When I was in high school I read that normal blood pressure was one’s age plus 100.  If that were the case, mine should be 186/?.  Over the years norms have changed and now my internist thinks I need a blood pressure medication if I go up to 138/80.  Do you know any old folks who aren’t on BP medication?  I don’t, but am going to start asking around to see if I can find someone who is old and isn’t on some prescription for blood pressure.   That should be an interesting survey.

For years I took daily atenolol (a generic) but when one internist retired and his replacement moved, my new internist switched me to a diuretic, hydrochlorothiazide (HCTZ) 25 mg once a day.   This went well until an appointment one day when my BP was 130/75 and the next time 138/80.  He thought this required more medication and Altace (ramapril) was his choice.  He told me that the most common side-effect of ramapril was a dry cough.  It’s nice to the warned in advance – I probably would not have guessed my cough was a side-effect of the medication – but I had it in spades.  It just felt like a throat tickle but I would cough and cough without having anything to cough up or at.  In the middle of the night.  In church when the priest was giving his homily.  Any place and any time. People would keep offering me Tic-tacs and cough drops.

So we switched to Diovan (no generic available) at $3 per pill, one a day.  The cough gradually subsided but major lightheadedness became a problem.  I could lie down after a meal, then get up, walk to the next room, and then feel like the blood was draining from my head.  Several times I had to lie down on the floor before I could pass out.  Also my brain did not feel as if it was hitting on all cylinders.

I found this unacceptable and was told to stop the ramapril and return in two weeks.  At that point we switched back to a combination of atenolol (which I had taken for years without a problem) plus the HCTZ.  Fortunately, also at that time, my daughter-in-law give me a wrist blood pressure monitor because she had one and I thought it wonderful.   Cute.  Handy.  Fast.   Battery-operated.  With a memory.  Inflates itself with the touch of a button.  Researching blood pressure monitors tells me that having the cuff around the upper arm when measuring pressure is more accurate so on my next visit to my MD we took simultaneous measurements with my apparatus and his.  They were taken on different arms and it seemed that the wrist monitor registered a higher blood pressure.  Anyway I was told to take my BP myself about once a week with my new gadget and come back in a month.  Remarkably, it was sometimes very low, often below 120/70, and my pulse also ranged in the 65 to 85 range.  I took my blood pressure as I was writing this and the reading is 119/66, with a pulse of 78.

I’m sure the doctor will find this acceptable.   If I have any recommendations after this little journey towards health it would be to get your own blood pressure monitor.  I know for a fact that I get “white coat” syndrome when my pressure is taken at the doctor’s office and it is good to know what it is under normal at-home circumstances.  Then, if it sometimes shoots up it is no big deal because on the whole it is in a good range.  Another recommendation would be to ask for a trial supply (or even samples) when experimenting with a new drug.  Asking for part of a
prescription at the drug store is often a bad idea because you may be charged the same amount regardless of the number of tablets received.  And, if at all possible, see to it that you get a tried-and-true generic rather than some fancy new medication that will run you $3 a pill, and is not yet available in generic form.

My remarkable little gadget came from CVS and it not only tells time and tracks the date, but it has  kept a record of my systolic and diastolic pressure as well as pulse ever since I got it.  Looking back I see a pressure of systolic 183 on 7/19 with a diastolic of 60!  Quite a range.

And right now, at 6 AM on 9/11, as I finally post this, it is 132/60 with a pulse of 76.  I guess I’ll live a while longer.

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A cheerful heart is good medicine, but a crushed spirit dries up the bones.  — Proverbs 17:22