When is BP too low?

[kickingandscreaming]

For most of my life I have been a high BP person.  Too high (170/50-- always low diastolic). Since my recent "little" heart troubles (heart block, A fib, and leaky mitral valve)  I was put on a new BP/heart medicine-- Metoprolal at 50mg-- and taken off my 2 other BP meds.  50mg turned out to be way too much for me and my BP went so low (under 100) that I was dizzy and off balance.  So they lowered me to 25mg and then to 12.5mg which is practically nothing.  I was worrried that my BP would rised..a lot.  But it didn't and has stayed quite low without any dizziness dor any other noticeable symptoms. In the last week these are my readings: 115/53; 116/63; 115/59; 107/51;104/47;117/55.

So when is BP too low?  My neph wants me to switch my PD regimen to use mostly yellow (1.5%) PD fluid whereas I now use an alternating mix of green and yellow.  She said I should be using my BP to direct my choice of fluid. And that my low BP suggests that I should use mostly yellows.

[cassandra]

According to the signs in hosp: 100/60 is too low (so either or) Just keep an eye on your bp. When it goes up you use a green ISO a yellow etc.

[Michael Murphy]

Since my heart attack, vtach and a fib incidents a year ago I have been on a lot of drugs clopidegrel (plavix), amiodarone, carvedilol (Coreg), lasix, lisinopril, montelukast, jantoven(warfarin), pravastatin, sensipar and  aspirin.  I am caught in a prescription war between my cardiologist and my nephrologist about the effect of these prescriptions on my blood pressure.  The cardio wants two lasix pills daily’ and the nephrologist wants 1 only on non dialysis days.  The nephrologist is worried about something called cardiac stunning which happens when your BP drops to low.  Since I am currently susceptible to Congested Heart Failure fluid management is critical to my health.  To low BP can kill those with a low BP.  Currently I am trusting my Cardiologist and taking  1 lasix pill every day and I am feeling pretty good.  However in two recent dialysis sessions aggressive fluid removal has ended up with me laying in the chair with my feet over my head with the tech pushing saline to get my blood pressure above 90/45.
The main problem is being dizzy and nauseous until my BP goes up to 100;70.

[Charlie B53]

I am amazed how some people's pressures can drop/run so low.  A Lady on my shift has chronic low BP and most every treatment day they have her still in her chair, waiting for BP to rise.  She very often gets as low as 70/40.  Very difficult to understand as I have been so chronically high for so long.  3 BP meds almost 4 times the 'normal' dose, but I'm finally under 150 again! Just not by much.

Wouldn't it be great to find that there is something like a fruit that would help 'normalize our pressures?  Who knows?

I just read an old thread, maybe should have brought it back up, on renal denervation.  Using a cath and ultrasound to kill the arterial nerve in the kidney, and stabilize blood pressure.  I thought it had great promise.

[kristina]

For most of my life I have been a high BP person.  Too high (170/50-- always low diastolic). Since my recent "little" heart troubles (heart block, A fib, and leaky mitral valve)  I was put on a new BP/heart medicine-- Metoprolal at 50mg-- and taken off my 2 other BP meds.  50mg turned out to be way too much for me and my BP went so low (under 100) that I was dizzy and off balance.  So they lowered me to 25mg and then to 12.5mg which is practically nothing.  I was worrried that my BP would rised..a lot.  But it didn't and has stayed quite low without any dizziness dor any other noticeable symptoms. In the last week these are my readings: 115/53; 116/63; 115/59; 107/51;104/47;117/55.

So when is BP too low?  My neph wants me to switch my PD regimen to use mostly yellow (1.5%) PD fluid whereas I now use an alternating mix of green and yellow.  She said I should be using my BP to direct my choice of fluid. And that my low BP suggests that I should use mostly yellows.

Hello K&S,
Please ask your GP and/or nephrologist about this medication and please try to be very careful about Metoprolol (or Atenolol). They are both a very "heavy" betablocker and extremely powerful. They not only can cause the BP to become extremely low, but they also can "make" the user feel extremely tired and totally lethargic, plus their extremities (i.e. hands/feet) may feel ice-cold.
Please take great care of yourself and please make an appointment with a medic as soon as possible.
Best wishes from Kristina
P.S I took a very heavy (I believe it was 250mg) dosage of these betablockers before suffering a stroke and since then I always feel alarmed, whenever I read about anyone taking them.
Please look after yourself and see your doctor about your low blood pressure in connection with your taking the betablocker Metoprolol a.s.a.p.

[kickingandscreaming]

Please look after yourself and see your doctor about your low blood pressure in connection with your taking the betablocker Metoprolol a.s.a.p.

The Metoprolal does make me tired and it's exacerbated my asthma (2 known side effects of beta blockers).  I am so doctored up that lots of my specialists and my Primary care doc. know exactly how my  BP is and are OK with it.  And I have many factors that could lead to a stroke, with or without Metoprolal.  And the dose that i'm on (12.5 mg) is absolutely miniscule and barely even registers.

My real problem is how hard it is to plan what to order from Baxter when my daily choice of fluid (yellow, green, etc) is dictated by my BP which changes from hour to hour and can't be predicted once a month when I have to place my order.  Last month I ordered based on my usual routine of alternating nights of green/yellow and green/green.   But my delivery for this month will be totally wrong for this "new" regime of mostly yellows and the occasional green (determined on the spot). My weight is very stable and my fluid regulation is very reliable (thank heavens) so I don't want to rock the boat.

The real issue I'm having

[Charlie B53]

I wasn't aware of the tiredness caused by Metoprolol.  Taking 100 mg TWICE daily. Plus Lisinopril and another that starts with an 'A'. Amalodipine? I've been complaining to my Dr's, all of them, of my near constant exhaustion for years!  I will have to ask again as I have another upcoming appt with Primary, what other med may be substituted.  No energy,, nothing getting done.  I got a huge list from Wife on 'Honey Do's' plus all my owon projects that have been left sitting.  I get very frustrated with myself when not getting anything much done.

[kickingandscreaming]

Beta blockers will totally knock the starch out of you.  I can't imagine surviving on 100mg of the stuff when 12.5mg does me in.

[GA_DAWG]

I do not know the exact numbers, but I do know that when the numbers on the machine are red, either high or low, they do not let you leave.

[Rerun]

My bp was high forever and now it is low.  When it gets below 80/?  they have to turn my uf off until it raises.  But, then they don't get my fluid off.  My doc said my body is now use to low bp but at which point it gets too low and my heart just stops.... we don't know.  So, the deal is 80/? and the uf goes off.  It usually comes back enough that they can get the fluid off.  That is why I'm on the 8 hour nocturnal shift.

[GA_DAWG]

Mine would do that so they removed one of the BP medicines I was on. Things have been back to a more regular BP since then.

[kickingandscreaming]

Mine would do that so they removed one of the BP medicines I was on.

I have nothing to remove.  I'm on a non-consequential dose of Metoprolal which is really for my heart.  All other BP meds have been stopped.  I haven't been under 90 ish, but I am frequently in the hight 90's and very low 100's.

[Riki]

My bp has been low for years. The top number (I can never remember which is systolic or diastolic *L*) is using 105-110 while standing before being hooked up.  Once I'm on, however, it drops to 90-95, and can go lower as the treatment goes on.  It's rare that I have any symptoms, and I have an order for the nurses to not react to the low readings as long as I don't have any symptoms, and the bp stays above 90.  I can go home at the end of treatment as long as I'm not driving (and since I'm also visually impaired, I never am) and my bp is 90/60 with no symptoms.  Usually, as soon as I'm off the machine, my bp is back up above 100.

What they are supposed to do, in my unit anyway, is if the bp goes below 100, they are to put you in minimum UF for a few minutes to see if your bp rises, but because of the order, they don't do that with me.  I'm a bit anal about fluid removal, and I don't like leaving fluid on if it's not necessary, because I had an acute case of pulmonary hypertension a few years ago that was caused by excess fluid and low hemoglobin.  I couldn't walk across a room without gasping for breath.  It wasn't fun, and I don't want to do it again.  Because of this, I have yelled at nurses who've put me in min without asking me first

[OldKritter]

I have the same kind of problem with my blood pressure.  I place my normal order for fluids and then add extra yellows.  I make sure l have at least 6 extra boxes of yellow in reserve.  This works for me so far.

With the extra inventory you need the delivery man rotate your boxes.

[LoneHighway]

Kickingandscreaming, have you ever tried or had suggested to you to try carvedilol instead of metoprolol? Carvedilol (Coreg) seems to have few adverse effects for most people.

[kickingandscreaming]

I had an allergic reaction to Coreg and Cardizem and ARBs and ACEis.  Had adverse reactions to several other BP meds too.

[Treasure]

My bp has been low for years. The top number (I can never remember which is systolic or diastolic *L*) is using 105-110 while standing before being hooked up.  Once I'm on, however, it drops to 90-95, and can go lower as the treatment goes on.  It's rare that I have any symptoms, and I have an order for the nurses to not react to the low readings as long as I don't have any symptoms, and the bp stays above 90.  I can go home at the end of treatment as long as I'm not driving (and since I'm also visually impaired, I never am) and my bp is 90/60 with no symptoms.  Usually, as soon as I'm off the machine, my bp is back up above 100.

What they are supposed to do, in my unit anyway, is if the bp goes below 100, they are to put you in minimum UF for a few minutes to see if your bp rises, but because of the order, they don't do that with me.  I'm a bit anal about fluid removal, and I don't like leaving fluid on if it's not necessary, because I had an acute case of pulmonary hypertension a few years ago that was caused by excess fluid and low hemoglobin.  I couldn't walk across a room without gasping for breath.  It wasn't fun, and I don't want to do it again.  Because of this, I have yelled at nurses who've put me in min without asking me first

I'm in this boat right now. I have Addison's Disease, so my BP drops pretty low-- and even moreso during dialysis. At my last clinic I had similar orders to yours about turning off UF-- but the new clinic likes to fight me over this. I have been doing this a long time and I know when I'm symptomatic because I have a few tells. I'm usually NOT symptomatic until my systolic drops below 70-- but when I was symptomatic at the last clinic, I would simply request to be turned off for 15 minutes. The new clinic just loves to give me fluid-- which doesn't really raise my BP substantially. This has been a disaster because they have not been pulling off the right amount of fluid in the month I've been at the new clinic, and I end up diarrheaing for a day as my body tries to do its own reset. Not good when I have appointments and traffic to contend with after I leave this new clinic.

And this is why I'm considering doing home dialysis for the umpteenth time-- shorter sessions, 4 days a week, may keep my BP in a range I and the home dialysis team can live with.

[cassandra]

Please don’t only consider it Treasure!!! Just do it!!