Blood Pressure Meds, the Probably-Not-Final Verdict

[marydell]

First, thanks to everyone who replied to my earlier post asking about blood pressure meds.  The advice and info was all very helpful, and it really put my mind at ease to learn that so many of my friends and e-neighbors are on successful BP treatment.

So, I got a home monitor for $30 (on sale) at Walgreens (drugstore & home care store) and started checking my BP in the morning and evening.  First discovery: OMG, my BP is high ALL the time.  The "high normal" readings I've been getting (130/80ish) are, in fact, the anomaly, and it's more usual for me to get readings in the mild-to-moderate hypertension range.  Maybe sitting in the doctor's waiting room reading for half an hour before getting my BP checked is throwing it off?  Anyway, one night after some moderate activity--bathing an energetic toddler and wrestling him into his jammies--I was kinda wiped out, and red in the face, which is a not uncommon feeling for me.  I decided to check it right then and it was 165/100.  At which point I decided that any lifestyle change wouldn't happen fast enough to make a difference before my already-scheduled doc appt, and so I stopped hoping to magically get out of going on something.   I saw the doctor today and she agreed ("Wow, well, you're definitely my only patient today who *wants* to go on BP medicine. But you're right.")  She's starting me on just a diuretic (HCTZ), with a re-eval scheduled for 3 months. 

Of course, the one lifestyle change that could make a rapid difference is to reduce the sodium in my diet.  I have discovered that this is pretty much impossible for a person who doesn't really cook.  I do "cook" sometimes, in the sense of applying heat to food, but most of what I cook is either packaged or uses packaged sauce.  Stir-frying chicken or steaming some rice and salmon in my rice cooker is about as adept as I get, but the stir-fry sauce I put on everything comes out of a bottle and is basically distilled salt with a little pineapple juice and ginger.   And stuff like Lean Cuisine frozen dinners may be low in calories, but apparently they achieve that by replacing all the calories with sodium.  Sigh. I won't have free time for learning any big new skills until Spring or Summer, so I'm kind of screwed on that front at the moment.  Also I am genetically predisposed to utterly suck at cooking. (Also: sodium, om nom nom. Yummy).

Anyway. Thanks again for the advice, and tips about HCTZ are welcome. I'm starting it tomorrow.

Comments

[etumukutenyak.livejournal.com]

Hydrochlorthiazide (HCTZ) is an old and well-known diuretic. Almost all of this kind of BP med will cause you to lose potassium through the kidneys, so you'll want to stock up onthings with K+ in them. I drink orange juice, eat oranges, grapefruit, bananas, dried apricots, and nuts, but I'm sure your doc can give you a list.

Most processed foods are high in sodium, so you do have to check labels. If you have a Trader Joe's to shop at, they offer replacements with lower Na+, and buying fresh produce will also help. What we did when our son was younger was make a lot of stuff at one time (like Sundays), and dine off leftovers all week.

Oh, the NHLBI has recipes for their DASH diet, which you can find -- I see it's also at www.dashdiet.org -- is another good resource.

Best of luck!

[roadnotes.livejournal.com]

Agreed. I've been on HCTZ (and metropolol tartrate) for several years now, and the loss of potassium has been the only noticeable side effect.

[marydell.livejournal.com]

Yay, that's good to hear. Did the potassium problem hit you right away? Because it seems to have for me (leg cramps), but that might just be my brain messing around.

[readinggeek451]

Leg cramps could be other things, too. In my case, diuretics seem to deplete vitamin B, causing cramps.

[roadnotes.livejournal.com]

I've been taking them for a couple of years, and have only had the leg cramps a few times. May have to do with my usual diet having enough potassium. Soren takes potassium, though; he's more prone to leg cramping, and now that's more dangerous.

[mrissa.livejournal.com]

Mangoes, blueberries, and yams are also high in potassium.

No-sodium yam recipe: peel yam. Chop yam into bite-sized pieces. Toss with olive oil and rosemary. Put on a parchment-lined cookie sheet in a 400-degree F oven for 30 minutes. Nom yam.

[etumukutenyak.livejournal.com]

Oh, yes, that is delicious.

[fledgist.livejournal.com]

By "yam" do you mean "sweet potato" or "Dioscorea"?

[mrissa.livejournal.com]

The list we got from timprov's doctor had both on it as potassium sources. Your sources of course may vary.

[marydell.livejournal.com]

I do something similar for Charlie, but with different seasoning--I'll try it with the rosemary. Rosemary always looks interesting but I don't really know what to use it for.

[mrissa.livejournal.com]

Rosemary is good. You can make rosemary buns (http://www.marissalingen.com/rosemarybuns.html), but those take time and work. You can throw some chicken breasts in the oven (about the same timing as the yams) with a little olive oil and some garlic cloves and rosemary, and it's an extremely low-effort dinner. You can do potatoes the way I've described the yams. You can put rosemary in the crockpot with whatever else you want in your beef stew or chicken stew or potpie fixings.

[marydell.livejournal.com]

I will try it on chicken breasts - I do manage to cook those with reasonable regularity. The rosemary buns sound great, but anything involving yeast is beyond me, and not just because activated yeast freaks me out.

[txanne.livejournal.com]

Have you thought about a crockpot? It's changed my life! No, really...you chop stuff up, and dump it in the pot, and add liquid, and then you walk away. A 6qt batch o' stuff feeds me for a week and a half.

[roadnotes.livejournal.com]

I second the use of a crockpot. I'm a lover of one-bowl meals, and ours has been wonderful for it.

[marydell.livejournal.com]

I am fond of my crockpot; the problem is what constitutes "stuff." I make chicken, for instance, with open pit BBQ sauce (395 mg sodium per 2 tbsp! as if anyone uses a mere 2 tbsp of bbq sauce). Also pot roast with Dale's sauce, which is basically tarted-up soy sauce. Learning to do something edible out of veggies and whatever you put on veggies besides bottled sauce is challenging for me. (My ethnic & culinary heritage is Irish, English and Scottish...weep). But once summer rolls around I'm hoping I'll be able to try recipes and so forth on the weekends.

[txanne.livejournal.com]

"If it grows together, it goes together." This is why tomatoes and basil love each other so much, and why garlic improves most things.

There's also this site, (http://www.supercook.com/) which I've found quite useful lately. Tell it what you have, it finds recipes.

You also have my email address. Use it. I'm good at kitchen alchemy.

[marydell.livejournal.com]

Wait, food *grows?*

I will take you up on your offer once the worst of the winter is past (winter traffic here eats a lot of my free time). You will regret it! Imagine teaching someone to knit, who doesn't know how to count. I have good physical cooking skills (chopping and whatnot) but no theory.

[txanne.livejournal.com]

Ooh, this'll be fun. :-D

[a-d-medievalist.livejournal.com]

OK, seriously...NO BOTTLED SAUCES! Except maybe salsa :-) And get low-sodium soy sauce.

Veggies do not need sauce. They taste good without!


If you have a crock pot, you really are in good shape. There are so many recipes where you dump a bunch of stuff together and leave it all day.

[marydell.livejournal.com]

Veggies do not need sauce. They taste good without!

Riiight. Next you'll be saying that Latin is fun and Santa is real.

EXTREMELY belated reply

[aedifica]

But Latin *is* fun!

[stillnotbored.livejournal.com]

I missed your first post due to life and work. I've been on blood pressure meds since the age of 28 thanks to some auto-immune issues. Other than the doctor making me come in for checkups once a year and making use I take them every single day, I don't dwell on taking them. The alternative is much worse.

HCTZ is really mild, but it as with all diuretics, it will suck the potassium and other minerals out of your body. Most doctors add a potassium supplement as well. It is almost impossible to eat enough potassium rich foods to make up for what the diuretic washes out of your body.

Keeping sodium and potassium in balance is important, and it isn't something you should try to tinker with yourself. Ask your doctor about this. They don't always remember.

For the same reason--washing minerals, etc. out of my body--my doctor put me on vitamins as well. Made a huge difference in how I felt.

[marydell.livejournal.com]

Thanks for this tip - I called the doctor today for a supplement.

[pameladean]

Only about a third of people with high blood pressure respond to reduction of sodium in the diet. Also, there is some evidence, though it is not conclusive, that the overall balance of sodium, potassium, calcium, and magnesium is more important than the amount of sodium.

Given that, as mentioned above, a diuretic can, though it won't necessarily, get rid of too much potassium, and that sodium and potassium are antagonists in the body, you might want to concentrate on ingesting more potassium. One of the things they'll do at the next appointment should be to check your potassium levels. Don't take potassium supplements unless they tell you to. But you can eat bananas and citrus and drink tomato or V-8 juices -- and those do come in low-sodium versions, which I mention mostly because the regular ones are insanely high in sodium and you are certainly not getting too little of that.

The only other thing I can think of with regard to HCTZ is that the most urgent effects happen four to six hours after taking it, so most people take it in the morning so they aren't getting up to pee half the night.

I've been on it since 2002. In 2007 my potassium got low, but it had been fine before that. Some people never have problems with their potassium levels while on it, others do.

P.

[marydell.livejournal.com]

Thanks for the tips! I took the first dose in the evening at home, just in case it were to have unexpected side-effects, but today I took it in the morning at work. After getting up, predictably, 4 or 5 times last night I was fine until I had a nasty charley horse in my leg at 3 in the morning, which hasn't happened in years. Hm. I called the doc today and told her about it, and reminded her that I'm allergic to bananas, and she called in a scrip for me to get a potassium supplement. My prescriptions all come in pairs now--the first one to treat a condition, the second one to treat the side effects of the first one. I suspect that's true for most people on prescription meds...

Otherwise I feel fine on it so far, and I believe I've found a window of time between my drive into the office and my drive home where I can take it and not be stuck on the highway needing to pee. Overall the effect is just a bit stronger than pamabrom (pamprin/aquaban/diurex), so it's not unfamiliar.

[pameladean]

Wow, that was FAST. I note from a subsequent entry that your blood pressure went down to a very enviable level, too. This may be a good med for you. My doctor was very resistant to giving me supplements -- he preferred a potassium-sparing diuretic instead, which idea did not end well at all. I know what you mean about one med for the condition and another for the side effects. Yiiiii.

A lot of people find that once the initial water comes off, they don't really notice the diuretic's effects any more. I always do, though. At least you are somewhat used to something similar.

P.

[marydell.livejournal.com]

My systolic pressure has come down nicely--my diastolic is still high-ish, but seems to be staying below 90 on the home monitor. So far, so good. My dad says he's on the same diuretic, along with some other BP meds and a potassium supplement, and he does ok on it. I'll hope that I take after him in the tolerance department!

When I've taken a diuretic before, I was usually down for the count because of cramps, so I didn't have to figure out commuting with it. This week has been surprisingly drama-free in that regard--I take the pill in the car on the way to work, and by the time I'm going home for the day it's mostly settled down. If I ever have to leave at noon I'll have to take a route with a lot of McDonaldses on the way! Also the other diuretics were really weak compared to this...my mouth is so dry right now I feel like I've been worked over by the Fremen. *goes to drink more water*

[geekosaur]

Which variety of blood pressure tester? Most wrist-style testers read high (go for the high-end Omron models if you prefer wrist testers; I have the HEM-637, which is one of the better rated ones, or was when I got it at least. It was also around $80, IIRC). Cuff-style testers are a bit more expensive but also more reliable in general.

There's also a known heisenbug that home testing often reads high just from anxiety. This effect lessens as you get used to your fate regular testing.

[marydell.livejournal.com]

I got this wrist-style one, (http://www.walgreens.com/store/catalog/Blood-Pressure-Monitors/Automatic-Wrist-Blood-Pressure-Monitor/ID=prod5484199&navCount=1&navAction=push-product) that seems to read a little high compared to the doctor--maybe as much as 5 points--but is consistent overall. Except when I jerk my hand while it's testing, but that was unintentional.

lower sodium stir fry

[bifemmefatale.livejournal.com]

Stir-fry: get some tamari, which is a lighter soy sauce, and some toasted sesame oil. Dress your stir-fry with a drizzle of each (seriously sparing on the sesame oil), after stir-frying in some minced garlic and ginger at the last minute. Add red chile flakes if you roll that way, and maybe a bit of chopped cilantro if you like it, or lime juice. You can also use a pinch of 5 spice powder, especially on pork.

[readinggeek451]

Diuretics: Yes, take it in the morning. Also, make sure you're drinking enough. And do watch your potassium intake. My doctor just told me to be sure to have a full glass of orange juice with breakfast, but you may need more than that. Everybody (and every body) is different.

If this one isn't doing the job, adding/switching to something else may be indicated. This is not a sign of failure, just of calibration to your particular needs.

[seawasp]

Good luck. I've been fortunate in that department; so far, despite variations in my weight and of course inevitable aging, my blood pressure when not under severe stress has remained firmly at 120/80 since I was 18, varying only a couple of points in either direction.

[marydell.livejournal.com]

Must be nice! :)

Any cooking tips for the un-cooky? Or are you also un-cooky?

[seawasp]

I do a lot of cooking; my wife and I steal recipes from the Food Network all the time, and I've invented a number of things on my own. I would gladly offer you tips, but lowering sodium, not so much. Diet = die with a T. I'm on a diet now, but it's purely a calorie one: I eat 500 calories in the morning, 250 for lunch, and 1250 for dinner.

[fledgist.livejournal.com]

One thing I've done in the past couple of weeks is make big bean soups in the slow cooker. No salt (though I added a dash of hot pepper sauce, which does have salt in it) but lots of garlic (six cloves). The first was a split pea soup, the second a mixed bean soup. Because Gail and I are meat-eaters, the first contained a hambone and the second turkey meat. Both lasted about a week.

Ingredients: 3 quarts of water, wild rice, brown rice, quinoa, a pound of beans (or split peas), garlic, meat to taste, hot sauce to taste. Start early. Eat late. Refrigerate. Rhymes provided to order. Perfect for the worker or hoarder.

[marydell.livejournal.com]

This sounds good, and hooray for rhymes, although I'll have to sub something for the hot sauce (because otherwise it would be HOT). The rice and beans--are they dry at the start of this process? Or do you do something to them (soak, cook) first?

[kalmn.livejournal.com]

i'm on htcz for fluid retention, have magically managed to find my left ankle again and i have a feeling the right one is in there somewhere, and i love it. pameladean makes a good point about taking it in the morning rather than the afternoon.

reading this i am getting the feeling i ought to eat more bananas, though. hm.

[marydell.livejournal.com]

Ankles are great--I lost mine for a while when I was on Camila (http://www.webmd.com/drugs/drug-64301-Camila+Oral.aspx?drugid=64301&drugname=Camila+Oral) but they eventually came back again after I stopped. Mostly. I still get cankles once in a while, which will probably clear up now I'm on the HCTZ.

[icecreamempress.livejournal.com]

It would be wise to check your home tester against the one in your doctor's office sometime; home testers can be off.

I hope you have good luck with the medication!

[pmrabble.livejournal.com]

Not on HCTZ, but Atenolol. Diet is really the biggest factor - we're so overloaded with sodium. It's a crappy time of year to need to get on the fresh fruits and veggies, but every little bit helps.

I did go out and got a simple steamer/rice cooker, and started experimenting with different spices and such to liven things up. Also, changing the salt you use itself is a help. Sea salt in a grinder was a big change - less salt and more flavor. I still use the iodized salt for cooking, but except for baking salt levels are usually half of what any recipe calls for.

[unhappytriad.livejournal.com]

Frozen vegetables are extremely simple to cook in the microwave (directions printed on package!) and if you get the kind with no sauce, they have little or no sodium.

Fresh fruit, also good.

[fledgist.livejournal.com]

One thing about home BP machines: they're not very accurate. I take three readings every morning because the first frequently frightens me. I don't think that my pressure Friday morning, for example was 150/140, which was the first reading. The third reading (126/85) was probably closer to right. This morning my pressure reading was 116/76, which suggests that the long weekend may be good for me.

[marydell.livejournal.com]

I got one reading that was 90/80, which I took with a figurative grain of salt. Had it been real a literal grain of salt would probably be in order...

[fledgist.livejournal.com]

If I got that as a reading it would scare me. I got thrown into hospital a couple of years ago because my pressure read too low, and my nephrologist worried that I was dehydrated and overmedicated.

Sauce

[redrose3125.livejournal.com]

Sauce:

Chop up some amount of onions and/or garlic. (I use one or two onions, and 3-4 cloves of garlic for a 28 oz can.) Fry in olive oil till the onion is translucent. Throw in the contents of a 14 or 28 oz can of tomatoes (crushed, diced, or sauced). Add 1/4 to 1/2 teaspoon of cardamom and some of the following: basil, oregano, pepper.

Serve over pasta or ravioli (which we get from the frozen section, but I do not know the salt content).

[janradder.livejournal.com]

Hi, I'm haddayr's husband and she sent me over here.

There really aren't a whole lot of prepackaged foods that I've come across which don't have a high sodium content, but there were a few it might be worth checking out. Gorton's (the frozen fish company) makes a bunch of grilled fish entrees that I think (though I'm not sure) are low sodium (they don't have any sauce or breading, just spices). There are also a lot of frozen vegetables that could go with them that have no salt added and are very easy to make (and they taste a lot better than canned vegetables). You might also want to to check out food co-ops/health food stores. The frozen entrees are quite often extremely low-sodium (Amy's is one of the companies that makes them. Again, I haven't checked the nutrition label, but my dad gets them all the time and he's pretty obsessed with salt content). Hope that helps somewhat.