High Blood Pressure

[ptlwp]

My htn was rx'd after I'd had a baby. I am an ex medical adm asst at a university hospital nearby. I dated a med student/resident for longer than I care to remember.

Both of my parents had hypertension. My father (RIP) had malignant htn and at the time, his doctors thought his aorta might burst. (It didn't). My mother also has hypertension.

Anyway, I have certainly no qualifications for giving advice and in fact, am seeing the doctor today for assorted and assundry items.

However, I might say that arthritis doesn't run in my family any which way, yet I, needed a THR-L 12/28/04, completely out of no where and in less than a year's time from start of pain to the DOS.

I say this only because while I'd like to exercise as much as can for my health, I also don't want to exercise so much that my hip needs a revision, or that my right hip fails, in the upcoming years.

Yes, I could lose weight; I'm not the 130 pounds I was at 25, but then again, I am not 25 either.

No, I can't do aerobics, jogging, and so forth but biking has been very good for trimming me down......not for losing weight as much.

The Diovan is helping just enough. I need to see my endocrinologist because I take Synthroid 137 mcg/day, but haven't been feeling quite so well.

Dear friends, stay 30 or under, and don't trust anyone over 30, for we are all quite unhealthy...... .

PS. Having babies seems to take quite a bit out of a woman's sap, since I was pretty much in fine health until I had my first dear one, my sweet angel from heaven, when I was 36. Have your kids when you are younger and your body is more up to the challenge, in my own opinion.

 

[kf5nd]

Genetics did it for me! Everyone in my fam has HBP! So I take a small dose of an ACE inhibitor, no side effects, and cheap (generic). For pennies a day, my BP is rock-solid below 120/80. I'm really happy about that.

 

[lennyk]

ACE Inhibitors and ARB's are quite frequently prescribed nowadays as they have little side effects.
ACE Inhibitors do have a possible side effect of a serious dry cough which I developed and had to switch the ARB's

 

[vbs]

Hi All

My Mum is on loads of blood pressure pills to keep it down, she is very over weight and does no exercise except walking round the shops. Her diet isn't too bad but its years of no exercise and over eating that has done it.

Saw my doctor the other day and he said my BP was slightly up and I wondered if there were any foods that could help me keep it under control. I am exerciseing more than I used to and trying to eat better but its hard.

Thanks

 

[Felt_Rider]

HBP runs in my family and my BP being high is what got me into cycling (and then I got bike fever and cycling became my addiction).

Before I started cycling my BP consistently tested in the range of 140/92.
I just had my annual physical last week and it tested at 116/80.

So as you can imagine I am very happy as to what my new addiction has done for me. I have been training with weights for over 20 years and to retain muscle mass I would only do cardio when approaching competitions, but now that those days are gone I can train to actually be healthy instead of just trying to have an outward healthy (vanity) appearance.

My diet is typically very clean, but since being threatened with being put on meds I did add omega fatty acids to my daily regiment, but again leaning out instead of being bulked up and cycling have been the best things that I have done.

 

[RickF]

Saw my doctor the other day and he said my BP was slightly up and I wondered if there were any foods that could help me keep it under control. I am exerciseing more than I used to and trying to eat better but its hard.

My diet is typically very clean, but since being threatened with being put on meds I did add omega fatty acids to my daily regiment, but again leaning out instead of being bulked up and cycling have been the best things that I have done.

Omega fatty acids are extremely helpful in controlling cholesterol and preventing cardiovascular disease caused by atherosclerosis, but they do very little in the way of controlling blood pressure. Controlling cholesterol is even more importent in people who have high blood pressure than it is in people with normal blood pressure, so I agree that the addition of omega-3 and omega-6 fatty acids to the diet is a good idea, especially in people with hypertension,; however, it is not because these oils will lower blood pressure.

There are foods such as salt, caffeine, and licorice, that will raise blood pressure and, therefore, should be avoided by people with high blood pressure, but there are no foods that will lower blood pressure. Keeping your weight under control and aerobic exercising on a regular basis (at least three days per week) will help to lower blood pressure, but being at the ideal body weight and exercising regularly is not always enough.

I have had high blood pressure all of my life. My blood pressure was no better when I weighed 175 pounds and swam 3000 to 5000 yards three to four times per week than it was when I did nothing and weighed 265 pounds. It is just in my genetic makeup to be hypertensive. Despite the fact that my weight and activity level has no effect on my blood pressure, I am still better off having lost the weight and cycling three to four days per week in terms of lowering other cardiovascular risks. Diet and activity level has some effect on blood pressure, but they are far more important in relationship to cholesterol concentrations and the risk of developing type II diabetes than they are in relationship to blood pressure.

 

[Felt_Rider]

Omega fatty acids are extremely helpful in controlling cholesterol and preventing cardiovascular disease caused by atherosclerosis, but they do very little in the way of controlling blood pressure. Controlling cholesterol is even more importent in people who have high blood pressure than it is in people with normal blood pressure, so I agree that the addition of omega-3 and omega-6 fatty acids to the diet is a good idea, especially in people with hypertension,; however, it is not because these oils will lower blood pressure.

You are correct. I did not clearly make the intended statement.

My intended statement in the last sentence was that the only change I have made to my diet and supplementation was adding in omega fatty acids and not that this particular supplement has any credit to my lower BP as recently tested. What I hoped was to give positive credit to in the last sentence was the activity of cycling resulting in better conditioning and improved body composition. Cycling has also proven to be a stress reliever for me and also lowered hypertension. Adding cycling to my training regiment has been a positive in many ways.

 

[RickF]

What I hoped was to give positive credit to in the last sentence was the activity of cycling resulting in better conditioning and improved body composition. Cycling has also proven to be a stress reliever for me and also lowered hypertension. Adding cycling to my training regiment has been a positive in many ways.

You will get no argument from me on that.

 

[trulymadly]

my brother was suffering from high blood pressure some years back and since he started doing cycling, he got better (it wasnt excessive cycling for him), but he felt like he was gushing out his High blood pressure by cycling! I heard that in certain cases, high blood pressure can lead to cardiac diseases too. Anywayz, cycling is a mega good sport!

 

[rjdirgo]

I found that if you exercise on the treadmill walking briskly or running 2-3 times a week in addtion to cycling, it helps to keep your blood pressure under control. In Covert Bailey's Smart Exercise book he says that the trick is in engaging more muscles in your exercise which results in more capillaries to dilate. If the blood has more room to travel in your body your blood pressure goes down. The trouble with cycling is it uses less muscles than walking or running and thus reducing capillary dilation. I think if you cross train, using the treadmill for jogging/walking briskly in addtion to cycling this mix will result in overall a lower of your blood pressure.

 

[RickF]

I found that if you exercise on the treadmill walking briskly or running 2-3 times a week in addtion to cycling, it helps to keep your blood pressure under control. In Covert Bailey's Smart Exercise book he says that the trick is in engaging more muscles in your exercise which results in more capillaries to dilate. If the blood has more room to travel in your body your blood pressure goes down. The trouble with cycling is it uses less muscles than walking or running and thus reducing capillary dilation. I think if you cross train, using the treadmill for jogging/walking briskly in addtion to cycling this mix will result in overall a lower of your blood pressure.

I agree to a point. Exercise will lower blood pressure, but in many cases exercise does not lower blood pressure enough to control hypertension. While it is true that being overweight and sedentary will cause blood pressure to go up, being active and in the normal weight range is no guarantee that one will not have hypertension.

When I was 17 years old, weighed 152 pounds, wrestled and played soccer, I was hypertensive. When I was 30 years old, weighed 190 pounds and swam for two hours per day four days per week and had a resting heart rate of 58, I was hypertensive. Now, I am 53 years old, weigh 210 pounds, and ride my bike 15 to 40 miles per day three days per week, and have a resting heart rate of 68, I am hypertensive. A year ago, I had no regular physical activity, weighed 265 pounds, and had a resting heart rate of 80, and my blood pressure was no worse than it was when I was 17 or than it is now. The only difference as far as my blood pressure is concerned is that the medications to control blood pressure have improved drastically over the years. I have been on an ACE inhibitor (lisinopril) and a diuretic (hydrochlorothiazide) for the past six years. I have had no adverse effects from the medication, and my blood pressure is under control.

 

[rippitupp]

couldn't have said it better myself

There's at least seven different categories...

cholinergics, diuretics, beta-blockers, calcium channel inhibitors, angiotensin II receptor blockers, ACE inhibitors, centrally acting medications.

All have different effects, and all will affect your cycling performance in different ways.

I would suggest an AT2R blocker, or an ACE inhibitor if you're wanting to minimise the effect on strenuous aerobic efforts. These inhibit primary the physiological mechanism that increases blood pressure, and doesn't slow down your HR or affect your peripheral circulation. They do have some other side effects, which you may or may not experience and may or may not be able to cope with. Most people tolerate AT2RBs and ACE inhibitors quite well.

If your cholesterol is high as well, you might benefit from being on a statin in addition to your BP meds.

HTH,

nerdag

 

[rippitupp]

i would not recommend the diuretic approach to an athlete, or cyclist. Hydration is very important for endurance sports, and a diuretic basically dehydrates you, which lowers your preload, and in turn your Cardiac Output and blood pressure
Vasodilators is a very vague classification of drug...infact most of the drugs you mentioned are vasodilators.....Beta blockers, calcium channell blockers, ACE inhibitors....just the mechanism of action differs.
i think the best choice is not to look for an answer on such an important health matter on this forum...find an internist, on who will listen to what your lifestyle and goals are, and taylor a treatment plan suited for only you...

This is the best post so far. I would stay away from hawthorn tea and other "natural" or "herbal" remedies. There are two major problems with these. The first is that they have never been put through rigorous testing to determine if they work. The second is even more serious, and that is that there are no standards to ensure uniformity from batch to batch, from year to year, or from growing location to growing location. Everyone recognizes that wine from California can taste entirely different from wine made from the same grape variety grown in France or Italy. Everyone also recognizes that wine from grapes grown in one year does not taste exactly the same as wine made from the same grapes grown in the same location in a different year. The same is true of any botanical product. Where it is grown and when it is grown will affect the composition of the product. Also, remember that just because it is "natural" does not make it safe. Hemlock, bitter almond, and cobra venom are "natural" - deadly, but "natural".

I have been hypertensive since I was 16 years old. My blood pressure was just as high when I was 25 years old and weighed 175 pounds as it was when I was 50 years old and weighed 260 pounds. I take lisinopril (an ACE inhibitor) and hydrochlorothiazide (a diuretic), and my blood pressure is well controlled.

An ACE inhibitor (or AT2R blocker) or a diuretic is the best thing to try first. If one agent alone does not control blood pressure, then add the other. These would be the least likely to affect exercise and training abililty, and are the ones that show the most benefit in terms of long term outcome (preventing stroke, renal failure, and heart attacks). Prevention of the long term effects is the reason that blood pressure should be treated. The one potential problem with most of the diuretics is hypokalemia (low concentrations of potassium in the blood). This usually can be prevented by eating fruits, especially bananas and apricots, but some people do require potassium chloride supplements. Hypokalemia will have a negative impact on exercise and training ability.

Beta blockers also have been shown to prevent the long term effects of hypertension, but beta blockers do not allow the heart to speed up in response to stress or exercise. While this is a good thing if you are trying to reduce the workload of the heart and reduce blood pressure, it will have a negative impact on exercise and training ability. Some beta blockers are especially useful in preventing heart failure in patients who have already had a heart attack and in treating heart failure, but the real goal is to prevent these problems in the first place. Beta blockers are not a good choice in patients who have asthma or chronic obstructive pulmonary disease (COPD - emphysema), because they can constrict the airways. This action, too, could cause a negative impact on exercise or training ability.

Calcium channel blockers should be reserved for patients who do not respond enough to the other agents. Head to head studies of calcium channel blockers and ACE inhibitors show that even though calcium channel blockers lower blood pressure better, ACE inhibitors are better at preventing the long term problems associated with high blood pressure. AT2R blockers are similar to ACE inhibitors in their effect, although they attack the problem from different sides. AT2R blockers block the effect of angiotensin II at the receptor. ACE inhibitors prevent the formation of angiotensin II. Even though AT2R blockers and ACE inhibitors should provide the same benefits (and most available data support this), there are far more data available on ACE inhibitors then there are on AT2R blockers.

Vasodilators are not used much now that the ACE inhibitors and AT2R blockers are available. Vasodilators do lower blood pressure, but they can increase the workload on the heart, and they can lead to some unpleasant and potentially dangerous side effects, particularly orthostatic hypotension (rapid fall in blood pressure upon standing). Orthostatic hypotension can be severe enough that people pass out when they stand up quickly. Vasodilators are still useful, though, in some patients in combination with other agents when ACE inhibitors (or AT2R blockers), diuretics, and beta blockers do not lower blood pressure adequately.

 

[RickF]

i would not recommend the diuretic approach to an athlete, or cyclist. Hydration is very important for endurance sports, and a diuretic basically dehydrates you, which lowers your preload, and in turn your Cardiac Output and blood pressure
Vasodilators is a very vague classification of drug...infact most of the drugs you mentioned are vasodilators.....Beta blockers, calcium channell blockers, ACE inhibitors....just the mechanism of action differs.
i think the best choice is not to look for an answer on such an important health matter on this forum...find an internist, on who will listen to what your lifestyle and goals are, and taylor a treatment plan suited for only you...

By vasodialator, I was refering to the direct vasodialators, like hydralazine. ACE inhibitors, ARBs, and beta blockers block mechanisms of vasoconstriction, but that is not the same as a direct vasodilator. The direct vasodilators drop the diastolic pressure, but they have very little effect on systolic pressure.

At the dose of thiazide diuretics that are used today (e.g., 12.5 mg of hydrochlorothiazide), there is no effect on hydration status or preload, but a major effect on blood pressure, especially when combined with an ACE inhibitor or ARB. The antihypertensive effect of the thiazide diuretics is not due to volume contraction and decreased preload. Loop diuretics (furosamide, et. al.) are a different matter, and I would agree that loop diuretics are not appropriate for athletes.

 

[rippitupp]

i realize HTCZ isn't a loop diuretic, but unfortunately all too often it is a loop diuretic that is the initial order.
I am confused by your statement about hydralizine. i realize is is a potent afterload reduction agent, but i have seen profound drops in SBP when giving it, infact most times it is ordered for systolic hypertension, especially when there is a component of renal failure or inotropic inpairment of contractility, inorder to avoid the negative inotropic effects of some of the other classes of drugs. Alpha and Beta antagonists both affect SBP do they not?

By vasodialator, I was refering to the direct vasodialators, like hydralazine. ACE inhibitors, ARBs, and beta blockers block mechanisms of vasoconstriction, but that is not the same as a direct vasodilator. The direct vasodilators drop the diastolic pressure, but they have very little effect on systolic pressure.

At the dose of thiazide diuretics that are used today (e.g., 12.5 mg of hydrochlorothiazide), there is no effect on hydration status or preload, but a major effect on blood pressure, especially when combined with an ACE inhibitor or ARB. The antihypertensive effect of the thiazide diuretics is not due to volume contraction and decreased preload. Loop diuretics (furosamide, et. al.) are a different matter, and I would agree that loop diuretics are not appropriate for athletes.

 

[RickF]

i realize HTCZ isn't a loop diuretic, but unfortunately all too often it is a loop diuretic that is the initial order.
I am confused by your statement about hydralizine. i realize is is a potent afterload reduction agent, but i have seen profound drops in SBP when giving it, infact most times it is ordered for systolic hypertension, especially when there is a component of renal failure or inotropic inpairment of contractility, inorder to avoid the negative inotropic effects of some of the other classes of drugs. Alpha and Beta antagonists both affect SBP do they not?

Your experience must be different from mine. I have never seen a loop diuretic prescribed unless there was fluid retention as an adverse effect from beta blockers or PPAR gamma agonists or from congestive heart failure. Thiazide diuretics, on the other hand, often are the first line treatment for essential hypertension.

I have seen systolic pressure reduction from hydralizine, but only at doses above those that cause significant reduction in diastolic hypertension. In most patients, if hydralizine is the sole agent used, by the time systolic pressure is controlled, diastolic pressure is so low that the patient has orthostatic hypotension. ACE inhibitors, ARBs, and thiazides tend to have a bigger effect on systolic pressure than on diastolic pressure, which tends to reduce the incidence of orthostatic hypotension.

Yes, alpha and beta blockers lower systolic pressure, but they are not direct vasodilators. Alpha blockers block vasoconstriction, but they do not directly cause vasodilation. Also, the antihypertensive effects of alpha blockers do not last in the long term, and pure alpha blockers are rarely used. Mixed alpha and beta blockers, like carvedilol and lebatolol, on the other hand, do have a place, but not in athletes with uncomplicated essential hypertension.

Beta blockers block the increased heart rate response from vasodilation, and they do lower both systolic and diastolic pressure to about the same degree, but again, they are not what I was referring to as direct vasodilators. While I have no problems with low dose thiazide diuretics to control blood pressure in athletes, I would not recommend a beta blocker as first-line therapy. The major problem is that beta blockers block the increase in heart rate that would be necessary to maintain performance under stress. Thiazide diuretics (again, at reasonable doses) and ACE inhibitors or ARBs would have much less impact on performance, yet are effective at controlling blood pressure and have proven records at preventing the long term detrimental effects of hypertension.