Please.Only Professionals Respond. I am diabetic and I am 43 years old.
I am 5′ 10 ‘ and weigh 275 lbs. Yes, I already know this is an issue. I smoke about a pack of cigs a day. Yes, I know this is an issue. I am on Avapro, Hydralizine and Clonodine. My BP is still, on average 170/110. Today, I was 190/140. I know many people with my weight and smoking habits that have BP problems, but they are consistently managing it with medication (That is not my goal. My goal is to drop weight and quit smoking). My question is how do I manage my BP with medication until I can make my lifestyle changes? I do not even need to use medications. Any answers that will allow me to manage my BP, not matter how unorthodox, I will consider. I will consider trying anything that makes sense and is proven. Also,does anyone out there know what BP becomes uncontrollable? When I was 20 years old and in good shape, worked out, no diabetis, I still had high blood pressure. Any assistance will be greatly appreciated.
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Congratulations on recognizing your currently very unhealthy status. If you have not yet had significant complications (stroke, heart attack, kidney failure) with your risk factors, it is most certainly just a matter of time. Therefore, the time to get you back on track is of the essence.
Getting your blood pressure under control is probably the thing you can do most immediately to affect improvement. If you have not already been advised, you need to keep a strict eye on sodium intake – both what you add and what’s already in the food. Generally speaking processed foods will have a lot of hidden salt (who would think pickles have a ton of sodium, for instance?) About 1200mg (or less) is what your daily intake from all sources should be.
Alcohol can have a significant effect, if you drink significantly and with any regularity. Also binge drinking can play a negative role (>4 drinks in any given setting, even if its not regularly) A single glass (4oz) of red wine every day, however, is fine.
You are currently taking an Avapro (angiotension receptor blocker), Hydralazine (vasodilator), and Clonidine (alpha 2 agonist). The other main classes (trade name examples) of blood pressure medications that you are not currently taking include:
1. beta blocker (Bisoprolol or Labetolol)
2. calcium channel blockers (Norvasc)
3. diuretics (Lasix or HCTZ)
4. long-acting nitrates (Imdur)
You could potentially be on any or all of the additional four classes of blood pressure medications in order to achieve adequate blood pressure control. Sometimes these medications are selected or avoided due to other reactions you hope to get/hope to avoid from them – like beta blockers are avoided in asthmatics. Ideally with your other health conditions, your goal should be to have a systolic pressure no higher than 130 – ever.
After being on three agents and still having difficult to control blood pressure, it would be in your best interest to ask for a referral to a cardiologist. These specialists in cardiovascular treatments are accustomed to dealing with especially difficult (blood pressure) cases and are adept at using complex combinations of medications routinely. Additionally a cardiologist will be keeping an eye out for your overall cardiac health – including congestive heart failure and coronary artery disease. He/she might order additional diagnostic testing to evaluate you – including to make sure there is no secondary reason for your high blood pressure.
Finally, with the blood pressures you are experiencing and your body size, I am suspicious for sleep apnea. It can often cause very high, difficult to treat blood pressures. Once treated, the patient’s blood pressure is often much easier to control. In addition to blood pressure there are other health problems sleep apnea can manifest – not the least of which is feeling exhausted all of the time.
The sooner you loose the cigarettes the better – and that could theoretically happen today. Medications and patches can be helpful with some people but many people successfully quit without them. You need to get to a half pack or less. Push off having the next cigarette until you can’t any more, further reducing the amount you are smoking. Pick a day in the future to quit. Tell everyone around you. Mark it on the calendar. Prepare for it. Make a plan for doing something other than smoking when you are wanting a cigarette – chew a carrot stick, suck on a (sugarless) hard candy, go for a walk….something. If you fall off the wagon, get right back on. Most everyone relapse, the people who succeed are the ones who stick with it.
Lastly modifying your lifestyle to include a healthier diet and exercise are more longer term plans but absolutely necessary.
Good luck. I hope this is helpful – your life depends on it.
http://www.nhlbi.nih.gov/hbp/treat/bpd_list.htm
http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_WhatIs.html
High blood pressure can have a heredity factor in addition to causes from existing health problems. If you blood pressure remains high on each reading, you should have been talking with your family physician already to get your blood pressure medication dosage increased so that it will lower your blood pressure to closer to normal ranges. And, you need to get moving – walking is easiest and most painless way to lose weight and to keep your diabetes in better control. Start slowly for short distances and gradually build up to walking at a brisk pace – you should be sweating – for longer and longer distances until you are walking 30-45 minutes each day. Your blood pressure will come down, your diabetes will be under better control. And, you need to follow a more healthy diet – make an appointment with a diabetes dietitian for teaching on what foods you should be eating. And, the smoking increases your blood pressure, no matter how many pills you are taking and you need to stop. There are medications to help you stop plus stop-smoking cessation classes – when used in combination – give you the highest chance of success to stop. You need to make some lifestyle changes quickly, otherwise, you may not live to be old.