I'm 26 and I've been on blood pressure meds since I was about 13 or 14, they couldn't find a reason after having me in the hospital for 2 weeks.
In the end they just put it down to probably being an extension of my existing condition, I think.
135/85 isn't all that high is it? I thought that was only just out of normal range. Mine, even on meds, is usually around there, or higher.
Sorry to hear you're having problems though. Hopefully they'll get it sorted. I'd try to remember to get it re-evaluated on a regular basis though, my dad was getting light headed, feeling faint and generally feeling terrible, and the doctor kept checking his blood pressure and upping his medication. In the end he was sent to a specialist who found there was nothing wrong with him and it was the meds making him feel that way. Turned out the doctor had a faulty syphgomanometer.
135/85 is the new 155/95.
Also, good blood pressure is now 110/70, not 120/80.
They've been moving the goal posts again.
J.
I wonder, what is the medical reason for changing this? I'm generally not a conspiracy theorist, but I can't help the nagging thought that there's at least some influence from drug companies.
When I was in the hospital a few weeks ago, with infection induced DKA, the doctors prescribed me ramipril and simvastatin, blood pressure and cholesterol medications. My blood pressure and cholesterol are fine, though, and were fine the entire time I was in the hospital (I was in the ICU and hooked up to the blood pressure machine, which tested it every hour, it never went above 115/73). In fact, I've never had trouble with either blood pressure or cholesterol, nor has anyone in my family. On top of that, with the exception of (usually) well-controlled type 1 diabetes, I am a healthy 26 year old. I couldn't imagine why I'd be prescribed these drugs, so I asked a couple doctors in the hospital and another in my subsequent ER visit (an IV had infiltrated and become infected, giving me a fever). They told me that the meds were preventative, and standard for diabetics -- type
one diabetics? I don't think so. The youngest of the doctors I asked seemed surprised that I was prescribed these meds, but after consulting another doctor repeated what I'd already been told.
I am not taking these medications. I know that as a diabetic I have a greater risk of developing hypertension and cholesterol problems, but I don't see any sense in taking such strong medications for problems I may or may not develop. In 13 years of being treated for juvenile diabetes no doctor has ever before mentioned such treatment. These are not benign meds! They have very, very serious side effects, including kidney failure (I already have to protect my kidneys as a diabetic), and even a rare, but terrible degenerative bone condition. My psychiatrist was shocked when I discussed the prescriptions with him, agreeing that preventative medicine does not include statins.
Anyway, that's been my experience, and it just makes me question these treatments. I think these meds can be invaluable for some people, but I also think a second opinion is required. I hope the OP will consider a second opinion, and lifestyle changes that could help to lower it naturally, to either avoid meds or to require lower doses.
To answer
J.'s question: the goalposts for treating diabetes seem to be moving all the time. It's generally thought that by keeping the blood pressure lower for diabetics, compared to non-diabetics, with hypertension (i.e. making the treatment more aggressive) the risk of further complications (heart disease, vascular problems, retinopathy etc.) is reduced even further. Diabetes itself already has a deleterious effect on the blood vessels, so to have even a marginally raised blood pressure (versus the "normal" of the general population) could be serious in the long run.
tsq, those medications were given to you with the intention of preventing complications in the long term. It's all about overall risk of macrovascular (heart) complications, and several things contribute to it: obesity, blood pressure, diabetes (either type) and in particular diabetic control, smoking history, cholesterol control, family history of similar diseases. As I mentioned in this post, diabetes is already a disadvantage, and while nothing can be done about family history, by targeting all the other risk factors aggressively through lifestyle changes, blood pressure control, lowering cholesterol etc. then the risk can be reduced as low as possible.
Whether you need those medications at this very moment in your life, however, is highly debatable, and whether or not there are other serious problems already picked up (e.g. the cholesterol already being quite high), you probably ought to seek a second opinion. I don't know many type 1 diabetics who are on those medications at the same stage in their lives - those that are, however, are usually poorly-controlled diabetics with a poor lifestyle who actually need those medications to keep above water (metaphorically speaking).
Ramipril can cause renal failure, but in the context of other problems - often if there is hypotension such as severe septic shock, but also in problems with the renal arterial vessels especially in inherited renal artery stenosis, and in combination with other nephrotoxic drugs like non-steroidal anti-inflammatories. In fact, ramipril (and other similar ACE inhibitors and angiotensin receptor blockers) has been shown to slow down the development of diabetic kidney disease (which is a glomerulosclerosis, a very different form of kidney failure as opposed to renovascular disease and the renal failure of ACE inhibitors) as shown by reduced leakage of albumin and protein into the urine - an early but very significant marker of diabetic nephropathy.
Simvastatin is a more contentious drug - it affects the liver quite significantly in many people, and has a small but notable risk of rhabdomyolysis (increased skeletal muscle tissue breakdown) in a few people. In general it is only given if it has the potential to lower the cholesterol in the individual person and thus reducing the risk of atherosclerotic complications (someone with a limited lifespan we tend not to give it as the risk outweighs the benefit). Some other statins (the more expensive ones) have been shown to reduce the mortality rate from heart attacks - here in the cheapo NHS we prefer the cheap and cheerful (and cost-effective) simvastatin.
At the end of the day it's all a risk-benefit analysis, and it's good to see you're keeping an open and informed mind about these things - informed consent and patient autonomy over decisions about their treatment is one of the cornerstones of all forms of medicine.
^The positive side of type 2 diabetes is that for many people it can be controlled by diet and exercise, and while some people really do need the meds, they can usually reduce the doses and/or number of different meds they need by changes in lifestyle.
That is true, but the treatment intentions are the other way around: lifestyle changes are started first in the treatment of type 2 diabetes with the intention of avoiding medications in the first place, as opposed to reducing additional medications later (although it does help overall of course). Medications are often required later as the risk of later complications of unmanaged diabetes (all types) is very high, in addition to type 2 diabetes's associations with heart and vascular disease. I had heard rumours that a few cases exist of people preventing their type 2 diabetes from progressing through a strict regime of exercise and diet only, although personally I'd take that with a pinch of salt (ironically
).
Oh, and
Australis, good luck with the tests.
I hope it isn't the myeloproliferative disease of polycythaemia vera as you suggest it might be.
(I always find it hard to reply to these sort of threads due to the confidentiality issues in each case - unless of course you're comfortable with discussing your personal medical problems here on an open public forum. For the sake of the thread topic, however, I'll talk in general terms where possible.)
I don't know where I am yet, and not sure if I want to ask. It's a wait and see. Until then... I keep dealing with the other stuff going on. Hey ho.
)