Blood Pressure Medications (Antihypertensives)

vividsailor7 said: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.

I'm 28g..
The folks at the Nephrology Institute just bumped my dose from 5mg to 10mg.
The tests they ordered are: plasma renin activity, renal and renal artery ultrasound, metanephrines and normetanephrines, 24-hour albuminuria, and an ECG Holter monitor...
There's more where that came from...
Just getting the tests done will take months, and they even told me to look for a Holter monitor at a heart clinic in St. Louis.
But honestly, my blood pressure isn't dropping at all... for the last two days, it hasn't gone below 150/100.
I feel absolutely terrible—everything is moving slower, and I can barely function!

Jeremy Fowler45 said:I'm 28g..
The folks at the Nephrology Institute just bumped my dose from 5mg to 10mg.
The tests they ordered are: plasma renin activity, renal and renal artery ultrasound, metanephrines and normetanephrines, 24-hour albuminuria, and an ECG Holter monitor...
There's more where that came from...
Just getting the tests done will take months, and they even told me to look for a Holter monitor at a heart clinic in St. Louis.
But honestly, my blood pressure isn't dropping at all... for the last two days, it hasn't gone below 150/100.
I feel absolutely terrible—everything is moving slower, and I can barely function!

Looking at that list of tests, it seems like they are being incredibly thorough and covering every single base.
How long have you been taking Amlodipine?

vividsailor7 said:Looking at that list of tests, it seems like they are being incredibly thorough and covering every single base.
How long have you been taking Amlodipine?

Since late October

vividsailor7 said: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.

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

It’s because everywhere I read, they say you can't just stop. If you do, things could get way worse than they were before (sorry!). Plus, my doctor just told me I'll be on this for life—no explanation provided, and she didn't listen when I explained that my blood pressure is only high when I'm worked up, otherwise it's fine. I assume she thinks my pressure is okay simply because I'm on the pills... but what she doesn't realize is that after my diagnosis, there was a period where I wasn't taking anything because she wasn't working. To explain—I ended up in the ER with terrifyingly high blood pressure after a stressful incident... they immediately put me on 10mg of Amlodipine, which I didn't actually start for another two weeks. In the meantime, my pressure was totally normal. See what I mean? I honestly thought that once I started antihypertensives, my blood pressure would NEVER spike again, no matter how stressed I got. It took me two years and several different doctors to finally hear this: take anxiolytics, but stay on the antihypertensives. I don't get why I need both. My GP also tried to push another antihypertensive on me (before the anxiolytics), but I turned it down without thinking twice. I don't need more meds that don't work.

I’d personally take the beta-blocker I take at noon... and an anxiolytic too. Both help, I can see that. One helps with the heart rate, and the other is there if things get crazy. For me, Amlodipine in the morning does absolutely nothing. Besides, as far as I know, it's harmful during potential pregnancy... so if something unplanned happens, it's more trouble than it's worth.

But I have to admit, I'm close to just stopping it altogether and seeing what happens. At the end of the day, if my blood pressure becomes unstable, I can always start again, right?

Summing it up: please, if you can, explain this to me—why should people who have high blood pressure due to anxiety attacks take antihypertensives when their readings are fine in between? Aren't those drugs meant for people whose pressure is constantly or mostly high even when they aren't stressed and are calm?

In my forty years, nobody has given me a straight answer. Everyone just gives me excuses. I want an answer. Even if someone tells me I'm talking nonsense, just tell me something!

Lisa Myers said:It’s because everywhere I read, they say you can't just stop. If you do, things could get way worse than they were before (sorry!). Plus, my doctor just told me I'll be on this for life—no explanation provided, and she didn't listen when I explained that my blood pressure is only high when I'm worked up, otherwise it's fine. I assume she thinks my pressure is okay simply because I'm on the pills... but what she doesn't realize is that after my diagnosis, there was a period where I wasn't taking anything because she wasn't working. To explain—I ended up in the ER with terrifyingly high blood pressure after a stressful incident... they immediately put me on 10mg of Amlodipine, which I didn't actually start for another two weeks. In the meantime, my pressure was totally normal. See what I mean? I honestly thought that once I started antihypertensives, my blood pressure would NEVER spike again, no matter how stressed I got. It took me two years and several different doctors to finally hear this: take anxiolytics, but stay on the antihypertensives. I don't get why I need both. My GP also tried to push another antihypertensive on me (before the anxiolytics), but I turned it down without thinking twice. I don't need more meds that don't work.

I’d personally take the beta-blocker I take at noon... and an anxiolytic too. Both help, I can see that. One helps with the heart rate, and the other is there if things get crazy. For me, Amlodipine in the morning does absolutely nothing. Besides, as far as I know, it's harmful during potential pregnancy... so if something unplanned happens, it's more trouble than it's worth.

But I have to admit, I'm close to just stopping it altogether and seeing what happens. At the end of the day, if my blood pressure becomes unstable, I can always start again, right?

Summing it up: please, if you can, explain this to me—why should people who have high blood pressure due to anxiety attacks take antihypertensives when their readings are fine in between? Aren't those drugs meant for people whose pressure is constantly or mostly high even when they aren't stressed and are calm?

In my forty years, nobody has given me a straight answer. Everyone just gives me excuses. I want an answer. Even if someone tells me I'm talking nonsense, just tell me something!

Reading this just makes me even more anxious... what you wrote here...
I've only been on meds for a short time, maybe two months..
but now I'm starting to wonder..
If I want to have kids, there's no way with this blood pressure, plus the risk of kidney disease (which hasn't even been confirmed yet) and these heart arrhythmias/tachycardia issues.

Man, I'm so young..
and I already feel like I'm totally wiped out..

If there's a plan in place, you can take steps beforehand. Usually, doctors weigh the risks of skipping your meds against the risks of taking them—it basically boils down to choosing between your health and the baby's health. My OB-GYN was very clear with me, and it’s explicitly stated in the prescribing info: ACE inhibitors are a hard no during pregnancy. Period. Generally, if a woman is taking them without realizing she's pregnant, things don't end well. I've heard beta-blockers aren't quite as dangerous for the fetus, but you really need to check your specific medication's warning label regarding pregnancy.

From what I gather, we're actually opposites here. Your blood pressure stays consistently high, even if it isn't off the charts. For me, my blood pressure never stays elevated all day; I just get these short bursts, much like my panic attacks.

I don't plan on having kids, but I still worry. Dealing with PCOS means my cycle is irregular, so I'm constantly wondering: what if I'm pregnant and taking all these medications? Even with protection, I know the chances are slim, but they exist.

I honestly don't know... I'm getting closer to just risking it, dropping the ACE inhibitor, and only taking my other meds when absolutely necessary. We'll see how it goes.

vividsailor7 said: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.

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

My primary care physician sent me there to get an ECG and provided a referral for blood pressure monitoring. I went to the specialists because he wanted to check if there was any underlying cardiac damage or similar issues.
Now, the next step is that they are referring me to the Mayo Clinic, where I've already made an appointment to assess the full situation.
As for why I am still taking the meds? Here is my answer. I am waiting for the test results to see what they reveal. If everything comes back perfect and shows no lasting complications, I will stop taking them immediately. After all, even if my pressure spikes occasionally, it isn't a crisis. I just want to know when I can stop. My readings are consistently around 130-135/70-85. The exact number doesn't matter much; in my opinion, it's not bad. I have confirmed my heart is in excellent shape—absolutely no issues there. I stay active, I exercise regularly, and my diet is significantly better than it used to be; lots of fruits and vegetables. I move more, and I'm less stressed since I stopped playing video games altogether. I'm finding a new normal. It's perfectly natural for anyone's blood pressure to spike occasionally; it happens to everyone, often without them even realizing it. I actually had a bit of bad luck during those two days when I had my ECG and follow-up exam; I panicked, and my blood pressure shot up for no reason. Once I got home, everything returned to normal. When I checked it in the evening, it was great. It's psychological. My issue is anxiety, not this.

Looks like I've got polycystic kidneys too
plus a whole bunch of other issues...
My blood pressure is just all over the place constantly..
I actually ended up in the ER yesterday because I couldn't get it down—it hit 190/120!!!
I never would've guessed it could get that wild, especially since I'm a healthy worker..
I've scheduled a kidney ultrasound, which is my starting point, and then we'll see about a Holter monitor in two months

You absolutely have to run all the tests first. Your blood pressure might be high because there's an underlying issue with your kidneys or something else, and you need those labs to know what you're dealing with. My own body is perfectly healthy—all my levels are great. My BP stays at 120/80 most of the time, occasionally a bit higher but still within range, and often even lower than 120/80. I’m saying this because when I’m calm and taking my medication, my pressure actually drops too low.

The real debate here is whether we should be taking meds if all our test results come back normal. Obviously, if they aren't normal, that's a different story entirely. Like Drew Miller48 said—we’re all just walking around here, and if doctors measured everyone's blood pressure right then and there and prescribed meds based on that single moment, everyone would be on hypertension medication! Just three months before I was "diagnosed" with hypertension, I had a rigorous physical for work. Everything was perfect—and I mean everything—including my blood pressure. Why? Because we were having fun, we were relaxed, the whole team was... but then, three months later, I hit a massive shock and the doctor immediately put me on a heavy dose of Amlodipine. After that, they just kept adding more pills. If I hadn't taken charge of my own situation, I’d be popping three different blood pressure meds today, plus Normabel and whatever else... At least this way, I pushed back and cut down on things I saw weren't necessary. My goal is to get off the Amlodipine and maybe just stay on a beta-blocker as my regular maintenance, using an anxiolytic only when needed. I just need to work up the courage to make that move. And honestly, knowing myself, I know I'll be fine. Not long ago, I actually ran out of my pills for a few days (forgot them on a trip, though I did bring my monitor), and my pressure was totally fine.

Man, I dread it when vividsailor7 shows up to lecture us 🤣. Look, vividsailor7, we don't have anything against medication, and we certainly don't have anything against doctors. It just increasingly feels like what Dr. Gayles or whoever is saying on TV is true: they just want to prescribe as many drugs as possible to keep Big Pharma thriving, right?

Oh, I forgot to mention that my doctor switched my prescription from Amlodipine to Ramace once. Anyone who knows their stuff will tell you—that was a lateral move. How am I supposed to trust that?

@Lisa Myers.

Look, if you have Hypertension, you take antihypertensives. It’s that simple.

And if your blood pressure spikes every single time you get worked up—well, maybe just stop getting worked up? Seriously.

So, here is the real question: who was the first doctor to prescribe this regimen to you, and what exactly were they basing it on?

If you're actually feeling stuck in this dilemma—and I'm not talking about readings hitting over 200 mmHg here—just taper off the antihypertensives over the course of a week. Then, go see a private specialist for a 24-hour blood pressure monitor test. Once you have those numbers, it'll be crystal clear whether you actually need the medication or not.

Mixing Amlodipine with Ramace... did Sanofi sponsor some medical conference or something? Because let's be honest, that isn't changing a thing for your actual situation.

Victoria, good luck 🙂
You’ll be just fine, I know it
It is clear you are persistent, and that is exactly how one must be. I always say it is far too easy to slap a diagnosis on someone based on a single conclusion.
That is why a 24-hour monitor and blood pressure tracking is necessary before any other conclusions can be drawn. Besides, we live in an era where we are constantly dealing with elevated blood pressure because we live in a country where you worry every single day about whether you'll lose your home. And don't even get me started on the rest. It isn't worth discussing.
One does not need 🙂 but simply needs to 😂 and even in the worst moments 🤣

Kate Collins67 said:@Lisa Myers.

Look, if you have Hypertension, you take antihypertensives. It’s that simple.

And if your blood pressure spikes every single time you get worked up—well, maybe just stop getting worked up? Seriously.

So, here is the real question: who was the first doctor to prescribe this regimen to you, and what exactly were they basing it on?

If you're actually feeling stuck in this dilemma—and I'm not talking about readings hitting over 200 mmHg here—just taper off the antihypertensives over the course of a week. Then, go see a private specialist for a 24-hour blood pressure monitor test. Once you have those numbers, it'll be crystal clear whether you actually need the medication or not.

Mixing Amlodipine with Ramace... did Sanofi sponsor some medical conference or something? Because let's be honest, that isn't changing a thing for your actual situation.

Lisa Myers, I'm not Victoria.
My first prescription came from an internist at the ER. Based on the measurements they took that day—since I showed up at the emergency room completely losing it, heart racing...—they didn't send me for a Holter monitor, an echocardiogram, or anything else related to my heart. I just had everything checked that might influence blood pressure. I had all the blood work done and an abdominal ultrasound. Everything was fine. My ECG was fine too. So, they slapped me with a diagnosis of essential hypertension. Even though I told the ER doctor myself, listen... that it was psychological, I ended up struggling. While I still had some money (I'm not working right now, and my primary doctor refused to refer me to a hypertension specialist or anything), I saw a cardiologist. She agreed that my blood pressure issues were stress-based and prescribed an anxiolytic along with the antihypertensives. My primary care doctor wouldn't even prescribe the anxiolytic. So, until about six months ago, I was stuck dealing with fluctuating blood pressure while my GP experimented on me with different pills, until I finally screamed that I wanted to see a psychiatrist! Since then, my blood pressure has been fine on anxiolytics, taken as needed... it's great. But even my psychiatrist says I have to settle the antihypertensive part with a specialist; he can't just tell me to stop taking them, which I totally understand.

I can't afford any private doctors right now, and my GP won't refer me anywhere. She doesn't even seem to like the psychiatrist's findings regarding the type of anxiolytics I'm using. My family feels the same way. So, until I find a job, I'm just fighting this battle on my own however I can.

My only regret is that I listened to doctors right from the start without doing my own research... but I learned my lesson. That lesson actually saved me from a useless orthopedic surgery. If I had listened to that first doctor, I wouldn't have a functional limb today, but now it's in almost perfect condition.

My apologies, Lisa Myers. Honestly, I hadn't seen that name before; I thought you were Victoria :P
It wasn't intentional, please accept my apology.
But I understand, because I went through the exact same thing. At the ER, they put me on those pills that I’m still taking today, though I plan to stop them on my own once I get my final results back from the Holter monitor and everything else...
In most cases, a person is their own best doctor. You learn what works for you and what doesn't. Of course, with a consultation from doctors, everything can be resolved.
You are strong—stay tough. You know better than anyone what's good for you and what isn't. As for being unemployed and under stress, unfortunately, I am in the same boat.😢
My doctor also prescribed me Normabel 5mg, so I take it here and there when I'm feeling agitated. Though, I definitely try to avoid taking it.
And here was the kicker. I was home feeling terrible, so I went to a local pharmacy where my blood pressure spikes so high every single time it's unbelievable. Their blood pressure cuff is simply faulty. I measured it myself and it seemed to be something like 160/140.
So I call emergency services, and they show up after about 30 minutes only to find it's 130/90. They acted like there was no reason for them to come and suggested I visit a psychiatrist instead. Absolute madness!
Who is the crazy one here?😁

Can Perineva mess with someone's mental edge? My wife's been on it for about 10 months now, and she keeps claiming that Perineva is killing her focus—like her sharpness is just slipping away. Is there actually a link there?

vividdrifter26 said:Can Perineva mess with someone's mental edge? My wife's been on it for about 10 months now, and she keeps claiming that Perineva is killing her focus—like her sharpness is just slipping away. Is there actually a link there?

It’s pretty rare, but yeah, it can happen.

Then again, it might just be that she was stuck dealing with high blood pressure for so long that her body is still trying to find its footing, and now her pressure is effectively too low for her usual baseline (though honestly, 10 months should have been plenty of time for her system to adjust 🤔).

What dose of Perineva is she taking, and what kind of readings are we talking about?

She really needs to be checking her pressure regularly and jotting down those numbers at least three times a day 😒

Anyone using Valsacor? Honestly, I feel like they're the weakest ones out there... I’d love to just stop taking them altogether. Also, does any athlete around here happen to be on Valsacor?

Thanks.

velvetmoose9 said:It’s pretty rare, but yeah, it can happen.

Then again, it might just be that she was stuck dealing with high blood pressure for so long that her body is still trying to find its footing, and now her pressure is effectively too low for her usual baseline (though honestly, 10 months should have been plenty of time for her system to adjust 🤔).

What dose of Perineva is she taking, and what kind of readings are we talking about?

She really needs to be checking her pressure regularly and jotting down those numbers at least three times a day 😒

Forgot to mention he's 45. High blood pressure was just some random thing found during tests for allergy reactions—after getting diagnosed with allergies to milk, feathers, eggs, and casein, he's basically living on a vegan diet. Maybe that vitamin deficiency is messing with his concentration too? Dose of Perineva? To be honest, I don't know (just one pill in the morning, but no clue on the dosage). Blood pressure? He "caught" it hitting nearly 160 (systolic)—don't know the bottom number, but since starting the Perineva, things have calmed down; it rarely goes over 130, and even then, only after hiking uphill or dealing with heavy stress. So, now what?

Yesterday I had an appointment at the Nephrology Institute, and since I’ve been battling hypertension for two decades now—managing my regimen with Concor 5 mg and varying doses of Monopril between 2 to 6 mg—my specialist decided to introduce Tomid 5 mg into the mix. To be perfectly honest, the dosage feels a bit heavy-handed to me; I find myself wondering if dropping down to 2.5 mg might be a more sensible approach. I sought medical advice because even when I stick to the 6 mg dose of Monopril, my blood pressure still decides to spike, hitting levels like 145/87—which is exactly what it was doing during my visit yesterday—though typically I settle for 4 mg, and during those sweltering summer months, it seems nothing works quite as well as the Concor. My potassium levels are also a constant source of anxiety; despite being on a variety of diuretics, they frequently run high. My last reading hit 5.8, which sent me into a complete panic, prompting me to head back for another test ten days later, only to find it had settled at a much more reasonable 4.4. I do consume quite a few bananas, though surely one a day isn't enough to cause such a dramatic shift. My doctor characterized Tomid as a mild diuretic, yet I recall someone else mentioning it has a much stronger effect? I am torn between asking my primary care physician about switching to Indapamide or simply opting for the 2.5 mg dose of this new medication.

Jason Vaughn482 said:Yesterday I had an appointment at the Nephrology Institute, and since I’ve been battling hypertension for two decades now—managing my regimen with Concor 5 mg and varying doses of Monopril between 2 to 6 mg—my specialist decided to introduce Tomid 5 mg into the mix. To be perfectly honest, the dosage feels a bit heavy-handed to me; I find myself wondering if dropping down to 2.5 mg might be a more sensible approach. I sought medical advice because even when I stick to the 6 mg dose of Monopril, my blood pressure still decides to spike, hitting levels like 145/87—which is exactly what it was doing during my visit yesterday—though typically I settle for 4 mg, and during those sweltering summer months, it seems nothing works quite as well as the Concor. My potassium levels are also a constant source of anxiety; despite being on a variety of diuretics, they frequently run high. My last reading hit 5.8, which sent me into a complete panic, prompting me to head back for another test ten days later, only to find it had settled at a much more reasonable 4.4. I do consume quite a few bananas, though surely one a day isn't enough to cause such a dramatic shift. My doctor characterized Tomid as a mild diuretic, yet I recall someone else mentioning it has a much stronger effect? I am torn between asking my primary care physician about switching to Indapamide or simply opting for the 2.5 mg dose of this new medication.

You could give the Tomid 5mg a shot, probably best to take it right at the start of breakfast.

Start checking your blood pressure a bit more frequently—and make sure you actually write the numbers down! That way you'll figure out if you really need to take the Tomid every single day, or if every other day or every third day does the trick.