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Low blood pressure since being on prednisone
Has anyone had blood pressure drop with either PMR or prednisone use?
I know prednisone is normally associated with increased blood pressure but, strangely, I'm finding my blood pressure is getting lower more often than before I started on it.
Historically, for decades my BP has always stayed at around 120 over 80. A couple of years ago I began to have periods when I felt really unwell all of a sudden so I'd check my BP and it would be around 200 over 90 which I thought was the reason I felt unwell. Then I'd go through exactly the same sensation of feeling really ill again, check my BP only to find it was around 120 over 80, so back to normal even though I was sure it would be high again because I felt just as ill as I did on the occasions when it was elevated. Couldn't make sense of it at all. My doctor agreed it made no sense in taking meds to control elevated BP if it's not constant but wasn't interested in finding out why it would fluctuate so much or why I was feeling so ill no matter where it was.
No, all of a sudden my BP is hovering around 110 over 70 (I still feel just as ill as ever) which is not what I expected at all seeing as I'm on prednisone.
On several occasions, in the past and to this day, during the night, I've been stirred from my sleep simply because I started to feel unwell, checked my BP and found that it was really low, well, around 80 over 60. I've thought it might be sleep apnea but I tend to sleep on my side. Told my doctor again but not interested. Not sure if PMR causes fluctuating blood pressure readings especially since I had this problem some time before the diagnosis. Or is it a precursory symptom of PMR?
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My blood pressure fluctuates a bit on prednisone, but usually within the normal range or a little lower. Whenever it (or my heart rate) is low I drink a couple of glasses of water and retest later and it's up again. A nurse told me once that dehydration can cause low blood pressure and/or low heart rate.
One of the symptoms of adrenal insufficiency is low blood pressure, and I sometimes notice a drop in pressure after starting a reduction. I take blood pressure almost every day to make sure I'm onto any possible adrenal crisis or insufficiency as the prednisone dose reduces. Currently reducing to 3mg and all is well. Make sure to keep up the fluids is all I can suggest.
While on prednisone (started Jan. 22, 2025), my blood pressure dropped as low as 86/55. and I had to cut my BP medication in half. I started to get chest pains that I thought was just heartburn/reflux. I ended up in ER with the chest pains on March 14th this year. The prednisone had put me into a type of heart failure called HFpEF. It has to do with the heart working too hard. It is also associated with pulmonary hypertension - which is what the ER found. The HFpEF was diagnosed after failing my heart stress test. It also created issues with my kidney function. I was started on Lasix because by the time all the testing was done I looked like a walking water balloon.
I had to wean off of the prednisone quickly, and now my HF is stable and my kidneys corrected. The trade off is... my pain is back. I've been trying to get in to see ANY Rhuematologist since January. I am hoping that some day, in my lifetime, I will be able to start some sort of infusion that will ease the pain and not destroy my heart and kidneys. One can only pray.
Terri
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2 Reactions"While on prednisone (started Jan. 22, 2025), my blood pressure dropped as low as 86/55. and I had to cut my BP medication in half."
Good point. I'd already cut my blood pressure meds and beta blocker (prescribed 9yrs ago after a heart attack) to half dose after PMR pain started, thinking the new pain could be caused by them, and didn't put them back up after starting on prednisolone. I take half the minimum dose. Combinations of medications affect everyone differently.
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