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Genetic hypertension?

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sue44688
sue44688

I have been prescribed Amlodipine 5mg and more recently 10mg . I have what I consider borderline high blood pressure and possible  'white coat syndrome'  as its always higher in the presence of Gp. I am suffering with swollen ankles and legs as a result of the highe dose. As I lead a fairly active life and have a healthy diet the Gp has concluded that I must have a genetically high BP ? How can this be assumed ? I have been told that whatever I do .exercise,diet , etc it will never reduce my blood pressure . Has anyone ever been advised the same?

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  • MrsO-UK_Surrey
    MrsO-UK_Surrey sue44688

    Posted

    Sue, Amlodipine at just 5mg caused sever ankle swelling which eventually led to a diagnosis of varicose eczema producing a red blotchy rash around my lower legs.  It was very uncomfortable walking and particularly on the stairs.  You need to either ask for a change of medication or a reduction back to the lower dose.  On the other hand if your blood pressure has been described as "borderline" or possible "white coat syndrome", then you really need further confirmation.  For instance, if you haven't already been fitted with one, a 24-hour blood pressure monitor might provide an answer as to whether you do, in fact, need treatment.  
    • sue44688
      sue44688 MrsO-UK_Surrey

      Posted

      MrsO. Sorry your treatment has resulted in these problems . I have already decided to reduce the dose and monitor my blood pressure at home and see if it reduces the fluid around my ankles . I still have an issue with the genetic connection as I feel this is a huge assumption to make without evidence and to be given no other option but to take a drug which potentially causes such problems. I intend to revisit a different GP to pursue this ,thank you.
    • MrsO-UK_Surrey
      MrsO-UK_Surrey sue44688

      Posted

      Sue, including as many known diuretic foods as possible into your diet might help to remove the fluid from around your ankles caused by the Amlodipine.  Asparagus, celery, garlic, melon, fennel to name a few.
  • ian21671
    ian21671 sue44688

    Posted

    The most common type of hypertension is the so-called "essential hypertension", which means that the specific causes are not known. Africans and Indians usually have higher hypertension values, but even this cannot be regarded as "genetic". If your  measured values are just borderline, you would be usually started on diuretics instead of immediately prescribing calcium channel blockers like Amlopidine. This approach would certainly not cause any ankle swelling or other edema.

    As to "white coat syndrome" , rest for 5  minutes before the docotr takes your readings of blood pressure. You can also purchase an inexpensive blood prerssure monitor which is nowadays stocked in most pharmacies and is very easy to use. They can also show you how to position the cuff on your arm, how to position your body (sitting(  and how to take a reading. Do not take it immediately after eating or alcohol consumption.

  • mike92384
    mike92384 sue44688

    Posted

    sue44688...I'm sure you've discovered that when you started taking the 10mgs of Amlodipine, that's when the swelling of your ankles started. Did you have that same

    problem when taking just 5mgs? I'm guessing you didn't. A very common side effect of Amlodipine are swollen ankles/feet & it can extend upward on the legs. I too had the same problem 3 years ago. The 5mgs didn't lower my bp..so my GP upped the dose to 10mgs. Coming off the Amlodipine resolved the issue.

    WHY your GP would say you have "genetic hyperstension" with just one

    bp medicine to me is nothing but hogwash! Why didn't he tell you that swollen ankles is a commone side effect of the Amlodipine & that there are several other bp meds that can be taken. Amlodipine is not be the all & end all of bp medications. Having a healthy diet, & exercise certainly CAN lower bp. It is a known fact that this certainly CAN lower bp..in fact my own GP told me as recenlty as 2 weeks ago, that a healthy diet, including some weight loss..& exercise results in many many patients experiencing the lower of bp. It may not lower it by 20pts., but it certainly DOES help lower it, & because of this factor, many patients don't have to take as much bp as they did prior to the healthy diet, weight loss, & exercise. You didn't say how high your bp was. Also, your GP should be taking into account that 'white coat syndrome" is known to cause an elevation in bp. You also said you have what you consider to be 'borderline" high blood pressure. What is  your definition of 'borderline' in this case? 

    Go back to your GP..& ask for another bp medication. Tell him there are Calcium Channel Blockers, ARB's., ACE's etc.He'll know what you're talking about.

    Don't just settle for the one medication...that's ridiculous & certainly not fair on you.

  • cpwood
    cpwood sue44688

    Posted

    Sue, you've received a lot of good advice here and you are doing the right things, number one on the list getting a second opinion.  I've learned over many years that medicine is as much art as it is science and trial and error is a major part of it.  You need a doctor who is willing to work with you to find the right solution and there very likely is a solution.  As you might guess, the people on this forum are very anti Amlodipine.  When my doctor switched me from 5 to 10 mg I developed Afib for life and even with a pacemaker, life is not totally back to normal.  He immediately changed my medication and my blood pressure is fine.  Good luck with a new doctor, there likely is a solution, but don't forget the other advice of exercise and diet.
    • MrsO-UK_Surrey
      MrsO-UK_Surrey cpwood

      Posted

      cpwood, I feel we should be on a bit of a crusade to find out just how many Amlodipine takers have been diagnosed with heart block necessitating the need for a pacemaker.  My hubby has been taking Amlodipine for some years and two years ago collapsed with total heart block which needed a pacemaker.  Our next-door neighbour was diagnosed with a heart problem after a while on Amlodipine and also had to have a pacemaker fitted.  I've come across others in the same situation.  I only took Amlodipine for a short while as I couldn't cope with the ankle swelling etc but then in fairness to the drug I do seem particularly senstive to most BP meds.  However, I read at the time that the Brigham & Women's Hospital had done some research into calcium channel blockers and as a result did not recommend them for women in particular, saying that it could lead to a heart problem.  I'm wondering if men are equally susceptible, although one of my renal consultants told me that the research didn't reach a finally proven conclusion....hmmm!  I don't understand that with so many people experiencing such horrid side effects from this drug, it is so commonly prescribed.....unless, of course, it is one of the cheapest available!  
    • cpwood
      cpwood MrsO-UK_Surrey

      Posted

      I would love to know that as well.  I do know it has had a dramatic effect on my life and I'm very unhappy about it.  It's unlikely we can do anything about it other than keep the conversations going until some independent group finally pays attention.  My doctor listens to what I have to say and did some research, but found nothing to support heart problems as a major issue, but I guess you and I know it is.  That's why I continue to respond to other people on this forum.
  • ian21671
    ian21671 sue44688

    Posted

    Personally, I have taken Amoc 5 (Amlopidine) for many years without any detrimental side effects. As I've stressed before, Amlopidine is not the first-in-line medicine prescribed against mild hypertension. A good GP will start with a diuretic, usually followed by an ACE inhibitor. Just like beta blockers, calcium channel; blockers are usually reserved for special cases due to their known side effects. However, it is also true that not everyone responds the same way to any medication. Bear in mind, that this blog is frequented by those who experienced adverse side effects, while there might be thousands whio did not, and therefore did not make remarks here..
    • MrsO-UK_Surrey
      MrsO-UK_Surrey ian21671

      Posted

      True, Ian, we do only hear on this board about those who experience problems but the case still remains that there are a lot of people experiencing very severe side effects from Amlodipine. My hubby didn't notice any discernible side effects until he collapsed with total heart block, never having experienced any problems with his heart previously.  The same applies to our next-door neighbour.
    • cpwood
      cpwood ian21671

      Posted

      What you say is generally true and I took 5mg amlodipine for several years with beneficial effects, but when I was switched to 10mg I developed Afib almost immediately.  The problem is that heart failure is not listed as a side effect for amlodipine, no matter how uncommon it might be.  If it truly is caused by amlodipine, there are many other drugs that should be tried before it is prescribed.  I hope you don't have the same effect if they ever raise your dosage.
  • ian21671
    ian21671 sue44688

    Posted

    If you used Amlodipine 5 mg beneficially and without any side effects, then why did you switch to 10 mg? 
    • sue44688
      sue44688 ian21671

      Posted

      Ian21671. The dose was increased because she was not happy with the BP readings . I do monitor it at home and have variable readings from 130/70 to 160/ 90 , odd I know . I am not overweight ,have been vegetarian for years and eat healthily ( I know some veggies exist on cheese & pasta!). I am 65 and still work part time on my feet most of the day. Walk miles and do yoga. I asked about diuretics as some have suggested I do  ,but was told  by my GP that this was the old fashioned approach and calcium channel blockers was the way to go. I have reduced the dose back to 5mgs and will take readings to see if things settle. 
  • ian21671
    ian21671 sue44688

    Posted

    Diuretics an old fashioned way to go? You mustr have a very young GP who. wants to push "modern drugs". Calcium channel blockers have been known for as long as diuretics. I am surprised that he has not heard of ACE inhibitors.( or ARB's if ACE inhibors cause coughing) which are the cheapest and most effective  blood pressure medicines. By the way, getting your weight down to normal, quitting smoking and excessive drinking do reduce  BP.  BP also changes throughout the day and night. If he is a fan of calcium channel blockers, there is, for example, a calcium channel blocker called Rawamil SR, 240 which has an extended efficacy.
    • sue44688
      sue44688 ian21671

      Posted

       My GP is certainly not  young ,has been at the practice for many years. I am sure he has heard of ACE inhibitors  too but if I remember correctly from my nursing days, these are mainly used where there is underlying congestive cardiac disease . I certainly do not wish to go down that route and hope that maintaining a healthy lifestyle I can avoid taking any drug . I  drink probably once a week ,am not overweight and very active . Thank you for your input .
    • mike92384
      mike92384 sue44688

      Posted

      sue44688..please don't be at all nervous of taking an ACE Inhibitor or ARB if the Dr. suggests it. These are very common medicines used for the control of hyperstension.

      Also remember to take your bp readings when you are relaxed. If you're the slightest bit tense, it could result in a higher than normal reading.

      Sit with your feet flat on the floor, with your back touching the back of the chair. The cuff should be applied to your LEFT arm, approx 1-1 1/2" above the bend in the arm. Be sure the 'wire" runs straight down toward the palm of your hand. Being a former nurse, I'm sure you're aware that if the cuff is too loose, or too tight, you may not get an accurate reading. Certainly for your age, a reading of 130/90 is very good! Well, the 90 may be a bit high, but nothing to worry about. When it gets to 160/90, that's high I'd say, but there could be factors causing this. Remember, bp fluctuates from minute to minute. How are you taking the readings?

      Take the first reading...& toss it away. Very likely it isnt accurate. Take 3 more, then average them out. The average is what you report.

      My kidney specialist says to take 3 readings, throw the 1st one out, then average the next two. So you see, even a specialist has their own ideas 

      as to how to take bp readings. Don't talk during readings...don't take the readings if you don't feel well or are in pain. Be sure you are in a relaxed quiet setting.

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