Managing Blood Pressure and Medication: A Patient's Journey

Q: Managing Blood Pressure and Medication: A Patient's Journey

Hello： You have a wide variety of medications, which may cause some side effects leading to discomfort. <br>It is recommended that you discuss this directly with the prescribing physician to better understand the correct reasons. <br>Dr. <br>Lin Chi-Hsiung

Blood pressure... medication issues?

Hello, Dr.
Lin.
This morning, I took my insomnia medication along with my high blood pressure medication, which includes 0.5 mg of Methylcobalamin (MeCbl) and "Yuli Shupan" tablets at 0.25 mg.
For high blood pressure, I take "An Yao De Wen" tablets at 5 mg, "Bai Ken" 10 mg enteric-coated tablets, "Fu Le Xin" 160 mg enteric-coated tablets, and "Fan Zhi Tuo" 10 mg enteric-coated tablets.
I also take "Ai Bi Mai" sustained-release tablets at 60 mg (I have been taking this for over 7 months).
I have a uric acid medication that I take once a week.
I generally do not consume seafood or have a large appetite, and I drink water and beverages but do not take any medication before sleep, except for "Jing De Ke" 0.5 mg and calcium carbonate tablets at 500 mg, along with a self-paid supplement called "Xin Bo Ning."
My blood pressure has been abnormal, with diastolic pressure often between 60 and 70, and systolic pressure sometimes ranging from 140 to 150.
The abnormal readings are often around 115.
Occasionally, I experience pain under my left rib cage.
Recently, I have been feeling a bit fatigued, and my neck feels very tight and prickly.
I would like to know what I can do to alleviate these symptoms, as I sometimes also experience headaches and dizziness.
I make it a point to walk after dinner every day and try to exercise more when I have time.
Last year, my weight was 115 kg, and now it is 98 kg.
I previously had arrhythmia, and my doctor prescribed medication for a year.
My thyroid-stimulating hormone (TSH) test result was 43, which surprised my doctor, and he advised me to stop taking the medication.
In March of this year, my blood test showed it dropped to 8.37.
My uric acid level is also high at 9.5.
Recently, in April, I visited the gastroenterology department at Chang Gung Memorial Hospital in Kaohsiung, where the doctor diagnosed me with gastritis.
Lately, I have been feeling a bit fatigued, and my neck feels very tight and prickly (the medications mentioned are from two different clinics).
I work as a warehouse manager, and my job is quite demanding.

Cai Xiansheng, 30~39 year old female. Ask Date: 2016/05/29

Dr. Lin Jixiong reply Cardiology

Hello: You have a wide variety of medications, which may cause some side effects leading to discomfort.
It is recommended that you discuss this directly with the prescribing physician to better understand the correct reasons.
Dr.
Lin Chi-Hsiung

Reply Date: 2016/05/29

More Info

Managing blood pressure and medication can be a complex journey, especially for patients with multiple health issues. Based on your description, it seems that you are dealing with a range of symptoms and medications that may be contributing to your overall health concerns. Let's break down your situation and explore some potential steps you can take to manage your blood pressure effectively.

Understanding Your Medications
From your message, it appears that you are taking several medications, including antihypertensives and other treatments for various conditions. Here’s a brief overview of some common medications you mentioned:
1. Antihypertensives: Medications like "安壓得穩錠" (likely a beta-blocker or ACE inhibitor) and "樂心膜衣錠" (possibly a calcium channel blocker) are typically prescribed to help manage high blood pressure. It's essential to take these medications as directed by your healthcare provider.

2. Thyroid Medications: You mentioned a history of thyroid issues, specifically elevated thyroid-stimulating hormone (TSH) levels. It's crucial to monitor thyroid function, as both hyperthyroidism and hypothyroidism can significantly impact blood pressure and overall health.

3. Uric Acid Medication: Managing uric acid levels is important, especially if you have a history of gout or kidney issues. A high uric acid level can lead to joint pain and may also affect kidney function.

4. Sleep Medications: If you are taking medications for sleep, it's important to consider how they might interact with your other medications and affect your blood pressure.

Blood Pressure Monitoring
You mentioned fluctuating blood pressure readings, with systolic pressures sometimes reaching 140-150 mmHg and diastolic pressures between 60-70 mmHg. These readings indicate that while your diastolic pressure is on the lower end, your systolic pressure is elevated. This situation can be concerning, as it may increase the risk of cardiovascular events.

1. Regular Monitoring: It’s essential to monitor your blood pressure regularly at home. Keeping a log of your readings can help your healthcare provider make informed decisions about your treatment plan.

2. Lifestyle Modifications: You mentioned that you walk after dinner and are trying to stay active, which is excellent. Regular physical activity, a balanced diet low in sodium, and maintaining a healthy weight can significantly impact blood pressure management.

3. Stress Management: Given your job as a warehouse manager, stress may be a contributing factor to your symptoms. Consider incorporating stress-reducing techniques such as mindfulness, meditation, or yoga into your routine.

Addressing Symptoms
You reported experiencing symptoms such as chest pain, neck tightness, fatigue, headaches, and dizziness. These symptoms warrant further evaluation:
1. Chest Pain: Any chest pain should be taken seriously, especially given your history of arrhythmia. It’s crucial to consult with a cardiologist to rule out any serious cardiac issues.

2. Neck Tightness and Headaches: These could be related to tension or stress, but they may also indicate other underlying issues. A thorough evaluation by a healthcare provider is necessary to determine the cause.

3. Fatigue: This can stem from various factors, including medication side effects, sleep disturbances, or underlying health conditions. Discussing your fatigue with your doctor can help identify potential causes and solutions.

Seeking Medical Advice
Given the complexity of your situation, it is advisable to have a comprehensive evaluation by a healthcare provider who can review all your medications, symptoms, and medical history. A multidisciplinary approach involving a primary care physician, cardiologist, and possibly an endocrinologist for your thyroid issues may be beneficial.

Conclusion
Managing blood pressure and overall health requires a collaborative approach between you and your healthcare team. Regular monitoring, lifestyle changes, and open communication with your doctors about your symptoms and medication effects are crucial steps in your journey. Don’t hesitate to seek a second opinion if you feel uncertain about your current treatment plan. Your health is paramount, and addressing these concerns proactively can lead to better outcomes.

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