Has anyone experienced this sort of crisis?



F

francispoon

Guest
I changed high bp medicine about a few months ago and have experienced
moments in which my bp seems out of control no matter what I do. I
went to see seversal doctors and was given several recipees. Each
usually worked for a week or so and then all of a sudden my bp just
refused to comply any more. I noted that most of the medicine used
falls into the category of calcium channel blocker. With the
co-administration of beta-blocker, they stand a chance but without
beta=blocker, the experience could be quite frightening. Some doctors
told me that is because i am too nervous, and other doctors pointed
out this is because I moved out of the old medication too abruptly and
therefore the body refuses to accept new medication.

Currently i am using two systems to protect myself. I take 5 mg of
Zestrial and a beta-blocker in the morning and 10 mg of nifedipine
around 2pm. While the Zestrial is sustained release on a 24 hours
basis, the tablet of 10 mg of nifedipine last only for 12 hours. I am
using these two medicines in case one fails me. I would welcome some
suggestion as to how to take out one and keep the other without the
same set of disarray that took place before. Given a choice, I would
keep Zestrial as i am under the impression that ACE Inhibitor is
better for hereditary bp and my blood vessels are getting less elastic
with age.

Thank You In Advance,

FP
 
francispoon wrote:

> I changed high bp medicine about a few months ago and have experienced
> moments in which my bp seems out of control no matter what I do. I
> went to see seversal doctors and was given several recipees. Each
> usually worked for a week or so and then all of a sudden my bp just
> refused to comply any more. I noted that most of the medicine used
> falls into the category of calcium channel blocker. With the
> co-administration of beta-blocker, they stand a chance but without
> beta=blocker, the experience could be quite frightening.


Hmm.

> Some doctors
> told me that is because i am too nervous, and other doctors pointed
> out this is because I moved out of the old medication too abruptly and
> therefore the body refuses to accept new medication.
>


Your doctors are guessing.

>
> Currently i am using two systems to protect myself. I take 5 mg of
> Zestrial and a beta-blocker in the morning and 10 mg of nifedipine
> around 2pm. While the Zestrial is sustained release on a 24 hours
> basis, the tablet of 10 mg of nifedipine last only for 12 hours. I am
> using these two medicines in case one fails me. I would welcome some
> suggestion as to how to take out one and keep the other without the
> same set of disarray that took place before.


What is your height and weight?

> Given a choice, I would
> keep Zestrial as i am under the impression that ACE Inhibitor is
> better for hereditary bp and my blood vessels are getting less elastic
> with age.
>
> Thank You In Advance,
>
> FP


You are welcome.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/
 
In article <[email protected]>, [email protected] (francispoon) wrote:
>I changed high bp medicine about a few months ago and have experienced
>moments in which my bp seems out of control no matter what I do. I
>went to see seversal doctors and was given several recipees. Each
>usually worked for a week or so and then all of a sudden my bp just
>refused to comply any more. I noted that most of the medicine used
>falls into the category of calcium channel blocker. With the
>co-administration of beta-blocker, they stand a chance but without
>beta=blocker, the experience could be quite frightening. Some doctors
>told me that is because i am too nervous, and other doctors pointed
>out this is because I moved out of the old medication too abruptly and
>therefore the body refuses to accept new medication.
>

I had a simular problem several years ago. My BP would suddenly
spike up out of sight. By the time I would get to a Dr. it would be back
down. After many visits I finally got there when it was still up. 220/150
and that was after it started coming down. The Dr. finally realized I had
not been lying all the other times. Don't know why someone would make
something like that up. She got it under control with Procardia.
 
"Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> francispoon wrote:


snipped...
> > Currently i am using two systems to protect myself. I take 5 mg of
> > Zestrial and a beta-blocker in the morning and 10 mg of nifedipine
> > around 2pm. While the Zestrial is sustained release on a 24 hours
> > basis, the tablet of 10 mg of nifedipine last only for 12 hours. I am
> > using these two medicines in case one fails me. I would welcome some
> > suggestion as to how to take out one and keep the other without the
> > same set of disarray that took place before.

>
> What is your height and weight?
>

I am 57-58 years ago and weight 160pounds. Currently i am following
the advice of a patient doctor. I am taking 10 mg of Zestril and 25
mg of beta-log in the morning at 8pm, and, if the bp is still too high
by say 4-5pm, say 140-150/90-95, i will take another 10 mg of
nifedipine and one lodoz. I will see how it goes. Now, I have
accepted that I may need to take medications twice and the old days of
taking just one to take care of the whole day could be a by-gone
memory. Also, I have discovered that beta blocker is quite important
in the overall mix. Seems that nothing works without it!

Rdg.,

FP
==============================================
> > Given a choice, I would
> > keep Zestrial as i am under the impression that ACE Inhibitor is
> > better for hereditary bp and my blood vessels are getting less elastic
> > with age.
> >
> > Thank You In Advance,
> >
> > FP

>
> You are welcome.
>
> Humbly,
>
> Andrew
 
[email protected] (GS) wrote in message news:<[email protected]>...
> In article <[email protected]>, [email protected] (francispoon) wrote:
> >I changed high bp medicine about a few months ago and have experienced
> >moments in which my bp seems out of control no matter what I do. I
> >went to see seversal doctors and was given several recipees. Each
> >usually worked for a week or so and then all of a sudden my bp just
> >refused to comply any more. I noted that most of the medicine used
> >falls into the category of calcium channel blocker. With the
> >co-administration of beta-blocker, they stand a chance but without
> >beta=blocker, the experience could be quite frightening. Some doctors
> >told me that is because i am too nervous, and other doctors pointed
> >out this is because I moved out of the old medication too abruptly and
> >therefore the body refuses to accept new medication.
> >

> I had a simular problem several years ago. My BP would suddenly
> spike up out of sight. By the time I would get to a Dr. it would be back
> down. After many visits I finally got there when it was still up. 220/150
> and that was after it started coming down. The Dr. finally realized I had
> not been lying all the other times. Don't know why someone would make
> something like that up. She got it under control with Procardia.


Thanks for sharing your experience. I experience spike=ups too and a
very useful tool i have always carried in my pocket is 'lodoz
tablets'. It contains 6.5 mg of hydrochloridediazide and 5 mg of
bisoprolol furamate. Whenever a spike-up comes, a lodoz tablet would
just knock it right down at least for a while.

Rdg.,

FP
===================================
 
[email protected] (GS) wrote in message news:<[email protected]>...
> In article <[email protected]>, [email protected] (francispoon) wrote:
> >I changed high bp medicine about a few months ago and have experienced
> >moments in which my bp seems out of control no matter what I do. I
> >went to see seversal doctors and was given several recipees. Each
> >usually worked for a week or so and then all of a sudden my bp just
> >refused to comply any more. I noted that most of the medicine used
> >falls into the category of calcium channel blocker. With the
> >co-administration of beta-blocker, they stand a chance but without
> >beta=blocker, the experience could be quite frightening. Some doctors
> >told me that is because i am too nervous, and other doctors pointed
> >out this is because I moved out of the old medication too abruptly and
> >therefore the body refuses to accept new medication.
> >

> I had a simular problem several years ago. My BP would suddenly
> spike up out of sight. By the time I would get to a Dr. it would be back
> down. After many visits I finally got there when it was still up. 220/150
> and that was after it started coming down. The Dr. finally realized I had
> not been lying all the other times. Don't know why someone would make
> something like that up. She got it under control with Procardia.


By the way, is Procardia a generic form of nifedipine? I had been on
20mg of generic nifedipine(taken twice daily) and my blood pressure
was under control. Then i went to visit a fancy doctor who graduated
from Stanford. She prescribed adalat gits 30 mg tablets to me, taken
once daily, in order to be more convenient. After some time, sudden
surges took place and i was frightened. I suppose these are two
different kinds of medicine though the name is the same 'nifedipine'.

Could you talk to your doctor and tell me what the Procardio you are
using?

THanks,

FP
 
francispoon wrote:

> "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> > francispoon wrote:

>
> snipped...
> > > Currently i am using two systems to protect myself. I take 5 mg of
> > > Zestrial and a beta-blocker in the morning and 10 mg of nifedipine
> > > around 2pm. While the Zestrial is sustained release on a 24 hours
> > > basis, the tablet of 10 mg of nifedipine last only for 12 hours. I am
> > > using these two medicines in case one fails me. I would welcome some
> > > suggestion as to how to take out one and keep the other without the
> > > same set of disarray that took place before.

> >
> > What is your height and weight?
> >

> I am 57-58 years ago and weight 160pounds.


Your ideal weight might be 135 pounds.

You might be 25 pounds overweight.


> Currently i am following
> the advice of a patient doctor. I am taking 10 mg of Zestril and 25
> mg of beta-log in the morning at 8pm, and, if the bp is still too high
> by say 4-5pm, say 140-150/90-95, i will take another 10 mg of
> nifedipine and one lodoz. I will see how it goes.


Why not another Zestril?

> Now, I have
> accepted that I may need to take medications twice and the old days of
> taking just one to take care of the whole day could be a by-gone
> memory.


If you lost 25 pounds, you might go back to just once a day.

> Also, I have discovered that beta blocker is quite important
> in the overall mix. Seems that nothing works without it!
>
> Rdg.,
>
> FP


Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/
 
"Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> francispoon wrote:
>
> > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> > > francispoon wrote:

> >
> > snipped...
> > > > Currently i am using two systems to protect myself. I take 5 mg of
> > > > Zestrial and a beta-blocker in the morning and 10 mg of nifedipine
> > > > around 2pm. While the Zestrial is sustained release on a 24 hours
> > > > basis, the tablet of 10 mg of nifedipine last only for 12 hours. I am
> > > > using these two medicines in case one fails me. I would welcome some
> > > > suggestion as to how to take out one and keep the other without the
> > > > same set of disarray that took place before.
> > >
> > > What is your height and weight?
> > >

> > I am 57-58 years ago and weight 160pounds.

>
> Your ideal weight might be 135 pounds.
>
> You might be 25 pounds overweight.


I AM 175 CM TALL. So by that standard i might not be that fat. I
used to be able to control my bp just a few months ago when i was
still around 160 lbs. What do you think?
>
>
> > Currently i am following
> > the advice of a patient doctor. I am taking 10 mg of Zestril and 25
> > mg of beta-log in the morning at 8pm, and, if the bp is still too high
> > by say 4-5pm, say 140-150/90-95, i will take another 10 mg of
> > nifedipine and one lodoz. I will see how it goes.

>
> Why not another Zestril?
>

I have found Zestril to have somewhat hindered my erection. Secondly,
Zestril is getting weaker and weaker since I tried it a few days ago.
It used to be able to last until 5pm before i experience the tension.
Now, by 1:30pm, it already starts the buzzing sound. The blood
pressure is 160/90 by 12:30 noon today. So i put on my nifedipine and
lodoz immediately.

Give me some ideas, please!

FP
=========================================
> > Now, I have
> > accepted that I may need to take medications twice and the old days of
> > taking just one to take care of the whole day could be a by-gone
> > memory.

>
> If you lost 25 pounds, you might go back to just once a day.
>
> > Also, I have discovered that beta blocker is quite important
> > in the overall mix. Seems that nothing works without it!
> >
> > Rdg.,
> >
> > FP

>
> Humbly,
>
> Andrew
 
francispoon wrote:

> "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> > francispoon wrote:
> >
> > > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> > > > francispoon wrote:
> > >
> > > snipped...
> > > > > Currently i am using two systems to protect myself. I take 5 mg of
> > > > > Zestrial and a beta-blocker in the morning and 10 mg of nifedipine
> > > > > around 2pm. While the Zestrial is sustained release on a 24 hours
> > > > > basis, the tablet of 10 mg of nifedipine last only for 12 hours. I am
> > > > > using these two medicines in case one fails me. I would welcome some
> > > > > suggestion as to how to take out one and keep the other without the
> > > > > same set of disarray that took place before.
> > > >
> > > > What is your height and weight?
> > > >
> > > I am 57-58 years ago and weight 160pounds.

> >
> > Your ideal weight might be 135 pounds.
> >
> > You might be 25 pounds overweight.

>
> I AM 175 CM TALL.


Which is 5'9" and would lead to an ideal weight of possibly 136 pounds if you are female and 145 lbs if you are male.



> So by that standard i might not be that fat.


You might still be 24 pounds overweight if female and 15 pounds overweight if male.

> I
> used to be able to control my bp just a few months ago when i was
> still around 160 lbs. What do you think?


You might be able to control your BP better if lighter.

> >
> >
> > > Currently i am following
> > > the advice of a patient doctor. I am taking 10 mg of Zestril and 25
> > > mg of beta-log in the morning at 8pm, and, if the bp is still too high
> > > by say 4-5pm, say 140-150/90-95, i will take another 10 mg of
> > > nifedipine and one lodoz. I will see how it goes.

> >
> > Why not another Zestril?
> >

> I have found Zestril to have somewhat hindered my erection.


Ok, so you are male.

> Secondly,
> Zestril is getting weaker and weaker since I tried it a few days ago.
> It used to be able to last until 5pm before i experience the tension.
> Now, by 1:30pm, it already starts the buzzing sound. The blood
> pressure is 160/90 by 12:30 noon today. So i put on my nifedipine and
> lodoz immediately.
>
> Give me some ideas, please!
>
> FP


Losing weight should help.

See:

http://www.heartmdphd.com/wtloss.asp

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/
 
Thank you for the reply.

Losing weight is good but is a long shot from here and here this
minute I need to take care of my crisis right now.

The leaflet of Zestrial clearly says that the starting dosage for
patients with essential hypertension is 10 mg while the effective
maintenance is 20 mg daily. I took 10 mg of Zestrial this morning at
8am plus a Lodoz. By 4pm, the bp is 142/80. It could be higher as
the evening progresses. Is this still too high? Could i raise it to
15 mg with a Lodoz in the morning.

Thank you for your quick reply.

Rdg.,

FP
===================================


"Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> francispoon wrote:
>
> > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> > > francispoon wrote:
> > >
> > > > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
> > > > > francispoon wrote:
> > > >
> > > > snipped...
> > > > > > Currently i am using two systems to protect myself. I take 5 mg of
> > > > > > Zestrial and a beta-blocker in the morning and 10 mg of nifedipine
> > > > > > around 2pm. While the Zestrial is sustained release on a 24 hours
> > > > > > basis, the tablet of 10 mg of nifedipine last only for 12 hours. I am
> > > > > > using these two medicines in case one fails me. I would welcome some
> > > > > > suggestion as to how to take out one and keep the other without the
> > > > > > same set of disarray that took place before.
> > > > >
> > > > > What is your height and weight?
> > > > >
> > > > I am 57-58 years ago and weight 160pounds.
> > >
> > > Your ideal weight might be 135 pounds.
> > >
> > > You might be 25 pounds overweight.

> >
> > I AM 175 CM TALL.

>
> Which is 5'9" and would lead to an ideal weight of possibly 136 pounds if you are female and 145 lbs if you are male.
>
>
>
> > So by that standard i might not be that fat.

>
> You might still be 24 pounds overweight if female and 15 pounds overweight if male.
>
> > I
> > used to be able to control my bp just a few months ago when i was
> > still around 160 lbs. What do you think?

>
> You might be able to control your BP better if lighter.
>
> > >
> > >
> > > > Currently i am following
> > > > the advice of a patient doctor. I am taking 10 mg of Zestril and 25
> > > > mg of beta-log in the morning at 8pm, and, if the bp is still too high
> > > > by say 4-5pm, say 140-150/90-95, i will take another 10 mg of
> > > > nifedipine and one lodoz. I will see how it goes.
> > >
> > > Why not another Zestril?
> > >

> > I have found Zestril to have somewhat hindered my erection.

>
> Ok, so you are male.
>
> > Secondly,
> > Zestril is getting weaker and weaker since I tried it a few days ago.
> > It used to be able to last until 5pm before i experience the tension.
> > Now, by 1:30pm, it already starts the buzzing sound. The blood
> > pressure is 160/90 by 12:30 noon today. So i put on my nifedipine and
> > lodoz immediately.
> >
> > Give me some ideas, please!
> >
> > FP

>
> Losing weight should help.
>
> See:
>
> http://www.heartmdphd.com/wtloss.asp
>
> Humbly,
>
> Andrew
 
[email protected] (francispoon) wrote in message news:<[email protected]>...
> Thank you for the reply.
>
> Losing weight is good but is a long shot from here and here this
> minute I need to take care of my crisis right now.


Why is losing weight a long shot?


> The leaflet of Zestrial clearly says that the starting dosage for
> patients with essential hypertension is 10 mg while the effective
> maintenance is 20 mg daily. I took 10 mg of Zestrial this morning at
> 8am plus a Lodoz. By 4pm, the bp is 142/80. It could be higher as
> the evening progresses. Is this still too high?


It is still high but not dangerously so.

> Could i raise it to
> 15 mg with a Lodoz in the morning.


You could with your doctor's supervision.

> Thank you for your quick reply.


You are welcome.

> Rdg.,
>
> FP


Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com
 
Now my bp is basically under control. My problem for the past few
months has been that most of the doctors here in China are not that
familiar with imported drugs and the two in HK, one of them happened
to have graduated from Stanford, have more theory than practices with
their combination approach. Finally, i resorted back to the old
medicine I used when i first had treatment.

Currently, i am controlling my bp with 10 mg of Zestrial and one
tablet of Lodoz, and 25 mg of short lived betalog in the afternoon
only when necessary. This is not an ideal combination as i still need
to put on that beta-log. But with time hope someone could make a
suggestion. Perhaps you could suggest a 24 hours sustained released
beta-blocker or low dosage.

Rdg.,

FP
==========================
[email protected] (Dr. Andrew B. Chung, MD/PhD) wrote in message news:<[email protected]>...
> [email protected] (francispoon) wrote in message news:<[email protected]>...
> > Thank you for the reply.
> >
> > Losing weight is good but is a long shot from here and here this
> > minute I need to take care of my crisis right now.

>
> Why is losing weight a long shot?
>
>
> > The leaflet of Zestrial clearly says that the starting dosage for
> > patients with essential hypertension is 10 mg while the effective
> > maintenance is 20 mg daily. I took 10 mg of Zestrial this morning at
> > 8am plus a Lodoz. By 4pm, the bp is 142/80. It could be higher as
> > the evening progresses. Is this still too high?

>
> It is still high but not dangerously so.
>
> > Could i raise it to
> > 15 mg with a Lodoz in the morning.

>
> You could with your doctor's supervision.
>
> > Thank you for your quick reply.

>
> You are welcome.
>
> > Rdg.,
> >
> > FP

>
> Humbly,
>
> Andrew
 
It is not advisable to use a short-acting beta-blocker for addressing
the "spikes" of what sounds like labile hypertension. The reason is
beta-blockers can cause rebound hypertension making things even more
"labile."

I would suggest that whatever beta-blocker dose (preferably
long-acting) that is determined to be optimal should be left alone.
If you are symptomatic from the BP "spikes", nitroglycerin can be
considered as a way of addressing this labile component of your
hypertension.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

[email protected] (francispoon) wrote in message news:<[email protected]>...
> Now my bp is basically under control. My problem for the past few
> months has been that most of the doctors here in China are not that
> familiar with imported drugs and the two in HK, one of them happened
> to have graduated from Stanford, have more theory than practices with
> their combination approach. Finally, i resorted back to the old
> medicine I used when i first had treatment.
>
> Currently, i am controlling my bp with 10 mg of Zestrial and one
> tablet of Lodoz, and 25 mg of short lived betalog in the afternoon
> only when necessary. This is not an ideal combination as i still need
> to put on that beta-log. But with time hope someone could make a
> suggestion. Perhaps you could suggest a 24 hours sustained released
> beta-blocker or low dosage.
>
> Rdg.,
>
> FP
> ==========================
> [email protected] (Dr. Andrew B. Chung, MD/PhD) wrote in message news:<[email protected]>...
> > [email protected] (francispoon) wrote in message news:<[email protected]>...
> > > Thank you for the reply.
> > >
> > > Losing weight is good but is a long shot from here and here this
> > > minute I need to take care of my crisis right now.

> >
> > Why is losing weight a long shot?
> >
> >
> > > The leaflet of Zestrial clearly says that the starting dosage for
> > > patients with essential hypertension is 10 mg while the effective
> > > maintenance is 20 mg daily. I took 10 mg of Zestrial this morning at
> > > 8am plus a Lodoz. By 4pm, the bp is 142/80. It could be higher as
> > > the evening progresses. Is this still too high?

> >
> > It is still high but not dangerously so.
> >
> > > Could i raise it to
> > > 15 mg with a Lodoz in the morning.

> >
> > You could with your doctor's supervision.
> >
> > > Thank you for your quick reply.

> >
> > You are welcome.
> >
> > > Rdg.,
> > >
> > > FP

> >
> > Humbly,
> >
> > Andrew