Low BP is only really a problem if it is causing symptoms.

The GCA and pred effect was possibly becasue the GCA was narrowing arteries and so increasing the pressure needed to get the blood through. When you started pred, the narrowing was improved with the inflammation being reduced and so the BP fell. It is often mentioned.

[pmac22]

thank you for your explanation it really helps.

[WhatNoCarbs]

I’m having a few issues with low bp atm. May have been after getting a bug or may be K2 deficiency (due to another long term med) or something nastier. Blood test said really low iron. GP’s currently trying to figure out why. Due for another blood test on Tue. It will be interesting if adrenals/cortisol issues come out as the reason behind it. Will await with interest. Iron tablets arriving tomorrow. More tablets to add to the list!