Help, advice, support 26 y/o female with high BP

Hi Jane,

Thanks for your response. Sorry, I said I am on losartan and bisoprolol, I meant propranolol ! That is what I take now with my losartan. 

They don't know what's causing the headaches, I had radial pain pre meds assumed to be as a result of hypertension, but post meds the pain changed to very pinpointed in the same place on my head. It disturbs sleep and I have it every day. Some days it is ok and manageable, other days it is so bad it makes me wince when I get the shooting pain (every few seconds). On average 3-4 days a week I suffer with severe pain. I did get relief with the sumatriptan today though. 

I've been working from home (the doc wanted to sign me off work but I was against that) so I really have been resting, but sometimes I just have to log off my computer and lie down it hurts so much. 

I forgot to mention, I have had symptoms of syncope and have fainted on numerous occasions. I probably near faint 4 times a year and actually faint 1-2 times a year. This has happened since my late teens. However, this is usually when I exert myself and has Never before been picked up on as an issue. About 3-4 weeks ago now, I was in Nandos and passed out when paying for my meal. Usual symptoms that I get, hot, very sweaty and clammy, dizzy, nauseous, hearing goes, pulse in my ears. Followed by fainting. My housemate said I just went into slow mo mode. This is the first time it has happened when I haven't been exerting Myself. The other night I fell asleep, woke up ten mins later and I was gasping for breath and couldn't hear again for a few minutes. 

My bp readings are done at home on my own monitor, they're done at the doctors and in hospital too. I have to email my doctor my readings a couple of times a week (I need to take them 2-3 times a day). 

I have no idea what's going on. I just don't know what to do anymore ! 

I've cut salt (I don't add salt to my food anyway as I don't like the taste), I exercise (gently at the moment as been advised to not go to the gym which I usually do 3-4 times a week so just going for countryside walks at the minute), I'm trying not to drink and if I do it is only 1-2 at weekends but only say one weekend in 3, I have cut sugar from foods (drinking water mainly and I make all meals fresh) and I am trying to sleep more and relax my mind as best I can.

Honestly, I don't know what else I can do ! According to the way I live, I should be fit as a flaming fiddle ! 

Yes you certainly should be as fit as a flaming fiddle living as you do! There does sound to be something really mysterious going on. As for the fainting, I may be wrong but I was under the impression that fainting or even just feeling light headed was likely to be due to LOW BP not high?

Hi Jane,

Spot on, usually a symptom of low blood pressure. This is when discussions surround cardio myopathy were raised as using the medical term, my heart may be doing 'weird things' haha. 

These episodes come on randomly or if I have been doing something strenuous or have been ill. Two days before by bp was tested in July, I almost passed out in the am ironing my blouse before work. Then I was ok until I went on hols end of August, I was ill and fully passed out. Then I passed out in Nandos in October. Then I had symptoms but lay down till I felt ok again following sex with my partner (sorry, TMI). It wasn't even THAT active ! 

So yes, not entirely sure what's going on. My bp is constantly high though, today I've had readings 158/110, 152/110, 158/106 and 164/110 so who knows. 

The GP today referred me to a specialist at another hospital who I will see a week on Tuesday so only time will tell I suppose.... What are the risks of high BP? Is it just stroke and heart attack? 

Hi Derek,

Thanks for your response. I had to stop taking the contraceptive pill I was on and am now on a progesterone only pill called cerazette. The blood pressure is still very high. I do not smoke, I am actively fit and I weigh just under 8 stone and of athletic build. 

It may not cheer you up but my BP has most days since 2000 been higher than yours but most evenings it then goes down to below normal. I do though have the excuse that I was 66 before I became hypertensive and even then had been doing all the right things for years, No smoking, no salt or prepared meals, little sugar and always active and walking as I don't drive.

I had all the tests you have had and many more drugs. At least at your age they will take more notice of your symptoms and eventually stabilise it.

I had an MR scan of my kidneys last week in yet another attempt to find a reason. A lot of research is going on at the moment on non drug options to control BP. Renal denervation looked promising and I tried to get on their trial program but it has now been halted for more research. Another is Rox flow coupler where a device inserted into your groin diverts some of the blood flow from the heart. 

Hi Derek,

My bp tends to be slightly lower in the morning, but these are when my headaches are at their worst. Then as the day goes on it tends to get higher. 

I've read the patient leaflet for my losartan which I am starting today, and this says it could be 3-6 weeks before it has a decent effect on my BP. it's all such a long haul hey !

I have been taking Losartan for most of the last thirteen years with ibrestartan, ramipril and perindopril  for short periods making me into a dull headed zombie.

Initially Losartan made me light headed when standing up. That took quite a long time to stop. I noticed when stopping it that a vauge itching feeling stopped. My GP said that its effect on the kidneys causes that in some people. 

This morning my BP was 209/90 50. Lunch time 163/93 63. Dinner ime after having been out most of the afternoon 112/64 51. What they call labile hypertension for Mrs O and I.

 

Hi Derek,

Thanks for sharing about the losartan. Just taken my first one. Was planning on heading back into the office tomorrow, I've been working from home for a while as the doctor said I shouldn't drive with my BP being so high, also due to a recent fainting episode and I've had these awful headaches. Now I'm worried about driving again if I'm going to be dizzy. Hmmm. I guess only time will tell. 

Oh the things our bodies do to us. 

Can't wait to get rid of this flaming cough. So hoping that is ramipril related and will now soon be out of my life !!! 

If people with high BP stopped driving the roads would be very quiet. When mine was first diagnosed at 210/110 they said that I should not do the flight to Barbados that we had booked for the next week. They would not do a stress ECG until it came down under 170. The meds brought it down to that level by the end of the week... but not for long.

I've never let it stop me from doing anything. As it comes down during the day exercise obviously helps. If I have a lazy day at home it stays fairly high.  

A point to bear in mind is that if taking out travel insurance you need to tell them. Controlled by two tablets OK. More than that they bump up the price.  

Hi mrs O,

Thanks for your response, your insight into head pain have been really helpful ! Thank you !! Desperately hoping the head pains stop now, I'm taking my first dose of losartan tonight. 

I was discussing ramipril and headaches with the doc today. As I know ramipril works by widening your veins, I also know migraines can occur through widening of the veins in your brain. However, I know there is a barrier to the head which may prevent the effects of ramipril being carried up into your brain. The doc said he was going to research and we can discuss next week. 

No family history of high bp, parents are slim and healthy (ish) not as active as they could be. But neither of them take any prescribed meds. 

r35506, I dare say you've been prescribed the Losartan as it is supposed to be the one with that causes the least side effects according to my wonderful pharmacist, especially as you've suffered side effects from a few others.  Are you taking the Losartan alongside the Propranolol and Bisoprolol or have you discontinued one of those now.  I've had horrid side effectsfrom many of the BP pills over the last 18 months.  Losartan seems to suit me but unfortunately is not reducing my BP sufficiently, sometimes hardly at all.  I am on just the 50mg but unlikely to be prescribed a higher dose as I only have one kidney which itself is low functioning.

Another thought going round in my head is whether you have had blood tests to check whether you have any inflammation showing in your body - namely ESR and CRP blood tests?

Have a good night and I hope the Losartan will work its magic as soon as possible. 

Hi Mrs O, 

I've had a whole load of blood tests although I don't know what for. A couple of weeks ago they took my temp and it was high though.. What significance could inflammation have ? 

r35506, there are viruses/infections and auto immune conditions that can cause raised inflammatory markers in the blood, and I wondered whether this could apply to you.  Your raised temperature is interesting - has it returned to normal now? 

That's a lot of propranolol. The professor I went to see when trying to get on his renal denervation program was a huge fan of propranolol . He wrote of it in such terms that my GP said that the practice had switched all of their patients on to it. I never did ask him how that worked out.  After about six weeks on 2.5 mg a day I asked to be put back onto Losartan.  

Hi mrs O,

I'm not sure about my temperature now, I've not had it taken since that initial time it was done. I should have got the doc to check yesterday. I have to email the doc my 3x a day BP readings on Monday so I may have to go in next week to see him at which point I will ask him to check my temp. 

Could I have had something wrong with me for months that could keep my temp raised ? Can you share any more info on this, it's really interesting and possibly could be the root of my problems !!! 

Hi Derek,

Thanks for your message about hypertension clinics, I will look into this! You were taking 2.5mg of propranolol a day? I'm only taking 30mg 3 times a day at the moment which I don't think is too much, I know they do a 40mg tablet too. 

Thanks for your advice on losartan, I was worried about driving to work today but I woke up this morning and felt better than I have in weeks. I didn't have a headache all day until this evening which is unheard of ! I forgot what it felt like to feel normal !!!

Cortrection I was taking Perindopril 2mg not Propranolol a very different animal. Sorry a touch of dyslexia on my part.

I hope that you feel better tomorrow.

If your head pain had disappeared this morning after starting the Losartan last night it could mean the blame lies with the high BP.  However, I'm not so sure that the stabbing head pain that you describe would be a symptom of high BP.  Stabbing pains through the head are usually nerve-related, as in plain neuralgia or trigeminal neuralgia, even the root of a tooth playing up.  I had a tooth drilled last year that resulted in horrendous neuralgia-type stabbing pains through the side of my head and my eye.  The dentist admitted she'd had to drill very close to the nerve, and it took a few weeks to disappear completely.  I had recovered just the year before from a very long term condition that caused severe head pain and I was concerned in case it had returned but no it was the dental work.

I think if you still had a temperature you would know about it, so perhaps you just had some infection/virus lurking at the time the temperature was found to be raised.

I'm so sorry to read your later post saying that your head pain has returned tonight.  If it doesn't improve over the weekend, I think if it was me I would go off to A&E - perhaps they will arrange a scan or refer you to a neurologist more urgently than waiting for your appointment a week next Tuesday.

A&E have never referred me to anyone apart from back to my GP. They will do an ECG or X-Ray type of thing or admit you if it is really, really  serious. I am surprised when I read of posters being admitted with high BP. I was once kept overnight for an angiogram after my GP referred me with my usual high BP and chest pain after the stress ECG they did resulted in what turned out to be my third such false positive.  

Ah but we don't know that this is 'just' "high BP", Derek and neither would A&E without investigating.  I am in touch with people who have gone to A&E with various severe symptoms, including horrendous head pain, some of whom have been lucky enough to be seen on the spot by a rheumatologist, been diagnosed and admitted.  In fact, the rheumatologist I was under for some years was often dashing off to A&E.

A lot depends on who you get at A&E. I could tell you a long story about my wife  not being diagnosed for severe pain in her lower left stomach after being kept overnight, investigated for all of the wrong things despite her protests and being discharged. She went to her GP after the weekend and he right away poked her in the stomach, she yelped and he said duodenal ulcer.

One of the paramedics who took her in had said it sounded like the pain he had with a duodenal ulcer and I knew that it was similar to when I had one.

 

Yes of course it does depend on who you get at A&E, also the time of day.  During the day there will be clinicians around but during the evening/night not necessarily.  We do hear good and bad stories but with someone very young and in severe pain you would hope they would be dealt with appropriately