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Doctors Lounge - Cardiology Answers
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| MRsh8b
- Wed Sep 09, 2009 6:45 am |
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I have been on lisinopril HCTZ 10-12.5 for about five years. In March my blood pressure went to 179-117 and the doctor changed the dosage from once to twice a day and gave me Xanax to help me sleep (and no worry so much about the BP). During the summer my blood pressure readings were as low as 100/65 so the dosage was lowered to once a day. It's been fine ( 125/82 three weeks ago at the MD) but now, as I return to teaching, it's back at 170/110. I'm 54 so menopause issues also come into play. Is this normal? Should returning to the twice daily dose fix this? I was taking Crestor beginning in January but due to the high copay have very recently switched to simvastatin. As the wild fluctuation was a problem before, I don't think that is the trigger here. It's a vicious cycle as the higher it goes the more I worry and it goes still higher. Should the MD be adding a second drug?
Thanks for your input.
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| John Kenyon, CNA
- Wed Oct 21, 2009 8:32 pm |
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 Hello -- Given the factors of return to work and menopause and given the numbers you've quoted here, it would seem twice-a-day dosing should be ideal for you. When your BP was at its lowest it was a perfectly acceptable level, and as it increased it stayed okay til stress acted on it to send it back to pathological levels. Since changing a statin drug would in no way set off the problem but increased stress (and possibly menopausal issues) would, it follows logically the halved dose would only hold up til a return to work. You may well love your work, but even if you do it is a stressful job, and menopause only adds to this.
I'm not a huge fan of combination drug (except for the type you're currently taking) therapy for hypertension except in severe, intractable cases, which doesn't seem to apply here. I think the twice-a day regimen should bring you back into a comfortable range. If not, addition of an additional drug might be justified. I doubt, given your history, this would be the case.
I hope this is helpful. Good luck to you and please follow up with us as needed.
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