Hypertension?

RE: Hypertension?

jim thornton — Mon, 24 May 2010 09:55:46 GMT

Hi, Mary. I, too, am 57, by the way. When I went to the doctor's office, the nurse suggested I cut back on salt. I didn't think this would do much for me. I'd always heard that there is a portion of the population that is "salt sensitive" and that when these folks cut back, it can make a huge difference. As a lifelong pretzel gourmand, and the kind of guy who leaves a salt ring at the dinner table when his plate is removed, I didn't think I was salt sensitive. But I decided to give it a whack, and it seems to have made a little bit of a difference. I also got diagnosed (in the interlude from starting this thread till now) with sleep apnea, a topic which I have started to cover in my swimming vlog (for anybody else out there who is interested.) It's possible that once I start sleeping with CPAP, this might help my bp a little, too. By the way, I don't have too many of the traditional red flags for sleep apnea. My BMI is around 23-24; my neck is skinny at 15 inches; I don't snore too much or too loudly; and I don't drink alcohol. My main symptom has been persistent daytime sleepiness (different from fatigue--I could work out hard, just very groggy while doing it.) Anyhow, feel free to follow my progress (I hope there will be some!) at my swimming vlog: forums.usms.org/blog.php

RE: Hypertension?

Former Member — Sun, 23 May 2010 13:48:32 GMT

I am bringing this thread back because my recent experience might be of interest to some. Getting back in the pool seems to have done wonders for significant hypertension. My blood pressure in January was, even with the medication I'd been taking for four years, 155/115. Far too high. Four months later my BP is 122/75. The only major change in my life is that I am now swimming about 3 times a week, about what I can manage with work and business travel. I am getting some form back, but am not even back to the (also slow) level I was at six years ago --but I was younger then, wasn't I, and am now 57. What's also interesting is that I am more compact. Thinner would be a nice concept but my BMI is over 30 and so that doesn't really seem the right word. And while everyone thinks I have lost weight, which I wish, I have not lost even a pound, but yes I am a different shape. The rise and fall of my blood pressure seems to correlate with changes from more active to more sedentary life and back, and age. But as the blood pressure seems to be responding to the swimming, I am increasing my yardage and my speed and talking to my physician about reducing the amount of medication I have been taking. This probably is not helpful for those swimmers who already are training at a high level. But it could be a word of encouragement to keep in the pool and active, because it seems that it was a lapse in the swimming at a certain age that led to this problem.

RE: Hypertension?

Jimbosback — Fri, 26 Feb 2010 06:54:49 GMT

If so, I will definitely bring up the lisopronil endorsement. Thanks again! FWIW, I also take lisinopril (and amlodipine) with no side effects and no impact on exercising that I am noticing. My pressure drops quite a bit after a swim workout then slowly creeps back up to normal.

RE: Hypertension?

Former Member — Thu, 25 Feb 2010 17:20:00 GMT

Oh, so that's what ISH stands for! I'm the opposite. Am usually about 110/50 and prone to passing out if I stand up too quickly.

RE: Hypertension?

jim thornton — Thu, 25 Feb 2010 12:15:47 GMT

I am wondering if any of you have been diagnosed with ISH, or isolated systolic hypertensions. Based on a number of readings over the last couple weeks, I feel I may have this. Like most swimmers, I want the problem to just magically go away, or barring that, yield to a cheap but effective treatment that won't slow me down in sprints of distance swimming, or leave me to brain addled to do my job. If anyone knows about this condition, which doctors worry about more in patients over 50 (I am 57), please check out my vlog and lease a comment there--advice, non drug intervention, drug intervention, what have you. I don't know if ISH is treated differently from mo re normal high blood pressure (where both numbers are elevated.) Thanks in advance for any help you might provide. forums.usms.org/blog.php

RE: Hypertension?

jim thornton — Thu, 25 Feb 2010 11:49:45 GMT

Low blood pressure, when it occurs, is usually a female problem. I think it's the females that give us the high bp..haha. Interesting point. Not to be too risque here, but I did an article on impotence once, and I was surprised to find that high blood pressure in males, at least over the short term, leads to harder erections. (Over the long run, of course, it hurts blood vessels and can contribute to impotence.) As the medical literature has convincingly proven, as evidenced by no shortage of Internet products, females clearly prefer erections with the rigidity of "cold blue steel." I don't think that it is at all paranoid to suggest that women, in hopes of short-term thrills for themselves, are inducing high blood pressure in men. Absolute selfishness on their part, if you ask me. Particularly when they do this in guys like me and have no intention whatsoever to have sex anyhow. Low blood pressure can be a sign of thyroid problems. My 18 year old's thyroid problem was discovered by by a couple lbp readings. Perhaps she and I could somehow help each other balance things out? Of course you really need to have a thoughtful internist who knows you to put this into perspective... I was always taught to worry more when then diatstolic is elevated on a chronic basis than when the systolic is elevated alone. Systolic elevation by itself can be from pain or stress. As a kid (14 yrs) I had elevated systolic BPs (although labile) with relatively low diastolics. My BP was often 140/ 70. I had a big workup at Boston Children's and then the nephrologist told me "you swimmers often have this.." I don't know what that meant, if anything. I am not sure if anyone still believes its true, but it was reassuring at the time and my blood pressure didn't become and issue again for about 25 years. Are you taking your BP yourself? Or are you in a nervous situation when its being measured? If you are using a home cuff check it against a professional's to be sure its calibrated, have someone else take it for you, try to relax when it is being taken and don't look at the machine when they are doing it. As far as anti-hypertensives...again you have to talk to your own doctor about what's best for you. There are some good reviews about athletes with hypertension which you can peruse or share with your physician. Personally I like the ACE inhibitors (like lisinopril) they work well, are available generic and don't appear to limit athletic performance. YMMV (as they say). Disclaimers: This is my opinion and should not be taken as specific medical advice. I am not an expert in adults with hypertension, I am a pediatric pulmonologist. I am also a middle aged man who began swimming again, recently, after 25 years "away" in an effort to treat his own hypertension, obesity and mood lability -- so I've thought about these issues some in recent months. Thanks Pendaluft! Joking aside, I think one of my first fears (after exploding head--again, I refer you to my short film at forums.usms.org/blog.php -- fast forward to the end, and you won't have to listen to my pointless blather) --was the thought that any medication I might have to take would reduce my swimming abilities. There are a bunch of studies now on ISH in older Americans. A summary for us laymen, courtesy of the National Heart, Lung, and Blood Institute, can be found here: www.nhlbi.nih.gov/.../whathbp.htm For what it's worth, I am no stranger to various physiological anomalies that may be related to swimming. For example, I have first degree AV heart block, which sounded terrible when the doctor told me, but much less so when he explained that it's not uncommon in people who train a lot and get a lower resting heart rate as a result (the interval between beats has to elongate somewhere, he said, and this is one way the well-exercised heart does it.) I have also been diagnosed with mild anemia for almost a decade now, with no apparent ill effect. One explanation that made sense to me, and I am sticking with so as to not worry about it, is that I may have sports anemia--a pseudo anemia caused by increased plasma volume from regular endurance exercise, thus diluting the RBC count, etc. Could my ISH (like your boyhood version of it) have anything to do with swimming? Is it possible it's not actually a bad thing, but rather the effect of swimming regularly over the decades? Am I worrying for naught? I suppose it's possible. It would be great if this were the case. I wonder if treatment norms are based on average Americans, the vast majority of which are pretty sedentary at age 57. So far, I haven't gotten any treatment for my anemia, and I sometimes wonder if this would do me more harm than good, especially if it really is the dilutional "sports" variety. If my ISH remains unchanged, I will ask my doctor's advice, and probably do what he says (if I can afford it.) If so, I will definitely bring up the lisopronil endorsement. Thanks again! And best of luck with your return to swimming. Quite possibly, the best one-stop apothecary available! Note: you mentioned mood lability. If you get Swimmer, check out my article on swimming's effect on mood in the current issue. You (and anybody else who is interested) can also email me at Jamesthornton1@comcast.net and I'll send you .pdf copies of this story plus a recent story I wrote for Men's Health on the multitudinous benefits of masters swimming.

RE: Hypertension?

pendaluft — Thu, 25 Feb 2010 09:44:16 GMT

I don't know if ISH is treated differently from mo re normal high blood pressure (where both numbers are elevated.) Thanks in advance for any help you might provide. forums.usms.org/blog.php Of course you really need to have a thoughtful internist who knows you to put this into perspective... I was always taught to worry more when then diatstolic is elevated on a chronic basis than when the systolic is elevated alone. Systolic elevation by itself can be from pain or stress. As a kid (14 yrs) I had elevated systolic BPs (although labile) with relatively low diastolics. My BP was often 140/ 70. I had a big workup at Boston Children's and then the nephrologist told me "you swimmers often have this.." I don't know what that meant, if anything. I am not sure if anyone still believes its true, but it was reassuring at the time and my blood pressure didn't become and issue again for about 25 years. Are you taking your BP yourself? Or are you in a nervous situation when its being measured? If you are using a home cuff check it against a professional's to be sure its calibrated, have someone else take it for you, try to relax when it is being taken and don't look at the machine when they are doing it. As far as anti-hypertensives...again you have to talk to your own doctor about what's best for you. There are some good reviews about athletes with hypertension which you can peruse or share with your physician. Personally I like the ACE inhibitors (like lisinopril) they work well, are available generic and don't appear to limit athletic performance. YMMV (as they say). Disclaimers: This is my opinion and should not be taken as specific medical advice. I am not an expert in adults with hypertension, I am a pediatric pulmonologist. I am also a middle aged man who began swimming again, recently, after 25 years "away" in an effort to treat his own hypertension, obesity and mood lability -- so I've thought about these issues some in recent months.

RE: Hypertension?

Bobinator — Thu, 25 Feb 2010 08:37:19 GMT

Low blood pressure can be a sign of thyroid problems. My 18 year old's thyroid problem was discovered by by a couple lbp readings.

RE: Hypertension?

Former Member — Thu, 25 Feb 2010 07:17:07 GMT

Originally Posted by joshua forums.usms.org/.../viewpost.gif Low blood pressure, when it occurs, is usually a female problem. I think it's the females that give us the high bp..haha. "Interesting point. Not to be too risque here, but I did an article on impotence once, and I was surprised to find that high blood pressure in males, at least over the short term, leads to harder erections. (Over the long run, of course, it hurts blood vessels and can contribute to impotence.) As the medical literature has convincingly proven, as evidenced by no shortage of Internet products, females clearly prefer erections with the rigidity of "cold blue steel." I don't think that it is at all paranoid to suggest that women, in hopes of short-term thrills for themselves, are inducing high blood pressure in men. Absolute selfishness on their part, if you ask me. Particularly when they do this in guys like me and have no intention whatsoever to have sex anyhow." Caught in the act :blush:

RE: Hypertension?

joshua — Thu, 25 Feb 2010 05:57:52 GMT

Oh, so that's what ISH stands for! I'm the opposite. Am usually about 110/50 and prone to passing out if I stand up too quickly. Low blood pressure, when it occurs, is usually a female problem. I think it's the females that give us the high bp..haha.

RE: Hypertension?

james lucas — Wed, 06 Jan 2010 01:44:34 GMT

See Monday's Wall Street Journal: online.wsj.com/.../SB10001424052748704350304574638331243027174.html Regular exercise has been shown to combat the ongoing damage done to cells, tissues and organs that underlies many chronic conditions. Indeed, studies have found that exercise can lower blood pressure, reduce bad cholesterol, and cut the incidence of Type 2 diabetes. In a study published in November in Circulation, the medical journal of the American Heart Association, German researchers compared two groups of professional athletes (32 of whom were in their early 20s, and 25 who were middle-aged) with two groups (26 young and 21 middle-aged) who were healthy nonsmokers, but not regular exercisers. The athletes had significantly less erosion in telomeres than their more sedentary counterparts. The study concluded that physical activity has an anti-aging effect at the cellular level, suggesting exercise could prevent aging of the cardiovascular system. Also: online.wsj.com/.../SB10001424052748704350304574638550059084962.html Dr. Williams' studies have shown that exceeding the federally recommended exercise guidelines can reduce the risk of stroke, heart attack, glaucoma, diabetes and other diseases by as much as 70% above the benefits of merely meeting the guidelines. "There is no gene or drug discovery that comes close" to the effects of more and more-vigorous exercise, says Dr. Williams, a staff scientist at the Lawrence Berkeley National Laboratory in Berkeley Calif. Official exercise guidelines—emanating from groups like the American Heart Association as well as the federal government—typically call for half an hour a day of exercise, including a portion at moderate to high levels of intensity. At 3.5 hours per week, most walkers and even runners would cover fewer than 20 miles. By contrast, Dr. Williams's research has found progressively greater health benefits for runners topping 30, 40, even 49 miles a week. Dr. Williams assumes—as do his critics—that similar effects would be gained from increased workloads among swimmers, cyclists and other aerobic athletes.

RE: Hypertension?

Rnovitske — Tue, 05 Jan 2010 10:35:10 GMT

About three years or so I was in the same situation and posted a message on this board. You may have even read it in your research. Whenever at the doctor's, my BP was elevated and I was told to get it checked out. I was not/am not overweight, don't smoke/drink, always exercise regularly, and had a reasonable diet. There was not much else to do that could bring the BP down since it seemed that lifestyle was not the culprit. Then our LMSC had an article in the newsletter about an athlete runner in his 30's that had a stroke. He had elevated BP but never did anything about it, believing the athletic exercise and diet would take care of it. Wake up call. I spoke with my doctor about my swimming needs and lifestyle, and was prescribed Lisinopril, 5mg daily, cost about $7 per month. It's been around for a long time, so it is well known. There are some known side effects possible in a few people, but they are not serious and I don't have any. About three years later, I am still on this and it keeps my BP acceptable. My experience is that it has not affected my swimming or training. I hoped that someday I could stop taking the medication, but am realistic enough to know that for me as for most people, it's not likely. (I also hope that someday I drink beer as much as I want and break Masters world records.) Are you a gambler?

RE: Hypertension?

Former Member — Sat, 02 Jan 2010 11:51:14 GMT

Exercise drops your blood pressure. Your sugar also levels out with exercise. Proper intake of food also levels out your sugar if you are diabetic. My sugar fluctuates between 5 and 7, my readings for BP 123 over 72. I work out but do not over do it. My goal is not to race but be fit. My weight today 250lbs I am 6' 2 and 3/4".

RE: Hypertension?

Former Member — Sat, 02 Jan 2010 10:09:44 GMT

Been on Lipitor for over 5 years & no problems training & swimming . was 140/85 now 125/75 . Consider yourself lucky and very fortunate, for the only problem with Lipitor (for some of us) is that you have to always fight the insurance companies that want you to take some non-evidence based (generic) drug instead.

RE: Hypertension?

orca1946 — Fri, 01 Jan 2010 12:18:39 GMT

Been on Lipitor for over 5 years & no problems training & swimming . was 140/85 now 125/75 .

RE: Hypertension?

Former Member — Thu, 31 Dec 2009 13:38:16 GMT

I have not heard of black tree fungus. Can you provide a URL to an article describing its effects on hypertension? Thanks. Sorry, but I'm on my way to Chinatown, to have my first big bowl of Jai or Buddha's Delight to start the new year. I've been eating the stuff for over 20 years before the age of URL's. So maybe you might try googling it? Good Luck and happy new year.:bliss:

RE: Hypertension?

Former Member — Thu, 31 Dec 2009 12:46:58 GMT

When it comes to Chinese food, make sure some of the dishes contain lots of black tree fungus, which will lower your blood pressure almost right of way, despite the sodium content and MSG in the food. Black tree fungus can also be purchased dried in plastic packs at most Asian markets, so you can prepare at home after soaking in water. I have not heard of black tree fungus. Can you provide a URL to an article describing its effects on hypertension? Thanks.

RE: Hypertension?

Former Member — Tue, 29 Dec 2009 10:43:03 GMT

after a meal high in sodium (like Chinese food) my body hoards water. Then several hours later it just lets it go. That is a clear sign for me that I had too much sodium. When it comes to Chinese food, make sure some of the dishes contain lots of black tree fungus, which will lower your blood pressure almost right of way, despite the sodium content and MSG in the food. Black tree fungus can also be purchased dried in plastic packs at most Asian markets, so you can prepare at home after soaking in water.

RE: Hypertension?

Former Member — Mon, 28 Dec 2009 16:11:30 GMT

I am still working on the low-salt diet. It is hard to come up with ideas of meals and snacks that are low-salt and somewhat exciting to eat. So far, I think I am able to limit myself to the 1500 mg of sodium per day, but it gets tough when I cannot calculate the sodium values. For example, we (wife and I) made eggs florentine for breakfast (Christmas breakfast), and I have no idea how much salt is in that. We had sushi the other night and I really limited myself to the soy sauce. If the food I am eating doesn't have labels I can only guess. I have been eating celery - 4 stalks a day, because I read several articles saying that celery can lower BP. Has anyone heard of this? "Celery contains a naturally occurring chemical called "apigenin" which has been shown to dilate the blood vessels and contribute to preventing high blood pressure. Celery also contains very small amounts of a chemical in called 3-n-butylphtalide (3nb) which lowers blood pressure by relaxing the smooth muscles that line the blood vessels. 3nb also lowers the level of stress hormones called catacholamines." www.healthstatus.com/.../Celery_Lowers_Blood_Pressure.html I don't really feel like my BP has decreased dramatically, but it has only been a week, if that. In the morning it is highest, an hour after swimming or running, it is great (normal). I have lost 6 pounds having to count my sodium intake. When I know I have 1500 mg to spend, I don't want to waste them on certain foods, and I will save them for some meals. It is possible to ingest 0 mg of sodium a day, but I imagine that is NOT advised. What is the minimum amount of sodium we need, especially as swimmers/runners? How do you know or feel when you are low on sodium? Also, how soon should one see results from doing the low-salt diet? My doctor said 2 months, but I am growing impatient after almost a week. Thanks. The RDI (Recommended Daily Intake) for sodium is 2400 mg (2.4 g). en.wikipedia.org/.../Reference_Daily_Intake I don't make a special effort to reduce salt intake. I have always been light with the shaker. I am a bit sensitive to the taste of salty foods - foods that don't taste salty to my wife taste salty to me. I notice that after a meal high in sodium (like Chinese food) my body hoards water. Then several hours later it just lets it go. That is a clear sign for me that I had too much sodium.

RE: Hypertension?

Former Member — Sun, 27 Dec 2009 14:04:58 GMT

The response to lifestyle modification is measured in months, not weeks. I'm sorry to trot out a tired old saying, but "Slow and steady wins the race". You do not want to reduce your sodium to zero; this would not be healthy, nor would it be appealing! Figuring out the sodium content of foods is a challenge. The best way to get the information you need would be to have a consultation with a dietician. There are charts and tables around that estimate the sodium content of a variety of whole foods, but I'm sorry I can't steer you to them. A dietician would be a very valuable resource. My suggestion would be to do a food diary for several days before you see one.

RE: Hypertension?

Former Member — Sun, 27 Dec 2009 11:27:58 GMT

Even though I am not a doctor. Be very careful about how much you reduce your salt intake. I was told by my doctor that several people have had heart attacks because they reduced their salt intake too much.

RE: Hypertension?

Former Member — Sun, 27 Dec 2009 11:03:08 GMT

RE: Hypertension?

Former Member — Sat, 26 Dec 2009 15:45:36 GMT

I'm a bit late to this thread but I hope I can add something. I am an internist who has treated many hundreds of people with hypertension. Most not nearly as active as Masters swimmers, but more than enough to give some broad perspectives. First, though hypertension should be carefully managed over the long term, stage I hypertension isn't a short term threat. It should still be managed, though. It is far worse off to intend to change your lifestyle somehow and ignore high readings for years. Its a bummer taking a pill, but by all means you should be able to find a bp medication that gives you no or almost no side effects; there are many available. Lifestyle management can be great for some, but on average we only get about 6-8 mm difference. It can be hard, but if you are motivated, use the DASH diet (you can google that). If you are stage I, give the lifestyle 6 months but don't ignore persistently high readings. Office hypertension is common, but you have to be careful in relying on home readings. Use an arm cuff, learn how to do it right; the right way to take your bp isn't hard, but there are a lot of ways to screw it up. BP is a moving target; highest in the first hour of the AM, lower during the day. You'll want to find your running average. And the target of home bp readings should be lower, probably 130/80, as for most of us our bp goes up in the office setting. That said, office readings are the most standardized assessment there is, and unless you can verify a strong discrepancy, I'd suggest you trust the office reading. There's no reason that hypertension should impede an active lifestyle. Even weights should be fine as long as the resistance is moderate and the reps are at least 5-6 (as a general rule). I also agree with making sure other vascular risk factors, such as blood sugar, lipids, and sleep apnea are addressed. Good luck, and don't let it slow you down!

RE: Hypertension?

Former Member — Sat, 26 Dec 2009 15:20:26 GMT

And, remember that the body does need a certain amount of salt to function properly. When I used to work in Saudi Arabia (extreme heat and nearly 99.99999% humidity) there were salt tablet dispensers next to every water cooler or fountain. We were told --by doctors -- to always rehydrate and to take a salt pill or two each and every time we drank. Perspiration also evacuates salt.

RE: Hypertension?

Former Member — Wed, 23 Dec 2009 17:02:23 GMT

Some people even say to bring your own machine to the doctor's office to see how the drive there and the anxiety of being in the doctor's office affects your blood pressure. Useful, also, to calibrate your own monitor against the doctor's. You might not be able to re-calibrate yours but you'll know that yours is off by this or that much.