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I have taken some readings with the Omron wrist blood pressure monitor in recent days. They all indicate mild hypotension.
98/59 (today). I have had similar readings in the previous two days.
I have none of the worrying symptoms of hypotension that might indicate an underlying cause, such as dizziness, fainting, light-headedness, blurred vision, heart palpitations (pulse is typically 60), confusion, nausea or weakness. I feel fine.
From March to today I have lost 64 pounds. I am 66 years old. I do exercise but haven't done much for the last few weeks as I am battling acid reflux.
I am on lisinopril/HCTZ 20/25 mg. I have been on this drug for decades. I am thinking I will stop taking it and see what happens. Does anyone see a problem with that approach? Should I taper?
It's not unusual for a small woman to run BPs 90s/60s-- BPs like that are not necessarily too low-- unless you exhibit the symptoms you listed above (good list).
I'm guessing the dose of lis/hctz that you were on at a heavier weight is now too much at your new, lower weight (good work! BTW) and can now be lowered or even discontinued.
I have a video visit scheduled with him for September 4. He doesn't know about the weight loss.
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It's not unusual for a small woman to run BPs 90s/60s-- BPs like that are not necessarily too low-- unless you exhibit the symptoms you listed above (good list).
I stole the list from an NHS website. (Socialized medicine! )
I'm not exactly a small woman. I was hovering around 250 lbs for many years. I'm about 5'4".
I'm at 187 lbs now and obviously still have more to lose, but my right knee doesn't hurt any more, even though there's no cartilage.
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I'm guessing the dose of lis/hctz that you were on at a heavier weight is now too much at your new, lower weight (good work! BTW) and can now be lowered or even discontinued.
Yeah, I hope that is the case.
I'm also on an acid reflux diet: brown rice, vegetables, oatmeal (not instant), multigrain bread, lean meat and no sugar or fruit except prunes (I need them to stay regular). I have not lost any weight in the two weeks I've been on it, possibly because of the sodium content of the veggies and canned chicken I have to use.
I am on lisinopril/HCTZ 20/25 mg. I have been on this drug for decades. I am thinking I will stop taking it and see what happens. Does anyone see a problem with that approach? Should I taper?
The HCTZ portion is Hydrochlorothiazide which is a diuretic. Since moving to Phoenix with heat/dry air, maybe you are sweating more while also being on a diuretic and having lost a lot of weight. Maybe the dose is too much now and dropping your blood pressure. Usually not a good idea to stop a med abruptly if you've taken it a long time. Lisinopril also comes in the standalone version without the HCTZ component. To your question and to test the hypothesis, you could skip a day and track your vitals.
I've found this site quite helpful when troubleshooting my mother's meds - reading about others' experiences. The directory is at the top of page (alphabetically) but I've plugged in your med:
I don't recall if you have a cardiologist or good internist yet in Phoenix (I read you had been to Mayo). Going off the HCTZ may cause a rebound bit of water retention which would then possibly raise your blood pressure. Would be good to have a trusted doctor available for help with meds to make sure all is A-OK.
edit: Sorry I didn't see you have a video visit with your doctor scheduled for later this week. I'll bet he says your weight loss has been great and enough to lower or go off your med. Will be interested to know what he says.
Last edited by wildflowers27; 08-31-2020 at 08:43 PM..
Your wt loss may have stagnated on the new diet because it's so heavy on grains/carbs. Curious--what diet allowed such a marked wt loss for you?
It's the rare pt who can take lisinopril without a diuretic. It often leads to fluid retention/leg edema when taken alone....Lisinopril is not particularly known to cause rebound elevation of BP on discontinuing it suddenly. There's a difference between "rebound" vs just a return to baseline...In your case, we don't know your baseline at this new wt...Your doc should make the decision. He may prefer tapering the dose. That would only take a few days longer, and may be wise if you have other risk factors involved.
Your wt loss may have stagnated on the new diet because it's so heavy on grains/carbs. Curious--what diet allowed such a marked wt loss for you?
I am high-risk for the virus. I have asthma and another chronic lung condition.
The weight loss came about because I had a nervous breakdown after the pandemic started. Everything I read was telling me if I got infected, I would die horribly because of my age and underlying conditions. I couldn't sleep, not even with sleep aids, couldn't eat more than a bite or two. I hallucinated. I freaked out every day when the sun went down. My memory of March and April is pretty foggy but I know I drank a lot of water instead of eating. I was confused and addled but knew enough to realize I was making bad decisions. So I asked my soon-to-be-ex-husband to move into the guest house and help me stay in isolation.
I had a psychiatrist prescribe anti-depressants for me. I never took them. He told me they would take four to six weeks to take effect, but I couldn't wait that long for sleep or to be able to eat. He prescribed sleeping pills (Ambien, Trazodone, Hydroxyzine, a few others) but I didn't take any of those either. I was concerned about the half-life of each should I need to discontinue them suddenly. I spent my sleepless nights endlessly researching this stuff. I had email conversations with a woman who manages her chronic anxiety with Zoloft, Xanax and Trazodone. She's addicted to the Xanax and knows it. That's not for me, even if I could get a script for benzos.
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It's the rare pt who can take lisinopril without a diuretic. It often leads to fluid retention/leg edema when taken alone....Lisinopril is not particularly known to cause rebound elevation of BP on discontinuing it suddenly. There's a difference between "rebound" vs just a return to baseline...In your case, we don't know your baseline at this new wt...Your doc should make the decision. He may prefer tapering the dose. That would only take a few days longer, and may be wise if you have other risk factors involved.
That which I had feared has happened: My doctor is refusing to help me. I guess I can call him my ex-doctor now.
I'm in Arizona. The clinic, Palo Alto Medical Foundation, is in California. PAMF has taken a hard line and is refusing to treat anyone who is not physically in California now. So my ex-doctor will NOT do a telemedicine visit with me. He wouldn't even call to tell me that. He had a nurse do it.
He will, however, consult with any doctor I find here. Big whoop. I don't have one, can't get one, can't be seen in person because I'm high-risk.
He had been my physician for nearly two decades. Having my access to medical care removed really hurts.
I guess it's back to Plushcare.com to find a doc du jour. I won't use MDLive, because Sutter Health owns it and PAMF is part of Sutter Health.
I’ve lost weight over the past year and my Lisinipril dropped from 10mg, to 5mg and 2.5 mg until I went off of it last November. Like you I would get hypotension and I felt it: dizzimess, weakness and I knew when my BP was low. My doctor worked with me and changed doses as needed.
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