Hypertension Issue ... Biking Content

[Spinner]

3 years ago while donating blood, I was advised that my bp was 158/98. I subsequently went to the doc who prescribed 40 mg Benicar. This worked for 6 months or so, then my bp jumped up again so 90 mg of Nifedipine was added.

This two pill regimen reduced my pressure for about 10 months then my bp shoots up again. The doc then added 25 mg Atenolol twice per day. Again, my pressure came down for some months and then rose to unacceptable levels. He finally added Triamterene/HCTZ 75/50 once per day.

Holy crap, I have been extremely healthy all my life, now I'm on 4 scripts per day.

I'm 6'00" and 190 lbs, 53 years old, have been actively riding multi-speeds for 35 years, competed in 36 triathlons and have been actively lifting weights for the past 15 years. I typically have a couple of glasses of wine per day. I have a family history of hypertension with both siblings struggling with the same issue.

This year my biking strength and stamina are deplorable; I simply can't enjoy cycling like I have in the past.

Ideas and input from any and all are welcome.

[CNY rider]

I think you need an evaluation for so-called "secondary" causes of hypertension. Things like renal artery problems, and diseases that cause secretion of hormones that raise blood pressure.

I'm just an oncologist, so as far as I'm concerned all the heart has to do is pump around the chemotherapy! I don't really do any hypertension management. There are others here who should know a lot more about this.

Good luck.

[spiderman]

i'd probably stop your beta blocker, etc....
and give you some benicar 160/25 samples
so we could ride at noon
and have you drop me like a rock!

[Kevan]

I take a very small dose of tenormin, also a beta blocker, daily, but wait until after my ride to pop the pill.

I used to pop them first thing and noticed my performance was worse than it typically is. Delayed the pill popping and everything got better. I don't suggest anyone else do this unless their doctor gives the nod. Mine didn't so much as nod as he smirked.

[zap]

How's work?

[Ken Robb]

How's work?
and other potential stressors? My BP dropped 20 points when I retired. A couple of weeks ago an old client and friend told me he was lsiting his home and buying another ($20,000,000+ of busineess) and my BP was up to 150/80 just thinking about it. I think I got out just in time.

I wonder (docs please comment) if a person has a very competitive attitude about riding if his BP rises as the time to ride nears?

[Bud_E]

I take a very small dose of tenormin, also a beta blocker, daily, but wait until after my ride to pop the pill.

I used to pop them first thing and noticed my performance was worse than it typically is. Delayed the pill popping and everything got better. I don't suggest anyone else do this unless their doctor gives the nod. Mine didn't so much as nod as he smirked.

generic Tenormin = Atenolol

I've been on the stuff for years and I'm sure my performance suffers but it works and I don't race anymore so I'll stick with it.

[pauly]

Everybody's different and some drugs are more potent than others in certain individuals. I was on Hyzaar (Cozaar + HCTZ (Diuretic)) and after a year of good numbers, the BP started to go up. Now I'm on generic Lotrel (Novasc & Lotensin) - a Channel Blocker and an ACE, and things are much better with no problems with my riding. I believe that genetics are usually half the puzzle with your health and you've got to play the hand your dealt. But don't mess with heart disease - at those numbers (which are close to mine) I think your at 4X the normal risk for a coronary event. So always follow your doc's instructions.

Paul

ps - I've also tried to avoid the beta blockers.

l

[Bill D]

I'm no doctor, but my docs have always told me that sometimes it takes a while to find the right drug(s) for your body. Talk to your doc and see if there's something else you can try that might not affect your workouts. There are SO many different drugs out there, and there's a certain amount of trial-and-error involved in getting it dialed for your body. What works for me won't necessarily work for you, and vice versa.

As I understand it, beta blockers sometimes affect people in the way you're describing, and my experience was very similar several years ago. I tried a beta blocker, a Ca channel blocker and a couple different ACE inhibitors before I found something that worked for me without any real side effects. Don't be afraid to be pro-active and ask your doctor if you can explore other options. Maybe there's a good reason you can't, but it's definitely worth having the conversation to explore it.

Good luck.
-Bill

[thwart]

I think you need an evaluation for so-called "secondary" causes of hypertension. Things like renal artery problems, and diseases that cause secretion of hormones that raise blood pressure. 1+ on that. Maybe a new doc is in order... ?

Shop talk... not on a bike forum.

[rpm]

i'd probably stop your beta blocker, etc....
and give you some benicar 160/25 samples
so we could ride at noon
and have you drop me like a rock!

I'm not a doctor, but I like Dr. Spiderman's advice. The big challenge in treating hypertension is to find drugs that work but don't mess you up with side effects. If you do find a promising one, ramp up the dosage to the max and see what it does. If it doesn't do the job, but still doesn't mess you up, then it's time to start adding a drug from another class. If you start multiplying drugs prematurely, then the probability of side effects and interactions goes up dramatically, and it's hard to pinpoint what's really responsible for the good and bad things.

I use three drugs: Diovan (maxed out), HCTZ, and Hytrin, which is an alpha blocker. Four seems like too many. You ought to be able to find two that will do the job, along with the diuretic.

It's also worth investing in a home blood pressure monitor. It will allow you to see at what times your bp is high and low. I keep mine in my office. My bp is always highest when I first come in, and lowest right after my noon hour ride or trip to the gym. Keeping a week's records of three or four readings a day is useful before your doctor's visit. Take it with you when you go, so that you can calibrate it against the doctor's equipment. When I do that, I find my bp shoots up just from the waiting room to the office. It's useful to know this because it helps keep the doctor from overmedicating me.

[Spinner]

... for your input.

My work has always given me a fair amount of stress and my current role is no different. I am seriously considering another doc, primarily because the idea of four different meds strikes me as too much. I did go to my current physician this week after a weekend of bp that was too low (81/68 and the like) for some blood work; no results reported yet.

Additional feedback is welcomed.

[Bill D]

Great suggestion to get a BP cuff you can use at home. You can get them at any drug store for something like $25 or $35, I think. I got a really simple digital one at Walgreen's. Track your BP at home and at work to see how it looks. Keep track of it and take it to the doc's office for him/her to see. Check your own BP and see how it compares to what the doc gets. My cheapo unit is surprisingly accurate.

I never *feel* anxious in a doctor's office, but almost without fail my BP is higher there than at home. My docs have told me that this is a fairly common phenomenon called White Coat Hypertension. It's good to know that because the key is for your BP to be good during your every-day life; it's not a big deal if it's high only at the doc's office. If your BP runs higher at the doc's office, you run the risk of over-medicating.

[sfghbiker]

just a quick thought. it would be worthwhile to purchase a home BP cuff, one of the electric jobs would be fine. take your BP at home everyday for a couple of weeks and try and get a sense of what your BP is consistently running and right it down. this will help you and your doc come up with a plan that works for you.

[Larry]

generic Tenormin = Atenolol

I've been on the stuff for years and I'm sure my performance suffers but it works and I don't race anymore so I'll stick with it.

I take Atenolol for shoulder/pectoral pain (injury from 43 years of violin playing.) I limit my dosage to 25 mg. per day. I take it at night, and indeed it does lower blood pressure significantly. Maybe too low during the day.
I can also have a tendency towards an elevated pulse without much effort
that is most likely caused by the pain and/or anxiety-related issues.

I think it has somewhat of a depressive effect. Anyone else experience this?
What side effects do you folks notice? I tend to think it is a good medicine over all.

[Larry]

... for your input.

My work has always given me a fair amount of stress and my current role is no different. I am seriously considering another doc, primarily because the idea of four different meds strikes me as too much. I did go to my current physician this week after a weekend of bp that was too low (81/68 and the like) for some blood work; no results reported yet.

Additional feedback is welcomed.

Spinner,

Let us know what your doctor says about bp of 81/68. Mine gets pretty low with low dosage Atenolol, but the medicine helps the shoulder/pec pain.
Is this too low? Are there risks concerning this issue of low bp.

Larry

[TimB]

My doc just started me on 5mg of Lisinopril daily, after taking me off 50mg Toprol XL about 2 months ago. I have a home BP cuff, and over the course of the two months with no meds, my BP was usually in the 120/80 range, occasionally higher or lower with hydration, stress, etc.

So I was feeling pretty good about no meds and a decent BP. Then he wants an EKG...comes back almost immediately saying something about the EKG shows my heart working too hard and wants me to start the Lisinopril. FWIW, as we're in the office my pulse is in the mid 50s, resting is about 47. So I'm left a bit confused by all these BP meds and what other uses they may be put to.

[Elefantino]

Intersting thread. I have, throughout my life, had very good (100/60-70) blood pressure. Six months ago, when I was at a dermatologist, my blood pressure suddenly registered 150/110. I thought it was merely a bad reading until, shortly thereafter, I took my blood pressure at a local drug store and it read almost the same.

Turns out that the high blood pressure gene that runs in my family has finally become active. After several fits and starts, I am now on two medicines that seem to have done the trick.

I don't appear to have had any issues with the medicine affecting my performance on the bike. In fact, one of the medicines is supposed to help with my oxygen somethingorother. The only side effect is that I appear to be more thirsty at times, but never dehydrated.

I do, though, now have a home BP cuff. Great investment. Almost as good as having a nurse for a wife … which I also do.

[tbushnel]

Spinner,
We frequently see patients in the sleep clinic with "refractory" hypertension (on multiple anti-hypertensive medications). A particularly common secondary cause of hypertension is obstructive sleep apnea. Whether this is a concern for you I can't say. But it is worth looking into as a potentially treatable cause.
Cheers,
Ted.

[SoCalSteve]

generic Tenormin = Atenolol

I've been on the stuff for years and I'm sure my performance suffers but it works and I don't race anymore so I'll stick with it.

Strong Medicine, for sure...

I was on it for years and hated excercising. I had surgery (for another heart related issue) and was able to go off the beta blockers and now I'm lovin' life on the bike again.

I am sure this is the reason for your poor performance and lack of enjoyment on the bike.

As for a cure for hypertension, diet and excercise seems to be working pretty well for me. Maybe cut out booze and caffeine.

I'm no doctor and dont play one on TV, so please take my opinion with a grain of salt.

Steve

[Spinner]

are in and the doc now advises to discontinue usage of Benicar as he believes that it has impacted kidney function.

He has also replaced: the Atenolol 25 mg with Metoprolol 25 mg; and the Triamterene/HCTZ 75/50 with Triamterene/HCTZ 37.5/25.

Thanks for the input and caring shared by all.

Time to go home and ride my Serotta.