Side effects of now normal blood pressure are unbearable.
May 10, 2018 9:44 AM   Subscribe

Long time high-blood pressure now well under control. However, the results are causing vast complications

43yo, male, 6', Polish extract, 4th generation American. Never drank, never smoked. Broad shoulders type guy. Avg adult weight, 205. All my adult life i have been treated for high blood pressure. The 190/100 kind. Diagnised as Essential High blood pressure. No kidney problems, no renal artery problems, no tumors. All genetic. Multiple ductors have tried multiple combinations of drugs, patches, diets to get it under control.

I have always been a VERY motivated, can-do, physical, mentally acute, strong , successful, driven... and basically happy. Until now.

5 months ago a cardiologist put me on a combination of drugs that now have me at a daily bp of 115/75. Perfectly normal. Unfortunately, ita made life unbearable. I now tire easily, have no endurance, am unmotivated and dont have any drive. I have ga8ned 40 lbs in the past 5 months.

I have talk3d at length with both my GP and my cardiologist about this and theyve tried all kinds of mood altering drugs, with even worse side effects, sleepiness, sadness, anger, suicidal thoughts. I am no longer on those.

When i had high blood pressure i could accomplish things, now my business and life are suffering. I can not get motivated to do anything. I went from a guy who goy more done by noon than anyone else did all day, to, what everyone twlls me is a "normal" existance. And I hate it.

I own mynown business and 50 employees rely on me and my decisions. Both of which are no longer reliable.

Started seeing a therapist (first time in my life) and they have been of no help. They say things like "can you try to motivate yourself..."

How does one cope with this? I preferred high blood pressure to fat, slow and unmotivated.

Have you had high bp and now have normal bp? How did you overcome this?

Sorry for typos, typing on a flight.
posted by anonymous to Health & Fitness (25 answers total) 7 users marked this as a favorite
If the cure is worse than the disease - go back to the disease? So, maybe dump your bp medication for a while & see whether you get your old self back.

Obviously high bp is a risk factor for a bunch of stuff - cardiovascular problems, stroke, etc - but it sounds like if you could get your motivation back, you should be able to control the _other_ risk factors for those things (diet, exercise, not drinking/smoking) pretty well without additional pharmaceutical help, and high bp is by no means the only thing that's going into the mix there.

Different cardiologist, maybe?
posted by rd45 at 9:59 AM on May 10, 2018 [5 favorites]

There are many drugs available to control hypertension. I'm curious why your doctors are trying to treat your side effects rather than finding a drug that treats the hypertension without side effects. This sounds like it calls for a second opinion.
posted by davcoo at 10:00 AM on May 10, 2018 [27 favorites]

I think it's unlikely that these symptoms are side effects of the low blood pressure in and of itself. It seems more likely that they are side effects of the medication, rather than the blood pressure.
posted by Ausamor at 10:02 AM on May 10, 2018 [25 favorites]

It's not your BP that's the problem--it's your BP meds. Your doctor should immediately switch you to a different BP medication. As davcoo says, there are many. And I mean hundreds. My doctor and I tried seven different BP meds before we found one that a) did its job, and b) didn't do anything else (no side effects). If your doctor is unwilling to try another medication, you need to try another doctor.
posted by tzikeh at 10:03 AM on May 10, 2018 [15 favorites]

Medication can definitely create this change. I've been on metoprolol (a beta blocker) since January, and it's the worst. Extreme fatigue, weird mood swings, nightmares, weakness, weight gain. After going to a specialist, I recently switched meds -- same class, but now the effects aren't quite so strong. I'm feeling closer to normal lately. It's amazing the difference, really.

I was on losartan (cozaar) for years and was wonderful stuff. Like, it just made life feel more harmonious, if that's a thing. It felt like thing. Have you tried that one yet?
posted by mochapickle at 10:06 AM on May 10, 2018

Your blood pressure might be normal for you, but on the borderline for everyone else. I am not your doctor or a doctor at all, but as a patient, if I was you, I would not be treating my high (but normal for me) blood pressure as long as there were no significant changes associated with doing so. Putting you on mood altering drugs is BS for physical symptoms likely created by the blood pressure medication.
posted by tooloudinhere at 10:34 AM on May 10, 2018 [1 favorite]

There's a very good book about the many different hypertension medications, Hypertension and You: Old Drugs, New Drugs, and the Right Drugs for Your High Blood Pressure, by Samuel J. Mann, which I recommend you read. The author recommends against beta blockers for most people because of side effects including fatigue and loss of motivation; for those people who do have to take a beta blocker in addition to their other hypertension medications, he talks about how certain beta blockers are better than others. (In general he likes betaxolol and does not like metoprolol or propanalol.)
posted by chromium at 10:35 AM on May 10, 2018 [3 favorites]

I think it's unlikely that these symptoms are side effects of the low blood pressure in and of itself. It seems more likely that they are side effects of the medication, rather than the blood pressure.

Uh maybe. Maybe not. I had a very similar experience to this (plus lady hormones weirdness) with two completely different medications for blood pressure — spironolactone and norvasc. The only commonality as far as I can tell is that they lowered my bp.

For me, it took a couple of months to adjust, but I was coming down from like 135/95, and I am significantly smaller than OP (and female — there was some weirdness with PMS too). Later, when the spiro stopped controlling my blood pressure and I had to add another med, I experienced a similar transition, only less extreme.

It wasn’t all bad for me — it also meant less anxiety etc. And FWIW, one of the first tells for me that my blood pressure was back up was noticing the changes in mood and energy — that’s why I checked it again. My doctors were all like “no that’s not a thing” until then. Now they’re like “huh that’s weird.”

Anyway, it might not be the meds. It might really be your blood pressure. Bodies are weird, anyone who says we understand completely how they work is lying.

It’s also possible that 115/75 is...too low, for you? I mean, IANAD, but I know the recommended range varies with sex and size, and then there’s no accounting for individuals.

I hope it’s just taking you a little longer to adjust, OP, and that you get your mojo back. But you’re not crazy, and if you’re informed of the risks of going off the meds and that’s still how you’d rather live your life, it’s your life.
posted by schadenfrau at 10:43 AM on May 10, 2018 [2 favorites]

Blood pressure meds can do weird things. One class of them is also used for people with adhd because it effects how the prefrontal cortex works. (And I took it for that and it made me a miserable unmotivated lump, so wondering if you got the same thing, but for bp). Anyway, I agree it’s probably the meds not the blood pressure.

A lot of doctors dismiss side effects, especially if “rare”. But they happen to someone. And the way drug trials are run, I always wonder about the dropouts that’s occur or studies that weren’t published.

There is something to be said about seeing if you can get used to the side effects and not stopping too soon. But it sounds like you’ve been on it for long enough that they should be subsiding.
posted by [insert clever name here] at 10:47 AM on May 10, 2018

If you are on a beta blocker, ask for one that is time released. I had to take a beta blocker when I was first diagnosed with Graves' disease. I was exhausted and very unmotivated. I complained to my doctor and he changed it to a time released option. Immediately felt better after one of the new pills. A co-worker was also on a beta blocker and I gave her this same advice. She felt better once she began taking the time released beta blocker.

Good luck!
posted by narancia at 10:51 AM on May 10, 2018 [2 favorites]

How about forcing your body to adapt to these new conditions with with heavy weightlifting?
posted by bdc34 at 10:57 AM on May 10, 2018 [1 favorite]

Now, beyond specific medical interventions, one thing I would recommend is checking out the book Mini Habits by Stephen Guise. He talks about motivation being an unreliable driver to get things done. He’s right (as someone that is very much lead by motivation, when it’s not there, I have a terrible time), but he also talks about willpower being limited. So the solution is very very small pieces. The quick example he gives is if you’re struggling to get started on a workout, doing one push-up is often the way to get started. It’s easy. Maybe that’s all you’ll do, but chances are, it’s just enough to get started. And even if it’s one push-up, that is one more than you did before.

It might be useful to you in the short term while you’re sorting the med issue.
posted by [insert clever name here] at 11:00 AM on May 10, 2018

I was on lisiniprol and had to stop it because I kept feeling like I was going to faint. It made my blood pressure ridiculously low, like 85/55, when I took it at home. I told my doctor and stopped taking it. I still take a mild diuretic.

Do you have home blood pressure monitor? I've found it really helpful. It could be that the reading you're getting at the doc's office is actually somewhat higher than it would be at home because of the stress involved with getting to the doc's office, the waiting, and all that. I brought my personal monitor to the doc's with me to show her that it gave the same reading as hers, and to show her all the saved readings from taking it at home. They're inexpensive, I got mine for around 30 bucks.
posted by mareli at 11:04 AM on May 10, 2018 [2 favorites]

Can you change the time of day you take your meds. My BP med (Beta Blockers) if taken in the morning put me in haze, take them before bed & I sleep like a baby.
posted by wwax at 11:06 AM on May 10, 2018

BP in the 190/100 range is seriously dangerous territory, and getting your blood pressure under control is absolutely essential. You said you've been treated for years - what was your blood pressure on your previous treatment, and why did your doctor think it needed to be changed to get you to 115/75? Not a doctor here, but a nurse who has seen the effects on patients and family of untreated high blood pressure. Whatever you do, please do not stop these meds abruptly or without medical intervention. If your PB is 190/100 at rest in a doctor's office, it will be significantly higher while exercising or while stressed, and you're already in potential for heart attack/stroke territory.

It is very true that many patients find beta blockers to be dulling and lead to weight gain, headache, and sometimes to sexual dysfunction. Different medication families (beta blockers, ACE inhibitors, diuretics etc.) have different side effects, and doctors often try to use them in combinations that are tolerable to patients. This often takes time because the meds take time to work and if you stop one, it takes some time for the effects to wear off.

Please work with your doctor, or if you'd like a second opinion, I'd suggest looking for a cardiologist who focuses on blood pressure control, and take detailed records of what you took, what your blood pressure was, and side effects while on that combination. You do have a home BP cuff, right? And use it regularly? I think finding a combination that has far fewer side effects is a reasonable goal, and achievable, but it will take a personality like yours, where you have determination, confidence in yourself, and will follow through. Good luck!

Also, there was a recently publicized study that White Coat Syndrome (higher BPs in medical office) is itself a risk for cardiac problems. The theory is that stress of any kind will raise the BP and that the lower home readings conceal risk.
posted by citygirl at 11:09 AM on May 10, 2018 [4 favorites]

I hope this doesn't sound too terribly fatuous, but did you try an extremely low carb diet before trying this medicine? Many people find that it lowers blood pressure effectively and the side effects are generally limited to being annoying in restaurants and maybe some constipation.
posted by fingersandtoes at 11:19 AM on May 10, 2018 [1 favorite]

There are so many categories of BP drugs, and even within categories they can differ in side effects. Over several years I tried lots of them, and always had the same side effects you mentioned, plus depression. My doctor was pretty much out of options, so he prescribed one that's hardly used anymore for BP: hydralazine. (Now it's used mostly for prostate problems.) It's not great because you're supposed to take it 3 times a day. I'm able to take 40 mg, 3 times a day. If I increase the dose to 50 mg, the depression comes around again. It helps quite a lot, though not well enough for my doctor's satisfaction. So he doubled my dose of hydrochlorothiazide, a diuretic. In many people that won't do much, but it brought a significant improvement. If your physician tells you diuretics or increased diuretics won't help, say you want to try it anyway.

Keep trying, and be a strong advocate for your own mental well-being. If necessary, you might be able to lower your blood pressure halfway and do away with most of the sluggishness.
posted by wryly at 12:54 PM on May 10, 2018

Another resource to consider is Jamie Shapiro at Connected EC. She's an executive coach who addresses health and wellness alongside leadership. What you are struggling with is totally in her wheelhouse.
posted by magnislibris at 12:57 PM on May 10, 2018

Try a different medication. I was on one that I liked for a long time until it started causing a terrible cough. I was worried about switching, but it's been completely fine. There are SO MANY BP meds out there, there's no reason to stay on one that's ruining your life.
posted by the sockening at 12:57 PM on May 10, 2018

You should absolutely get your meds changed, or the dosage lowered. These are unacceptable side effects for you, and your doctor should work with you. Beta blockers are known to do this type of thing (assuming you're on those). There are other classes of drugs (BPNs, calcium channel blockers, etc.) that lower your BP in other ways, and may not give you the shitty side effects.
posted by misanthropicsarah at 1:59 PM on May 10, 2018

non-ninja edit: i meant ARBs, not BPNs, which are a heart med but not bp med.
posted by misanthropicsarah at 2:05 PM on May 10, 2018

This is exactly what happened to my husband after he had a stroke. One doctor had him on 40mg of Lisiniprol which brought his blood pressure so low he wanted to die. (He was used to a VERY active life and now he could hardly move.) We got a new doctor and she allowed him to let his blood pressure go up to 130/80 and that has worked for him for years.

The new blood pressure guidelines are 130/80 mm Hg (rather than the old 140/90). So I don't know why your doctor is making you keep your blood pressure so low. (I am not a doctor!)

My husband manages his BP with a meditation recording (Joseph Clough) and Cup of Calm tea. He only takes Lisiniprol when he has work stress or his favorite teams go into double overtime. We take his blood pressure almost every day and he takes an aspirin every other day.

We think that high octane coffee (which he loves) may increase his bp so we are drinking chicory coffee as an experiment.
posted by cda at 3:44 PM on May 10, 2018

I'm about the same weight only half a foot shorter. My BP was 145/90 and my dr wanted to start me on statins. I really didn't want to take a medication that I would be dependent on so I started taking 1000mg Fish Oil Omega 3 and an omega 3-6-9 capsule daily and my BP went down in two weeks to 120/68 and has remained that low for the last few years. I am not a believer in woo. It's been the only nutritional change that has really made a difference for me. Of course, YMMV.
posted by a humble nudibranch at 9:03 PM on May 10, 2018

FWIW my doctor thinks that driving BP too low with meds is likely to cause problems. Like if your normal BP was 115/75 that would probably be AOK.

But if you are driving it that low with meds that might cause problems.

So one thing to try would be adjusting dosages to get more to 125/80 or 130/80 and see how that goes.
posted by flug at 11:14 PM on May 10, 2018

Also I would nth what has been mentioned above, that various BP meds can have unexpected effects.

I'm having a certain unusual symptom right now and it turns out it is similar to a serious symptom that about 0.002% of people who take this med have. That's not 2%, not 0.2%, not 0.02%. It's 0.002%, or roughly one in every 50,000.

So it doesn't affect very many people, but if YOU are that one in 50,000 then it doesn't matter one whit that 49,999 other people have no problem at all with it. YOU are the one that does have that problem, the problem is serious, and you have to get off it and onto something else. ASAP.

I will also mention that, for some reason, doctors often have a very, very difficult time accepting that drug side effects are happening. Like with ACE inhibitors, the #1 most common and most well known side effect is a little, otherwise inexplicable, hacky cough.

So it is very common and the exact mechanism is very well understood. It is listed in EVERY drug sheet for this drug as a COMMON side effect.

So you can find reports from all over the internet of patients who put up with this annoying hacky cough for YEARS as their doctors denied the possibility that it was a side effect and tried every cough drug and remedy known to man to "solve" the cough.

The story inevitably ends when after $X years the patient goes to another doctor or whatever, changes prescriptions, and the cough disappears in a day.

Point is: Don't tolerate this, ask for changes, insist on them, this is very clearly drug and/or treatment side effects.

Also "No Dr. Google" is common advice but in fact it is very worthwhile to google around for side effects of your particular medications. Try to stick with reputable sites rather than Dr. Turnip-Enema or whatever. But if you are having symptoms X, Y, and Z and those turn up as common side effects of your medications then that tells you a lot right there.

If you switch to different meds and your symptoms go away in 2 weeks that will tell you even more. This is a super simple experiment to perform and in fact is what I am currently doing myself since I suspect this unusual side effect of my own BP med. I might be wrong but I'll know for sure in just a week or two of switching to a different BP med. That is so much easier and cheaper than going through arrays of tests and treatments for the condition--which I have also done, they are expensive, invasive, have their own considerable risks, and haven't shown up anything definite. So compared to that, just switching to a different BP med for two weeks to see what happens is simple and easy. It will quickly rule one possibility in or out.

I would strongly suggest that kind of simple test for your situation.
posted by flug at 11:36 PM on May 10, 2018 [3 favorites]

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