Blood pressure

[cheshiremaserati]

Wow...so you were the main man on this stuff, excellent. I'm not diabetic but because blood pressure and heart issues run in my family the Doc decided to put me on Cholesterol lowering medication anyway to reduce my risk. I was hovering between 4.7 and 5.0 before medication.

Sensible advice from your doctor - the game is all about what they call "risk stratification". based on modifiable and non-modifiable risk factors, If you have a strong family hisotry it makes sense to intervene early. That dose of lisinopril was a test dose to see how the patient responds to this class of antihypertensive. They were titrated upwards to target BP in a matter of 2-4 weeks to reach maintenance dose of 10-20 for BP (higher for heart failure). I'd be surprised if 2.5 has you at target BP. In fact that dose is not available in some countries with all patients starting at 5mg. once daily. Atorva 20mg is good. I launched its competitor Rosuvastatin. It is good - so good that NICE pigeon-holed it after other statins failed to deliver target lipid levels! That killed it off in UK. But Internationally, different story. We went head to head against Pfizer with their Atorva (Lipitor). It has expired its patent so is dispensed as cheap as chips generic from Indian and Eastern European Manufacturers. Cardiovascular medicine is fascinating.

 

[Silvercat]

Sensible advice from your doctor - the game is all about what they call "risk stratification". based on modifiable and non-modifiable risk factors, If you have a strong family hisotry it makes sense to intervene early. That dose of lisinopril was a test dose to see how the patient responds to this class of antihypertensive. They were titrated upwards to target BP in a matter of 2-4 weeks to reach maintenance dose of 10-20 for BP (higher for heart failure). I'd be surprised if 2.5 has you at target BP. In fact that dose is not available in some countries with all patients starting at 5mg. once daily. Atorva 20mg is good. I launched its competitor Rosuvastatin. It is good - so good that NICE pigeon-holed it after other statins failed to deliver target lipid levels! That killed it off in UK. But Internationally, different story. We went head to head against Pfizer with their Atorva (Lipitor). It has expired its patent so is dispensed as cheap as chips generic from Indian and Eastern European Manufacturers. Cardiovascular medicine is fascinating.

Really appreciate the information. I was put on 2.5mg of Lisinopril 18 months ago, had my blood pressure formally checked three times since then by the local surgery nurse but no one has suggested going on a higher dose. I have my own ' Omoron' BP testing machine and Systolic pressure is still around 130-138 but the Dyostolic is consistently below 80. Sounds like I need to re- visit the Docs again after the Covid-19 crisis has settled down a bit.

 

[allandwf]

I was told my cholesterol was exceptional at 3.4 given I didn't really eat healthily. The nurse said it was the red wine, and not to change anything

 

[CatmanV2]

I was told my cholesterol was exceptional at 3.4 given I didn't really eat healthily. The nurse said it was the red wine, and not to change anything

Tested mine three times about a year ago. The first two came back as zero LDL

C

 

[lozcb]

Mine was 6.3 a fair while back but I did eat a lot unhealthy food. Now it's 3.9 I think....

**** ,listening to all this stuff makes me realise how lucky I am , 65 smoker , had hepatitus, malaria twice , denge fever lol, lungs burnt in a fire giving me mild copd , kidneys shut down 5 years ago through dehydration , and I'm still not able to do the 100m running this side of Xmas, but I can walk the hind legs of a donkey when I have to
Knowing my luck and probably kick over all of a sudden , possibly the nicest way to go , rather than dribbling all the way to the pearly gates

 

[Wanderer]

While I was in hospital basically waiting to see if my condition could be ablated with laser or I'd have to have the ICD (which I did) a number of surgeons spoke to me about stents etc (initial diagnosis was blocked arteries - they're clear) and one of them starts telling me I'll need a quad-bypass etc, doom, doom, doom. Told the other people who were looking after me what he said and he said 'I've warned him about that, he's always doing it, painting the bleakest picture'. Just shows even the experts are humans with character traits!

Some have positive outlooks, some negative, some in the middle. Trouble is, as we are not experts, we take the worst view I think.

The amount of worry that guy caused me tho, I'm still not happy about that 7 years later.....

 

[lozcb]

Got a nice piece of platinum and gold given to me by 'Johnson and Mathey', from the Rustenberg platinum mines ( Merensky Reef) in SA. Now that did get the blood pressure heading in the wrong direction!.

Kinda does something to you that nothing else quite manages to achieve , you be surprised at the number of very intelligent very successful business men , that get involved with gold ,and all their gut feeling and business acumen goes straight out the window lol

 

[Wanderer]

**** ,listening to all this stuff makes me realise how lucky I am , 65 smoker , had hepatitus, malaria twice , denge fever lol, lungs burnt in a fire giving me mild copd , kidneys shut down 5 years ago through dehydration , and I'm still not able to do the 100m running this side of Xmas, but I can walk the hind legs of a donkey when I have to
Knowing my luck and probably kick over all of a sudden , possibly the nicest way to go , rather than dribbling all the way to the pearly gates

I get thi'!

I've never looked after myself, but have never smoked or took drugs, like a pint but didn't start drinking until I was 28 so I'm still catching up lol! I used to eat burgers and kebabs all day and night hence the cholesterol but now I don't, don't go all salad but chicken and Fisk, rice etc.

I used to be a decent boxer, and sprinter when young, probs fastest 100yds (at it was then) in school, but it all turns rank when you approach 40. Kids sports day, Annan, Dumfriesshire, 1998, I was 37, parents race, I though 'I'll pìss this' - 10 paces in knees went wonky and I finished second last! I was gobsmacked!

And also my BIL married a very nice young lass, very pretty, 28 years old a lot younger than him but hey-ho, she got cervical cancer was dead in 2 months. And she was a picture of health, certainly looked after herself which neither have me or BIL have. Must be gene pool related.

 

[lozcb]

While I was in hospital basically waiting to see if my condition could be ablated with laser or I'd have to have the ICD (which I did) a number of surgeons spoke to me about stents etc (initial diagnosis was blocked arteries - they're clear) and one of them starts telling me I'll need a quad-bypass etc, doom, doom, doom. Told the other people who were looking after me what he said and he said 'I've warned him about that, he's always doing it, painting the bleakest picture'. Just shows even the experts are humans with character traits!

Some have positive outlooks, some negative, some in the middle. Trouble is, as we are not experts, we take the worst view I think.

The amount of worry that guy caused me tho, I'm still not happy about that 7 years later.....

In my view their should come a time in every man's life ( and only you can decide when) that it's time to take stock , draw up that bucket list ,and start ticking them off, give life planning a rest and a bit of a back seat , and get on with some doing , when your at least half way through the list , re assess the rest , in my case it's to get the missus to enjoy it with me , it's a struggle at times

 

[Wanderer]

Death doesn't worry me, I'd rather not of course, but I am fed up with the endless same-old, same-old, and again, while I'll fight tooth and nail for any extra time on earth, there will come a time when I'll say 'sod it...'

Assuming a bus doesn't flatten me...

 

[lozcb]

I get thi'!

I've never looked after myself, but have never smoked or took drugs, like a pint but didn't start drinking until I was 28 so I'm still catching up lol! I used to eat burgers and kebabs all day and night hence the cholesterol but now I don't, don't go all salad but chicken and Fisk, rice etc.

I used to be a decent boxer, and sprinter when young, probs fastest 100yds (at it was then) in school, but it all turns rank when you approach 40. Kids sports day, Annan, Dumfriesshire, 1998, I was 37, parents race, I though 'I'll pìss this' - 10 paces in knees went wonky and I finished second last! I was gobsmacked!

And also my BIL married a very nice young lass, very pretty, 28 years old a lot younger than him but hey-ho, she got cervical cancer was dead in 2 months. And she was a picture of health, certainly looked after herself which neither have me or BIL have. Must be gene pool related.

Yeah life is full of unexpected surprises, mostly bad ones , my uncles favourite saying ,this ain't a dress rehearsal son ,you gotta make it real first time round , its stuck with me all of my life that and never buy on credit that which you can't afford , and that was from a guy that openly admitted the war years were the best years of his life ,he was a right adrenaline junkie and I guess some rubbed off on me

 

[2b1ask1]

One life; live it, this is no dress rehearsal!

 

[2b1ask1]

I fully intend to hand back this mortal frame in tatters!

 

[Wanderer]

Yeah life is full of unexpected surprises, mostly bad ones , my uncles favourite saying ,this ain't a dress rehearsal son ,you gotta make it real first time round , its stuck with me all of my life that and never buy on credit that which you can't afford , and that was from a guy that openly admitted the war years were the best years of his life ,he was a right adrenaline junkie and I guess some rubbed off on me

When my time comes I'll tanking the CC's the limit, see if the Maser will do 171mph on the motorway (3am M6 after Tebay, no cars, did 140 in my old Alfa 164 there once), try Crystal Meth. With my luck though I'd do all that, get caught, get cured and end up in prison til I die.

But I could do an Andy Dufresne, tunnel out, go to Mexico and invite Morgan Freeman to paint my boat....

 

[CatmanV2]

I fully intend to hand back this mortal frame in tatters!

Well done. Managed that bit

C

 

[lozcb]

When my time comes I'll tanking the CC's the limit, see if the Maser will do 171mph on the motorway (3am M6 after Tebay, no cars, did 140 in my old Alfa 164 there once), try Crystal Meth. With my luck though I'd do all that, get caught, get cured and end up in prison til I die.

But I could do an Andy Dufresne, tunnel out, go to Mexico and invite Morgan Freeman to paint my boat....

Sounds like the makings of a good plan , just omit the crystal meth and I'll sure it,ll happen

 

[cheshiremaserati]

Really appreciate the information. I was put on 2.5mg of Lisinopril 18 months ago, had my blood pressure formally checked three times since then by the local surgery nurse but no one has suggested going on a higher dose. I have my own ' Omoron' BP testing machine and Systolic pressure is still around 130-138 but the Dyostolic is consistently below 80. Sounds like I need to re- visit the Docs again after the Covid-19 crisis has settled down a bit.

The diastolic is the more serious number. Aiming for under 80mm Hg is good. The systolic at 130 is a good number but target BP depends on age and weight and co-morbidities such as diabetes and Chronic Kidney Disease to name just two examples.
BP is dynamic - it changes minute by minute hour by hour, day v night etc. The Omron machine is a snapshot at that moment in time.
I have one. It is very good. but there is only one true and real way to assess BP - and that is over 24 hours. For this they use a Holter Monitor that straps a BP cuff on with a walkie talkie size monitor to your waist and sets it to inflate every 30 minutes or 60 minutes for 24 hours. The next day, the monitor has all your readings downloaded onto a PC and shows total BP peaks and troughs, the average BP load and average BP over a 24 hour period. It is used to assess if BOP tablets are needed (that is to define if someone is hypertensive or not and not just White Coat Hypertension) but also to assess the effectiveness of their medication in controlling BP over a full 24 hours. It may be a good discussion topic to establish the full 24 hours BP control. Of course it cannot be used for every patient - those borderline ones or where the dose of tablet is very low v therapeutic (label) range to establish if there is good control over 24 hours at that dose.

I had a 24hr monitor before being put on treatment and then again at the interval to establish target BP was met. I met many doctors in my professional life - some really impressed me. I wont be unprofessional and knock any of them. Those who did not impress me I'd just describe as we differed on opinion and judgement versus evidence-based guidelines - because we have so many extremely bright clinicians in our family, I am never short of securing a second opinion or establishing what does the evidence point to in terms of good management. I get all my blood test results in print form - none of this "normal - no action needed" and track the numbers on Excel. It has been invaluable on several occasions when I was fobbed off with "normal" results but the numbers were going the wrong way - towards abnormal!

 

[D Walker]

I’m on 10mg lisinopril. Nothing for cholesterol even though mine was high. Nurse told me off and said I had to change my diet. Dr told me it was high but because my “good” cholesterol was far higher than the bad he said no issues. Changing diet may change it 10%, so don’t bother.

 

[cheshiremaserati]

I’m on 10mg lisinopril. Nothing for cholesterol even though mine was high. Nurse told me off and said I had to change my diet. Dr told me it was high but because my “good” cholesterol was far higher than the bad he said no issues. Changing diet may change it 10%, so don’t bother.

Hmmmm.....

https://www.nhs.uk/conditions/high-cholesterol/cholesterol-levels/

Good HDL cholesterol for a man is around 1.0 - 1.2
There is no way the good can be greater than the badunlress your total cholesterol is around 2! Controlling through diet gives small change that is rarely sustained.
I know people who eat a lipid rich diet but are having cholesterol in the 'normal' range around 5.5 - 6.0. And I know tee-total veggies with cholesterol over 7.0!

It is not a simple relationship between ingestion of lipids and levels of cholesterol. It is more an imbalance with the cholesterol metabolism pathway (which is the level statins work,). Check out the NHS guidelines and NICE for yourself. Then consider having an educated discussion with your GP
https://www.nice.org.uk/guidance/cg...ary-heart-disease-and-stroke-pdf-315944122309

https://www.nice.org.uk/guidance/cg181/chapter/1-Recommendations

May the fat go with you!

 

[D Walker]

I have probably put it into words badly. I’ve had 3 visits since. My blood pressure hasn’t increased or my need to change my dosage.
cholesterol remains in same range. As you say it’s very personal.