New to the world of Hypertension Meds

Hi @wigreenthumb. Welcome to Mayo Connect. I'm not sure I can be greatly helpful, but you interested me with your main points. As for you, I have been on Lisinopril at 40mg at bedtime for 6 or 7 years. My nephrologist says that dose is the daily maximum she'd prescribe. Metoprolol was banished from my list of beta blockers -- not on the basis of its side-effects for me personally, but because so many people complained of so many side effects, and my doctor and I decided not to take the chance; instead, I have been on another beta blocker, Carvedilol, for the last 4 years. Others have side-effect problems with that drug as well.

The other point is your middle-of-the-night blood pressure spikes. Would you mind sharing how you began measuring your blood pressure while you sleep, and why? Finally, BP of 200/110 is definitely significant, but other factors might help to explain it: For example, your age is crucial to understanding your symptoms, along with your diet, your activity, your weight. I hope you will have the chance to discuss with your physician what role these factors might be playing in your status and your plans for stabilizing it. Sorry if my experience doesn't point to some ways to resolve your concerns. Martin

Thanks for your response. I was started on lisinopril about 2 1/2 months ago, now 40mg, after a sinus infection and insomnia raised my BP up to 200/110. Then one evening a couple weeks ago, I awakened, and found myself fully awake and energized. Thinking this was very unusual, I decided to check my BP, and found it to be rising, and it rose to 203/110, which headed me to ER. Two nights later, at bedtime, I found again my BP had risen to 203/110, so I headed to an ER, and was given a prescription for clonidine to use for future BP spikes. Living in fear of future nightime spikes is giving me more insomnia, and my provider then gave me metoprolol a couple days ago, and this helped lower my BP to 130/70, and seems to be keeping the spikes at bay. However, early this morning I had stomach pain at 6 out of 10 rating, which took 4 hours to suddenly go away, and was wondering if the metroprolol was the issue. I am nervous that this will be a continuing issue, and it is not helping the insomnia either. Do you have any insomnia from your BP meds? By the way, I am 66. Thanks for your welcome!

Hi, @wigreenthumb. Sounds like you're well on your way to resolving some of your most troublesome symptoms. It's good to hear that Metoprolol worked to bring your blood pressure down. It's hard to guess whether your stomach pain might come from Metoprolol, but I'd be surprised at that. I have been on Clonidine myself for a few months, and it was effective at bringing my blood pressure under control as well. In my case, the Clonidine compromised other medications, so I moved off it. I hope you won't worry so much about bedtime BP spikes, unless your personal medical team (not the ER staff) counsels you to be especially concerned about them. Higher levels of BP are expected as we age (I'm 83), although 200/110 is beyond those expectations and worthy of special attention. Insomnia has never been a problem for me, even these days; if I lose sleep once in a while at night, it's because of some social or financial problem, and I make up for lost sleep with a nap of an hour or two the next day. I hope you can establish a strong conversational relationship with your medical team so that you can get timely answers to your questions and concerns without going to the ER. Martin

Hello @wigreenthumb

Many of us on Connect have discussed the problem of sleep and the use of Metoprolol. I tried it for several weeks and then called my doctor and he switched me to another beta blocker, Atenolol. It also works on BP and heart rate but I do not have the same side effects as I did on the Metoprolol. Here is a website that discusses Metoprolol, https://medlineplus.gov/druginfo/meds/a682864.html.
If you scroll down to "Side Effects" you will see stomach pain as one side effect. On other websites I have also seen sleep difficulties.

If you continue to have these problems, your cardiologist could probably help you find another med that would help you without these side effects.

I have been taking Atenolol for a number of years and it has kept my blood pressure stable. At one time at the same time I was also on Lisinoprol which had a number of side effects and didn't do much for keeping the bp under control. At the doctor's office in December 2018 my bp reading was 120/70 The dosage I take is one 25mg Atenolol at 6 a.m and another one at 6 p.m.

@predictable- Martin, thank you for your comforting tone and wise words! Your experiences inform us all so well! Jim @thankful

@welcome to this great group we listen tell of what helps us and see if something will help you From this post it sounds like your B.P. Is fine and the Atenolol is doing its job ,what concerns you about your med.?

I don't have any concerns about Atenolol but wonder about how it affects the drops I use in combination to control eye pressure for Glaucome Suspect which I have had for the last 20 years. I take the Atenolol at the same time in the morning that I take two of the drops-- Brimonidine and Timolol Maleate--and sometimes feel a little lightheaded. The Opthomolist is aware of this but does not seem to know why this happens.

@ladybugmg I have glucoma and M D can I ask do you space out the drops from the Atenlol wonder if they are to close together ? Dr has me on Lataoprist at bedtime I take my B.P earlier in evening

Thanks for the reply. I wonder how far apart should the drops and the Atenolol be in the morning?