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I started taking Enalapril last Sunday. Now day 5 and have increased dose to 15mg but BP still not gone down much. Is this usual sometimes?

Posted , 5 users are following.

june52476
june52476

Reading this morning 191/111. This evening still 183/95.

0 likes, 24 replies

24 Replies

  • derek76
    derek76 june52476

    Posted

    You have increaed dosage or your doctor has instructed you to?

    Getting it under control takes time and often a change in medicaton.

    • june52476
      june52476 derek76

      Posted

      Thanks Derek. I started with 5mg and just today reached 15mg. Doctor told me to monitor my BP and gradually increase until it came under control. He on holiday now. What I didn't know is whether it takes a long period of time to control. My BP has swung down over the day but on average it is still too high and the drug doesn't seem to maintain the lower level. Going to see a specialist next week but am anxious about having high BP and the risks. 
    • derek76
      derek76 june52476

      Posted

      All I can say is that despite every medication mine has not been controlled after 14 years. I started at 210/110 and it is often back at that level in the mornings but they tell me it is the average that counts:-)

      I'm surprised that he allowed you to increase it so quickly. Increasing it in only five days is hardly gradual and sounds irresponsible to me. I started off on 2.5 mg of Enalapril but I was already taking Verapamil.  

      Seeing a specialist after having only having had high BP for a short time is nothing short of amazing! All my GP's have said that if they referred hypertensive patients to a consultant there would be a queue from their door to the hospital.

      From a manufacturers web site:

      Start (Oral): 2.5-5 mg/day then increase as required, usually at 1- to 2-week intervals; usual dose range (JNC 7): 2.5-40 mg/day in 1-2 divided doses. Note: Initiate with 2.5 mg if patient is taking a diuretic which cannot be discontinued. May add a diuretic if blood pressure cannot be controlled with enalapril alone

    • june52476
      june52476 derek76

      Posted

      Thanks for the information Derek, and putting it all into context for me.
    • derek76
      derek76 june52476

      Posted

      Let us know how you get on with the consultant. The problem is that they prescribe drugs as if they are Smarties and cast you out and ignore any possibilities of the side side effects you may suffer and say that they will see you in three months or are you seeing one privately as you have such a swift appointment?

      I took Enalapril for five months until a dermatologist said that it was the cause of a rash I had developed.

      After 14 years I have finally managed to be referred to one of the few Hypertension Referral Centres but I am not holding my breath that they will find any previously undetected reason for my Hypertension.

    • june52476
      june52476 derek76

      Posted

      I understand that in the majority of high BP cases they cannot find any cause. It appears to be a mystery and a minefield once you have started any medication. Good luck when you go to the Referral Centre, after 14 years you deserve it. I expect I won't be much the wiser until the results of blood tests, scans, etc are known.  It is the anxiety it causes when you know your BP is very high because of all the information given out about "the silent killer" causing heart attacks and strokes etc.  So every headache and chest twinge raises the stress (and BP!). It is a very lonely place and the support given by other people in the forum with similar experiences is reassuring and some comfort.
    • derek76
      derek76 june52476

      Posted

      Take solace from the fact that after 14 hypertensive years I am about to become 80:-) But I should not temp the Grim Reaper to visit.

      It is worrying when it shoots up but more so when mine drops to 69/54 sometimes by bedtime. That lets them say the average is 147/74

      I did have kidney tests last year when tyring to get on the now suspended renal denervation programmre.

      I now put every every chest pain down to indigestion and ignore it.

  • MrsO-UK_Surrey
    MrsO-UK_Surrey june52476

    Posted

    Hi June

    I was told by my pharmacist that it can take up to a couple of weeks to see any improvement.  I am taking Diltiazem and Losartan, and the Losartan leaflets says allow 3-6 weeks for it to work.  I have been taking Diltiazem for about 6 months and Losartan for about 10 weeks.  My BP is described as "labile" which means it fluctuates.  It was 200-210/90+ pre-medication, and is now much improved although not at the figures my consultant would like to see.  However, he doesn't take it at the hospital any more as it became obvious that although it was reducing at home, it was soaring at the hospital - white coat syndrome!  Not adding anything else at this stage though as I have just a sole kidney and chronic kidney disease.

    It is important that you have a blood test after about a month on the medication and no doubt your specialist will arrange this next week.  Good luck.

    • derek76
      derek76 MrsO-UK_Surrey

      Posted

      When I was first diagnosed at 210/110 I was going on a long haul flight in eight days time. They said that I should not travel unless it came down to a more reasonable level and they could do an ECG on the treadmill.  It was 168/?? five days after starting medication.

      I think that my middle name should be 'labile'

    • june52476
      june52476 MrsO-UK_Surrey

      Posted

      Thank you MrsO. It is good to know the experiences of other people. You don't think you are so alone when the stress kicks in because the BP keeps rising. 
  • jane243
    jane243 june52476

    Posted

    Have you only just been diagnosed with hypertension June? I agree with Derek when he says you are trying to go too fast. All that I have read says to increase slowly.  When I was diagnosed a year ago I asked to try and sort it by lifestyle and gave up salt, lost some weight though I wasn't that overweight, stopped drinking wine every day and walked at least half an hour each day. After 2 months I had to go on medication - Ramipril [lowest dose] and that was raised after 1 month. That brought the BP down to acceptable levels but I developed the nasty cough, so it was changed to Losartan, which I understand works in a similar way. The  'pril' meds are all calcium channel blockers I think and I specifically didn't want to have those as you can't eat grapefruit for breakfast!  I do think lifestyle changes have worked for me at any rate. If I didn't exercise I think I would be on a higher dose and I hate taking pills of any sort.
    • june52476
      june52476 jane243

      Posted

      Hi Jane. You are probably right. My anxiety getting the better of me and expecting results almost immediately from the pills!  I too have tried diet and exercise. Not overweight, never smoked, don't drink much, lifelong vegetarian, swim, walk dogs every day, Yoga.  But the BP has just shot up recently from being mild hypertension. Called 'spikes'? It is the stress of it seeming out of control and the worry the information given out about the "silent killer". So every headache and chest twinge or ache becomes a worry. Comforting to hear from others in this forum. Agree with you about pill taking and I'm sure lifestyle helps even if it is not the complete answer.
    • derek76
      derek76 jane243

      Posted

      I stopped using salt and sugar eleven years before my BP went up and stopped smoking seven years prior. As I don't drive I have always walked a lot.

      I believe that it is walking that brings my BP down during the day. Perhaps I should sleepwalk. As rain kept me in today it did not go down much .

  • unnipreetha
    unnipreetha june52476

    Posted

    Though I am not a doctor, as a person who is on medication for BP for the last 10 years, I would like to give some advices.

    1. Reduce youir salt intake to the lowest possible level. But dont completely stop taking salt

    2. Be physically active. I do half an hour on treadmill at 6km/hr . Also I walk home from work-place for lunch. 

    3. Be positive . Engage in gardening or any activity that you like. Help people and see their smile.

    I have been following these steps, and my BP is well within the limits

     

    • june52476
      june52476 unnipreetha

      Posted

      Thanks for the input. It appears you have got it sorted. Well done you.
    • derek76
      derek76 unnipreetha

      Posted

      How much medication are you taking and has it been reduced over the ten years?
    • unnipreetha
      unnipreetha derek76

      Posted

      For the first five years I was on Atenol 25mg ( Beta Blocker ). .Doctor advised to change as it was not that effcetive. for the last 5 years I am on Olmasartan 20mg . Quite effective with exercise . For the last 5 years my readings have been  near to 120/80.
    • MrsO-UK_Surrey
      MrsO-UK_Surrey unnipreetha

      Posted

      Hi Unipreetha - do your blood tests show any rise in Creatinine on Olmasartan?  Just wondering as I am on Losartan (from the same family) and it has increased my Creatinine which is being monitored.
    • unnipreetha
      unnipreetha MrsO-UK_Surrey

      Posted

      . I did my last check up in Nov 2013. As such I  dont find any change in the level. It is some where  in the mid range. 
    • MrsO-UK_Surrey
      MrsO-UK_Surrey unnipreetha

      Posted

      Thank you for your reply, unnipreetha. I'm glad your creatinione levels are unaffected - it may just be something that's peculiar to me with these drugs as I only have one kidney (reduced functioning), which means that some BP drugs are out of bounds for me.  Being monitored though so hopefully if it hasn't risen any further at the next test then I'll be able to stay on Losartan.  Stay well.
    • unnipreetha
      unnipreetha MrsO-UK_Surrey

      Posted

      Dear MrsO

      After seeing your post, I had a telecon with my GP. He says, this is a common side effect of   angiotensin receptor blockers. His half a dozen patients have the same issue. Nothing to worry about. You need to monitor the level and adjust the medication accordinglty. He says he would even suggest a combination of Beta Blocker and  angiotensin receptor blocker to minimise the side effect. You need to discuss this with your doctor. I would also suggest you to take a second opninion. I am sure you will be alright.

    • derek76
      derek76 unnipreetha

      Posted

      Olmasartan sems to have more side effects listed against it than Losartan.

      I was on Irbesartan a few years go and had to stop it after about nine months 

    • MrsO-UK_Surrey
      MrsO-UK_Surrey unnipreetha

      Posted

      Hello unnipreetha and thank you for your comforting and helpful post.  I don't really need a second opinion now as you've passed me one from your lovely sounding GP!  

      Although I am under a renal consultant with a special interest in hypertension, it still always helps to hear another point of view.

      I doubt whether I will take a beta blocker, having taken one for 3 years some 8 years ago, and I didn't like the way they slowed me down and made it very difficult to keep weight off.  I am taking another tablet alongside the recently added Losartan 50mg, which is Diltiazem, a Calcium Channel Blocker - that one causes fluid retention in my ankles though not as bad as when on Amlodipine for a month.  I have been on the Diltiazem for some 9 months and the Losartan for about 2 months.  I seem to be getting a worsening bowel problem which started on Diltiazem and now seems to be worsening with the added Losartan.  I seem to be so sensitive to so many of these BP meds and I really hope that I'm not facing yet another switch.  

      It's difficult knowing whether to put up with the side effects in order to control the blood pressure or whether ignoring them could lead to more serious problems in the future.

      Has anyone else noticed bowel problems with their meds?

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