Dr. Rowena on high blood pressure

The following questions were sent by our readers and answered by Dr. Rowena, our Medical Director:

Questions & Answers
What is the effect of salt on your blood pressure?
Updated at: 2017/12/03
Can music improve blood pressure and sleep?
Updated at: 2017/11/20
Is there a connection between being Overweight and Atrial Fibrillation
Updated at: 2017/11/12
Can Sauna lower my blood pressure?
Updated at: 2017/10/15
How many eggs can I eat per day?
Updated at: 2017/10/08
What is the effect of flu vaccine on your heart health?
Updated at: 2017/09/24
Do vacations lower your risk of heart attack?
Updated at: 2017/09/11
What is the effect of your gut health on your heart?
Updated at: 2017/08/21
What is the connection between your teeth health and your heart health?
Updated at: 2017/07/31
Is Shingles disease a cause for heart attack and stroke risk?
Updated at: 2017/07/16
What is the importance of friends for a healthy heart?
Updated at: 2017/07/02
Is it safe to fly with high blood pressure?
Updated at: 2017/06/12
how reasonable exposure to the sun, may lower your blood pressure?
Updated at: 2017/06/04
What is the risk of heart attack in taking pain killers of the NSAID group?
Updated at: 2017/05/22
Are eggs good for your health?
Updated at: 2017/04/23
What are the risks of Fasting while taking Blood Pressure Medications?
Can my hearing improve as a result of lower blood pressure?
Q: Dear Dr. Rowena, Since I have used my Resperate I began to perceive an improvement in my hearing condition. I’m 64 years old and I think that is possible once the relaxation of the vessels enable a better irrigation of the blood. Do you agree?

A: To my knowledge, clinical studies have not been looking at use of the Resperate in hearing disorders. However, it is certainly possible that getting your blood pressure into better control has helped with your hearing. Many Resperate users report good effects other than lower blood pressure from regular Resperate use. The most frequent is improved sleeping at night.

Updated at: 2016/11/13
Do Blood Pressure Medication Lose Their Effectiveness Over Time?
Updated at: 2017/02/12
Are all Strokes attributable to High Blood Pressure?
Strokes that are the result of bleeding into the brain are related to blood pressure. Strokes that are caused by a blocked blood vessel in the brain aren’t necessarily related to high blood pressure.
Updated at: 2017/02/09
How does the time you take your medication affect its effectiveness?
Q: Does the time of day make a difference in how certain blood pressure medications work?  For example, would it be better to take a beta blocker in the am or pm; a calcium channel blocker in the am or pm?

A: Medicines that need to be taken once a day should be taken at the same time every day.  Taking a medicine in the morning or at night is largely a matter of personal preference. You want to take medicine when it is easiest for you to remember. However, some people have fewer side effects when they take their medicine at bedtime.  Also, the effectiveness of some drugs may be less right before the next dose is taken. Because of this, your doctor may recommend you take your medicine in the morning because blood pressure is higher when you are awake and active.

Updated at: 2016/11/13
Is the numb feeling in my hands and feet connected to my high blood pressure?
Q: I have been hypertensive now for over 20 years. When I get cold, my hands turn white as if all the blood has left and become numb. It’s starting to happen in my toes now. Is this related to a symptom of hypertensive people or something else?

A: It sounds like you are experiencing symptoms of Raynaud’s disease. It may be related to your high blood pressure. Some blood pressure medicines can cause this as a side effect. It also could be the result of worsening of your vascular disease.  Other medical problems  also cause Raynaud’s and sometimes no cause can be found at all. You should discuss your symptoms with your doctor.

Updated at: 2016/11/10
Can I Adjust blood pressure medication on your own?
Q: I am taking Linisol for high blood pressure in the morning per my doctor. It made me drowsy for driving and office work so now started taking before bed. Is it okay to adjust on my own?

A: Changing the time of day when you take medication can help control side-effects.  Since your drug made you sleepy, it was reasonable to start taking it at bedtime. The important thing is to consistently take your medicine about the same time of day so you establish a constant level in your blood.  Advise your doctor of the change at your next visit.

Updated at: 2016/11/03
No longer overweight, but still on blood pressure medication, why?
Q: I’m a male who eats a healthy diet, workouts regularly, lost over 50 lbs since being diagnosed with high blood pressure and am not stressed. No one in my family is in shape or eats right, yet they have good blood pressure. Why can’t I come off of my medications? (lisinopril hctz 20/12.5)

A: You did not mention your current blood pressure..is it still high?  If you are in excellent control since your 50 pound weight loss, it is possible you may be able to get off your medicine. You should discuss this with your doctor.  It sounds like your family members are lucky or perhaps just younger. Being overweight and out of shape takes a toll on the body.  If your blood pressure is still high, it may be that you just need a bit more time till it goes down now that you are eating healthy and exercising. Keep up with your healthy lifestyle choices and discuss your blood pressure with your doctor.

Updated at: 2016/10/26
What to do when the side effects of your meds are unbearable?
Q: I take Diovan 320 mg once a day. I have been on it for about 4 months. Since I started taking this medication my scalp has become very tender, itchy and my hair is getting thin. I had beautiful long hair before I started taking this. My Dr. said he CAN’T give me anything else. No other explanation. I can’t stand how my scalp feels. It’s driving me crazy. I have dropped my dose to half a tablet a day to see if this helps, I have lost about 12 LB since I started on the med. through diet and exercise. I’m also a type two diabetic, diet controlled only.

What will happen to me if I go off this medication all together?

A: Hair loss and an itchy scalp are not acceptable side effects. There are many medicines to treat high blood pressure. Your doctor may feel this is the best medicine for you, but you are not tolerating it. If you tell your doctor that you are planning to stop the drug because of side effects, I am sure an alternative will be found.  You also might want to consider using the Resperate to help you lower your blood pressure naturally without any side effects.

Updated at: 2016/10/20
Why is blood pressure lower in the summer?
Q: I am 68 years old with hypertension and taking amlodipin 5mg 1 tablet daily since 2008. I take daily walks 3-4km and have cut down salt intake. Now my average blood pressure readings are 130/83 in winter and 117/75 in summer. Please explain why blood pressure readings are lower in summer?  Can I cut down amlodipin to 1/2 tablet daily?

A: It is well known that blood pressure is lower in the summer. The reason for this is complicated and probably involves factors that are yet to be discovered. The lowering is certainly related to the immediate response of the body to a warmer temperature which causes blood vessels to relax, and the response of the long term regulatory systems of the body. You should talk to your doctor before you make any change in your blood pressure medicine.

Updated at: 2016/10/16
What If Someone’s Blood Pressure Dramatically Increases During Minimal Exercise?
Q: My boyfriend (age 53) takes medication for high blood pressure. At rest his blood pressure is always on the low end of the normal range like 100/64 to 110/70.

However when he exercises his blood pressure goes up to 200/110 with hardly any exertion and he doesn’t even feel like he’s worked up a sweat yet. He is dieting to lose 25 extra pounds. He’s basically avoiding eating red meat and chicken in his diet. Any further suggestions?

A: It sounds like your boyfriend’s blood pressure is not in good control if minimal activity makes it go sky high. He needs to see his doctor. He may want to consider the DASH diet for blood pressure.

Updated at: 2016/10/03
Does alcohol cause High blood pressure?
Q: I went to see my doctor a few days ago and my pressure was 175/118. She gave me hydrochlorothiazide 12.5 mg. I never had this problem before and I want to know if it is because I drink a lot of alcohol every day. I don’t want to take the med because of side effects. I’m only 33 and am too young to be on this med. What can I do to bring my BP down without the med?

A: Your blood pressure is in the range that needs treatment. Starting treatment with a diuretic is standard. You are young and can make lifestyle changes now that will greatly influence your health for the rest of your life.

It is reasonable to stay on the diuretic until you have made all the appropriate lifestyle changes and your pressure is under control. At that time, you and your doctor could consider attempting to stop or lower your medication while carefully monitoring your blood pressure. Excessive drinking is very hard on the body.

Updated at: 2016/09/28
What is Blood pressure levels difference sitting up vs. laying down?
Q: I have hypertension for 15 years. BP is high (about 150/100) when measured sitting up, but normal (< 140/90) laying down, measured within minutes. It has been this way all along. My doctor’s answer does not sound very unconvincing, and I just want to know more about the big difference?

A: Blood pressure measurement varies with position. It is harder for your heart to get blood to your head when you are sitting. Your heart is a pump.

In the upright position, the heart has to pump uphill because your head is located at a higher level than your heart. When lying down, your heart and your head are at the same level. Your heart does not need to pump as hard so your blood pressure is lower. By medical convention, blood pressure is measured in the sitting position.

of blood pressure are standardized to this position. It is well known that blood pressure is lower in other positions but to determine the need for treatment the seated position is used. In other words, to make a treatment determination in a non-emergency situation, your doctor should use the blood pressure taken while you are sitting.

Updated at: 2016/09/27

Dr. Rowena, MD. is a family doctor in Atlanta, Georgia. She has over 20 years of practice experience. In 2016 she joined the RESPeRATE team as the medical director.

Dr. Rowena is in charge of RESPeRATE’s “Ask Dr. Rowena” section, in which she answers general questions regarding hypertension, diet and general health from our newsletter subscribers.