BP ALways High at GP and Hospital but not at Home

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I have been taking Enalapril 5mg for 6 years I am 58 years old... Called in for annual review at my GP's and BP was up 146/86 returned following week saw Nurse BP 150/86! Referred me to GP gave me another 2.5mg (now 7.5mg) returned this week BP 160/90......... Have been given Amlodipine 5mg to add to the other BP Med well I tried to tell my GP of over 20 years that it was not that reading at my home just 15 minutes before and now having read up on all the negative side effects I am VERY VERY Worried as to start the new meds sad My readings at home are always between 130/75 GP has asked me to record my readings for a whole week and see him next week I REALLY DONT WANT TO START THE AMLODIPINE have I got the right to refuse neutral

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    Hello, I appreciate your concern and I'd like to reassure you that all medication and treatment advocated by your GP their recommendation only. You can refuse and ask for an alternative (and there are others of three main types). I worked in the NHS in Community Health and I'm acutely aware that people feel obliged to follow the GP's judgement. I'm on my third hypertension medication (Ramipril, Losartan and now Amlodipine) and over ten years have had problems with all of them. The fact that my GP has changed his recommended medication means that he is only going by "trial and error", as all three are of different types. Talk to your GP and ask for their reassurance about what they are prepared to do if the side effects are too unpleasant. As your BP is different from when taken at home, why not ask for a "twenty-four hour tape". This is where your wear a BP cuff monitor on your upper arm for 24 hours which is attached to a battery pack and recording unit. It gets activated every hour and will inflate/deflate the cuff automatically and record your BP. BUT! it is an uncomfortable sensation and for me, my BP was erratic and raised, as I found it unsettling through the night. Ask anyway, as it could give your GP more relevant information. GP's are reluctant to swap medication and remember that if you went to a different GP they might well advocate a different drug. Best wishes.
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    Thanks for the reply smile I have had the 24 hour monitor and basically yes I had similar results to you sad the cuff was way too tight and bp was around 140/90... I am very happy to stay on Enalapril but as Ive said even raising it by 2.5mg I'm having strange side effects why cant they be "happy" with my machine readings? Infact the GP has asked me to bring in my machine to make sure I am putting the cuff on correctly!!!! I am still apprehensive with regards to this type of med.
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    I'm now under a renal consultant who is listed as having a special interest in hypertension. At the surgery and at the hospital over the last few months following one too many stressful and serious health-related problems with my family) my systolic BP has consistently recorded as 120+. He asked me to record my blood pressure at home for 14 days, taking it 3 times in succession and recording the average of the lower two readings. The readings ranged between 155 and 170 systolic and between 67 and 87 diastolic, so although still too high they are way below those taken at hospital (white coat syndrome).

    Amlodipine was stopped after 2 months of ankle swelling, rash and uncomfortable legs. Have been on Diltiazen for 2 months but in spite of increasing the dose (an again causing ankle swelling), it hasn't brought my BP down sufficiently so now Ramipril was added 3 days ago. I was told that perhaps the Ramipril would reduce the swelling - it hasn't so far, and providing blood tests are normal in a couple of weeks they intend to increase the dose. I, too, am hating taking these drugs along with their obvious side effects, let alone those side effects that are not obvious!

    Michywishy, perhaps you could suggest that you record your readings at home for a couple of weeks in case you, too, are a victim of 'white coat syndrome'.

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  • Posted

    Many thanks for that smile I def have White Coat/Gown! Syndrome think I was born with it joking apart, I suffer with OA in every joint having undergone a total knee replacement(very successful) 9 years ago the other knee will need replacing sooner rather than later I cant worry about extra swellings I find it hard enough to walk and move around now but do manage, Enalapril is fine and doing its job but according to the "professionals over 55's need another BP med? Its just another tick box I think, I know Im sounding very matter of fact, but my BP is borderline and if I have these side effects from Amlodipine I wont be taking it confused plus pretty scary statistics if you look on the US website for this drugsad

    Thanks again

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    ps my readings today have been 133/80 for all three reading, 8am 1pm 6pm smile

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    hi, 133/80 not too bad considering all the different readings you have had taking your own BP at home do make a big difference I have the same problem. at the moment mine is 145/70 if I take it early evening when I am more relaxed it will be something like 130/65, 10mg of amlodipine and 2mg of doxizosin do keep it under control as my BP have been as high as 212/95 when I had a T.I.A mini stroke. they put me on Ramprill 15mg but my kidneys very soon started to play up . the amlodipine worries me a lot with the after effects but I have been on a few drugs that have given me even more problems, I do not want to take amlodipine, so I wish there where a safer alternative. I take atorvastatin 20mg to keep the cholesterol down that stays at around 5 for some resone it do not go any lower. its very hard to know if we are taking the right meds we have to put a lot of faith in our doctors and the companies who produce the drugs, but they should be made to disclose all there findings and reports so that we can make an informed decision about what we are taking.
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    I have been reading this with interest, and I note Ian7 that you are taking doxigosin. Can I ask how long you have been taking it, and if you have had any side effects?

    Also MrsO, I see you are seeing a renal consultant. I too have now been given an appointment to see one in a couple of weeks. Apart from the obvious blood results showing too high/low levels of sodium and potassium with different BP meds. I feel so bl....ill all of the time. It really seems as if all the BP medications are damaging to the kidneys.

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  • Posted

    Hi l have been on doxizosin for 2 years since ramprill messed with with kidney . Bendroflumetheside made my potasiam drop to 2. So now i am on amlodipine and doxizosin. Nothings simple.
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  • Posted

    Len - I'd be interested to know how Ramipril affected your kidney please? What were the symptoms/side effects?

    I have only one kidney and Chronic Kidney Disease Stage 3 and have just been put on Ramipril. I've heard from another lady who says that Ramipril reduced her kidney function to an even lower level than mine at Stage 5. Needless to say, I'm worried!

    The consultant says that even though my kidney function will reduce further on Ramipril, the drug will protect my kidney in the long term.

    I guess that all the BP drugs can have a bad effect on the kidneys, but we're between a rock and a hard place as we need to reduce our BP to protect us from heart attacks and strokes.

    Perhaps in your case, it was the high 15mg dose of Ramipril that affected your kidneys. I hope they returned to normal when you discontinued it.

    Annie

    I'll be really interested to hear what your renal consultant recommends - good luck!

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  • Posted

    hi mrs o, sorry to hear about your kidney problems. When I had a mini stroke my blood pressure was very high they started me off with a tritation pack of rampril start at 5mg then 10 mg then 15mg over a 3 week period as well as cloperdogrel an bendroflumethazide. after 2 weeks they sent me for bloods they rang me to go to the surgery and said my kidneys were not coping with rampril took me off them right away, sent me for a scan one kidney have got a very reduced blood supply and that could the cause of why some blood pressure meds are not suitable for me. now I have got amlodipine but very uncomfortable with the after effects. the doxizosin is just a back up to help to keep my diastolic down that was still running too high. because we are all different I think it takes a long time to get a happy mediam on what suits us its just so frustrating that it takes so long to get it right. ive got my review tomorrow see how it goes this time. look after yourself and I hope you feel better soon... len7.
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    hi annie 255, I have been on doxizosin for about 3 years now I must say its probable the only drug I haven't noticed any after effects with taken at night only because they can make you drowsie and a little bit dizzie so I take mine just before bed, its the other meds I have problems. I hope this helps.... len 7
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  • Posted

    Thanks Len7 for the info.

    Great to hear that you are happy with Doxizosin. It maybe an idea for me to change when I take mine. At the moment I take it first thing in the morning. It is not so much the immediate first reaction but very shortly after I get the panic/anxiety attach. Stomach aches in a knot and a generally feeling of being unwell. I will obviously have to be careful with my timings.

    I see you are going for a review today, hope all goes well. Do let us know how you get on.

    Mrs O. Many thanks for your good wishes and I certainly will report back. Hope you can get some satisfactory answers soon.

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  • Posted

    Thanks for your reply, Len, and for your good wishes. Good luck to you, too, with your review today.

    MrsO

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  • Posted

    Just had 2 conflicting calls from doctors surgery. First one to give results of blood test yesterday, and to say that kidney function back up to 73% (had been decreasing) so this was good news. THEN within half an hour another call from surgery but another doctor to say potassium level high and need to have ECG and is causing concern. Got to wait until tomorrow, really worried. Had felt so pleased after first call, as thought this latest med. was okay, not it looks as if it isnt. Oh dear, so very worried..
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  • Posted

    Annie

    I don't really understand what "kidney function back up to 73%" means. "Back up" from what? I usually ask for the eGFR reading. I have noticed in the past that when I commence certain BP pills, my eGFR sometimes increases to a better level. However, from chatting to a lady on the Nat. Kidney Federation Helpline the other day, she mentioned that if the eGFR increased, it probably meant that the creatinine levels had increased too, and that isn't such good news but some of these BP meds do cause increased creatinine.

    How odd for you to have two such conflicting calls one after the other and I can understand your concern but perhaps the ECG is routine when potassium levels stay elevated. Good luck tomorrow.

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