Blood Pressure Issues AGAIN...
 

My doctor told me to monitor my blood pressure twice a day until my next appointment. It had been elevated at 163/93 the day I last saw him last week. Meanwhile, I dropped my Prednisone .5 mg 3 days ago. Tonight, all of a sudden it is 187/74, Pulse 55... I have not done anything at all to stress myself out. House is quiet. Husband is out of town, no TV, nothing... Some pitting edema in lower legs/ankles. It is my understanding that Prednisone is prone to causing BP elevation. For some reason, mine seems to go up when my Prednisone goes down...

Does anyone else have wierd BP problems? I have never had high BP like this, nor such a wide Pulse Pressure. Do any of you more informed people know of any reason why Prednisone might lower BP, rather than raise it? This stuff is scaring me...
Cathie

actually...
 

your blood pressure has come down, by reducing the prednisone.

Your diastolic number (the second number) is almost 20 points lower.
This number is the destructive one.

The upper number is systolic, and variable. Often fluid retention, and age,
can make it higher. In the past higher systolic has often been ignored by doctors,
but today it is more aggressively monitored. You might see the upper number
change if you eat high potassium containing foods. Prednisone depletes potassium on a daily basis.

While prednisone certainly can increase your BP, as Mrs D says, there are other factors which are important also. Blood pressure can move up and down for reasons that may never be clear, but when the overall picture is hypertension, it's probably important to detach from the neuropathy/connective model and begin to think about general lifestyle issues: weight, diet, exercise. So, without any intention to offend---is your weight under control? Are you eating a heart-healthy diet? Are you getting any exercise? Yes, I know the last is hard for us, but the thing that bowled me over early in learning that I had pn was an article by Dr Latov, showing that people don't die of pn; they die of becoming sedentary and overweight.

Here's WebMD on the hypertension: http://www.webmd.com/content/article/96/103783.htm

Cathie, you raise good questions...
 

and the replies you've gotten also raise questions...at least from my viewpoint.

Cathie- what were your b/p #'s before going on the pred.? Did the #'s go up gradually and peak? While you mite not know exactly what they were...you probably have some clue.... Also, keep in mind that like blood work and reactions to meds...each person's ideal normal is a bit different-that's why 'normals' are always put in a 'range...hi/lo' format. Then go back to before the prednisone, and onset and all that and look hard at how your life has changed, gotten more complex, how your medications list keeps getting 'added on' to and how you are able to move around...or not.
Mrs D - I'm going to check that out, as I get flummoxed easily with such things [like I do w/the blood tests] and tend to 'reverse' input into the brain receptor memory bank... You say that the 'diastolic is the destructive one'...by destructive do you mean it shouldn't be a high number? or are low #'s more concerning? I'm interested because during my IVIG infusions I've had changes during the course of the process and have wondered if it was due to simply more 'stuff' being pumped into me....Tho it's always been in what I understand to be 'normal' ranges....those ups and downs of 10-15 points on either set of #'s is disconcerting, at best.
LizaJane I promise I'm going to look more closely into the hypertension issue, as 'enforced' limb immobility [yep another fracture this year] is keeping me off my feet and there's only so many lo-impact, non-weight-bearing exercises one can do to keep any leg/ankle/foot muscle tone or build up any better of same.
Cathie Back to you....have you called your doc and left the old message of; 'X is happening...should I be worried or not?' I'm not a doc, but this way you let the DOC know what's happening and he can make the call...unless something completely different happens that makes you feel like compost needing an ER trip [we all KNOW to avoid those!] Think positive things in the meantime? Look in the meantime at your meds -if there have been changes...well some cause quirky variations that set my teeth on edge. I sure hope I'm the only one - j

diastolic....
 

When the second number (usually the lower one) is elevated that means
the blood vessels are constricted all the time --- this puts pressure on the heart when it contracts, and can lead to heart failure, or aortic aneurysms.

The upper number goes up with activity, after a hot bath, when upset, with age (with hardening of the arteries), and reduced kidney functions.
The systolic can vary all day long...higher in the morning, lower at night. Caffeine, drugs (stimulants--certain antidepessants like Effexor/Cymbalta) can also affect/raise systolic.

The diastolic varies less with situations. It has only been recently that systolic pressures are being treated more aggressively now. In the past a "certain" elevation was accepted for the elderly. There are people with very high diastolic numbers with not so high systolic ones. Like 150/100.

Blood pressure can elevate with pain, stress, eating, sex, illness, all sorts of activities. It is always a good idea to keep a log, showing daily variations.
Many people show higher pressures in the morning, (when cortisol is highest) and lowest while sleeping (this is called dipping). Some 20% or so people do not dip while sleeping...so there are special treatments for non-dippers.
People who "dip" alot and take blood pressure meds besides can get seriously low pressures during sleep, which can impact the brain and retina. That is why blood pressure meds are usually taken in the morning.

The autonomic nervous system also has effects. For an anecdotal example:
Anticholinergics, lower my blood pressure dramatically. If I use Levsin for my GI issues, (which I don't often), I have to lower my Blood pressure meds.
I've had diastolics go to 60 on Levsin. Which is very odd...but it happens for me. So something unique is happening there for me!!! That is to keep in mind, since people vary tremendously with blood pressures..Some very labile, others very stable.

OK, so, is Levisin...
 

Like Lasix? I ask, as I was put on it long before PN symptoms, and during its use my 'diastolic'#'s[low?#'s] went below well, 60? At that point, I kind of went, well, it's NOT alleviating what it was prescribed for, an abmormal ankle swelling...and felt that given the #'s I was getting , well I should either be dead or improved...Since neither was the case..I quit the Lasix, called the doc explaining why, and had heard peep none since...other than an "OK' from the nursoid. All I can say is, it's good that it wasn't something to be 'titrated'?

BTW that ankle is now swelling and docs, don't know what to do...Its scary that they don't and at times because they don't, don't follow-up. At the same time, squeaky wheels get grease..but we don't want to be too squeaky? Gosh, the Rocks'n hard places we find ourselves in!

Don't know about anyone else, BUT = I WANT A SUPER VACATION!
Otherly put, OUT! for at least, a bit? - j

Hi Cathie
 

I developed BP issues after I got PN. Although hypertension runs in my family, I still wasn't expecting it in my early thirties.

For a long time I thought it is all PN connected,and I finally resigned myself to the fact that I probably have some degree of essential hypertension.

I also have gained 13 kilos the last year and a half. My GP put me on meds for the BP, and I am really glad for that.

I don't know about BP as a side-effect of your med, but high BP is something that needs to be monitored closely.

weight
 

Aussie---I just did a conversion, and that's 30 pounds. That's a huge amount to gain in a year, and could easily be the cause for your increase in BP. I don't know how much weight gain Cathie has had (are you talking, Cathie?), but this is what Dr Latov was talking about in his article - that being sedentary is the death of us. I've gained 10 pounds this year, since becoming sedentary after the surgery.

It's good to have a concerned doctor who will prescribe medications, but it's still incredibly important to put exercise into our lives and control diet, even, and especially, when sedentary at home.

I'm guessing everybody on this board has gained substantial weight since developing pn, and that also, a substantial number of us have become hypertensive.

Perhaps we could do a poll?

I am here... :)
 

Got sidetracked when hubby returned home...

To answer your questions:

Before Prednisone, my BP was about 100-110/60-65. It still did not change at all for years. I have been on Prednisone daily now since 1993. I gained 80 pounds in a very short time, get little exercise and now the BP issue. Repetitive use of my muscles makes my burning PN really severe, so I am not moving around a lot, other than going to store, etc...

My friend also mentioned the Dash diet in that article, Liza Jane, and I guess it is going to come down to where I need to just starve myself out of some of this. I have considered seeing a surgeon for bariatric bypass surgery. Although my neighbor has done very well with this surgery, she was in good health... MY diet and exercise definitely need work.

I will try going back to the Natatorium and walking in the water. In 2000, I had a renal artery aneurysm repaired and lost weight pre surgery by going to the water and also walking outside. (This was VERY light water exercise.) It was a fairly easy way to drop 25 pounds, but it really drove me crazy, because you self focus so much on weight, food, scales, exercise, etc...

I have an appointment to see the Internist for followup next week. It it continues to be elevated, I will go in earlier. This afternoon, it was 170/76, tonight 144/75. It didn't help my confidence a lot when he said he hoped this was not due to my kidneys...

MrsD: Is there an over the counter K+ that will work as well as the prescription? My Internist won't give me any, even though I was hospitalized at one point due to low potassium. He says I don't need it since the lab is normal. I know you can get a lot in things like canteloupe, but a lot of the fruits and veggies fire up my ulcers...

Thank all of you for your input,
Cathie

BP/Pain
 

Well, if systolic will elevate in response to pain, I sure am having a lot of that today. This burning is NOT fun...

Cathie