Blood pressure high after increasing medication dose

[historicalnews]

Moved up from 2.5mg ramipril to 5mg in January. Average BP 148/88 but as a few readings over 150/90 nurse thought best to increased.
Really struggled with dizziness side effects for few weeks but settled eventually (had changed to taking at night.)

Blood pressure hasn't improved significantly but no worse.

Had phone check up booked in on Monday so took readings Sunday night and they were high. Repeated Monday before Dr due to call and highest was 175/109 (resting - had sat for a few minutes first.) Average was 167/100. Couldn't believe it as originally nothing like as high.

Dr said to change to taking split dose. 2.5mg in morning. 2.5mg in evening.

Did that today but then highest today 183/103 (average similar to yesterday.)

He says to try that for few days and if doesn't help then try 5mg in morning and see if side effects ok. I'm not convinced though that moving times is actually going to improve results.

Anyway - has anyone had similar high numbers after increasing dose ? And any tips. The high numbers have made me nervous. (I'd been on 2.5mg for 6 years. Early 50's. Not overweight. Don't smoke or drink.)

DH can only keep his BP under control using two different medications at the same time - if he comes off either one it shoots up again. Ramipril and Amlodipine I think.

Thank you
(Seems odd though that I've gone from nurse not sure if really needed to increase to then being so high over relatively short period of time.)

One reason I'm on beta blocker (Bisoprolol) at 2.5 for High BP (and some days I take half) is that Both Ace inhibitor type BP tablets and channel blockers actually didn't reduce my BP that much - but beta blockers did and I felt better on them- weird I know. Usually around 128/78

Thanks @Crikeyalmighty - I think you replied to my other thread about side effects too so thank you.
I'm finding these numbers quite scary but trying to stay rationale because I realise that being anxious won't help '

Was high again this morning so not just a blip. Would be really interested to hear from anyone on medication but also needs to do other things to reduce BP alongside it.

Is he overweight?

Mine wasnt that well controlled on meds and I also had an episode where I was put on an extra med to my usual candasarten, I went for a 2 week check up to see how it was doing for me and it had gone through the roof. I was then put on doxasozin which made me dizzy and unwell. I stopped taking it and the GP said he will check me again once I've had my weight loss surgery, he said its pretty much the only way Im going to get it down

I will go and see him in a few weeks and see if this is right.

So all your high readings have been on the same monitor at home? Maybe the monitor is faulty? Can you try it on someone else and see what readings you're getting?

agree, certificated/approved monitor is important.

that took my attention and i think it is a good point.

agree with that, too.
and good luck op.

I was on 10mg ramipril, BP still high, added amlodipine, BP rocketed, GP increased amlodopine - BP increased even more. Then added in doxazosin and BP came right down. I’ve dropped out the amlodopine and it’s stayed down - everyone is different, and needs an individual approach

Apparently beta blockers are considered 'old hat' these days, but I do know from many forums on the internet they are often beta tolerated at low doses and Bisoprolol which I'm on is heart specific. It also brings heart rate down slightly , is good for BP related headaches and inhibits adrenaline and I was incredibly anxious (and appalling headaches) when my BP was at 185/120 -

Thank you so much for the messages really helpful.
Just to answer couple of questions:

• not overweight
• machine was calibrated at chemists and seems to be very accurate. DH received regular hospital treatment. He has very good BP but they still take it every time. Our machine shows his as exactly the same as the hospital.

Are you leaving a month between increase in dose changes before doing more readings?
Have you had your kidney function checked each time?

Yes it's 8 weeks since the increase in ramipril to 5mg.
Initially I took 5mg each morning but I was very very dizzy (had no side effects on 2.5mg) so 3 weeks ago changed to taking it in evening.
(That did really help with the side effects.)

(Yes had a blood test two weeks after starting the 5mg dose.)

Yesterday moved to splitting the dose. So 2.5mg in morning and 2.5mg to see if that makes any difference.
What doesn't make sense is that BP is significantly worse in last few days than it was when I was just on 2.5mg

Ramipril had no effect at all for me. I'm now on Lercanidipine which is keeping my GP happy if not me.

@Elphame do you get lots of side effects on the Lercanidipine? Glad it's working though

I have a constant low level fatigue and fits of dizziness which are 3 months are showing no sign of going away. Also a constant feeling of being under par. At least I'm not getting the nightmares I had with amlodipine nor have I got swollen feet so I'm marginally better off.

I have severe white coat syndrome though which extends to home monitoring so I'm still not convinced I actually have high blood pressure at all. My surgery doesn't do 24 hr monitoring but I'm seriously thinking of stopping the medication and hiring one privately.

I think I replied to your other thread OP?

I had my dose increased to 5mg from 2.5mg but it made me so dizzy that they told me to split the dose. It didn't bring it down enough so they added in 5mg of Amlodipine in the morning too, which has slowly brought it down.

I'm 52, type 2 diabetic but well managed.

That sounds really unpleasant @Elphame - hope you get it sorted.

You did @Badger1970 ! Thank you for your help on there. It's all so bizarre because my BP wasnt as high as this when I was taking 2.5mg. Doesn't really make any sense.

I'm going to keep this as bit of a log if ok as useful to write down.
Switched to split dose on Wednesday (2.5mg in morning and 2.5mg in evening) but although readings seemed bit better on Thursday they were very high again on Friday / Saturday.
Going to monitor today and then might switch back to trying the full dose (5mg) in the morning as GP suggested trying that too.
Have also been drinking more water - going for walks etc. Diet is pretty good and I don't have any caffeine etc.
still totally confused re why it's gone significantly higher than when I was just on 2.5mg in total.

Moved back to 5mg in one dose at 7.30am this morning.
Managed to find a quiet space at work and sat for 10 minutes but unfortunately readings still v high.
(Resting pulse seems higher for me too. It's normally about 85 but it was 103 and then 100 twice.)
BP : 173/103 average came out as 168/100 :-(

@historicalnews can you keep a week's worth of readings and send them to your GP?

Hi @Badger1970 - yes that's what I'm planning to do.
(Thank you for keeping up with my ramblings!)