Orthostatic Hypotension and Cardio visit

Posted by fiesty76 @fiesty76, Dec 4, 2019

Mr. McConkey: Found the place to post…sigh, mark it up to old age confusion.

Yesterday's visit with cardio left me unsettled. I had an annual Doppler carotid scan. When asked doc specific #'s for each result, he replied "Normal" and said since it was same as last scan, we'd skip a year before next Doppler. He seemed rushed and abrupt and so I didn't press.

His nurse practitioner had done the ortho test of b.p. lying, sitting, standing and the gap bet. standing and sitting was 25 pt drop. N.P. suggested a calcium heart test when doc came in. Doc said, we know the patient has hardening of the arteries so that won't be necessary.

Doc told me last visit that I could "self-regulate" my med with big b.p. drops but I failed to ask more specifically. My primary question for this visit was at what systolic reading do I stop amlodopine 5mg with ortho drop and at what reading do I resume taking the med. My second question was what b.p. was I aiming for. I had taken diary of b.p. readings over past mos for him to note the frequent drops in b.p. He asked "how" I take readings: 1st thing in morning and sitting at my breakfast bar. Then asked if I needed to take it standing because he'd said if gap was 20pt diff on sys. bet. sitting and standing it was ortho..which I already knew. He said no to my question about standing but didn't answer my questions.

Told him since last annual had been diag. with both CKD Stage 3 and acute Diverticulitis episode and had learned impt of regulating b.p. with CKD. He made no comment and left saying I'll see you in a year. I am troubled, feeling discounted and that because I am 76 yrs with other chronic conditions, he had no interest in helping. Am I overreacting?

Have others here with ortho hypo been advised about when to stop and then resume taking b.p. meds following large drops in b.p.?

Hi @fiesty76, I see that your discussion questions went unanswered. I don't have any answers for you but was wondering if you have ever talked to your pharmacist about the timing question of when to stop and then resume taking blood pressure medications following large drops in blood pressure.

@cehunt57 @that_girl and @predictable may have some experience to share with you on Orthostatic Hypotension medications and when to take them.

Liked by fiesty76

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Talk to your GP. This maybe more in the realms of neurology

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@johnbishop

Hi @fiesty76, I see that your discussion questions went unanswered. I don't have any answers for you but was wondering if you have ever talked to your pharmacist about the timing question of when to stop and then resume taking blood pressure medications following large drops in blood pressure.

@cehunt57 @that_girl and @predictable may have some experience to share with you on Orthostatic Hypotension medications and when to take them.

Jump to this post

I have a history of orthostatic hypotension. My BP & meds are monitored by my nephrologist because I have chronic kidney disease. I take Losartan at bedtime and Torsemide (a diuretic) in the morning. When I have a follow up appointment my Dr. takes my BP while I’m sitting and standing to see if there is any major difference. Also asks if I have any symptoms of light headedness or feeling feint. Monitors my weight also. Discovered I once had too much meds for my size.

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@johnbishop

Hi @fiesty76, I see that your discussion questions went unanswered. I don't have any answers for you but was wondering if you have ever talked to your pharmacist about the timing question of when to stop and then resume taking blood pressure medications following large drops in blood pressure.

@cehunt57 @that_girl and @predictable may have some experience to share with you on Orthostatic Hypotension medications and when to take them.

Jump to this post

@johnbishop, Thanks for your response, John.

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@cehunt57

I have a history of orthostatic hypotension. My BP & meds are monitored by my nephrologist because I have chronic kidney disease. I take Losartan at bedtime and Torsemide (a diuretic) in the morning. When I have a follow up appointment my Dr. takes my BP while I’m sitting and standing to see if there is any major difference. Also asks if I have any symptoms of light headedness or feeling feint. Monitors my weight also. Discovered I once had too much meds for my size.

Jump to this post

@cehunt57, Thank you for your response. I also have kidney disease. At my 1st visit to a new cardiologist, I was tested for the sitting,lying down, standing b.p. and diagnosed with orthostatic hypotension. He also referred me to a neurologist where a p.n. diagnosis was confirmed. The cardio advised me to stop my Amlodipine (5mg) following a hypotension incident until my b.p. came back up for a couple of consecutive days of 130 systolic readings. I am still 25 lbs under my normal weight and your post makes me wonder if some of my multiple conditions and meds for them should be reviewed. Thanks for this insight; hadn't considered the wt loss and meds issue before. I so appreciate what we learn from sharing of experiences in these groups!

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