Would you take blood pressure medication?

Same for me, I quit taking my low dose meds because I didn’t want to get dizzy and fall in the pool. No clue why it fluctuates so much.

Hi Frank @frenchfrank51, My PMR is currently in remission but I've been on prednisone twice for 2 different occurrences of PMR. I'm 82 now but have been on blood pressure medications since my mid 40s. I only started monitoring my blood pressure the last 10+ years but I have had it vary quite a bit sometimes though not as high as you mentioned.

I was in a Rochester Mayo heart study in my 50s after I had been on blood pressure meds for about 8 or so years and wore a Holter monitor for blood pressure during the day and while sleeping for about a week along with daily appointments at a local hospital. The result of my participation was that they changed the diagnosis for why I had high blood pressure. They determined that the hypertension was due to primary aldosteronism and changed my medications to spironolactone 5mg and hydrochlorothiazide 5mg daily which has worked much better than the previous meds (Lisinopril or Enalapril) to control my high BP.

You mentioned that you have talked to doctors many times but they haven't come up with anything. Have you thought about seeking a second opinion with a specialist or cardiologist?

@johnbishop
I have been on a small amount of two blood pressure meds before PMR but now my blood pressure has been out of control. I’ve doubled both meds and it seems to be better. I have situational blood pressure issues and wonder if it’s related to cortisol variations.
I’ve seen an endocrinologist but he hasn’t connected any dots to why I have blood pressure issues. Maybe as I taper off prednisone soon things will get better. Very frustrating.

@johnbishop
That's very interesting regarding aldosteronism. I've googled it and it could be a possibility for me. Certainly some of the symptoms match mine including muscle aches and weakness, fatigue and confusion, poor and fluctuating vision and trembling and tingling. They've all been there for me at times since I started to feel unwell about 14 years ago. I suppose I'm going to have to find a good endocrinologist now. I saw one recently due to the fact that I had started taking prednisone and now need to monitor my adrenals. But she was another of those doctors who tunes out of the conversation after about 5 minutes and thinks you've taken up enough of her time.

I know that one thing that isn't often considered when looking at high blood pressure as a cause is pain. Acute pain in particular. I know when I have a spike or a flare in my pain levels thanks to arthritis in multiple places, my blood pressure can rise for a while. I've found the following statement online from a spine doctor website

"Pain can have an impact on blood pressure. Acute pain can temporarily increase blood pressure due to the activation of the body’s stress response. On the other hand, chronic pain may contribute to high blood pressure through various mechanisms, including an impairment of the autonomic nervous system, inflammation, and the psychological toll it takes."

I have seen a cardiologist and had a 48 hour monitor test. The results came back showing very high blood pressure at times. As high as 240 over 130 and that I needed to start taking meds. I said that was impossible as during the 48 hours I hadn't felt particularly unwell at all. They checked the monitor and found it was malfunctioning. I could have been on the meds for no reason at all. That was about 8 years ago and I've seen a heart specialist since who wasn't worried about my blood pressure even though I told him about the fluctuations.

I'll check out endocrinologsts now.

Thanks again.

@caroljeand

Thanks Carol for your reply.

I've taken a look at situational blood pressure issues and what seems to be mentioned predominantly is anxiety or white coat syndrome. Which I know in my case don't apply but have often been told is the reason. I've never had any sort of anxiety issues and don't fear doctors. I simply feel very unwell at times. I know I have a lot of pain in multiple places due to arthritis and after the PMR diagnosis about a year ago.

And possibly, like you, I'm wondering if part of my high blood pressure problem is caused by stress hormones reacting to pain levels. I still can't work out why my blood pressure levels can be high one time and then normal the next time when I feel deathly ill on both occasions. I I've found the following online....

"Studies have found that high blood pressure and chronic pain often coexist. Researchers dug deeper and found that persistent pain can interfere with your body’s baroreflex, its mechanism for keeping your blood pressure consistent. Pain messing with that mechanism can cause your blood pressure to rise. Other chronic pain factors can also play a role. Pain is stressful on the body, meaning it can encourage your system to release more stress hormones like cortisol and adrenaline. These can cause a blood pressure increase. Chronic pain also interferes with sleep, and insufficient sleep links directly to higher blood pressure."

I presume if you have PMR you must have some levels of pain and fatigue.

John has replied to this post and mentions an endochrinological link to his blood pressure issues that you might find interesting.

Good luck anyway. I hope things soon improve for you.

@frenchfrank51
For me it’s not always detectable that I am anxious. In fact I’m not anxious about seeing the doctor, but I think it’s more the fact of what is going to be determined at that visit. Also, I can just be at home “relaxing “ and it can be high. Who knows what can be subconsciously going on inside of me.
Last night my blood pressure was so low that I wondered if I should even take all my meds. I’ll have to check out the condition you mention to see if it fits my circumstances.

I wouldn't take blood pressure medications if I didn't need to. For some reason I needed 3 blood pressure medications when I was on prednisone. I also took a atorvastatin for high cholesterol and warfarin to prevent a recurrence of another pulmonary embolism. I was told by an endocrinologist that I should have been taking metformin the entire time I was on Prednisone to prevent insulin resistance.

I wouldn't have taken Prednisone except I couldn't tolerate the pain. I never expected "no pain" but my pain was way over the top of what I could tolerate. Now that my pain is "tolerable" --- I don't need prednisone anymore. For some reason, I don't seem to need all the other medications that I listed in the first paragraph anymore. However, my rheumatologist says I still have PMR but it isn't treated with Prednisone anymore.

@caroljeand

Blood pressures readings at a doctor visit aren't the best readings to evaluate. It is often referred to as "high coat hypertension." When we see anyone in a white coat we get anxious.
https://my.clevelandclinic.org/health/diseases/23989-white-coat-syndrome
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The high blood pressures while relaxing at home are a bit more worrisome. Lower blood pressure before bedtime aren't so worrisome but I would tell your doctor about it because your medications might need to be adjusted.
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Funny story --- I was in the emergency room because some nurses wheeled me there when my blood pressure was 200/100. They checked my blood because I told them my blood pressure was 210/110 at home.

When I got to the emergency room they verified a very high blood pressure and put me on telemetry with every 15 minute blood pressure checks. I waited for a doctor to visit me while some lab tests and X-rays were done. When all the tests were completed after 2-3 hours my blood pressure was normal again.

A doctor visited with me and said all my tests were good and everything was normal. The doctor asked me what I was doing when I checked my blood pressure at home. I explained that my primary care doctor wanted me to check my blood pressure more often at home because they were "slightly elevated" during my doctor visit,

The emergency room doctor told me that everything looked normal so I could go home. The recommendation was for me to NOT check my blood pressure so often at home because that was making me anxious!

So true! Although checking often shouldn’t make it go down.
Anxious to see what readings I get once I get off prednisone however I’ve had issues before prednisone, only not needing twice the amount of medication to keep it under control. We’ll see.

@caroljeand

Prednisone has a way of causing things to not be regulated properly. My blood pressures were going extremely high after every prednisone dose until the effects of my daily prednisone dose lessened later in the day. Later in the day, my blood pressure tended to be lower.

My blood pressures were called "labile" but my blood pressures still needed to be prevented from going too high. I needed 3 blood pressure medications when I was on prednisone.

Things have stabilized during the years since I tapered off prednisone.

Off prednisone --- I don't need any blood pressure medications and they have all been discontinued. Now my body is regulating my blood pressure without additional medications.