My adventure with blood pressure meds

Prior to my two knee replacement surgeries, I’d never taken medications to reduce my blood pressure. I didn’t worry about it. The few times I’d had my blood pressure taken in a doctor’s office it was always high—the “white coat effect.” When I take my blood pressure at home, it hovers somewhere in the 125-145 range—sometimes lower, sometimes higher. As I feared, at my pre-surgery appointment, my blood pressure was 190 over something, a number that alarmed the medical personnel and led them to require my local doctor—whom I hadn’t seen in 20 years—to give the go-ahead for my surgery.

At my doctor’s office, as I predicted, my blood pressure was also very high. I needed some kind of intervention that would make it possible for me to have the surgery. My doc prescribed a medicine that combines lisinopril and hydrochlorothiazide. Lisinopril relaxes the blood vessels; hydrochlorothiazide, a diuretic, reduces blood volume. I started taking that medicine—what I call the “combo” drug.

One morning prior to my surgery, I felt a little light-headed and took my blood pressure. It was 87 over something. Whoa! Normal is supposedly 120 (systolic) over 80 (diastolic). (Systolic is the highest arterial pressure just after the heart contracts; diastolic is the minimum pressure during relaxation.) Thinking that the combo drug was overkill, I asked the doc to give me a prescription for just the diuretic, which he did (12.5 mg dose).  

Returning to my doctor’s office, my blood pressure was low enough that he gave the go-ahead for the surgery. To make sure my blood pressure was reasonable prior to my surgery, I took the combo drug for two days before going in, but in between surgeries I took just the diuretic. Prior to the second surgery, I took the combo drug again, just to make sure they didn’t kick me out. After that, I continued taking just the diuretic.

Three weeks after my second knee replacement, I quit taking any blood pressure drug. Since then, I’ve been taking my blood pressure twice a day. As before my surgery, it has stayed mostly in the 125-145 range. That seems OK to me. I relayed this information to my local doctor and he agreed.

It seems to me that an old person shouldn’t be expected to have the same blood pressure as a young person. I’ve started researching this. It appears that nobody really knows what the target should be for  for people my age (85). Some say 150/80. Some say more, some say less. I’ll say more about this next week.

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