Keith’s GoutPal Story 2020 Forums Please Help My Gout! Gout Related Gout friendly BP medication?

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  • #2671
    cjeezy
    Participant

    Well I had a routine doctors appointment and when they checked my BP it was 148/84.  They seemed very concerned with that and told me that if it wasn't lower in the next couple months that they were going to put me on another medication.  Well, I've done everything I could to try and lower it over the past 4 months…I'm only 31 (I quit smoking, cut out salts, I go to the gym 4+ days/wk, etc) and its gone up.  Anyays I'm kinda just discouraged right now but I just wanted to know if any of those on BP medicine could offer some advioce on what to take and not what to take.  Appreciate any comments

    #7330
    trev
    Participant

    Hey- CJ, you've hit the right spot here 😉

    Both Zip and I are on the Furosemide + Losartan combo for BP.

    It's supposed to give up to 15% reduction in SUA as well as reduce BP. Losartan isn't that good at BP reduction though it reduces libido less than most apparrently.  I also take other meds for BP.

    My UA level is down since last year on it, that's something.

    The Furosemide [aka Lasix] worsens my high pitch tinnitus* a  fair bit- as does the Losartan ,potentially. *A lot of meds can do this. bendroflumethiazide is the one to avoid- it is a gout specialist !  I take both diuretics -unless I have an attack threatening- bit of a juggling act really. Spreading  the load !

    My BP was 190/90 the other day but I'm twice your age- your lower[ Diastolic] read is on the high side for your age but a lot of people react to 'white coats' – and the stress lifts the readings.

    Gout and Hi BP go together rather a lot. A report a couple of years back showed in NY that AlloP reduced BP in  a huge number of young cases- in a trial.

    #7331
    cjeezy
    Participant

    I guess I'm just bummed a bit because I don't want any more side effects and I dont want to have to take all these drugs.  Is there one pill I can take or does high BP usually need multiple drugs?

    #7333
    zip2play
    Participant

    Boy, does THIS open up a can of worms.

    In general No BP medication is best but we probably DO need to control BP…a dilemma.

    I have found weight control to work wonders. It doesn't have to be to wraith levels but a 10% drop in bodyweight from slightly overweight to normal can often have BP return to normal in 90 days. VERY moderate drinking will lower BP but moderate to high drinking will raise it considerably. Overindulgence in salt, aka the normal Western diet, will raise it precipitously.

    Now the harder part, medicinal cures:

    With the single exception of losartan (Corgaard) all BP meds will raise urate levels (corrected typo.) The worst offenders are the diuretics, especially thiazides. They work by preventing the kidneys from reabsorbing salt in part of the loop of Henley…don't ask. THing is that the body ultimately tries to stay in electrical balance so some potassium must also be lost (bad) and uric acid must be SAVED (worse.)

    Since all BP meds ultimately operate in a similar manner even those that start out affecting other mechanisms will ultimately dump sodium and conserve uric acid. So the body's modest ability to excrete small a,mounts of urate is subverted, day after day after day. (Your doctor may give you an argument about these mechanisms, but the poor dears read nothing but glowing reports on all these meds from drug manufacturers….in 2 paragraph leaflet form. 

    There is an exception: LOSARTAN (Cozaar) which is uricosuric, single in that distinction. Even others of it's drug class, angiotensin receptor blockers, show no such ability. Even losartan has problems becasue by itself it is a rotten BP regulator, very weak. So look up the oft mentioned study in the GP forum about losartan-furosemide combo and how to take it. BUT that works best for people who are salt sensitive hypertensives (like me) and not so well for those who are RENIN hypertensives, more common.

    Even the losartan has another big problem, it dumps urate but ALSO urate homologs (twins) like allopurinol, and oxypurinol…not so good if you are on allopurinol.

    There is SO much to say about this but in short, BP meds usually make gout worse, in fact often CAUSE gout in the first place. If you are going to take something try 40 mg. furosemide taken with your allopurinol and then a couple hours later take 50 or 100 mg. Cozaar (losartan.) Alas, in the U.S. Cozaar is still a $$pricey$$ patent med. If it controls your BP, then that's the best you can do…if it doesn't work well, then there's always LOURDES or worse, a very low salt diet!

    #7334
    trev
    Participant

    Well- there's a sort of progression normally followed. Diuretics are usually first- followed by beta Blockers and then angotensin type blockers/retarders. There's some new ones  -like direct renin Blockers and they all have side effects to some degree. The body is very complex in this area.

    They almost have to have them to be any good [laymans view]- though of course they vary between individuals.

    The 'keep up' rate for these drugs is quite poor, apparently.

    it's a bit like gout- you need your own measuring kit, insight into your physique and lifestyle, hereditary tendencies and a good awareness of meds  available.

    It's more  understood than gout by a long way- but multiple meds are more common with BP -from what I see.

    Again like gout- worry about side effects only if you need the meds first -and then if you actually suffer them!  At least you don't get the rotten pain driving you along!

    #7336
    phofab
    Participant

    cjeezy said:

    I'm kinda just discouraged right now but I just wanted to know if any of those on BP medicine could offer some advioce on what to take and not what to take.  Appreciate any comments


    The BP reading could be due to “White Coat Syndrome”, very common.

    Check out a product ( natural) RESPERATE :-

    resperate.com/us/welcome/index.aspx

    Works extremely well for me and I find it a pleasure to lie down and go through the exercise each day for about 25/30 minutes. It's like meditation,hypnosis, yoga all in one.

    Even though I had pretty severe respiratory troubles last year I was able to use the exercise, whilst ill and it increased my lung capacity and worked my heart out whilst not able to do physical exercise. I am positive that it had a great deal to do with my recovery and dropped my BP dramatically, like 74 points.Smile

    210/100 in the surgery( freaks the doctors out) now since Sept 2009, 136/68 at home.

    When you do the exercise you seek to drop your breathing rate to below 10 breaths a minute. I achieve regularly down to 3/4 breaths a minute and have been down to 1.9.

    The problem is managing to stay aware of the machine and not drop off into a relaxed sleep or deep meditation mode.

    I understand that Hypertension and Gout are inter related.

    #7338
    Utubelite
    Participant

    I am an example of “White Coat Syndrome”. Whenever I visit a doctor, my first BP reading is 140-155 / 90-100. My second reading taken within 5 minutes of first one improves dramatically, generally 125-140  / 85-90…..and if my diagnostics with doctors are satisfactory, the reading drops to 110-125  / 70-80.

    It is a challenge for me when I visit a new doctor and tell to take my BP twice. They do not understand it at first. After few visits, they realize my point and then they do not care about my first reading.

    Another known fact is that those who have WCS generally also suffer from Anxiety. This is another loop as anxiety can cause higher BP. I have suffered from anxiety a lot as I reported in another post earlier. The root cause of a lot of these things is Anxiety e.g. thinking too much about own body and own symptoms. WCS is also anxiety about BP being out of control or anticipation of something wrong. The moment that feel of something wrong goes away, the BP drops.

    Once I got my head struck against a wall and thought something wrong. The whole night I had dizziness and uneasy feeling. Next day at doctor's clinic, the BP was 170 /105. After the tests performed on head( CAT scan and EEG) showed everything fine, the BP dropped back to 115/72.

    So, I would suggest before starting on any BP medication, make it sure you actually have BP problem. BP medications are another loop like Allopurinol….once you start them, it is very difficult to get out of them.

    In my Gout episode, Mortin 800 mg dosage 4 times a day started higher BP in my case and I saw my BP going up to 190/110 one day as I was taking the reading every 2 minutes. I went to emergency room and was prescribed Tenormine(it is a Beta Blocker) 25 mg twice a day and Ativan .5 mg 3 times a day to control anxiety.

    Ativan made situation worse and for the first time in my life, I showed enough courage to get out of the loop of Ativan( Not taking it anymore). Tenormine is also reduced now to once a day. I do not know if it makes Gout worse though the doctor told me that it has no effect on Gout.

    My own guess is that your BP is most likely due to Anxiety induced WCS.

    #7340
    trev
    Participant

    I agree Utube- in your general appraisal.

    Like Gout , BP needs to be manged properly and the medics don't really 'get it' in too many cases.

    They will generally offer lifestyle chioce ammendments as preferable' first moves'.

    Fine- but being all too human, like their patients- they know that,  in a complex and stress driven world, this is usually p**ssing in the wind.

    Meds are more predictable and legit to prescribe, so it's no wonder the progression through to them is almost instant from professionalls. They have insurance cover  & careers to worry over!

    I have used a similar program to yours and get down to 4 breaths /min. I must get back to it, as I under-rated the good effects. Thanks for reminding me…Cool

    #7341
    cjeezy
    Participant

    HI everyone,

    Thank you so much for the information and words of encouragement.  I'm just feeling a little down on myself lately because I may have to take all these meds and I'm only 31 :(…but I'll live I'm a pretty resilient person.  I swear I'm the most unhealthy healthy person I know! I have a lot of pressure at work (especially for someone my age) so maybe I need to make some life changes.  On a somewhat good note (I guess), I tested my BP 3X immediately upon waking this morning and it was around 120's/60's.  On another note, I have somehow gained 17 lbs and 3-4%+ body fat % over the past 3-6 months so maybe losing that will help (I'm currently 6ft 197lbs with 16% body fat).  The challenge is that I exercise regulary (flat bench 300lbs, walk/jog 5-8 miles/wk and do the typical weight training programs)…maybe I need to step up my cardio a bit more too.  I'm going back home (up north) in a few weeks and plan to visit my family Dr and have my annual check up.  Do you get use to the BP med symptoms? Am I going to have to step up to a higher dose of AP (I'm at 300mg now)?….This just plain sucks!

    #7342
    cjeezy
    Participant

    Also I forgot to mention, my Dr. seemed waaaaay more concerned about my systolic number than my diastolic number.  His exact words were “I can live with it being around 130, but once it gets close to 150 or above we need to discuss medication. I want you to come back in 2 months for a check up.” My diastolic has been around high 70's low 80's consistently for years.  Not sure if that means anything as I know very little about BP. 

    #7344
    trev
    Participant

    CJ I would love your BP profile 🙂

    Without looking back through piles of data – I think for younger people like you the lower [Diastolic] reading being high is more indicative of problems.  As you are keeping fit exercise-wise, your cardio output will be stronger than many, thus transitions under stress are more likely to surge BP readings. The judge is – How do you feel?

    If you are feeling faint, headachy or fogged/dizzy you need to worry more- but I think you need to wind down, lose that extra poundage and settle out a while at home!

    If you are really worried then a  24hr mobile test is possible to see your daily responses- you don't want uneccesary meds over this issue.

    #7345
    cjeezy
    Participant

    Thanks Trev. Up until last Friday, I felt perfectly fine.  Then after a workout at the gym my equilibrium has been a bit off and I'm pretty sleepy.  I tested my BP on Sunday as I still had symptoms.  My BP was 135/84.  My inner ears have been a bit sore too and it kinda felt like I was getting a sinus infection yesterday.  I was actually going to cancel my Dr appointment yesterday, however since I felt a bit under the weather I went in and had him check me for an inner ear infection.  He said he didn't see any infection and gave me a home exercise test to help with the vertigo.  Aside from being extremely sleepy and the slight equilibrium issue, my body has felt perfectly fine up to last Friday.  I just dont want to cause any permanent damage to my body with high BP. 

    #7348

    Utubelite said:

    I am an example of “White Coat Syndrome”. Whenever I visit a doctor, my first BP reading is 140-155 / 90-100. My second reading taken within 5 minutes of first one improves dramatically, generally 125-140  / 85-90…..and if my diagnostics with doctors are satisfactory, the reading drops to 110-125  / 70-80.

    It is a challenge for me when I visit a new doctor and tell to take my BP twice. They do not understand it at first. After few visits, they realize my point and then they do not care about my first reading.

    Another known fact is that those who have WCS generally also suffer from Anxiety. This is another loop as anxiety can cause higher BP. I have suffered from anxiety a lot as I reported in another post earlier. The root cause of a lot of these things is Anxiety e.g. thinking too much about own body and own symptoms. WCS is also anxiety about BP being out of control or anticipation of something wrong. The moment that feel of something wrong goes away, the BP drops.

    Once I got my head struck against a wall and thought something wrong. The whole night I had dizziness and uneasy feeling. Next day at doctor's clinic, the BP was 170 /105. After the tests performed on head( CAT scan and EEG) showed everything fine, the BP dropped back to 115/72.

    So, I would suggest before starting on any BP medication, make it sure you actually have BP problem. BP medications are another loop like Allopurinol….once you start them, it is very difficult to get out of them.

    […]

    My own guess is that your BP is most likely due to Anxiety induced WCS.


    This is almost an exact description of my own situation. I got a high BP test result and an appointment in a few days to discuss with my usual doctor (it's a group practice). I had so many “symptoms” that I had to make an immediate appointment, with any doctor, and was lucky to draw one who was newly qualified and as yet unjaded. He explained to me the lack of symptoms with high blood pressure and suspected anxiety. A 24 hour portable monitoring device proved the point – no BP problem despite the enormous girth.

    This is the first time I've heard the phrase “White Coat Syndrome”, but it is clearly common enough that doctors should be extremely wary before prescribing gout-risking BP drugs.

    This is in no way meant to demean the treatment where it is necessary – treatment of genuine high blood pressure is a good thing. Just make sure that anxiety is considered before taking pills.

    I'll sign off now to start the weekend, and avoid more anxiety with a trip to the pub Smile

    #7350
    trev
    Participant

    I must admit that Diastolic figure @84 does look odd against a mornings' 60.

    Is it your machine accurate?- maybe a cross check is worth while. I have two, one manual pump [digital readout] and the other battery pumped.

    Repeatability, accuracy- batteries?

    I wouldn't worry too much  over 'damage' at these figures. The risk is usually in the long term unless you have a serious underlying condition.

    However it IS being attended to by your HC Provider.

    Like with SUA -long term monitoring is the trick!

    You may find the deep breathing methods helpfull mentioned by Phofab -and used by me too.

    #7351
    cjeezy
    Participant

    I guess I should have said diastolic 68-74 and systolic was around 120-130

    #7355
    hansinnm
    Participant

    phofab said:

    Post edited 12:43 am – January 22, 2010 by phofab


    cjeezy said:

    I'm kinda just discouraged right now but I just wanted to know if any of those on BP medicine could offer some advioce on what to take and not what to take.  Appreciate any comments


    The BP reading could be due to “White Coat Syndrome”, very common.

    http://en.wikipedia.org/wiki/W…..pertension

    #7359
    hansinnm
    Participant

    I agree with phofab’s comment.

    That’s why my doctor (unfortunately retired) never paid any attention to my BP, taken when I first came into the clinic. As a matter of fact, he even explained why not.

    Then things changed (summer of 2006) when his younger replacement (about 25-30 years<) would not listen to my explanation of (relative) high BP (somewhere around 160,165/90,95.) She insisted that I take it. (30 ? 5mg LISINOPRIL, whatever that is, once a day.) Well, I took it and after about a week, literally, the ?shit hit the fan?. At midnight, I barely made the 15 feet to say hello to st.john. (3 times that night) Next night, act #2 of the same opera. Third night (same time, same place) act #3. That was IT. I closed the theater, canceled the opera (no more LISINOPRIL), dismissed the director (my doctor) and life returned to NORMAL again. Haven’t seen her ( there were additional other reasons) or any other doctor for a physical since. My BP is till the same as it has been for the last 12-15 years (135-160/75-90). I just took it for good measure: 160/83. Weight: 167 lbs (165-170 average range) I am about as healthy as a guy of about 80 can be, except for Mother Nature’s way of keeping my arrogance under control by ?goutying? me, which works better than a gun on my head. And between GoutPal, you guys, and Her, I may yet regain control over myself again.

    #7357
    cjeezy
    Participant

    Hansinnm, how long has your BP been in that range? Anyways, thank you all for the feedback and it gives me some more insight into all of this!  I REALLY apopreciate everyone here! I'm going to have a complete workup during my annual physical in a couple weeks and go from there.  I'm also going to try and drop about 10-15lbs and see if that helps.  I'm not so much worrying about all of this now…I'm more just plain angrybecause, again someone my age, who doesn't meet the “typical” profile for these things, who doesn't smoke, is not overweight, does not heavily drink and exercises regulary has these issues. Just throwing this out there, but could there be some underlying kidney issue that is causing my high BP and gout (aside from the under-excreting overproducing UA aspect)? I know when I originally was diagnosed with gout my Dr said he was going to run some kidney tests to check on them, but I never heard anything back so I'm assuming everything came back fine (with whatever he tested me for).    I'm not trying to overanalyze things but I'm just tired of feeling like s*** and want some answers. Anything in particular I should ask for during my next check up?

    #7361
    phofab
    Participant

    Gee I'd love to have the BP's recorded above. I have a record that in 1973 my BP was 180/84.

    It mainly stresses the Doctors out. My wife's view is that it hasn't killed me yet, so don't worry about it. I haven't got any insurance to collect, so that's not a reason, she encourages me not to worry about it. I'm 6'1″ and about 86 kgs. Non smoker and light drinker, very diet conscious.

    I have had so many bad experiences with Doctors over 30 years that they really do terrify me. Just for kicks ,try having a colonoscopy without being sedated. You end up like a truck tyre ready to burst. The staff stuffed up and didn't sedate me so as his time was running short he carried on regardless with a sister holding me down on the table and another holding my hand which I crushed. I have many such tales. We're a tough breed.

    As to the ambulatory BP test, I found it a waste of time as you have to stop what you are doing every time it starts and as it is set to a regular test time-30mins. Your body soon picks up on this and you tense up waiting for the machine to start just prior to the machine kicking in.

    I have attempted 4 types of tablets with no improvement and many side effects. The last Prazosin was the worst. I had to reduce from 200mg a day within a day and a half as I was verging on passing out and other nasties, contacted the Doc and reduced to .25 mg per day and by the end of 5 days, I was almost on the way out, grey in colour, couldn't eat and quite ill on .25mg a day.

    The Resperate and bike riding have greatly reduced my BP. Worth a real try. Results within a couple of months.

    #7363
    Richard Bell
    Participant

    There is a BP medication out there that may not interfere with allopurinol and may be worth a mention to your doctor. Diltiazem hydrochloride may be effective for people that don’t want to stop work outs.

    http://www.drugs.com/pro/dilt-xr.html

    #7367
    hansinnm
    Participant

    cjeezy said:

    Hansinnm, how long has your BP been in that range? …


    About 8-9 years. I got records going back to 1996. I used to take my BP 4x a day: In the AM when I got up, b/4 sauna in the PM and after sauna, and b/4 going to bed. Between 1996 and 2000 my BP was around 130,135/70,75 and after that it has been around 150,160/80/85. I got a divorce in 1998/99 and I don't know if or to what extent it had a bearing or just my life style as a single person.

    #7368
    Utubelite
    Participant

    cjeezy said:

    I guess I should have said diastolic 68-74 and systolic was around 120-130


    If the above readings are not considered normal, I was born with high BP thenLaugh

    I am really surprised how some one can say 84 diastolic as high BP. And in my visits to so many doctors in my life time, no one ever said 84 as high. Now I am 47 yrs young but even when I was 25 years, my readings were always near 90 at doctors clinic and no one ever said it was high….though they said keep a watch but it has been like that for more than 20 yrs that I remember…..I went thru a series of tests including Treadmill and ECHO…all were normal….

    Even my current doctor says that in the clinical environment, BP of a lot of patients go up…besides, the pain and infection causes BP to go up…that's why people in gout pain( at time of pain) or any other pain will have high BP…same is true for BP before surgery. You walk into doctors clininc from parking lot and the nurse immediatly takes the BP as you walk in..it would be high….I think, thinking too much into few minor raised BP readings will cause more problems.

    I still clearly remember that at age of 25, when I visited the doctor 2-3 times in a month as my readings were around 125-130/85-90, he told me clearly – You are absolutely OK at this time but if you will keep on getting anxious and nervous about it, you will for sure get BP and many other problems sooner than your age – and he was absolutely right….

    #7373
    phofab
    Participant

    Utubelite said:-


    If the above readings are not considered normal, I was born with high BP then…

    XXXXXXXXXXXX

    I feel that I have been blessed with high BP all my life – stress, anxiety. It wasn't until I was about 27, when I started to have my BP checked and high BP noted.

    Up until about 7 years ago the upper level before the Doctor's got excited was 140/90 then about 2002 it was suddenly agreed that the desired level was to be 120/80.

    I suspect the the Drug Companies had come up with some research and could see a marketing angle.

    As we all know very well, each persons body is different, so why can't our BPs be different. Personally the meds make me extremely unwell, stress me out and increase my BP.

    An observation about this POST – have you noted the connection :-

    Gout, BP, stress, anxiety?

    It is common to a lot of POSTERS, so that this discussion on a GOUT site is very relevant.

    More good info, note the preparation before self measuring your BP, how often is that undertaken in the surgery and generally only one test is made, which is high. My BP can drop 20/30 points between the first and second tests in about 5/10 minutes.

    http://www.heartfoundation.org.au/

    [Search for blood pressure self measurement – old link has moved]

    #7374

    phofab said:

    I suspect the the Drug Companies had come up with some research and could see a marketing angle.


    Marketing angle! Hmm…

    #7385
    zip2play
    Participant

    Up until about 7 years ago the upper level before the Doctor's got excited was 140/90 then about 2002 it was suddenly agreed that the desired level was to be 120/80.

    Ha, Ha…and when they vlaim that 100/60 is the upper limit GP's will make a FORTUNE. My feweling is that GP can do nothing anymore than:  Measure BP; prescribe drugs; refer to a specialist for everything else.

    Given this scenario they MUST make sure everyone on the planet is being treated for hypertension and the only way to do that is to make the standards preposterously low. Decent studies showing any benefit from medicating to these super-low numbers are nonexistant.

    I would cange the progression slightly as such: Stress>>anxiet>>high BP>>High BP MEDS>>gout.

    Remember, a “perfect” blood pressure of 0/0 is only achieved by cadavers. (60/40 is the pre-cadaver state.Surprised)

    A drug company released the most AMAZING study a number of years ago…I cannot find it now so you will have to trust me. It compared the risk of heart attack at different BP's treated and untreated. Believe it or not, the risk of untreated 140/90 was considerably LESS than a treated 120/80…and this was advertising from a major DRUG company, selling the BP pills.

    Treating 140/90 relaxed and recumbent with both feet on the ground and and empty bladder is MALPRACTICE.

    #7386
    hansinnm
    Participant

    GoutPal said:

    phofab said:

    I suspect the the Drug Companies had come up with some research and could see a marketing angle.


    Marketing angle! Hmm…


    GoutPal, you keep this ad for that company in the UK and your commission up and I'll report you to the BBB. Oh, I forgot: You guys don't have a BBB. That's only us guys here in the US of A, and I am not quite sure if their employees' salaries aren't paid by the big Pharmas.

    PS: BBB DOES NOT stand for Black Bean Broth but  for Better Business Bureau (for those who aren't familiar with the term BBB here in the US of A.)

    #7430
    cjeezy
    Participant

    Hi Everyone,

    So I kept an eye on BP over the course of this weekend and found some consistencies.  Boy does it flucuate which makes its very challenging to determine what is accurate! For example, If I walk from 1 room to another sit down and immediately take a reading it is around 140-160/85-100.  If I “chill out” for a couple minutes and take a few deep breaths it falls to around 125-135/75-85.  I'm a high energy person by nature 🙂 so I noticed that even (at first) hearing the cuff tensing around my rist would get my heart rate up a little and give me a higher reading.  I tried taking very slow deep breaths for a few minutes and got the reading down to 117/68 at one point.  I guess I'll just let my GP know this next time I visit and see what he recommends. 

    #14098
    KeithTaylor
    Participant

    This bendroflumethiazide and gout topic is now closed.

    It covers several variations on a theme, including:

    • Bendroflumethiazide and gout
    • Can Blood Pressure (BP) meds cause gout?
    • Gout and high BP
    • Gout-friendly blood pressure meds

    I will move the relevant parts of the discussion to a new common questions section, as time allows. In the meantime, you can easily search for current discussions, or start a new discussion.

    You can find the search box at the top of every page, or at the foot of the right-hand sidebar. Even easier, please use the gout search page.

    Please read Diuretics Cause Gout for more information.

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