High Blood Pressure

RickF

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.

ptlwp

This is true; many natural things are quite frankly poison.....have a cuppa tea with me?

We have some nice deadly nightshade outside. I could fix us some lovely tea.

I will stick with Diovan 160/hct 12.5, thank you very much, for now.

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"All that is necessary for evil to succeed is for good men to do nothing." Sir Edmund Burke

RickF

I can bring some foxglove and horse nettle from my yard to add to the tea. For me it is lisinopril 20/hctz 12.5. If I ever need digoxin, it will be Lanoxin, and not a tea made from digitalis (foxglove). I prefer knowing exactly how much of these useful, but potentially toxic compounds I am getting, rather than relying on what the growing conditions were or how long I steeped the leaves or how hot the water was.

nerdag

Digoxin is used for heart failure - if you'd gotten to that stage, you'd probably be struggling with a 20m walk along flat ground, let alone riding a bicycle.

Do very much agree though RE: precise doses - there is a very good and comprehensive evidence base in cardiovascular medicine, and failure to manage hypertension effectively is usually (but not always) because the affected person is not adhering to their prescribed medications, diet and exercise plan - not that failure to comply is necessarily their fault.

There are usually good reasons for this, since proper managment of hypertension can be quite complex and time consuming.

I would avoid diuretics if you're going to do strenous exercise. They have more annoying side effects (needing to urinate more being a common one). More seriously, though, if you're exercising and losing lots of fluid in sweat which is not replaced with regular hydration, then you can end up with a relative polycythaemia, however transient it may be.

Most definitely NOT a good thing for your cardiovascular system.

BTW, I am almost a doctor (18 months to go), so I do say this with some authority...

HTH,

nerdag.

RickF

Digoxin is also used to control ventricular response rate in patients with chronic atrial fibrillation. I just through digoxin in because it is a good example of a drug that is derived from a common plant, but it is too toxic to rely on the unpredictable quantities of the active moiety that would come from a tea made from foxglove leaves (not to mention the fact that the whole leaf digitalis or the tincture of digitalis also contains digoxigenin, digitoxigenin, digitoxin and ouabain). Heart failure, though, can be the end result of not treating hypertension, so in a way it is germane to the discussion.

The point about the need for adequate hydration during exercise is well taken; however, hydrochlorothiazide at 12.5 mg per day will not cause dehydration in most people. After a week or so of use, the excessive urination, if any, lasts only a couple of hours after the dose. Now in the "old days" when we used to give 50 mg once or twice a day, that was a different story. Hypokalemia was a major problem, and everyone was borderline dehydrated. At today's doses of 12.5 mg or 25 mg once per day, hypokalemia and dehydration are the exception rather than the rule. They still can happen, but they are not common.

BTW, I am a PharmD with 28 years of clinical pharmacology and drug development experience, the last 12 of which have been in cardiology, hypertension, and dyslipidemia. I used to teach pharmacology to nursing students and medical students, so I, too, know a little bit about the topic.

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.

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"All that is necessary for evil to succeed is for good men to do nothing." Sir Edmund Burke

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

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

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

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!

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