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Have A Mitral Valve Prolapse. Taking Bystolic. Have High BP. Prescribed Diuretic In The Morning?
I have been going about 1-2 times per month for past 3 months to internal med phys for fluctuations high (highest 195/191) to lows (lowest 76/66). I have had EKG, renal ultrasound, adrenal 24 hour urine testing. Waiting on adrenal results but other tests were fine. I have a mitral valve prolapse but he said that was minor. He has been trying several different meds. Right now I am taking 10mg of Bystolic each morning and when my number is over 160 or over 90, I take as needed clonidine. Since Bp has been consistently high all week and today at his office it was 136/96, he prescribed a dieuretic for tomorrow morning. However tonight it dropped to 90/66. This is very baffling. Should I be concerned or looking for another physician or is this normal to take so long to get right combination? I am a little worried to take the diuretic in the morning! Thank you!!!
Mon, 8 Jul 2013
Hi and thanks for the query,
It is but certain that the diuretic certainly should be effective in reducing your blood pressure. The reduction however is drastic, but the limits of 90/66 are still however acceptable. I would suggest observance and careful supervision of your blood pressure and other signs and symptoms of severe low blood pressure (hypotension). Blurred vision, fatigue, rapid pulse which is weak should be checked for.
I slight reduction in the dose of the diuretic, without altering the dose of the other usual drugs could be helpful till you meet your physician.
Other conditions in mitral valve prolapse like prophylactic antibiotherapy for fear of endocarditis and vaccines against Hemophilus and Pneumococci should always be remembered within your patient care plan.
Thanks and hope this helps.
Kind regards,
Bain LE, MD.
It is but certain that the diuretic certainly should be effective in reducing your blood pressure. The reduction however is drastic, but the limits of 90/66 are still however acceptable. I would suggest observance and careful supervision of your blood pressure and other signs and symptoms of severe low blood pressure (hypotension). Blurred vision, fatigue, rapid pulse which is weak should be checked for.
I slight reduction in the dose of the diuretic, without altering the dose of the other usual drugs could be helpful till you meet your physician.
Other conditions in mitral valve prolapse like prophylactic antibiotherapy for fear of endocarditis and vaccines against Hemophilus and Pneumococci should always be remembered within your patient care plan.
Thanks and hope this helps.
Kind regards,
Bain LE, MD.
I find this answer helpful
Thanks for your question.
I would suggest that you should monitor your blood pressure at home three times daily and keep a record.
Morning, afternoon and before going to bed. It is necessary to monitor blood pressure at home at different time intervals because of 2 reasons;
1- you might have an exaggerated blood pressure response while in clinic (White coat hypertension).
2- At there is normally 10% decrease in blood pressure at night time, therefore, increasing the dose might decrease blood pressure significantly at night time.
That way you and your physician would be able to manage blood pressure more appropriately without any wide fluctuations.
Hope that answers your question
I would suggest that you should monitor your blood pressure at home three times daily and keep a record.
Morning, afternoon and before going to bed. It is necessary to monitor blood pressure at home at different time intervals because of 2 reasons;
1- you might have an exaggerated blood pressure response while in clinic (White coat hypertension).
2- At there is normally 10% decrease in blood pressure at night time, therefore, increasing the dose might decrease blood pressure significantly at night time.
That way you and your physician would be able to manage blood pressure more appropriately without any wide fluctuations.
Hope that answers your question
I find this answer helpful
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