Postural hypotension
Kolaga Xiuhtecuhtli
This is getting really annoying. My BP tonite is 107/61 and my pulse
is 46. I take 10mg Zestril / day. I've lost 60 lbs and I am
exercising on a regular basis including 3 mile jog.
For the past two weeks when I get up off the couch, I feel faint
or dizzy and I have to brace myself and wait for things to settle
down.
I know this is postural hypotension and my doctor has put me on
5 mg Zestril / day on account of my improved BP after losing all
that weight.
Is this dangerous? I don't have the problem at work or during
the day but then again I only lay down on the couch in the
evening.
Alvena Ferreira
If it is equally as low in the mornings, you may need even less
medication that you are currently taking. It's not dangerous, but if it
gets any worse or rears its ugly head other times of the day, it could
be. You should consult with your doctor. And congratulations on
accomplishing the monumental feat that is bringing your b/p down: weight
loss. It is the single thing that would help many overweight
hypertensives that is seldom done easily or quickly, and you are to be
commended for the hard work that has no doubt brought this to fruition.
alvena
Howard H. Wayne, M.D., F.A.C.C., F.A.C.P
after there has been a significant weight loss such as you have had.
The effects may not only be limited to changes in position but there may
be a sense of fatigue during the day. Interestingly, in my experience,
postural hypotension has been the most common with Zestril than
with other ACE inhibitors, although it will happen with all of them.
Your doctor's action in reducing your dosage from 10 to 5 mg/day was
quite appropriate. For more information on drugs in hypertension see my
Web site at http://www.heartprotect.com
Howard H. Wayne, M.D., F.A.C.C., F.A.C.P.
Cardiologist
In article <376c74ce...@netnews.worldnet.att.net>,
$Xiuhte...@worldnet.att.net (delete $ to reply via e-mail) wrote:
>
> This is getting really annoying. My BP tonite is 107/61 and my pulse
> is 46. I take 10mg Zestril / day. I've lost 60 lbs and I am
> exercising on a regular basis including 3 mile jog.
>
> For the past two weeks when I get up off the couch, I feel faint
> or dizzy and I have to brace myself and wait for things to settle
> down.
>
> I know this is postural hypotension and my doctor has put me on
> 5 mg Zestril / day on account of my improved BP after losing all
> that weight.
>
> Is this dangerous? I don't have the problem at work or during
> the day but then again I only lay down on the couch in the
> evening.
>
>
--
Howard H. Wayne, M.D., F.A.C.C., F.A.C.P
Noninvasive Heart Center
San Diego, CA 92103
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Stewart Rowe
Kolaga Xiuhtecuhtli ($Xiuhte...@worldnet.att.net) writes:
> This is getting really annoying. My BP tonite is 107/61 and my pulse
> is 46. I take 10mg Zestril / day. I've lost 60 lbs and I am
> exercising on a regular basis including 3 mile jog.
>
> For the past two weeks when I get up off the couch, I feel faint
> or dizzy and I have to brace myself and wait for things to settle
> down.
>
> I know this is postural hypotension and my doctor has put me on
> 5 mg Zestril / day on account of my improved BP after losing all
> that weight.
>
> Is this dangerous? I don't have the problem at work or during
> the day but then again I only lay down on the couch in the
> evening.
>
Sounds very familiar. One trick I find helpful (aside from trying not to
just bounce up from a nap and run for the phone or whatever) when I
feel like I'm about to black out under similar circumstances,
is to bend over at the waist until the upper body is approximately
horizontal, which lets the blood reach your head easily, then
when the wooziness disappears in a couple of seconds, carefully
stand upright again.
I should expect the problem to ease after your have been on the lower
dose for a while. But some of us, especially old geezers like me,
have partially lost the speed at which the system adjusts to posture.
The blood vessels actually adjust to (normally) maintain an
adequate supply to the brain whether you're upright or horizontal.
Stewart Rowe sr...@fuse.net
Kolaga Xiuhtecuhtli
<theh...@apex.net> wrote:
>Your bp does sound a little low, what is it running in the morning time?
In the morning, it's 132/67 or so. This hypotension occurs mostly
in the evening. My BP was borderline when I started on the meds.
> If it is equally as low in the mornings, you may need even less
>medication that you are currently taking. It's not dangerous, but if it
>gets any worse or rears its ugly head other times of the day, it could
>be. You should consult with your doctor. And congratulations on
>accomplishing the monumental feat that is bringing your b/p down: weight
>loss.
Being put on BP medication was a shock. I guess going for a stress
test clinched it. It was time to lose weight.
> It is the single thing that would help many overweight
>hypertensives that is seldom done easily or quickly, and you are to be
>commended for the hard work that has no doubt brought this to fruition.
The diet isn't too bad. I prefer exercise over starvation, so I eat
wisely and only experience hunger for an hour or so before meals.
The exercise is an hour of mild pain every day. Once I finish I feel
virtuous the rest of the day.
>alvena
J P Diesch
: knees.
The problem with this, and the previous suggestion of bending from the
waist in a standing position is that they both increase intrathoracic
pressure quite considerably - almost if not quite a Valsalva, and although
BP rises it may drop reflexively when the intrathoracic pressure is
released.
Another suggestion for those feeling pre-syncopal symptoms, ie: dizzy,
light-headed, hot, about-to-faint, is to cross the legs, whilst still
standing, and squeeze them together as hard as possible, simultaneously
tensing the stomach muscles also helps. This technique mechanically
increases venous return, and brings the BP up without any of the nasty
vagal effects of a valsalva manoeuver.
Thoughts?
J.
J P Diesch
: light-headed, hot, about-to-faint, is to cross the legs, whilst still
: standing, and squeeze them together as hard as possible, simultaneously
: tensing the stomach muscles also helps. This technique mechanically
: increases venous return, and brings the BP up without any of the nasty
: vagal effects of a valsalva manoeuver.
In addition:
The ideal method of preventing a syncopal attack is of course to
lie down flat, with or without raising the legs.
Not always possible whilst climbing ladders etc. though.
J.
Joel Guss
hypotensive attack, wouldn't the most important action be to prevent
a fall? I would think that getting to the ground while you can do so
in a controlled manner would be my primary goal.
Joel