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Decreasing Blood Pressure

Old 07-24-17, 02:37 PM
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doctor j
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Decreasing Blood Pressure

I have a semi-annual appointment with the doc tomorrow. We've been discussing my blood pressure, blood pressure meds etc. I'm taking Lisinopril and have been for the last several years.

Three months ago, I started collecting a lot of readings/data for tomorrow's appointment and trying to get at least three readings per day, once when I get up, once after rides, and once at bed time. When I plotted the data last night, I noticed that my BP is decreasing. I took the data to the doc today, so the doc will be prepared tomorrow.

To the best of my knowledge, I've not made any significant changes in diet, lifestyle etc. that might account for the decrease in pressure. I'm wondering if the decrease is related to increasing temperature outside? We've had some intense heat indices of late. I've stayed fairly active this year. If I'm not riding, then I'm usually outside engaged in some sort of physical activity. I'm almost 500 cycling miles ahead of where I was last year at this time.

Have any of you seen something like this occur? Obviously, the doc and I will cuss and discuss this tomorrow, but I'm curious if anyone else has had a similar occurrence.
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Old 07-24-17, 03:16 PM
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My BP has been dropping for at least 3-4 years. In fact, my GP removed my hydrochlorothiazide pill and cut my Lisinopril in half. No lifestyle changes or weight loss here, either.

I'm 66 and had been on BP medicine since age 39.
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Old 07-24-17, 03:45 PM
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My BP has been dropping steadily this season. At the start (January) I was approx 140/75 and just a few weeks ago it was 106/60. The difference is hammering the hills on single tracks with my beloved Hummer (97 Trek 7000).
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Old 07-24-17, 05:21 PM
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In my experience, warm weather does bring better readings. Lots of miles ridden and weight loss also produce better scores. However, since all of my riding is commuting and I ride as much in winter as summer, the temperature effect is clearly real.
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Old 07-24-17, 07:42 PM
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My BP has been more erratic this year, not consistently lower or even stable. At 59 I've never needed meds for blood pressure (although I was prescribed BP meds to help control migraines years ago, but they didn't help). But I may need to reconsider. It's not as consistently low as it was in 2016 when I'd been back on the bike for a year.

At times even two hours after a ride, including today, my BP was 140/90 and pulse was still 95. It didn't settle down to 120/70 and 75 bpm until I took a nap and rested for a couple of hours. While my resting pulse is often higher than average (70-75 bpm is low for me), I'm seeing a more persistently higher diastolic and more fluctuations throughout the day and week.

Might be related to the Hashimoto's syndrome, might be related to the old neck injury -- occasionally a pinched nerve from a C2 injury has caused BP spikes. The neck position forced by the drop bar road bike I got in June might be contributing to the neck aggravation. Guess I should get it checked out.
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Old 07-24-17, 08:32 PM
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Increasing fitness usually drops BP and the other way 'round, too. My HR was 54 today, standing by our tandem and ready to ride. I'm in top shape, tapering for an event. My BP is usually ~106/68. No meds. I'm 72, but I ride quite a bit and a good bit of that, hard. I think the OP's extra 500 miles so far might qualify as a change in lifestyle. Keep on moving the ball. Somewhere between 3,000 and 5,000 seems to me to be a sweet spot, with the upper end being preferable. Eat clean, ride hard, lose weight, live long and prosper.
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Old 07-24-17, 09:30 PM
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Originally Posted by Carbonfiberboy View Post
Increasing fitness usually drops BP and the other way 'round, too. My HR was 54 today, standing by our tandem and ready to ride. I'm in top shape, tapering for an event. My BP is usually ~106/68. No meds. I'm 72, but I ride quite a bit and a good bit of that, hard. I think the OP's extra 500 miles so far might qualify as a change in lifestyle. Keep on moving the ball. Somewhere between 3,000 and 5,000 seems to me to be a sweet spot, with the upper end being preferable. Eat clean, ride hard, lose weight, live long and prosper.
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Old 07-25-17, 02:03 AM
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Unfortunately cycling does nothing to improve my blood pressure. I think there's probably some other underlying issues for me.
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Old 07-25-17, 08:46 AM
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I'm not blessed with good BP genes, lifelong issue. i too take lisinopril and I monitor my BP every day -- well most every day -- usually in the morning, taking the average of five readings. The past few months I started taking my BP after a ride and noticed a substantial drop in BP for multiple hours after a ride. For example, my BP is usually about 125/70 and after a ride it will drop to 110/60 or lower. I asked my cardiologist about this and he says it is not unusual for this to happen after exercise. I don't average those readings into my daily BP recordings!

I have been using an Omron 7xx for multiple years and the inconsistency of the readings always drives me bonkers, which is why I take five readings and average the most consistent ones. I took the device into one of my cardio appointments a few years ago to compare with the sphygmomanometer reads it mine unit reads a bit high, but our of five readings there can be a 15-20% difference between the high and low systolic pressure. I am shopping for a sphymamonometer unit to replace the Omron in hopes of getting more consistent readings.
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Old 07-25-17, 10:14 AM
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Due to genetic factors (narrow renal arteries, courtesy of my maternal grandmother, who occasionally hit 260/200 (!)) I have to work to keep my BP down. Exercise does help, and losing even a few pounds, even though I don't have that much to spare, helps even more.

Fortunately, thanks to genetic dilution, my mother's BP problem was not as bad as her mother's, and my sons' problems are not as bad as mine. My father's extreme (-13) myopia is likewise getting diluted with each new generation.
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Old 07-25-17, 10:21 AM
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Well, I got to the doc and was pronounced alive. Doc was pleased with decreased pressure but did not have a bang-your-fist-on-the-table-definitive answer as to why. Possibilities included fitness and acclimation to heat. Prior to retirement, I lived and worked several hours north of here, where heat/humidity were not as intense as they are here. Whatever the reason, we'll take it and be glad of it, but we'll still be curious as to the cause. Doc decreased the dosage of Lisinopril. We'll keep collecting data and see what gives.

Relative to post ride pressures, I've had them as low as 90/61. The lowest pressure I see during a non-riding day is the one I get when I arise for the day before I take my med. On riding days, the post ride reading is typically the lowest. Typically, the highest reading is the one just before bed. I took the difference between morning and night pressures each day and averaged the numbers. Average daily increase was 19 systolic and 3 diastolic in round numbers.

I use an Omron 7XX as well, and it appears to be consistent with what the doc gets with the sphygno. I've wondered about the consistency of blood pressure measurements in general. My background is in lab chemistry, so I'm accustomed to some fairly accurate and precise measurements. I'm guessing that the physical method for measurement of BP is not all that precise and is somewhat "noisy."

To those who responded, thank you. I suspect most of us are not physicians, but it's nice to hear real-world experiences from fellow cyclists of our vintage.

Now that that's done, I think I'm going to go and "enjoy" some heat/humidity and catharsis on my bike.
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Old 07-25-17, 10:56 AM
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I have boarder-line high blood pressure and high cholesterol and was on meds for awhile. I then decided to quit taking all meds and said screw it. Diet and exercise was my go to fix. After three years or so of being off meds my doctor didn't seem to get too upset at my results even though its not optimal. I figure those numbers are made up by the drug companies anyway and both my parents are in their '90s so I think I'm okay.
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Old 07-25-17, 08:50 PM
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Originally Posted by doctor j View Post
I have a semi-annual appointment with the doc tomorrow. We've been discussing my blood pressure, blood pressure meds etc. I'm taking Lisinopril and have been for the last several years.

Three months ago, I started collecting a lot of readings/data for tomorrow's appointment and trying to get at least three readings per day, once when I get up, once after rides, and once at bed time. When I plotted the data last night, I noticed that my BP is decreasing. I took the data to the doc today, so the doc will be prepared tomorrow.

To the best of my knowledge, I've not made any significant changes in diet, lifestyle etc. that might account for the decrease in pressure. I'm wondering if the decrease is related to increasing temperature outside? We've had some intense heat indices of late. I've stayed fairly active this year. If I'm not riding, then I'm usually outside engaged in some sort of physical activity. I'm almost 500 cycling miles ahead of where I was last year at this time.

Have any of you seen something like this occur? Obviously, the doc and I will cuss and discuss this tomorrow, but I'm curious if anyone else has had a similar occurrence.

I'm 65 and have my yearly physical in 3 days and I've been treated for hypertension for maybe 20 years now and my bike riding has not made any difference. Lisinopril is one of the few hypertension drugs that gave me problems (wheezing upon exertion) so I stopped it. The second drug I stopped which I had taken for some years was Atenolol which would slow my heart rate. Unfortunately it would suppress my heart rate even when I was trying to climb a railroad overpass and I was dying by the top. My lungs would be screaming to the heart, "Pump faster, pump faster! More blood, more blood!" but the heart would answer, "Naah, I don't think so". So getting off Atenolol was a great lifestyle changer for me.
But my current meds manage my BP with no side effects and I'm content with that. It is keeping my BP so low that I don't think I would notice any change from riding my bike.
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Old 07-26-17, 07:13 AM
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My last doctor thought I was pre-hypertension. I thought he was a quack, so I guess that made us even.

Blood pressure readings can fluctuate a lot depending on the immediate environment. and on other factors relating to the individual. Physical fitness, of course. In my own case, I've seen a correlation with changes in diet and stress levels.
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Old 07-26-17, 10:43 AM
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Last year my MD put me on a beta blocker. Damn near killed me. A friend who is a ND suggested that I toss the meds and take 100% beet juice daily. Did that and my BP dropped dramatically without side effects. Much better.
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Old 07-26-17, 10:50 AM
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Stay out of the A&S forum or your BP might rise significantly.
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Old 07-26-17, 11:58 AM
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I have white coat fever. I go into the doc's office, where a nurse takes my blood pressure, and it's typically 134/80.

By the time I leave the docs office, the doc takes it again it's 115/78. Taking my BP at home has confirmed the same.

Now that I think about it, that nurse is pretty hot. Maybe it's not white coat fever after all ...
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Old 07-26-17, 12:12 PM
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Originally Posted by Biker395 View Post
I have white coat fever. I go into the doc's office, where a nurse takes my blood pressure, and it's typically 134/80.
By the time I leave the docs office, the doc takes it again it's 115/78. Taking my BP at home has confirmed the same.
Now that I think about it, that nurse is pretty hot. Maybe it's not white coat fever after all ...
That tends to happen with me too and I expect it could happen this Friday when I go for my yearly physical.
My BP is not really bad, it's just not as good as it is otherwise. I would donate blood plasma every 2 weeks and they would take my BP and it would be great, but then higher at my doctor's office where I would need to remind them that I just rode my bike 4 miles to get there.
Over the years I have found that how I feel at the time I get my BP checked makes little difference. There have been times when I've felt stressed before I got there ant it's normal and then other times when I'm feeling great and relaxed that it's high. Go figure.
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Old 07-26-17, 12:22 PM
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For stress-related, see Mayo Clinic...

Stress and high blood pressure: What's the connection? - Mayo Clinic
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Old 07-27-17, 01:40 PM
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I'm on lisinipril too, and I've noticed that on hot days I'm more prone to dizziness when standing, even though I'm hydrated. I even had to stop taking it for a few weeks last summer after picking myself up off a friend's living room floor.
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Old 07-28-17, 10:15 AM
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My background is in lab chemistry, so I'm accustomed to some fairly accurate and precise measurements. I'm guessing that the physical method for measurement of BP is not all that precise and is somewhat "noisy."
Unfortunately, you are correct. Taking a single measurement at a single point of an arterial system gives only the "a general" hint of whats going on.

I've monitored my BP for 30 years. I monitored my pressure right up to and after surgery for aorta/aortic valve replacement. (not to mention the 24/7 monitoring while in hospital)

Since you mentioned your background in chemistry then you should appreciate that affinity between water and sodium and how dynamically fluid and sodium retention are adjusted through kidney function. In addition, all the factors regarding stress and the subsequent release of hormones that affect blood vessel constriction and you have a jigsaw puzzle that never gets completely solves.

Big picture comment - bicycling or endurance exercise is another component or "lifestyle choice" that needs to be factored into any understanding of medication dosing and actual results. Just as drinking and smoking need to be considered when assessing health risks.
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Old 07-28-17, 12:39 PM
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Originally Posted by BlazingPedals View Post
I'm on lisinipril too, and I've noticed that on hot days I'm more prone to dizziness when standing, even though I'm hydrated.
I'm experiencing those same issues. If I squat to look for something, work on something, play with the cats etc., sometimes I'll have to stand back up in "phases" to get my equilibrium. There's a name for that, and my doc called it hypo something or other. We touched on that briefly during my appointment.
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Old 07-28-17, 01:19 PM
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I was on Lisinopril 2x per day. Doc then added HCTZ to it. Taking this, when I came to a stop, especially when riding hard, I would get very light headed to where I felt like I might black out. So I started doing one with HCTZ and one without. This fixed the problem. Doc was OK with it next time I saw him and that's where I still am. Would like to get it lower and reduce/drop meds, but it doesn't seem like it's going to happen.
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Old 08-30-17, 11:43 AM
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This is a great thread! I'm 47 on BP meds and found that when I was actively riding, my BP was consistently on the lower end. I had to stop riding for six weeks after an injury and I gained 10 pounds plus my BP edged higher. I'm back on the bike now and hoping to bring both back down before it gets too cold to ride...
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Old 08-30-17, 11:51 AM
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Ambient temp definitely affects BP.

When you're hot the blood vessels under your skin dilate in an effort to cool you. This increases the volume capacity, lowering the diastolic BP. By the same token, the peripheral blood vessels contract when you're cold, driving blood back to the core and increasing your BP.

This is why folks with cardiac issues have to be cautious about sudden cooling, like jumping into cold water on hot days.
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