Question about blood pressure

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SarahP
Veteran Member


Date Joined Mar 2005
Total Posts : 1185
   Posted 3/18/2006 9:05 PM (GMT -7)   
My mother is having some severe b/p issues and I just wondered if anyone has any info for me. Her doc is sort of stymied also.
With no warning signs whatsoever, my active 65 year old, never been sick a day in her life mother, had a TIA with blood pressure at 220/115 by the time I got her to ER. Okay, sent her to bigger city hospital, put her on meds and send her home. Finally get her a doc... she's really never been sick and been to doc... and her b/p is 200/100 at first visit. Back to the hospital she goes, but stays here. They do an MRI on her kidneys and find a greater than 75% blockage in left renal artery. Okay, doc says this is reason for impossible to treat b/p. She has angioplasty done and stent inserted and artery is wide open now. Go back to ER for b/p 190/100... while there I noticed strange things on her heart monitor... point out to nurse who prints a strip and runs to doc.. it was PVC's.. they say her potassium is low give her some and send her home.
Finally doc gives her xanax for evenings and she quits monitoring her b/p at home b/c it was driving her literally crazy.
Last doc visit, b/p was 190/95... he told her to up her meds. Okay.. well he just looks at me and shakes his head. He feels that her b/p should have come waaaay down after the surgery and he has no idea why it's still so high. Even while taking a 60 mg Nephedipine in morning, and a 30 mg at night.
She has had a nuclear stress test, no blockages in coronary arteries, and her heart is good and strong. She's had ultrasounds on neck and legs, small blockage in neck, but normal for age and no medical treatment necessary. Had MRI of brain, no blockages and thank God no damage from the TIA.
Does anyone have any ideas why she is still running such a high b/p and what damage this could do to her? Also, I know the general signs of a stroke, but are there more subtle ones that I could overlook?
Thanks
Sarah
I'm not procrastinating----I'm still doing yesterday!!!! 
I have no medical training, any medical opinions expressed in my posts are just that....opinions.


els
Veteran Member


Date Joined Oct 2005
Total Posts : 4031
   Posted 3/19/2006 11:40 AM (GMT -7)   
Wow Sarah,  That is a awfully high blood pressure.  Has she seen an endocrinologist regarding it?  It is just a suggestion but sometimes blood pressure high or lows can be a result of a malfunction of the adrenal glands. Since she had a blockage in the renal artery maybe this would be appropriate for her.  I really dont know.  Hopefully someone will have some ideas for you.  Please keep us updated on how she is doing.....
~elisha
 


deltacece
Regular Member


Date Joined Aug 2005
Total Posts : 95
   Posted 3/19/2006 2:36 PM (GMT -7)   
Sarah i'm soory your mom is still having problems. Pts. i took care of in the past that had renal blockages or renal problems had problems with their b/p. Most after renal block stent, the kidneys are sore which is normal after this procedure. It would take several weeks for b/p to go down. If your still concerned, i would keep on the docs blank until i had the right answeres. Good luck. DELTA

{ Listen to your body talk. } Deltacece


Aldo
Regular Member


Date Joined Jan 2006
Total Posts : 289
   Posted 3/20/2006 8:04 AM (GMT -7)   
Hi Sarah, I am sorry to hear about your Mother. I replied to you yesterday, but my modem went to sleep and I lost the post :( I think Delta may have give you good advice.... BP don't always react to procedures, and/or medication like we think it should. The brain and body control BP, and I think it takes time for it to adjust to new conditions, but I'll bet your Mom's will :)
One thing for sure is she needs to get her BP down. You said she was taking "medicines". The only one you mentioned, Nifedipine, is not a common BP control medicine, I don't think. Her doctor needs to try a different medicine, or combination of medicines such as beta blockers, ACE inhibitors, or diuretics in order to bring her BP down. She is at a high risk for having a stroke, as long as it remains this high.
 
I have had 2 light strokes, while my BP was controlled with medicine. The first I was never aware of because it happened during a heart attack. It was found by an MRI. The second happened during what I thought was a TIA. I was hospitalized after the fact, and I knew very well what had happened. One can have them and never realize they had one because the ability to realize you have changed is lost, due to damage from the stroke. TIAs are a medical emergency in and of themselves, as you know. If one develops into a stroke, they have a medicine that they can give in the ER, that really limits the damage done. Time is of the essence here.
 
I have had several TIAs, maybe 5. Most follow a certain progression ie, starts with visual disturbances, a wierd, numb type headache occurs, then the mind goes into an altered state of consciousness. A very far away feeling. Not all of these symptoms have to occur though. I would like to point out that these strokes that I speak of are caused by arterial blockages within the brain, not the kind that is caused by a hemorrhage.
Remember that once you have had a TIA or stroke, the risk of having another, especially within a year, really increases. Mine were 2 years apart. I have small vessel disease (SVD) that is affecting the small arteries in my gourd :)
 
Watch your Mother for any changes in her personality, expressions, gait, etc. If you are with her a lot, watch for any non-sensical conversation or altered state of consciousness. She should be taking an aspirin per day, but only if her doctor agrees. In the past, she probably would have been started on Plavix, but recent studies (I think) have shown that taking Plavix with uncontrolled high BP, can do damage. Plavix and aspirin are anti-platelet compounds. I cannot tolerate aspirin, so I take Plavix and will for the rest of my life for 2 reasons. One, because of 4 pet stents I have to keep open and two for prevention of, or help in preventing another stroke.
I went to a good pharm site and looked up Nifedipine. Here is some info and the URL:
----------------------------------------------
Nifedipine
INDICATIONS
Vasospastic Angina
Nifedipine is indicated for the management of vasospastic angina confirmed by any of the following criteria: 1) classical pattern of angina at rest accompanied by ST segment elevation, 2) angina or coronary artery spasm provoked by ergonovine, or 3) angiographically demonstrated coronary artery spasm. In those patients who have had angiography, the presence of significant fixed obstructive disease is not incompatible with the diagnosis of vasospastic angina, provided that the above criteria are satisfied. Nifedipine may also be used where the clinical presentation suggests a possible vasospastic component but where vasospasm has not been confirmed, e.g., where pain has a variable threshold on exertion (or, in the extended release tablets, in unstable angina where electrocardiographic findings are compatible with intermittent vasospasm), or when angina is refractory to nitrates and/or adequate doses of beta blockers.
------------------
It does mention later on that it is used to treat high BP....
 
 
Good luck :)
 
Rj

heartangel
Veteran Member


Date Joined Mar 2004
Total Posts : 638
   Posted 3/21/2006 8:42 AM (GMT -7)   
Sarah
I am a Vol First responder with uor local Fire and rescue Dept
first thing is she  taking all her meds correctly
second thing  are any of the meds haveing the same side effects
third thing have her  adernal glands checked to see if she has a tumor on hem it is a 24 urine tes
 fourththing is she adding salt or a poattisum supplement to her foods
 also she could be ahving white coat  syndrome  haveher take it at home or  gotot eh local fire Dept and have them take it.  write down all her meds then yuo check ouot the side efefcts of each one  for so many meds  contrdict each one too. I have had patients who have had TIAS's and nehad there  crtoid artery blocked and one was not taking his meds as prescribed yuo wouldbe suprised onthe clls we all get  and mosyly from elderly people just not taking their meds right or  one   has the same side effect as another one. But please  write downllher meds and even OTC Over the counter meds too and check on the side effects like  fish oil nd aspril also  thin outthe blood and so does garlic and if yuo are on a blood thinner it thins it even more. but for me  just check it uot ok and atch her closely too and  like I said mointer her BP at home and  hermeds too. Hugssssssss
Heidi
Heidi
 
MIghty Hands Are Guding Me to Protect Me from What I Cannot See.


els
Veteran Member


Date Joined Oct 2005
Total Posts : 4031
   Posted 3/21/2006 3:17 PM (GMT -7)   
Heidi, I used to be a first responder too.  What a coincidence!  Anyway, I have problems with my blood pressure but mine doesnt want to stay up ( I have very low BP ).  I monitor my BP twice a day at home as heidi suggested.  I also have had to increase salt intake and sometimes that doesnt even work.  Anyway, I just wanted to say very good suggestions..... :-)
~elisha
 


jtu91952
Regular Member


Date Joined Mar 2005
Total Posts : 137
   Posted 3/23/2006 7:04 PM (GMT -7)   
I too have had a stroke about three yrs ago. After leaving the hospital i was put on toprol xl, lisinopril and hctz. My bp still runs about 180/90, but in the last two wks, my bp has finally stabilized to 130/80.

My new dr. prescribed clonidine .01 4x daily, verapamil 120, and avaprol 150. Bcuz of side effects i cut the pill in half, and my bp is now 130/70. I hope your mom gets better results with her meds as time goes bye. Keep us posted.

SarahP
Veteran Member


Date Joined Mar 2005
Total Posts : 1185
   Posted 3/23/2006 7:40 PM (GMT -7)   
Well, all my mom takes is an aspirin and a nephedpine.. or how ever you spell that. She takes 60 mg in morning, and 30 at night. She was taking Lisinopril also, before her surgery, but the docs took her off it afterwards.
She quit taking her b/p at home, b/c it bothered her so much to see it go up. Now she just gets it done in docs office... I offered to take it and not tell her but she doesn't want me to. She does get the "white coat syndrome" but it would be just as high at home. I really feel like they should be doing more to treat this, but not sure how to push for it.
She does sometimes complain of a strange feelign in her ears, like they are stuffy and of dizziness. She seems fine most of the time though. BUT, she seemed fine before her TIA too, so I guess you can't judge by that.
It's just really aggravating to know that she could have a stroke at anytime at this b/p but the docs kindof not do much about it.
Thanks for the replies!!
Sarah
I'm not procrastinating----I'm still doing yesterday!!!! 
I have no medical training, any medical opinions expressed in my posts are just that....opinions.

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