Blood Pressure Medications (Antihypertensives)

I have a few questions here:

1. Why bother giving antihypertensives to someone with psychogenic hypertension in the first place? It’s not like they actually work in those cases.
2. Once those meds failed, the person was prescribed anxiolytics, and now everything is fine—blood pressure has normalized. So why leave them on the antihypertensives?

All other test results have been perfectly fine from the start. The only issue is that the person is overweight, though they've been losing weight over time, and it hasn't made a dent in the blood pressure. They still have some extra weight, but this is a young person and I don't see any reason for them to be on blood pressure medication.

Can someone explain this?

Oh, and there is a family history of strokes and heart attacks, but those didn't happen until everyone was already in their 80s, so I figure that's pretty much expected at that age.

Drew Miller48 said:Greetings.
I’ve returned from my annual checkup and completed my blood work.
I received the results yesterday, and here is where things stand:
AST-17
ALT-30
GGT-22
Cholesterol-5.3
HDL-1.24
LDL-3.44
Triglycerides-1.3
On a positive note, I have lost 29 kg in just 7 months. I went from 114 kg down to 85 kg.
Here is a photo showing the blood pressure readings I recorded about a month and a half ago, at most.
http://imageshack.us/photo/my-images...120921234.jpg/
I actually stopped tracking them because I was starting to get on my mother's nerves with all the measuring, but there it is.
Please excuse the messy handwriting; I write as best as I can.😢
I saw my doctor yesterday, and he said my blood and urine results look fine. Regarding medication, he suggested I continue taking the Amlodipine/Hydrochlorothiazide. I told him I would like to stop, as it feels pointless to keep medicating myself. He countered by asking if my blood pressure would spike if I quit. After a few minutes of discussion, his stance changed slightly. Since I had already taken the pills a few days ago, he told me to finish those and then remind him to switch me to something else.
He mentioned he might prescribe me either Ramipril 2.5 mg or Hydrochlorothiazide. I am not entirely sure which one, but it will likely be just one of the components found in the Amlodipine/Hydrochlorothiazide blend. I am supposed to take this for one more month, and then that should be the end of it. During our talk, I also brought up an issue I've had since starting these pills: a sense of constant anxiety and a sort of depression since I began taking the Amlodipine. He insists it isn't the medication, but rather psychological. And there is something else...
Occasionally, I feel an uncomfortable sensation on the left side of my chest, near the nipple, which bothers me and leads me to imagine the worst possible outcomes. There is also an intermittent stinging sensation, almost like being pricked by a needle through my spine, though that is extremely rare (though it did happen for the first time yesterday, two or three times in one day). I had an ECG four or five months ago and everything was normal. It simply feels as though I am terrified of everything, and this fear torments me more than the actual physical condition. He told me that when these moments occur, I should take some Normabel to calm down and stop dwelling on such thoughts.

I am interested in your opinions. Thank you in advance.

1. I don't quite follow—if you feel like you're poisoning yourself, why are you even taking them?
Personally, I'm on Ramipril plus two other antihypertensives along with a lipid-lowering med, and everything is fine.
Are you on Amlodipine/HCTZ?
Looking at your BP log, your pressure seems regulated. You only need to check it 3-4 times a week; there's no need to do it at all hours of the day.
Keep working on reducing blood pressure and stick to a low-cholesterol diet.

vividsailor7 said:1. I don't quite follow—if you feel like you're poisoning yourself, why are you even taking them?
Personally, I'm on Ramipril plus two other antihypertensives along with a lipid-lowering med, and everything is fine.
Are you on Amlodipine/HCTZ?
Looking at your BP log, your pressure seems regulated. You only need to check it 3-4 times a week; there's no need to do it at all hours of the day.
Keep working on reducing blood pressure and stick to a low-cholesterol diet.

That’s just what people say, that all these pills are nothing but chemicals. 🙂
But if I didn't have to take them, I wouldn't be taking them.
Yes, I am on Amlodipine/HCTZ.
The goal remains reducing blood pressure (likely through weight loss).
As for the diet, that is still a work in progress. 🙂
No salt and no fat.

vividsailor7 said:1. I don't quite follow—if you feel like you're poisoning yourself, why are you even taking them?
Personally, I'm on Ramipril plus two other antihypertensives along with a lipid-lowering med, and everything is fine.
Are you on Amlodipine/HCTZ?
Looking at your BP log, your pressure seems regulated. You only need to check it 3-4 times a week; there's no need to do it at all hours of the day.
Keep working on reducing blood pressure and stick to a low-cholesterol diet.

If you don't mind me asking, how old are you and what exactly is your diagnosis?

Lisa Myers said:If you don't mind me asking, how old are you and what exactly is your diagnosis?

I'm just entering my early forties.
Essential Hypertension diagnosis,
Hyperlipidemia,
and an old Hyperlipidemia Hyperuricemia diagnosis from nearly 20 years ago.
Currently on Ramipril, Amonex, Bisoprolol, Allopurinol, and Rosiglitazone.

vividsailor7 said:I'm just entering my early forties.
Essential Hypertension diagnosis,
Hyperlipidemia,
and an old Hyperlipidemia Hyperuricemia diagnosis from nearly 20 years ago.
Currently on Ramipril, Amonex, Bisoprolol, Allopurinol, and Rosiglitazone.

So, how did things get to this point where you're taking all these medications at such a young age? Honestly, I was a little shocked. I'm around the same age, and I'm already on two blood pressure pills and one anti-anxiety med—and everyone, including my doctors, thinks that's perfectly normal. 😲 Whenever I hear this... look, you're a doctor. Every single physician tells me the same thing: all these blood pressure issues just vanish once you start exercising and lose some weight. 🙄So, that's what I'm wondering about.

Look, this is actually really important to me. Could you please take a look at my original post at the top of this thread and give me an answer? I’ve searched everywhere—online and even asking my doctors—but I just can't find a straight answer to this question.

Hey there! 🙂

Quick question about Co-Perineva 4 mg/1.25 mg:

I’ve gone through the entire list of side effects on the package insert, but I want to know if anyone here actually deals with throat irritation, sneezing, or watery eyes while taking it. I’m looking for real-world experiences because my mom hasn't stopped coughing since she started this medication..

Thanks!

🙂

Doctors usually warn you about coughing being a side effect when you first start taking hypertension medication. I actually did some extra digging and found that in many drug manuals for various antihypertensives, they mention the cough can sometimes persist long after the initial start. I'm not sure if that means you eventually have to switch medications or not, though—you'd definitely need to ask a doctor about that.

Note: I don't feel like hunting for the info right now, but I'm assuming the drug is an ACE inhibitor? If it is, the instructions will say so, and it will almost certainly list a cough as a side effect.

Personally, I never had any issues with that specific group of drugs. However, I did experience side effects from beta-blockers, and honestly, I still deal with them. They really do help with blood pressure, though, so I can't complain too much.

Lisa Myers said:So, how did things get to this point where you're taking all these medications at such a young age? Honestly, I was a little shocked. I'm around the same age, and I'm already on two blood pressure pills and one anti-anxiety med—and everyone, including my doctors, thinks that's perfectly normal. 😲 Whenever I hear this... look, you're a doctor. Every single physician tells me the same thing: all these blood pressure issues just vanish once you start exercising and lose some weight. 🙄So, that's what I'm wondering about.

Look, this is actually really important to me. Could you please take a look at my original post at the top of this thread and give me an answer? I’ve searched everywhere—online and even asking my doctors—but I just can't find a straight answer to this question.

In my case, it isn't even certain yet if we're dealing with essential/primary hypertension.
But look, there are people much younger than me who have pressures hitting 150/something, undergo full workups, and get diagnosed with primary hypertension despite having a perfectly normal weight. That’s actually a huge focus in pediatric hypertension medicine right now.
It’s funny how everyone assumes doctors are somehow immune to health problems. Unfortunately, that's not the case. We deal with hypertension, blood sugar issues, heart problems, digestive issues—we aren't exempt from disease either.
As for your question regarding why specific drugs are prescribed, I honestly don't know. You’ll have to ask the people who actually make those calls.

Brian Murphy3 said:Hey there! 🙂

Quick question about Co-Perineva 4 mg/1.25 mg:

I’ve gone through the entire list of side effects on the package insert, but I want to know if anyone here actually deals with throat irritation, sneezing, or watery eyes while taking it. I’m looking for real-world experiences because my mom hasn't stopped coughing since she started this medication..

Thanks!

🙂

Coughing is a very well-known side effect of ACE inhibitors. What needs to happen is for her to see an internist, because ARB - Valsartan is the alternative to ACE inhibitors, but that's only by medical recommendation.
Something like Valsartan 80mg + Indapamide 1 tab could work.

After digging through endless piles of medical literature, my bottom line is this: people dealing with hypertension should—or at least can—take magnesium and Vitamin C supplements. I saw those two mentioned everywhere. However, when it comes to calcium and potassium, the advice gets messy. Some sources say don't even touch them, especially potassium, while others suggest taking extra.

It seems to me that it all depends on which blood pressure meds you're on and whether kidney issues are driving the high pressure. Is it ACE inhibitors, beta-blockers, or... one of those calcium channel blockers? I take the first two, so I'm not too familiar with the third group. My kidneys are doing just fine, though.

Does anyone know more about this? Which of these supplements are actually okay for me to take, and which should I skip?

Lisa Myers said:After digging through endless piles of medical literature, my bottom line is this: people dealing with hypertension should—or at least can—take magnesium and Vitamin C supplements. I saw those two mentioned everywhere. However, when it comes to calcium and potassium, the advice gets messy. Some sources say don't even touch them, especially potassium, while others suggest taking extra.

It seems to me that it all depends on which blood pressure meds you're on and whether kidney issues are driving the high pressure. Is it ACE inhibitors, beta-blockers, or... one of those calcium channel blockers? I take the first two, so I'm not too familiar with the third group. My kidneys are doing just fine, though.

Does anyone know more about this? Which of these supplements are actually okay for me to take, and which should I skip?

Look, it all depends on your specific meds. For instance, thiazide diuretics can trigger hypercalcemia, while other diuretics actually help conserve potassium—though you have to watch out for hyperkalemia.
Indapamide can cause both hypercalcemia and hypokalemia.
Then you've got ACE inhibitors and ARB - Valsartan, which can lead to hyperkalemia—think Ramipril, Iruzid, or Valsartan.

Honestly, I don't get why people bother taking supplements when they already have sufficient levels in their system. It’s completely nonsensical. It’s like adding extra sugar to a cake that’s already sweet enough, or dumping more salt on food that's already salty. Total waste.

When it comes to managing hypertension, there are several different classes of drugs available:
Beta blockers can be split into newer generations—like Bisoprolol—and the older stuff.
Combined Alpha and Beta blockers—like Carvelol.
Calcium channel blockers: 1. Those that primarily target the vasculature—Amonex, Pinox.
2. Those that act directly on the heart, like verapamil.
ACE inhibitors—like Iruzid or Ramipril.
Combinations involving diuretics—Ramipril/HCTZ or Iruzid.
ARB - Valsartan—like Valsartan.
Diuretics—Lasix, or high-ceiling diuretics like Tomid.
And the low-ceiling/weaker ones like Tiaren or Indapamide.
Alpha blockers—like Doxa.

Thanks for such a detailed response. My answer might not be exactly what you want to hear, but—I've started leaning a bit more toward alternative treatments. That doesn't mean I'm ditching my meds because I feel like it or that I'm against conventional medicine; I'm just trying to broaden my horizons.

What are the potential consequences of "overdosing" on magnesium and Vitamin C?

Here is the situation. Most of you are already familiar with my case, but for those who aren't, check my previous posts. The core issue is my elevated blood pressure.
I was recently at the cardiology clinic over at Draskovic to review my ECG results. The doctor told me my heart looks fine, just beating slightly fast. I told him I already knew that—I get anxious about all of this, and whenever I start measuring, I can actually feel my heart racing. Now, here is the other thing: whenever I mention wanting to stop taking my medication (Amlodipine/Hydrochlorothiazide), people act like I’ve lost my mind. They claim my pressure will spike and go through the roof. I am honestly fed up with these condescending doctors who seem more interested in pushing pills than listening.
Right now, my home readings are showing 132/78 with a pulse of 72. Yet, just two hours ago while I was downtown at the doctor's office, it hit 160/110 with a pulse of 98. Despite that, he tells me there is no reason to stop and that I actually need to take two of those a day. I told him no, and that is that. My current readings suggest there is another underlying cause, because I know my baseline isn't that high.
For context, I used to weigh 240 lbs and lived a pretty sedentary lifestyle. Things have changed completely. I’ve dropped down to 176 lbs, I'm eating much healthier—lots of fruits and vegetables—and whenever I check my pressure, it stays around 135/80, give or take five points.
I am at a loss for what to do next. They are referring me to the Mayo Clinic for specialized blood pressure testing (some specific department, I'm not sure which one). I'll have to wear a Holter monitor and undergo several tests. We will see what happens, though I personally think this is all unnecessary. My only goal is to reduce this medication regimen and stop taking them entirely, because I feel great. Just yesterday, for instance, I had a sudden headache, blurred vision, and some shimmering in my sight; I ended up taking two 5mg doses of Normabel to manage it. That doesn't happen to me very often.

Drew Miller48 said:Here is the situation. Most of you are already familiar with my case, but for those who aren't, check my previous posts. The core issue is my elevated blood pressure.
I was recently at the cardiology clinic over at Draskovic to review my ECG results. The doctor told me my heart looks fine, just beating slightly fast. I told him I already knew that—I get anxious about all of this, and whenever I start measuring, I can actually feel my heart racing. Now, here is the other thing: whenever I mention wanting to stop taking my medication (Amlodipine/Hydrochlorothiazide), people act like I’ve lost my mind. They claim my pressure will spike and go through the roof. I am honestly fed up with these condescending doctors who seem more interested in pushing pills than listening.
Right now, my home readings are showing 132/78 with a pulse of 72. Yet, just two hours ago while I was downtown at the doctor's office, it hit 160/110 with a pulse of 98. Despite that, he tells me there is no reason to stop and that I actually need to take two of those a day. I told him no, and that is that. My current readings suggest there is another underlying cause, because I know my baseline isn't that high.
For context, I used to weigh 240 lbs and lived a pretty sedentary lifestyle. Things have changed completely. I’ve dropped down to 176 lbs, I'm eating much healthier—lots of fruits and vegetables—and whenever I check my pressure, it stays around 135/80, give or take five points.
I am at a loss for what to do next. They are referring me to the Mayo Clinic for specialized blood pressure testing (some specific department, I'm not sure which one). I'll have to wear a Holter monitor and undergo several tests. We will see what happens, though I personally think this is all unnecessary. My only goal is to reduce this medication regimen and stop taking them entirely, because I feel great. Just yesterday, for instance, I had a sudden headache, blurred vision, and some shimmering in my sight; I ended up taking two 5mg doses of Normabel to manage it. That doesn't happen to me very often.

Check this out, read it...
http://en.wikipedia.org/wiki/White_coat_hypertension

What would that even look like, this white coat syndrome?
Why does this never happen with my own primary care physician, but only when I'm at the hospital?
Terrifying. I am going to read this entire thing carefully; so far, I have only skimmed the surface of what is going on.

In practice, any experienced doctor will look at your home blood pressure readings—not just what you show them in the clinic. Even I know that much, and I’m not even a professional. For example, my own pressure would regularly drop from 160/100 down to 120/80 after just a few minutes of casual small talk with the doctor, without them giving me anything at all. What does that tell you? It’s all in your head. At home, my numbers were always perfectly normal. Yet, here I am, taking antihypertensives I don't actually need. Honestly, I'm fed up with doctors who refuse to believe me when I say my home readings are fine. Only one doctor actually took the time to listen to me; she said, "You don't need blood pressure meds, you need something for anxiety because you're stressed." After that, I felt fine. But I'm still on the medication because most doctors insist I need it. Ugh, I don't even know anymore. I'm just angry.

In my opinion, it's because they think the patient is overweight! Everyone I know who is a healthy weight gets the "oh, you're just a little anxious" excuse if their pressure is high at the office. But anyone overweight? They get slapped with a prescription immediately. And that's for blood pressure, obviously. I was put on meds after just one single reading—it was very high, sure, but I was in total shock that day, so... meanwhile, my brother went for his driver's license exam with 180/120 and nobody cared. Another friend of mine, a model, saw her pressure spike after losing her job—they rushed her to the hospital immediately to run every test under the sun, only to find out nothing was wrong. But for people carrying extra weight? It's just: "Here are your pills, now go lose weight." Great. Just great.🙄.

Doctors shouldn't take this personally. It isn't an attack on them. I truly respect the medical profession (even if it doesn't feel like it right now), but this blatant discrimination really burns me up. It has honestly shattered my trust in doctors. Sometimes I feel like I'm my own best physician. (By the way, that exact realization saved me from an unnecessary surgery once, so how could I think any differently?)

That much is clear to me.
Just a heads up, I always tell my doctor that when I visit him, my readings are perfectly normal. Even right now, I just checked and I'm at 134/87, and I haven't even taken my medication yet. It's all just nonsense.
I’ve been keeping a blood pressure log and showed it to my physician; he said everything looks steady. As for my weight, I'm currently 80kg and about 6'2". Since all of this started, I've lost 34 kilos. My ECG is excellent. He mentioned my heart rate is slightly elevated, though I wasn't aware of that since I can feel it racing the moment they hook me up to any equipment. Honestly, the easiest thing is to just drown someone in pills to get them off your back. Right now, I'm taking Amlodipine along with 5mg of Normabel, which helps calm me down nicely and lowers my pressure further.
Well, we'll see what happens. I'm heading to the Mayo Clinic to bring that Holter monitor and undergo more testing, then we'll see. I'm fed up with all of this, and I know most of it is unnecessary.
I just called the Mayo Clinic and scheduled my appointment for January 18th, 2013, for the Holter and further tests. That's that. Now, I'll just keep my wits about me and try to enjoy life.😁

Drew Miller48 said:Here is the situation. Most of you are already familiar with my case, but for those who aren't, check my previous posts. The core issue is my elevated blood pressure.
I was recently at the cardiology clinic over at Draskovic to review my ECG results. The doctor told me my heart looks fine, just beating slightly fast. I told him I already knew that—I get anxious about all of this, and whenever I start measuring, I can actually feel my heart racing. Now, here is the other thing: whenever I mention wanting to stop taking my medication (Amlodipine/Hydrochlorothiazide), people act like I’ve lost my mind. They claim my pressure will spike and go through the roof. I am honestly fed up with these condescending doctors who seem more interested in pushing pills than listening.
Right now, my home readings are showing 132/78 with a pulse of 72. Yet, just two hours ago while I was downtown at the doctor's office, it hit 160/110 with a pulse of 98. Despite that, he tells me there is no reason to stop and that I actually need to take two of those a day. I told him no, and that is that. My current readings suggest there is another underlying cause, because I know my baseline isn't that high.
For context, I used to weigh 240 lbs and lived a pretty sedentary lifestyle. Things have changed completely. I’ve dropped down to 176 lbs, I'm eating much healthier—lots of fruits and vegetables—and whenever I check my pressure, it stays around 135/80, give or take five points.
I am at a loss for what to do next. They are referring me to the Mayo Clinic for specialized blood pressure testing (some specific department, I'm not sure which one). I'll have to wear a Holter monitor and undergo several tests. We will see what happens, though I personally think this is all unnecessary. My only goal is to reduce this medication regimen and stop taking them entirely, because I feel great. Just yesterday, for instance, I had a sudden headache, blurred vision, and some shimmering in my sight; I ended up taking two 5mg doses of Normabel to manage it. That doesn't happen to me very often.

First off, I have no idea why you even bothered seeing a cardiologist.
You should have gone straight to a hypertension specialist at the Nephrology Institute.
A Holter monitor is an incredibly valuable diagnostic tool.

Lisa Myers said:In practice, any experienced doctor will look at your home blood pressure readings—not just what you show them in the clinic. Even I know that much, and I’m not even a professional. For example, my own pressure would regularly drop from 160/100 down to 120/80 after just a few minutes of casual small talk with the doctor, without them giving me anything at all. What does that tell you? It’s all in your head. At home, my numbers were always perfectly normal. Yet, here I am, taking antihypertensives I don't actually need. Honestly, I'm fed up with doctors who refuse to believe me when I say my home readings are fine. Only one doctor actually took the time to listen to me; she said, "You don't need blood pressure meds, you need something for anxiety because you're stressed." After that, I felt fine. But I'm still on the medication because most doctors insist I need it. Ugh, I don't even know anymore. I'm just angry.

In my opinion, it's because they think the patient is overweight! Everyone I know who is a healthy weight gets the "oh, you're just a little anxious" excuse if their pressure is high at the office. But anyone overweight? They get slapped with a prescription immediately. And that's for blood pressure, obviously. I was put on meds after just one single reading—it was very high, sure, but I was in total shock that day, so... meanwhile, my brother went for his driver's license exam with 180/120 and nobody cared. Another friend of mine, a model, saw her pressure spike after losing her job—they rushed her to the hospital immediately to run every test under the sun, only to find out nothing was wrong. But for people carrying extra weight? It's just: "Here are your pills, now go lose weight." Great. Just great.🙄.

Doctors shouldn't take this personally. It isn't an attack on them. I truly respect the medical profession (even if it doesn't feel like it right now), but this blatant discrimination really burns me up. It has honestly shattered my trust in doctors. Sometimes I feel like I'm my own best physician. (By the way, that exact realization saved me from an unnecessary surgery once, so how could I think any differently?)

Question for both of you: if you think you don't need these medications, why on earth are you still taking them?

With younger people, doctors usually hunt for the root cause of high blood pressure first—that way, they actually have a clue how to treat it.
Until they actually implement that, you're gonna have to stay on TH.
I'm on Amlodipine... and honestly, my blood pressure just won't budge.
So now I'm on a higher dose, but it still isn't budging... I can't just quit cold turkey either. What am I supposed to do? Just live with 190/120 or my usual 150/100?
No way... I'm stubborn as hell and I am going to figure out exactly why my blood pressure is through the roof.

Jeremy Fowler45 said:With younger people, doctors usually hunt for the root cause of high blood pressure first—that way, they actually have a clue how to treat it.
Until they actually implement that, you're gonna have to stay on TH.
I'm on Amlodipine... and honestly, my blood pressure just won't budge.
So now I'm on a higher dose, but it still isn't budging... I can't just quit cold turkey either. What am I supposed to do? Just live with 190/120 or my usual 150/100?
No way... I'm stubborn as hell and I am going to figure out exactly why my blood pressure is through the roof.

Amlodipine is typically the go-to first choice for older patients, especially when dealing with systolic hypertension.
You didn't mention your age, but your BP is definitely elevated, so you really ought to get a full workup at the Institute of Nephrology and Hypertension at the Mayo Clinic.
They’ll need to run a whole battery of tests—things like glucose, insulin, electrolytes (K, Na, Ca, P), kidney function (creatinine, urea, urates), urinalysis, 24-hour proteinuria, TSH, VMA, aldosterone (serum/urine), cortisol rhythm, ACTH, catecholamines, a lipid panel, and so on.
Basically, it all depends on your specific clinical indications, overall status, and general findings.
Follow-up diagnostics might also include a TTE, CT angiography, renin levels, etc.