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Blood Pressure Medications

todd121's picture
todd121
Posts: 1425
Joined: Dec 2012

Before my kidney cancer, I was told that my weight made it likely I was going to have blood pressure issues "soon". My blood pressure was actually pretty good even though I was overweight before the surgery. It was generally in the 120's/high 70's range. Since my kidney was removed, my BP has gone up some and so now everytime I'm in a doctor's office they want to lower my blood pressure with medication to protect my only kidney. (When I say "they", I mean my nephrologist or or primary care doctor).

My family doctor tried me on hydroclorothiazide (something like that first), a diuretic. It made me feel like crap and I started having a feeling like my heart was racing. So they stopped that. Then they put me on metropolol, a low dose. It didn't have much effect on my BP, so they increased the dose (I can't remember the dosages, either it was 25mg to start with then to 50mg or 50 then to 100). I was having issues with my hands swelling for no apparent reason, feeling anxious like my heart was pumping to hard/fast (even though my heart rate had gone down while I was on the drug), and one day I ended up going to the emergency room thinking I had a heart attack. It did work as far as lowering my blood pressure was concerned. By the way, it did not help libido and seemed to make me gain a little weight (which makes sense, because it lowers your heart rate along with your BP).

I tried to go off it on my own, and my heart raced like crazy the day I skipped my dose. Then I found out you're not supposed to just stop it. That you can actually have a really bad event (I can't remember if it was stroke or heart attack) if you stop suddenly. So, I went back on it. Then I weaned myself off it. My hand swelling problem seemed to go away. However, it turns out it didn't. It's still happening, but less often.

I saw a new nephrologist today. My old one retired. I really miss him. He was great. The new one is a young lady. Very smart. She's worried about my one kidney and wants to protect it. She says at my age and with my health, and my reduced kidney function, I have a good chance of outliving this kidney and needing dialysis so I really should do something to keep my BP down. Normally my BP is in the 130's/85 range, but sometimes it spikes up in low 140/90, or even 150/90, but rarely this last number. Today in the doc office it was 142/92.

I talked to the doctor and did some reading, and I'm having trouble really telling for sure if the doctor's have even figured out positively if high BP causes kidney damage, or if kidney damage causes high BP. I have a feeling they don't know which causes which. (Anybody feel free to chime in here if you know and can point me to scientific evidence.)

The new BP medicine she wants me to take is lisinopril. It's an ACE inhibitor. Now it's making me a little nervous that this drug can cause slight decreases in kidney function "at first" (she says) but in the long run it's supposed to protect the kidneys. When I read around about it, I saw that it can actually cause decrease kidney function and/or increased potassium levels. The doc does want me to come in after a week to have these checked.

Now how does something that decreases kidney function protect the kidneys? I'm not sure how they know that, or if they even know that....

Are any of you guys taking this drug? Did it help your BP? Do you remember what effect it had on your creatinine levels?

I read somewhere online that 20-30% increase in creatinine was considered ok. My creatinine is about 1.7-1.8 right now. So I'm guessing it'd be ok to have my creatinine go up to 2.3. That makes me pretty uncomfortable.

Does anybody know what creatinine levels need to be before you need dialysis? I have no idea how far 2 or 2.5 is from being kidney failure. I know lots of folks on here have 1 kidney and are under 1.5 (which is normal even for 2 kidneys).

I asked the nephrologist if a BP of 140/90 is even harder on 1 kidney than on 2. She seemed to think it was, but actually I didn't get a great feeling that she really knew the answer to that question. She did say that with 1 of my kidneys gone, the total number of nephrons doing the job was reduced by half at least and that that means my other kidney is having to work twice as hard as before to do the same job, so she thinks I'm at greater risk for "wearing this kidney out". I can imagine that, but is a kidney different than a muscle and does it not get better with exercise? :)

Thanks for listening to my rant about kidneys, BP, and having only 1. I'm just not sure if I'm going to take this drug tomorrow. There's a rare side effect where it causes swelling in the throat and face that requires hospitalization (and they have to insert a tube so you can breathe). Now that one scares me. I feel like I'm playing Russian roulette with my health when I take some of these pills. I guess the good news is there are like 100,000 empty chambers and only 5 bullets in the case of this particular problem. I just hope the benefit is worth the risk. I wish my doctor convinced me that she really knew the benefit would be worth the risk. When she said "the theory is...", that didn't give me great confidence. I don't want to take potentially dangerous drugs based on theories!

Todd

 

Jojo61's picture
Jojo61
Posts: 1310
Joined: Oct 2013

Well Todd, I am kind of curious to know this answer as well. It is sort of the "what came first? the chicken or the egg?" quandary. They say kidney problems are caused by blood pressure, or is it the bp medication that causes the problem? I have taken BP meds for some time now. But about 2 years ago, my blood pressure got pretty high,and the doctor kept trying different meds to get it down. He finally did and it was olmetrec with a diuretic. I am still taking it today. However, I wonder if the doctor should have investigated more back then to see why my pressure was being difficult to control. My tumour would have been discoverd a lot sooner. When I had my kidney out in December, my family doctor asked me to ask the specialist if I should stay on the BP meds (he was new, young doctor - but I liked that he thought that far!) My specialist was very non-chalant about it and said "is your blood pressure normal right now while taking the meds?" I said yes. "Then stay on it". I have since had to go to my family doctor (had a seizure or a mini stroke) so he took my bp and it was perfect. And I had not taken my meds that day. So now I need to monitor it more closely and see how it goes.

All these worries and concerns...it is never ending! lol. I guess I am officially an old person! *sigh*

icemantoo's picture
icemantoo
Posts: 3218
Joined: Jan 2010

I have been taking blood pressure medicine for at least 30 years. The dosages and types were increased when my nephrologigt wanted to get my blood pressure down to 120/80 because of Stage 3 Chronic Kidney Disease. I have been pre diabetic and overweight for years. It got to a point where I was lethargic and did little activity and I had enough. I wanted to get off all this medicine. In March my weight reached a new high of about  242. I was eating fast food too much and not really wathching my portions or the type of foods I was eating. A diagnosis of reflux and pre Barrets Esophogus stopped my after dinner snacks. I lost a couple  pounds. I stopped eating fast food. I lost a couple more pounds. I started watching what I was eating and lost a few more pounds. I went in for a physical and had lost a total of 20 pounds. But my blood numbers should I had diabetes. On my lasy 2 visits to the Neph doctor my blood pressure was too low. My bp medications and dosages were reduced each time. My GP sent me to a Medicare approved diet program. I have completely changed the foods I eat except I still have a large steak every week. My bp regularly reads 120/70 with 1/3 of the bp medicine I was on in the past. Today I finally got below 210 pounds ( a 10 year low),  on my way to the 190's. I still am planning a big barbeque rib dinner for the 4th of July, but with healthy sides. My solution to high blood pressure-lose weight. If  I can do it anybody can. I am feeling better with 3-10lb bar bells removed from my mid section.

 

Next week I have a follow up visit with my Urologist for an enlarged Prostate and high PSA numbers.  A few weeks ago he was thinking of a biopsy. Sorry, wrong board. The fun never ends. I will be 71 this month.

 

 

GSRon's picture
GSRon
Posts: 1304
Joined: Jan 2013

Lots of causes for high BP. but some of the Cancer drugs have that as a side effect.  I am on Metroprolol, which is working just find for me...  There are a bunch of different BP drugs... diet and weight are two factors for sure.

Ron

NewDay's picture
NewDay
Posts: 273
Joined: May 2012

I had HBP for many years and took Norvasc which seemed to control it very well.  I was told to stop it when my pressure was on the low side, oddly soon after my RCC was discovered.  I have had to go back on it since I started Inlyta.

I have chronic kidney disease.  According to what I have read, including on the National Kidney Foundation website, they don't really know which comes first, the CKD or the high blood pressure.  If one gets worse, so does the other.  Kidney function is usually measured based on our eGFR (estimated glomuler filtration rate).  It is calculated using your creatinine, age, race, and gender.  A young, healthy person would have a eGFR of 100 meaning their kidney function was 100%, but it drops as you age.  Normal for my age would be around 75.  My creatinine got as high as 1.9 after my nephrectomy which meant my eGFR dropped to 27.  That put me at stage 4 CKD.  You need dialysis when you get to stage 5.  You  become stage 5 when your eGFR drops below 15.  In my case, my creatinine would have to rise to 3.3 for that to happen.  Fortunately, over time, my creatinine has gotten back down to 1.5 putting me back at stage 3 CKD.  You can google to find a website with an eGFR calculator that lets you plug in your age, creatinine, race, and gender.

I’ll mention here that eGFR is an estimated number using your serum creatinine.  To get an exact GFR, you have to have a 24 hour urine test.

I’m not in the medical field, so I’m not an expert.  This is just based on some of what I have read and some of what my nephrologist told me.

I hope this helps.

I recently made a trip to the emergency room with a BP of 202/136.  They told me that they didn't worry about it being that high unless it stayed that high for a long period of time and I also had symptoms which surprised me.

Kathy

 

 

GSRon's picture
GSRon
Posts: 1304
Joined: Jan 2013

Hi Kathy... Norvasc or Amlodipine..  is OK in small doses, but not good in larger or regular doses, according to our depated pal Trevor.  I was on Norvasc as a suppliment to the Metorprolol before my P.V. was discovered.  Now back only on the Metroprolol.   I get headaches when my BP gets to around 150 / 99.  This early warning allows me to react a bit quicker.  High B.P. is not good for several reasons... 

Ron

todd121's picture
todd121
Posts: 1425
Joined: Dec 2012

Hearing the creatinine numbers that would be kidney failure makes me feel a little better. I'm pretty far from that at the moment at least. The kidney I'm left with was the smaller of my kidneys and it also has a small cyst in it. I just hope the drug helps.

Best to you Kathy. And thanks to everyone that responds. I read everyone's responses and appreciate your feedback (Jojo and Ron), even if I don't respond to every person's comment.

Todd

todd121's picture
todd121
Posts: 1425
Joined: Dec 2012

Congratulations on your weight loss!

I'm 5'8" and my weight is about 217 right now. Frustratingly, I don't eat that bad or that much. I rarely eat fast food, don't snack, rarely drink alcohol. I try and eat lean meat in small quantities, and vegetables/legumes regularly and fruits and only whole grains. I use only olive oil, rarely eat fried food. Rarely eat ice cream. I'm pretty sedentary at my job where I have to sit all day at a computer, but do try to get 1-2 miles brisk walk in 2-3 times a week.

Obviously I need to do more.

After my nephrectomy I got down to 207 or maybe even 203. I was up at 224 before that I think. 5 years ago I had a big stress when I was going through my divorce. Following my divorce I had no appetite. In 6 months my weight went down to 190 and eventually to 185. I stayed there for a couple of years, then I started having issues that interfered with my exercise routine. Shoulder injury then I had to have a hernia surgery which really interrupted my exercise routine. My weight started creeping up again.

I started my first dose of lisipronil last night before bed. The nephrologist said it had kidney sparing qualities even if BP wasn't reduced and that it should help protect my kidney function. I just don't know if they've proven what she's saying. She said it might cause slight increases in my creatinine and potassium so I have to go in next week to monitor that.

I felt a little dizzy when I started the drug and a little bit today as well, but not bad. My BP was down 128/78 this morning, which is good. I hope it does what she says. I'm so tired of taking drugs that they seem to not fully understand what they do or how they work or even for sure if they work, and risking other health. The body just seems like if you push one place, something pops up/bulges in another place. Lol.

Todd

 

LynninNC
Posts: 16
Joined: Jul 2013

Hi Todd. It was elevated BP that was the first sign something was going on with me 2 and a half years ago. I became more tuned in to my body when a regular medical visit showed my BP was "stroke level" . That got my attention. 2 weeks later my tumor was discovered.    I then had elevated BP  (130/90 range) as I was screened for a clinical trial for votirent 2 month post-op. Votrient increases BP so I needed to get mine down in order to qualify for the study. I was put on a low dose of lisinopril, 25 mg I think. I remained on the meds until June 2014. I was no longer on the study regimen and my BP was registering low. My surgeon had suggested I shoulod stay on the medication for kidney health but the study docotr agreed I could try to go off it. I exercise, have a good diet and am aware of salt intake. I still have occasional spikes but feel like it is under control. Emotionally it helps....another thing I can take control of. 6 or 7years ago I really went into a funk when I started taking thyroid meds....my first forever prescription. So going off the lisinopril made me happy.   I had no problem with the medication and hope you do not either! Cheers. L~

thaxter's picture
thaxter
Posts: 124
Joined: Jan 2014

I was treated for BP a couple of years before my tumor was found. hadnt been to any doc for years and went when my BP measured 170/110. It had always been borderline high 130/90 without any treatment. Started on lisinopril/HCTZ and later amlopidine. My weight went from 250 down to below 200 in about two years which was due to the kidney cancer. It did lower my BP and A1C though. Following surgery I was about 180 but gained weight and felt better. was off of any meds except IL-2 rounds in 2014. BP was 120/80 and A1C down to 6.7--no diabetes meds. Votrient started last Nov raised BP to 150/100 and asked the doc what would be easiest on my kidney to control BP. i take 12.5 mg of HCTZ and that has it down to 130s/80s. I now weigh about 215 at 6 feet tall. Blood sugars are OK. My creatinine has been 2.0 to 2.2 ever since the nephrectomy in 9/2013. But last one was 1.9. I don't get IV contrast for my scans.

aamdsi
Posts: 284
Joined: Apr 2014

I went in for an eye exam (found a blind spot in my vision one moring) and was immediately admited to the hospital Cardio unit.  Dr.s were surprised I hadn't "Imploded" my BP was so high!  I hadn't been feeling bad or anything, and beyond a headache most mornings - life was good. In fact had done a loing swim that very morning.

Then it was when they were trying to determine what caused such extreme hyper tension (220/100 - yes that is what it was), they discovered the tumor. 

Had a open partial a year ago and am now on Lotrel.  Was on something before this, but it ended up making me so dizzy, they lowered the dose.

Someone earlier mentioned the "Chicken or egg" thought behind cancer and HBP, but I still have it a year later and if that's the worse that comes from all this - so be it.  One pill a day is okay  to me 8-)

Oh - since I have started taking meds for HBP, I have yet to have another headache AT ALL!  Nor (for some odd reason) have I had to take any allergy meds. (am/was allergic to molds and mildews).  Weird.

BellaBinksMom's picture
BellaBinksMom
Posts: 78
Joined: Sep 2014

Todd -

I have taken Hydrochlorathiazide for many years.  I do notice then when I lose weight, my BP stabilizes.  I have lost apprx. 35 lbs. since my nephrectomy in December and my BP now stays at 118/72.  I no longer take the Hydrochlorathiazide daily.  I believe that getting to a healthy weight when we have only 1 kidney can't hurt, right? 

I asked my urologist and my Primary Care doc if the BP meds are harmful to the remaining kidney and should I stop them - both said that high BP was more harmful and that my losing weight would go along way in helping me to lower my BP naturally. 

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