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Blood pressure medication

rainbowbluebells

Senior Member
Messages
248
Hi. If any of you have high blood pressure, or orthostatic hypertension or hyperadregenic PoTS, what medication do you take? I have heard that ACE inhibitors sometime make people with ME feel worse and mess their blood sugar around.
I may need to take something for this, as in the future I will need surgery and the doctor would like my BP to under control. So want a list of potential meds that are not as bad for Me patients, when I speak to the doctor.

Thanks :)
 

bertiedog

Senior Member
Messages
1,738
Location
South East England, UK
Hi. If any of you have high blood pressure, or orthostatic hypertension or hyperadregenic PoTS, what medication do you take? I have heard that ACE inhibitors sometime make people with ME feel worse and mess their blood sugar around.
I may need to take something for this, as in the future I will need surgery and the doctor would like my BP to under control. So want a list of potential meds that are not as bad for Me patients, when I speak to the doctor.

Thanks :)


I have a tendency to high bp especially in the mornings and also hyperadrenergic POTS. What really suits me is at lest 10 mg Propananol before I get up and another dose at lunchtime. Some days that is all I need but when its warmer or hot then I need more. Also if I have been sweating a lot which I have a tendency to do then I need half a tablet of Fludrocortisone and that also makes a really big difference to my energy and muscles.

BTW I have been on this low dose of Propananol for over 20 years without any ill effects, it always makes me feel better.

I have two negative SNPs for ACE but I have never had an ACE inhibitor. I also have to be very strict about my eating because I have a tendency to slightly too high blood sugars after a meal unless I have some exercise. Again I have so many SNPs that put me at risk for Type 2 but have managed to avoid this thankfully by eating lower carb and lots of good fats etc.

Pam
 

ryan31337

Senior Member
Messages
664
Location
South East, England
Hi. If any of you have high blood pressure, or orthostatic hypertension or hyperadregenic PoTS, what medication do you take?
Ivabradine (Corlanor) is the drug that seems most effective for many with POTS and orthostatic hypertension.

The literature talks of its heart rate controlling properties but not its ability to control blood pressure. Some literature even goes so far as to say its a better POTS drug for people with low BP, because it doesn't lower BP further like a beta blocker does. This isn't correct though, they really miss a major useful feature of Ivabradine, which is that it appears to lower stress response that contributes to labile hypertension, especially for those with orthostatic hypertension/hyperadrenergic POTS.

There is actually a study published specific to the use of Ivabradine vs Beta blockers to control hemodynamic response during anesthesia and surgery, it should be very relevant: https://www.sciencedirect.com/science/article/pii/S1110184916300915 .

Before Ivabradine an older drug was sometimes uses, Clonidine. From what I gather it has more unpleasant side effects and would generally only be used if the Ivabradine wasn't helping - I don't know if it has any other contraindications for use in surgery.
 

rainbowbluebells

Senior Member
Messages
248
Hi Ryan, yes I take Ivabradine 15mg a day. It has definitely helped bring my blood pressure down and it’s not as variable and temperamental. However I do find that it still spikes, especially when panicky / stressed / exertion / sitting up for some time. It’s not just when I’m upright - it can spike with the smallest amount of stress even when lying down. (Although the increases are generally a lot lower than they used to be).

in general It wouldn’t be as big a priority for me. However because of needing the surgery soon and so it would be best for me to have a BP med that I can take - or something to bring my BP down a bit - so that during surgery and anesthesia, my blood pressure is even more stable. As they explained to me, during anesthesia the BP and HR can become even more volatile, and I want to try to reduce my risks as much as possible, because due to me being not very mobile and ill, I’m already quite high risk.

So any additional meds suggestions for high BP (esp when it goes high with stress / autonomic kinda things) would be appreciated
 

rainbowbluebells

Senior Member
Messages
248
I have a tendency to high bp especially in the mornings and also hyperadrenergic POTS. What really suits me is at lest 10 mg Propananol before I get up and another dose at lunchtime. Some days that is all I need but when its warmer or hot then I need more. Also if I have been sweating a lot which I have a tendency to do then I need half a tablet of Fludrocortisone and that also makes a really big difference to my energy and muscles.

BTW I have been on this low dose of Propananol for over 20 years without any ill effects, it always makes me feel better.

I have two negative SNPs for ACE but I have never had an ACE inhibitor. I also have to be very strict about my eating because I have a tendency to slightly too high blood sugars after a meal unless I have some exercise. Again I have so many SNPs that put me at risk for Type 2 but have managed to avoid this thankfully by eating lower carb and lots of good fats etc.

Pam

Thanks. I had wondered about beta blockers. The only worry I have is with my asthma, it’s sometimes contraindicated.
 

ryan31337

Senior Member
Messages
664
Location
South East, England
Glad you're getting help from Ivabradine @rainbowbluebells! Its been wonderful for me too.

You could bring up the possibility of Clonidine but I'd imagine you'd be well outside the comfort zone of most doctors when mixing those + surgery. I think you'd be better off asking the doctor to speak to his specialist colleagues for advice at this point.