Dyazide

[Sleepless on LI]

Does anyone know anything about dyazide? Of course I am going to do my normal researching everything I can get my hands on, but I was put on that today to try to avoid going back on my Diovan HCT for high blood pressure.

What is weird is, when I found out I had OSA, I decided to stop my Diovan and see if the oxygen desats they said I suffered from at night was the cause of my high BP; and in the beginning of my therapy, my BP dropped quite a bit. It wasn't perfect all the time, but it was still under the point of needing medication to control it. Now that I've been exercising and eating healthily, my BP has gone up higher than before. This week, it's averaged between 140/94 and 150/104. Not good.

Now, I am sick with a cold, but I don't really think that is what causes your BP to be elevated. I was supposed to go in on Sunday to be hooked up to a 24-hour BP monitor, but was so sick that I cancelled. But I've been taking my BP at home and the numbers got worse. So I called the doctor today and asked her if we could try the lesser of the two evils, which would be a diuretic. This is supposed to be one that won't cause potassium problems, as I was once hospitalized many years ago for unexplained severe potassium deficit. There was almost none in me and I suffered for two weeks with incredibly strong arrhythmia that caused me finally not to be able to breath. They infused me with IV potassium overnight in the hopt. and I was fine; however they never figured out what it came from.

So I was wondering if anyone here takes or took dyazide and what I can expect, other than more frequent trips to the bathroom in the hours just after taking it. I was warned not to take it after 6 PM as I could be up during the night. Just what I need, something else to disturb my sleep cycle...

[christinequilts]

Its funny you mention the potasium issue as that is one thing I remember about it from when both of my parents were put on it. I would still make sure you get a little extra potasium, just in case...I always remember my parents spliting a banana since that was suppose to be enough...not nearly as much fun as a banana split, though. Other then that, I think it is like a lot of the other diuretics...they want the water out so I would plan on lots of bathroom visits.

I just posted a like to ResMeds SnoozeNewz letter on HBP for Lonerider- its interesting to see how prevalent SBD is with cardiac problems.
http://newsletters.resmed.com/Newslette ... 0328r1.pdf

[Sleepless on LI]

Thanks, Christine. You mean I can't use this as an excuse to eat a banana split? Sure I can...I know my mom years ago was put into a hospital and it turned out to be she had been taking a water pill for 20 years and the doctor at the hospital said she should have been supplemented with potassium all along, too. She was really ill, but thank goodness it turned out fine.

Thanks for your input. It's appreciated.

[jdschooler]

Be careful with the potassium...the myocardium (your heart muscle) works using a microscopic sodium & pottasium pump at a cellular level to allow the cells to discharge and fire allowign the muscle to contract. In other words too much pottasium can cause electrolyte imbalances that can cause cardiac arrhythmias...however...the Hydrochlorothiazide will cause some of your serum potassium to be excreted in your increased urine output so just don't over do it and most of all consult your physician to decide if you should take it.

About the Hydrochlorothiazide...I take it every day along with the maximum dose of Divan...works great to lower my B/P to tolerable levels 130/70.

Regarding your recent hypertension...you said you have a cold....have you been taking over the decongestants or antihistmines...ie pseudophed, benadryl, allegra....These medications will help your cold symptoms but almost always raise blood pressure.

[Sleepless on LI]

Jeff,

Before the cold came on, on Thursday I was at my doctor's office and had 145/94. Today it was higher, although I have used nasal spray at night for three nights and last night took Nyquil. Good point.

In any event, I think it's time to do something about what's going on. I don't know if an oncoming cold can raise your BP. If so, maybe that had something to do with it.

Thanks for the thought.

[WAFlowers]

Nyquil contains pseudoephedrin which will raise your BP. Any readings taken right now are in suspect and a doctor shouldn't diagnose meds for hypertension based on them, IMO. Did you inform your doc of all the meds (including all OTC) you'd been taking?

[Sleepless on LI]

Nyquil contains pseudoephedrin which will raise your BP. Any readings taken right now are in suspect and a doctor shouldn't diagnose meds for hypertension based on them, IMO. Did you inform your doc of all the meds (including all OTC) you'd been taking?

Oh, Bill, I wish the readings were post-Nyquil. That might be why yesterday they were so high, but I was at her office on Thursday and they were elevated then, too. I know things like nasal sprays and decongestants can do that. She's been watching my BP for the past few months, since I stopped taking my Diovan HCT, and she was always saying, "You're still borderline..." But when she saw the readings twice on Thursday, before the cold, she was not happy.

Thanks for the thought, but unfortunately the timing wasn't that way.

[jdschooler]

Sleepless,

From a Paramedic who has OSA and Hypertension.....A Cold can definitely cause hypertension even without and OTC Med's the body is a miraculous machine that has a compensatory mechanism for almost everything that can go wrong with it. The increased physiological immune responsee to a virus or bacterial infection cause increased levels of epinephrine and norepinephrine to be released to help keep up with the metabolic needs of the body to fight the invading bug....The OTC Meds can just make it worse but sometimes can't be avoided....It sounded to me that you are already Diagnosed with Hypertension and medicated before and stopped taking the Diovan....did your Doc tell you to stop or did you stop cause your B/P seemed under control???? The later I Bet...While CPAP and weight loss will most likely help keep your B/P down you will be very lucky to get rid of the need for antihypertensive medications....In addition abrupt cessation of these medications can actually cause chest pain and even heart attack or stroke so NEVER stop them without consulting your Dr. first.

[Sleepless on LI]

Jeff,

Thank you so much for that great information. I was wondering if the onset of a cold, ie., an infection in your system, could elevate the BP. I stopped taking my Diovan HCT when I knew I was going onto CPAP because since they told me my oxygen desats were moderate, I could only believe that was what turned my normally low BP into borderline hypertension. I figured if I stayad on the medication and my BP did go down, I wouldn't know if the CPAP would have done so without meds.

When I first started CPAP, yes, the BP dropped. A lot of times, I could get readings of 117/70 but other times it was 135/88. It fluctuated But I was told that rule of thumb to be on BP meds. was 140/90 and above, so I thought I was okay. Every time I'd go to the doctor, it would be just under 140/90, and she thought I might have white coat syndrome.

Well, when I went last Thursday for a bad elbow, she took my BP and it was high two times, 140's over 90's. She said she wanted me on a 24 hour BP monitor and I was supposed to be hooked up this past Sunday if it weren't for feeling so sick from the cold. So I cancelled. But in the interim, I was taking my BP on my Omron and it was not good at all. So when I saw 150/104 yesterday, I panicked and called her and asked if we coudd try a diuretic first since I had lost 3 pounds overnight, thinking it may be a water retention problem before going back on the BP med. She agreed, and that's where I am today. I did lose. believe it or not, 7 1/2 lbs. this week, with 4 lbs. coming off from yesterday. Tells me something about water weight, no?

So I guess I'll have to wait and see what happens. If the BP doesn't go down with the Dyazide, I will know for sure it's not a water retention-induced hypertension. If it does come down, phew!

Thanks for your concern, Jeff. It is appreciated.

[Guest]

Sleepless,

Sounds like you have a good Dr. that is listening to your input....In medicine the good healthcare providers know to listen to there patient....they usually are right as it sound like you might be...Can't beat lowering your B/P and losing wieght at the same time...The recent B/P guidelines have lowered the target B/P to like 120/70 I think...bet then again these are the same people that say I am supposed to weigh 179 lbs....Ha....I'd look like asack of bones....I'd be happy with 220. Well, Good Luck

[Sleepless on LI]

Guest,

Thanks for the reply. In the old days (a few years back AND my whole life), I had extremely low BP, but averaged around 118/68. For me to see numbers like 150/104, it could almost give me a stroke (God forbid) just by looking at them.

I am not expecting my BP to be that low until I lose ALL my weight; which, according to this morning's numbers, another 15 lbs. to go (I bought a new scale that is now equal to the doctor's scale-didn't like that initially). My doctor also said genetics and extra weight can do that, in addition to processed foods and salt. The latter two are not my problem. The first two are. My maternal grandfather died when I was 3 due to a massive coronary and my mom said he had high BP, and I still have a few lbs. I want to get rid of, although my weight is considered okay according to Weight Watchers' standards.

I am starting to wonder, though, what is happening. From yesterday morning to last night, I lost another pound. And then when I woke up, I weighed myself again and lost another pound from last night. Then, just to make sure it was true, before showering a couple of hours after I woke up, I got on the scale and lost another. Six lbs. in two and a half days on the water pill and four before that from one night to the next. I just pray everything is all right. When I told my husband, his reply was, "You're never happy, are you???" But 10 lbs. since last Friday? Hmm...if I'm fine, I'm thrilled. If this is an indication of something else...I guess I'm never happy. He's right.

[sleepybarb]

Hi Lori:

A few things you should watch out for:

All diuretics except the potassium sparing ones (like spiranolactone) will cause potassium loss. You should get your potassium levels checked (especially if you get any leg cramping or arrythmia) and see if you need supplemental potassium. Unfortunately if you are losing a lot of potassium a banana a day isn't enough--it means taking supplements (which taste foul!)

That much fluid loss after initiating diuretics could (not does) mean that your heart may not be pumping too efficiently. You may want a cardiologist to check you out with an echocardiograph--this is not invasive and doesnt hurt but gives an idea of the pumping efficiency of the heart. Sustained hypertension (even what used to be called mild) frequently leads to diastolic dysfunction of the heart, in which the heart does not relax to let enough blood in before pushing it out. This is not intended to scare you, just to say get checked out. There are also good options for managing blood pressure (such as ACE inhibitors) which also help the heart; a cardiologist can advise re this.

My third bit of advice is restricting sodium--the average American diet has way too much salt in it! This will help reduce blood pressure and decrease fluid retention.

[Sleepless on LI]

Sleepybarb,

Thank you so much for your caring post. I truly appreciate your taking the time to tell me all of that information. I do want to address each point.

First off, Dyazide is a trademark for a drug combination of hydrochlorothiazide and triamterene. I believe the latter is a potassium sparing diuretic. That is the reason my doctor put me on this one in particular. But of course I will stay on top of my blood work. I am very, very pro-active in any of my healthcare matters and never take things lightly, no matter how trivial it may seem. I've had things go wrong in my life already pretty badly and I don't take my health for granted in any way. I'll do whatever I can to keep it.

Next, about the loss being possibly related to the heart and the diastolic pressure, it actually is lowering. From 104 the other day pre-diuretic, it was 88 this morning. Much, much better. Also, I don't feel any problems and I've had some pretty heavy cardiac problems in my life that were corrected finally by two cardiac ablations, the last one in 2001 which lasted over five hours. Haven't had a problem since, thank God. I am very, very sensitive to my heart and when it is not right and I'm thrilled to say that I haven't felt anything out of the ordinary since starting the Dyazide. I have had many an echocardiogram and am very familiar with them. It's one of the easiest tests associated with cardiac problems other than an EKG. I have also undergone two EPS, electro-physiology studies, you can't get more invasive than that, where they go in through the groin and, in my case, the neck, too, into your main artery and send a catheter with a camera to investigate your heart. I'm oversimplifying it because I have a feeling you know what it is because you sound very educated about heart disease. I am no stranger to it, either, believe me.

Lastly, when I was trying to manage my tachycardia and arrhythmia many, many years ago by medication, before deciding to undergo all the invasive procedures to finally correct my problem, I was put on all sorts of blockers and inhibitors and they, as I put it, make me feel like someone tied my laces together and told me to run. I cannot tolerate them. I have a career, three kids and a husband and I cannot be made to feel that lethargic. They are not anything I can entertain. One of the reasons I ended up undergoing my EPS and ablations. Also, I do not cook with salt, I do not add salt to my food and I do not eat processed foods or foods high in sodium. I know all about how even bagels are full of sodium and can raise your BP. I'm telling you, I do my homework usually.

Thank you very much, again, for the info. I will, of course, pass this on to my PCP today and see what she says just to be safe. I doubt I am going to continue to lose 10 lbs. in a week, though. If I do, then for sure I will think something is seriously wrong. No one can continue to lose 10 lbs. a week and think it's normal. But in the old days, when I started Weight Watchers, my first week would always be that successful, with an 8-10 lb. loss with no diuretic at all, so I can't help but believe my plateau has finally been broken and the water weight is being eliminated. Thanks for your concern, really.

PS: I just wanted you to know that I took your post very seriously and called my doctor. She said I shouldn't worry at all, that it is doing its job and that I should be happy. But she also said I shouldn't expect to keep getting this type of weight loss; that should be it. But once again thank you for bringing it to my attention.

[Guest]

Sleepless,

Not too make you worry but to give you something to think about or research before your next Dr. Visit is the possiblity that your hypertension is caused by renal insufficiency....not renal failure....renal insufficiency can be caused by decreased blood flow to the kidney or kidneys and can sometimes be corrected by inserting a stent in the renal artery thereby increasing the blood flow which will increase the blood that is filtered and increase your urine output. I have patients that have completely come off of B/P meds and diuretics as a result. Something to look into since your weightloss is so quick with the use of diuretics....

Sometimes Dr.'s need cues from their patients to find the real cause...it is real easy to give a medication..see that it worked...and go not further instead of finding the cause....Your Dr. most likely has a lot of patient's with many different problems and I can only imagine how hard it would be to have so many medical conditions to ponder and try to solve at one time...


Ohh...by the way this is Jeff...The NoLonger Sleepy Medic.

Keep good spirits and good luck

[Sleepless on LI]

Jeff,

Thank you for your advice. Wouldn't I have other symptoms, though, of renal insufficiency if that were the case? Other than my hypertension that just recently went back to where it was troublesome, and I'm happy to report as of today was 123/83, which I'm finding now from what others have said could have been from the infection in my body and the week long cold I just am getting over, I have no complaints. Wish I could sleep through a night occasionally, but don't feel ill or even get up during the night anymore, since starting therapy, for the bathroom.

I am going to look up this condition. I do have to say on my doctor's behalf, she is incredibly wonderful and has always been, since I've been using her for the past eight years, an excellent diagnostician. She has never missed anything yet and knows what is wrong right off the bat. The first time I went to her, she pegged me as having hyperparathyroidism, which, if you aren't familiar with it, is a disease where your body releases your calcium from the bones in the form of crystals into the bloodstream, they end up causing severely painful stones as each crystal is like a snowflake whose edges are razor-like, and they are one of the most painful to have. But she met me for the first time, said, after doing some in-office tests (I won't get specific) that she felt I had a stone and sent me for a sono. When the results came back the next day that confirmed the stone, she said, "I think you have hyperparathyroidism. I want to draw some blood to see." I asked her if it was, what did that mean. She told me, it's only curable by surgery. I thought this woman was an alarmist, a crazy person. She was one hundred percent on the money. I never heard of the disease, let alone knew a doctor who, from just examining you and finding out you had a stone, could call the diagnosis so perfectly. Since then, she hasn't failed me yet. I find her amazing. I have put my trust in her and she was not at all concerned when I called her after reading Sleepybarb's post to me today. Said the Dyazide did exactly what it was supposed to do. Said it was wonderful that I had lost 7 lbs. in such a short time, but not to expect this to continue as it had served its purpose. She was not at all concerned.

So I thank you very much for your caring. It really means a lot to me. I do always research things to death and I will now go do some investigating into signs and symptoms of renal insufficiency. I would think, though, that there would be some signs or symptoms that would give me a hint other than losing 7 lbs in water weight on a diuretic. As she said, it did its job.