Changing pressure meds

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Hey, guys. I’m 22 years old and I was diagnosed with hypertension about 7 months ago over the summer. My doctor started me off with 50 mg Metoprolol. That wasn’t helping so she increased my dosage to 100 mg with a diuretic to take along with it. I had been taking the 100mg with the diuretic for the last 5 months. They were helping my pressure but I was gaining weight, even with the decent eating and excerising no less than 4x a week. The Friday before New Year’s, I made an appointment with a new doctor (reccommended by family bc I had a feeling my current wouldn’t hear me out about the beta-blockers side effects). The doctor ended up putting me on a new medication because as I had suspected, I gained over 10lbs (I was scared to get on the scale at home). The new meds is an ACE inhibitor. My doctor told me to stop the beta blockers and start with the ACE inhibitors, a low dose of course. But now I am afraid. Should I have weened myself off the beta blockers first or at least asked him about it? Or have I not been on them long enough to? I don’t go back until the end of the month. I had been having the usual side effects with starting the ACE inhibitor. Headaches, but nothing I couldn’t handle. Yesterday (Saturday) would make a week of me taking the ACE inhibitor, and today when I got in bed to take a nap, my chest started feeling tight. Not to a point where I couldn’t function, but enough to notice. And I immediately thought about the potential danger of stopping beta blockers abruptly. Should I be worried? Should I call a doctor? Also, I started back taking my iron supplements because I’m anemic. I also heard that ACE inhibitor can cause iron deficiency. The tightness started right after I took the iron pill. I took my pressure meds earlier this morning. I’m rambling, but I’m a hypochondriac and I am getting worried. Making the tightness worse. What do you guys think? Anything would be helpful. Thanks. 

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4 Replies

  • Posted

    Hi Jay,

    On the assumption you told the new doctor exactly what you'd been taking and for how long, you have nothing to fear. He wouldn't have suggested anything harmful.

    As you rightly say, the perception of tightness in your chest could well be subjective, due to your current anxiety. We all start feeling as if we can't breathe properly once we start concentrating on our breathing. Unless you have some kind of rare allergy, the iron pill wouldn't cause a mild sensation of tightness in your chest. If it was having any effect like that, you would immediately have gone into anaphylactic shock, in which case you really wouldn't have been able to breathe. But that always comes on in a matter of minutes, so you don't have to worry about it now.

    The sensation of chest tightness is more likely to be down to symptoms of beta-blocker withdrawal. This is quite a common withdrawal symptom (as is a feeling of anxiety) but normally is only potentially dangerous in older patients with pre-existing heart conditions. I don't think you need to worry about this unless you start getting severe central chest pain and/or sudden pain or altered sensation in your left arm, jaw or neck. In this event you'd need to get yourself to a hospital asap. However, I'd reiterate that someone your age and in generally good health, like you, would be very unlikely to suffer any heart complications from beta-blocker withdrawal.

    If you have any left, you could try taking a small dose to see if that alleviates the symptoms, which would prove that you haven't suffered any harm.

    Otherwise, you might want to make an appointment to go back to the second doctor to discuss this.

  • Posted

    Hello jayy - I was switched directly from a beta blocker to another BP med some years ago.  It turned out to be sheer coincidence that I got ill with an autoimmune condition very soon afterwards but my pharmacist did say at the time that patients it is always wise to taper off BP medication - she recommended one week for each year of taking a particular drug.  As you were only taking Metroprolol for 5 months, then I would have thought there wouldn't be much problem just stopping it or perhaps just tapering off it over a couple of alternate days of one week.

    Having said that,more recently my kidney consultant switched me from another pill that I had been on for a few months to another beta blocker.  Immediately after the direct switch, I started getting nasty palpitations, particularly after getting back into bed following loo visits in the night.  I texted my kidney consultant for his advice and he said it was quite expected to experience this as the pill I stopped was inclined to cause a slightly faster heartbeat whereas the beta blocker would slow the heartbeat down.  He reassured me that this would settle down, and it did, and I hope this helps to reassure you.  However, always best to check out any odd experiences like this with your prescribing doctor, as I did at the time.  Worrying and stressing over it won't help.  

  • Posted


    ?Please repost with additional info.  Unless I missed it I didn't see what you BP was when you first discovered it was high 7 months ago.  Are both the Systolic and Diastolic (Top Number and Bottom Number) high?  Or just one or the other?  Also what is your Height and weight - which will provide your BMI.  Regarding BP Meds there are Beta Blockers, Alpha Blockers, Calcium Blockers, ACE Inhibitors - and all with and without Diuretics.  And all have some Side Effects.  IF and only IF - You require BP Meds, You may as well know you may go through 6, 8, or more before you find one that works AND has either no noticeable  Side Effects or very minimal ones. At 22,  Unless your are overweight or have a genetic predisposition towards high BP, I'm going to go out on a limb and guess your main High Pressure is the Systolic - which is normally caused by Stress and/or Anxiety.  Have you experienced any Panic Attacks?  Panic Attacks are harmless but will scare the Dickens out of you and cause you to feel faint, weak, shortness of breath, etc.

    ?Let some of us on here have more info.  This is a great Forum and there are some Great People on here.  

    ?I'll watch for some Follow Up info from you.

    ?BTW, a Specialist in BP will likely be more understanding if You should HAVE to be put on BP Meds and the multiple Trial Meds you may have to go through. 

    Good Luck and I'm confident you're going to be Fine!

    • Posted

      Yes, I am overweight. I’m above the 220s and have gone up since I started the beta-blockers. I also have a genetic predisposition towards high BP.  My mother has hypertension. So does my sibling. And I also suffer from anxiety, and have since I was a little girl. 

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