Managing Cholesterol and Blood Pressure: Medication Effects and Women's Health

Cholesterol and Blood Pressure: Side Effects of Medications and Management

Hello Dr.
Wu,
Recently, I discovered that my heart rate was particularly fast while measuring my blood oxygen levels, and I also found that my blood pressure was quite high, which prompted me to start monitoring it.
After measuring for a month, I noticed that my blood pressure remained consistently high (from mid-July to mid-August, the readings ranged from 116-153 / 71-103), so I went to a large hospital to see a cardiologist.
Additionally, I have systemic lupus erythematosus and have been receiving treatment since 2012.
I have also been experiencing elevated cholesterol levels (both HDL and LDL are high), but my previous lupus specialist indicated that this might be a side effect of the lupus medication, and that these issues would likely improve once the medication dosage is reduced.
However, it seems that it will still be some time before I can reduce the medication (I am currently taking five steroid pills), so I also asked the doctor if I need to manage my cholesterol and blood pressure simultaneously.

On that day, the doctor inquired about any plans for pregnancy, subtly mentioning my young age, and advised me to measure my blood pressure again in three months, along with incorporating exercise and adjusting my sleep habits (I usually stay up late), to see how the results turn out before considering medication.
At the time, I didn’t think to ask the doctor clearly about the concerns regarding medication, so I would like to ask you, Dr.
Wu, whether medications for high blood pressure or cholesterol could have any adverse effects on female fertility? How do they affect it?
Additionally, the doctor mentioned that my cholesterol levels were already high during the early stages of lupus treatment, which might be hereditary (as there is a family history of cardiovascular disease), and also stated that dietary changes have a limited impact on cholesterol levels.
Therefore, I would like to ask whether cholesterol can only be managed through medication? Are changes in diet and lifestyle really that limited in their effectiveness?
Thank you!
Ann

Ann, 30~39 year old female. Ask Date: 2022/09/06

Dr. Wu Xueming reply Cardiology

1.
If planning for pregnancy, it is important to choose antihypertensive medications that will not affect fetal development.
2.
In addition to medication, controlling blood pressure and lipid levels is also very important through diet and exercise.

Reply Date: 2022/09/06

More Info

Hello Ann,
Thank you for your detailed inquiry regarding the management of cholesterol and blood pressure, especially in the context of your medical history with lupus and the medications you are currently taking. It’s important to address your concerns comprehensively.

Impact of Medications on Blood Pressure and Cholesterol
1. Blood Pressure and Cholesterol Medications: Many medications used to manage blood pressure and cholesterol can have varying effects on women’s reproductive health. Generally, most antihypertensive medications, such as ACE inhibitors, beta-blockers, and calcium channel blockers, do not have significant adverse effects on fertility. However, certain medications, particularly diuretics and some beta-blockers, may affect libido or sexual function, which can indirectly impact reproductive health.
For cholesterol management, statins are commonly prescribed. While statins are effective in lowering LDL cholesterol, there has been some debate regarding their impact on fertility. Current evidence suggests that statins do not adversely affect fertility in women, but they are typically not recommended during pregnancy due to potential risks to the fetus. If you are considering pregnancy in the future, it’s crucial to discuss this with your healthcare provider to evaluate the best approach to managing your cholesterol while planning for pregnancy.

2. Cholesterol Management: You mentioned that your cholesterol levels have been high, potentially due to the medications for lupus. It is true that certain medications, particularly corticosteroids, can lead to increased cholesterol levels. In your case, since you are on a high dose of steroids, this could be a significant factor.
While lifestyle changes such as diet and exercise are essential components of managing cholesterol, they may not be sufficient alone, especially if there is a genetic predisposition to high cholesterol or if medications are contributing to the problem. It is often necessary to use pharmacological interventions alongside lifestyle modifications to achieve optimal cholesterol levels.

Lifestyle Modifications
1. Diet: Although you mentioned that dietary changes might have limited effects, they are still crucial. A heart-healthy diet rich in fruits, vegetables, whole grains, and healthy fats (like those found in fish, nuts, and olive oil) can help manage cholesterol levels. Reducing saturated fats and eliminating trans fats can also be beneficial.
2. Exercise: Regular physical activity can help lower LDL cholesterol and raise HDL cholesterol (the "good" cholesterol). Aim for at least 150 minutes of moderate aerobic exercise each week, which can include walking, swimming, or cycling.

3. Sleep Hygiene: Improving your sleep habits can also positively impact your overall health, including blood pressure and cholesterol levels. Aim for 7-9 hours of quality sleep per night, and try to maintain a consistent sleep schedule.

Conclusion
In summary, while medications are often necessary to manage high blood pressure and cholesterol, lifestyle modifications should not be overlooked. They can complement your treatment plan and may help improve your overall health. It’s essential to maintain open communication with your healthcare provider regarding your medications, especially considering your plans for pregnancy and your history of lupus. Regular monitoring and adjustments to your treatment plan may be necessary as your health status changes.

If you have further questions or concerns, please feel free to reach out. Your health and well-being are paramount, and it’s important to ensure that you are receiving the best possible care tailored to your unique situation.

Best wishes for your health journey!
Sincerely,
Doctor Q&A Teams

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