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Questions and Answers
Kidney Dialysis, diarhhea, low blood pressure and fatigue? My friends father has "Focal Segmental Glomular sclerosis" and he has low blood pressure frequently when he is done with dialysis although they continue to give him 200mg of metoprolol and lisinopril every day. He also has chronic fatigue and diarhhea. His elecrolytes are being monitored from time to time per my mother but he is so tired. He has been on dialysis for 3 1/2 years now. Is diarhhea normal for dialysis patients?

impurrfect10 replied: "Yes it is. My husband was on dialysis and now has a new kidney. I hope your friend feels better soon."

After I had a stent put in-blood pressure is low? would appreciate some suggestions other than metoprolol (which I am taking now) cause I also take xanax, which lowers my heart rate. My pressure was 90/50 at my 3 month checkup. Dr. said it just meant my heart didn't have to work as hard but I think it is too low. I have NEVER had HIGH blood pressure even when they found the blockage. Can you help me? and Thanks

waltcosmos replied: "do you get tired more than normal? And why was a stent put in? Which artery? Not that it matters. I had 3 put in and about 6 or 8 months after the operation, I discovered I had developed anemia for some reason. So I started taking iron and that helped more than I dreamed. Before that, I thought I'd NEVER see Europe again. Now, I friggin LIVE here!"

Will birth control pills make you blood pressure go up? I started taking Ortho-Tri Cyclen 2 months ago. After the 3rd pill from my 3rd pack, I threw them away. My blood pressure was shooting way up. I had never had blood pressure problems before. Now I am taking low dose of Metoprolol and HCTZ. Will my blood pressure return to normal after these get out of my system? My gyno says it will take 4 -6 weeks. I am 39, don't smoke and have never had high blood pressure. It does run in my family.

ฬ. ♡ replied: "Go see your doctor, and discuss it with him. he should have checked your blood pressure before giving you a new prescription."

Barbara replied: "Yes it can. I know from experience. I was on Ortho-Tri and then changed to Yaz. My blood pressure increased to 160 over 100 (normal is around 125 over 80) plus or minus of course because it does range of course. I had to go off of birth control and it took me a year to get my blood pressure under control. Now it is hard to say if it is 100% from your birth control, because there are so many stressors in our lives. However, if you smoke or are overweight birth control can make this increase especially. But yes there is some evidence to indicate that it does increase your blood pressure. Please see your doctor. I ended up having to go on pills to decrease my blood pressure because it is dangerous. Good luck! :)"

Apart from Beta Blockers what other drugs lower blood pressure? I am on Metoprolol, but because it slowed my heart rate down, the doseage was reduced, but I am still tired all the time even on 25mgms

Diane A replied: "There are several classes: 1. diuretic types (common one is HCTZ) 2. beta blockers 3, Calcium channel blockers 4. ACE (angiotension converting enzymes) inhibitors 5. some newer ones. Make an appointment to sit down & really discuss your side effects with your doc."

Keeshu replied: "Diuretics, ACE inhibitors, vasodilators are a few, and there are a number of others."

cheryl v replied: "once you get use to it you shouldnt get sleepy as much but apple cider vinager tsp 2x day and garlic just sprinkle some on your food daily that will lower your blood pressure."

cardiophile replied: "Several groups: alpha blockers, combined alpha and beta blockers, diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers etc."

How long does metoprolol work for blood pressure? And what about heart rate? Hi, I have been having trouble getting my bp down and yesterday my dr put me on 50 mg of metoprolol er and is also having me continue a low dose diuretic. Before taking metoprolol my bp was running 140/90 with a resting pulse of about 73. After taking just one pill my bp is improved 125/90 which is great. Will I continue to see improvements with my bp as I continue to take it, or will it begin working right away? Also, I'm very concerned that my pulse is too low already. It was about 57 today. I realize that's not that low, but if metoprolol takes a while to "kick in" should I be worried about my pulse? Any advice would be appreciated- I'm only in my 20s and am very worried about this!!

JoelKatz replied: "It's hard to predict exactly what you'll see. There will be some increasing effectiveness with increasing blood levels. There will be some decreasing effectiveness with increasing resistance. Hopefully, your diastolic pressure will continue to come down a little bit. If your heartbeat drops below 50, you should start to get concerned. This is a drug with many side effects and downsides. You should definitely work on a long-term plan to get yourself off of these drugs if at all possible. That may include weight loss, diet changes, increased exercise, and so on. Are you sure your resting pulse readings of 73 and 57 are reliable? If you only took each one once or weren't resting very long, they may not be terribly meaningful. But metoprolol definitely does cause heart rate reduction. If you smoke, you need to work on quitting."

chantal_mullen replied: "Metoprolol is a beta blocker. Look up beta blockers and their actions... which in turn lower your heart rate. Plus you are expensing the fluid from your system at the same time. The doctor should want to see you back soon? It will take your body some time to get used to it. Metoprolol does come in an extended release formula that doesn't "bottom you out". It is called Toprol XL. Which I in fact take. Your bp is great and metoprolol is a great medicine. Watch your sodium intake and keep track of fluids going in and out. It would be smart to buy your own bp cuff if you haven't already. Follow up with your md. BTW I take my toprol at night to make myself feel better and if you are taking your pulse at rest it will be low. Normal is 60-100 beats a minute. Just keep an eye on it."

SZO replied: "Metoprolol also reduces the force of contraction of heart muscle and thereby lowers blood pressure. By reducing the heart rate and the force of muscle contraction, metoprolol reduces the need for oxygen by heart muscle. Since heart pain (angina pectoris) occurs when oxygen demand of the heart muscle exceeds the supply of oxygen, metoprolol, by reducing the demand for oxygen, is helpful in treating heart pain."

I had a stent put in my RCA - I have never had high blood pressure? But my cardiologist put me on blood thinner - metoprolol - and when I went for my 3month check up my blood pressure was 90/50. I thought that was low but was told it just meant my heart didn't have to work as hard. I also take xanax for my panic disorder and xanax also lowers my heart rate. So - I don't want to take the metoprolol and need something for my heart which won't make my blood pressure so low. Would really appreciate some suggestions. Thanks so much. SORRY - the medication is for high blood pressure NOT A BLOOD THINNER. The blood thinner is a statin, which I DO TAKE along with an 81 mil of baby aspirin. It is the blood pressure medication I think I do not need. All this medical stuff is confusing. !!!

formerly_bob replied: "You really need to talk to your doctor about this. Most of the time, blood thinners are not needed with a stent, but some types of stents don't work right without blood thinners. Ask your doctor if you can discontinue the blood thinner, lower the dose, or switch to a different thinner. A blood pressure of 90/50 is low, but OK as long as you aren't experiencing dizziness, fatigue, or fluid retention (puffiness in extremities)."

Tracy M replied: "How do you feel? If you feel fine, then the blood pressure is not something to be concerned about. Since you have known coronary disease, your doctor prescribed you metoprolol (a beta blocker) to reduce your risk of a heart attack. It does lower blood pressure, but in your case, it was probably given to you to reduce the workload of your heart. If you feel poorly, then he/she can reduce your dose or maybe even stop it. Keep a little log book of your heart rate, blood pressure and how you feel to take with you to your next appointment. This will help your doctor decide if you should stay on it or not. You mentioned a blood thinner, I'm guessing Plavix, which works along with Aspirin to keep your stent patent. It's important you keep taking it for as long as your doctor wants you to take it, do not stop without his permission. Some stents can develop clots in them if you stop too soon. The statin is a cholesterol medicine, which in some cases can reduce your risk for a heart attack as well. This will not affect your blood pressure. Talk to your doctor before stopping it."

michael G replied: "Statins are not blood thinners. They treat cholesterol. Plavix or heparin, along with aspirin, is usually prescribed as a blood thinner."

mago replied: "metoprolol will lower your BP and it will decrease your heart rate...and yes a lower blood pressure makes for less pressure in your body that your heart has to pump against....these are all good things for you...you need to discuss your concerns with the cardiologist or a nurse in their office so you understand the importance of this treatment for your heart's benefit...do not stop taking this medication..."

What is the best natural thing to do for high blood pressure? I am 56 yrs. old and have always had low blood pressure. Just recently my blood pressure has gone up. I have had severe head aches, lots of pain in my chest, arms and cramps in my back and legs... Since I have acid reflux also I never know if the pain is from that... I am on thyroid medicine. I thought maybe it was too high. The Dr. says no. I was put on 25 mg Metoprolol once a day. The last few days I have been taking it twice a day because my blood pressure has been going up in the evening also. I feel real awful when my blood pressure is high. It is very hard to function... I have 3 teenagers to care for and am finding it almost impossible....

centraljew replied: "The best natural thing to do is to limit the amount of sodium in your diet. Stay away from foods naturally high in sodium and do not add salt to ANYTHING. I would also advise you talk to your doctor. If the metoprolol alone is not controlling your blood pressure you probably need to be on a different drug or a combination of drugs. There are many other drugs that you can use in addition to metoprolol. I am always leery of taking herbal supplements to control blood pressure as they are unreliable and often times inconsistent. Call your doctor fairly soon as high blood pressure can carry serious consequences."

Elsie replied: "The only natural things that I have found to work is plenty of exercise and staying away from caffeine and salt. My sister had a similar problem with her blood pressure going up at night. The doctor gave her a vasodialator (catapress) that seems to have cleared up the problem.... She is 42. She had previously tried taking her regular blood pressure med as you did twice a day, but the doctor thought that the cause of her blood pressure problem was hormonal and a different type of med would be better. Ask your doctor about it."

Journeying through Yahoo! replied: "Better Stress Management.... You said NATURAL..... Otherwise a mild sedative, legal or illegal....;-)..... Your teenagers will know about the illegal ones.... Remember, DEATH will also cure the high blood pressure issue....."

David S replied: "Sodium sensitivity is a significant factor in hypertension. Hydration can also make a difference so drink a lot more water and cut out coffee and especially soda with artificial sweeteners. Family history can be a guide but if your parents or grandparents seemed "fine" with a particular thing in their diet, don't take that as a green light for your diet. The new field of epigenetics suggests that gene expression is more complex than anyone ever imagined. Let your doctor worry about your "sickness" and focus on wellness. That's the other side of the coin and that's the part which is your responsibility. Good luck!"

Alicia M replied: "i'm 30 and have high blood pressure already. it used to be low, but i started taking an antidepressant that caused my bp to rise. some things that have helped me a lot: 1. change in diet. low/non fat, low/no cholesterol, low sodium. cut out red meat, or better yet, all meat (beside fish), cut out/down on cheeses (esp. hard cheese), try to cut out sodium as much as possible, cut out caffiene and alcohol if possible (i still love coffee, but i'm drinking much less). cut out all processed foods. 2. don't smoke. that is a really big one. 3. manage your stress. meditate when you can; and remove yourself from stressful situations if possible, even if only for a few minutes. 4. garlic is shown to help blood pressure. also, i SWEAR by flaxseed oil, and fish oil and primrose oil (taken separately) are also proven to help. vitamin E improves heart function and acts as a blood thinning agent (do not take with prescribed blood thinners). take your multi vitamin too! 5. eat a high fiber diet (very important) and lots of fresh fruits and veggies. 6. avoid over the counter cold and allergy meds and anti histamines. 7. ask your family if you snore when you sleep. people with hypertension often suffer from sleep apnea, which can effect high blood pressure. 8. excersize! (i know, it sucks) at the least, try to walk at least 30 minutes per day. aerobic excersize seems to be the most effective for lowering blood pressure. it also helps to maintain weight, which plays a major role in blood pressure problems. these are just a few of the things you can do to help. there are good books out there to help you out too."

Wrscorpio replied: "You're just going to have to take time to take care of yourself. You also need to talk to your physician because you are taking more than the recommended dosage of the metoprolol. Metoprolol is one of many beta blockers used to treat hypertension; there are also things called calcium channel blockers and ACE inhibitors your doctor could try with you. Stress does have a huge effect on your blood pressure. I'm a nursing student and tend to go, go, go. I ended up at the doctor w/ a blood pressure of 156/101 and I'm 22. I'm having to prioritize and realize that my health comes before an A, or before trying to be a super friend, super daughter, etc. Talk to your teens and tell them that you need for them to help pick up or you may cause yourself serious illness or death. If they argue about not wanting to, just remind 'em that if you've passed away, then they won't have any of your help at all."

Susan Yarrawonga replied: "Fish oil, garlic and many other natural remedies that you can find in a search for "high blood pressure" + "natural remedies"."

how does blood pressure medication work? Well i kind of get the jist of how it works I just don't understand how your body knows when to make it stop working. I have been taking metoprolol for a few weeks now and I have been monitoring it at home and it has gone done from it being 160 over 102 in the doctors office ( I get the white coat syndrome, at home it was mid 140's over 90) but I just took it again and it was 125/80. So my question is really if i stay on the meds will it keep lowering and then cause a low blood pressure problem? Thank you

Dr.kafi obad. MD replied: "WELL,it is important to make the diagnosis of hypertension clear..that is by Clinical evaluation including Fundoscopy& making: Echo,ECG,.... Currently you checked your blood pressure while you are taking Metoprolol,and this mean that either this is the drug which bring it down or you are not having hypertension. This drug is not bad for your health even if your not hypertensive. Don't stop it until your cardiologist till you to do. BEST WISHES"

THOMAS W replied: "The simple answer is no. You have been on the medication for a number of weeks and not suffered any symptoms. It appears as if the medication is doing the job it was designed to to which is to get your blood pressure down"

Queryman replied: "It is a misconception that when you take a fixed dose of anti-hypertension medication, the BP will go on falling till you reach very low levels. Once the dose is titrated against your BP, that is what you need to keep your BP under control. It is like weighing on a physical balance: When two sides are in balance, unless the contents of any of the two panes - in this case, your BP on one side and the fixed dose medication on the other - changes, the state of balance does not change."

Dr. B replied: "There are many blood pressure medications available and each class has a different mechanism of action. Metoprolol is a beta blocker that decreases the heart rate, force of contraction of the heart and causes dilation of the blood vessels. The blood pressure lowering effect of any medication is determined by the dose. Most patients with high blood pressure require blood pressure lowering medication for the rest of their life otherwise their blood pressure will return to previously high levels. Blood pressure medication at the same dose will not continue to lower blood pressure, because it should lower the blood pressure to around the same level when you take it. For example in your case your baseline blood pressure is around 140/90 and you would always expect to get a blood pressure of around 125/80 when you take the same dose of your medication. I hope that makes sense, but if not let me know. Sometimes if too high of a dose of blood pressure medication is given then a low blood pressure can occur. The dose of the blood pressure medication should be reduced then. Good luck."

My diastolic pressure blood pressure is really high and I'm pregnant? ok so, I'm on Metoprolol to lower my heart rate. I am a 5'8" 130 lbs 21 year old female with circulation problems. I am also 12 weeks pregnant My doctor wanted me to monitor my blood pressure and heart rate standing and sitting and report back to him in 2 weeks but the standing pressures seem very high and weird so I called him and neither him or his nurses or in the office today. Here are my pressures, what should I do? I don't want to miscarry! *I take them three times in a row couple minutes apart sitting then 2 or 3 times a couple minutes apart standing* Last Night First reading (not so bad in my opinion) 8 pm - sitting - 107/87 HR 86 113/80 HR 88 111/85 HR 96 -standing- 126/96 HR ? 129/89 HR 108 127/89 HR 120 Second reading (where I start to get a little worried): 11:09 pm- sitting- 135/86 HR 82 130/88 HR 88 127/79 HR 80 -standing- 135/96 HR 107 137/ 99 HR 118 This mornings reading (didn't take my metoprolol yet): 9:30 am - sitting- 126/87 HR 86 118/77 HR 84 122/83 HR 86 - standing- 126/95 HR 124 117/99 HR 144

Kathryn M replied: "You're doing the right thing by monitoring your pressure so closely. What concerns me is that sometimes, high blood pressure (namely the bottom number) is sometimes an indicator of a bigger problem. For example, my blood pressure was crazy last spring but I had no history of high blood pressure. My doctor discovered that I had thyroid cancer. I don't say this to scare you, just to tell you that sometimes, it means there is something causing the jump. The other possibility is gestational hypertension. This can be controlled with medication, however, your risk of preeclampsia is higher. Your doctor needs to refer you to a cardiologist to have the proper tests done. Good luck!"

Question about my blood pressure medications? My doctor prescribed 2 blood pressure medications for me. Since February of 2006 I have been taking both medications. One is a Beta Blocker and the other is an Ace Inhibitor. One is Metoprolol 25mgXL & the other was a very small dose (2.5 mg) of Lisinopril. A couple of months ago I started feeling sick, I was seeing spots, feeling tired, lightheaded, weak, and dizzy all the time. I have a blood pressure machine at home and I would check my BP every other day and it was always kind of low, sometimes 99/55. Sometimes even lower. Even checking while at stores it would be kind of low. At my doctor appointment my BP would run 101/64. I complained to my doctor about how I've been feeling and asked about being taken off the small dose of lisinopril but he didn't think that I should stop taking it. He said it was a very small dose and my BP is great. Well...... I have to confess that I eventually took it upon myself to discontinue the lisinopril on my own. I did it slowly, skipping doses every other day, then only takeing it 2 times a week to eventually not taking it. It's been about 3 weeks since I've been off the med now and as far as my symptoms, I'm feeling better that way. BUT.... I've noticed several times throughout the day my heart feels like it skips beats. My blood pressure is running 124-76 or lower and I won't see my doctor again until the end of January. My question is: could my quitting the lisinopril be the reason I feel my heart thumping like it skips beats? Thanks for all advice. I'm 34 years old and have already had a stent placed in my LAD in Feb. of 2006 I should also mention that I also have a history of a Pulmonary Embolism, and as a result of that I was tested for clotting disorders after coming off the Coumadin therapy. I tested positive for Antiphospholipid Antibody Syndrome and now require lifelong coumadin therapy.

zini replied: "Aside from your true question I personally would have reduced your dose of the beta blocker as these are currently out of favour with NICE guidelines and are a last choice treatment for high blood pressure. Your palpitations (skipped beats) are probably nothing- everyone's heart may miss or add a beat every now and then, but if the sensation is lasting for a while (10seconds+) and is noticed quite often (several times a month) it is a bit more concerning. I suggest you go to the doctor about this to have your heart rhythm checked. I think it's unlikely related to your stopping the ACE inhibitors as these lower the blood pressure without involving the heart. You dont mention how old you are but two possibilities your doctor should rule out are hyperthyroidism and atrial fibrillation."

Bradgideet replied: "I agree with atrial fibrillation. Ask your doctor about the possibility of an arrhythmia for sure."

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