its so unfortunate to hear about your situation. I'm an internal medicine resident, eventually hoping to become a cardiologist, and work in a county hospital and VA and hear about this all the time.
Most of the medications you were on have generics that can be bought at walmart/target for 4$ if you qualify for their program, which I think you would given you've lost coverage and you have a medical condition such as heart failure and diabetes.
Unfortunately, the reality is if you had bp in the 200's, then coming off your meds is going to cause your bp to increase, not necessarily to 200's, but possibly to 150-170's. Your goal is going to be less than 130/80 given you have heart failure and diabetes.
The consequences of not having controlled blood pressure (bp) is going to be have your heart strain harder to overcome the resistance from bp and it already consume more oxygen than it already does in its weakned state. That can lead to 1) heart attack which would further damage the viable heart muscle you have left 2) possibly put you into a decompensated state where fluid can build up in your lungs and you'll have trouble breathing. Of course this most likely wouldn't happen in a day or two, but over weeks could lead to a hospitalization. This is important because there is a correlation with how often you're hospitalized for heart failure and mortality.
More importantly, some of the medications you're on not only lower blood pressure but have been proven to decrease mortality associated with your heart failure condition. Namely, metoprolol and ramipril. Metoprolol being a beta-blocker and ramipril being an ace-inhibitor. These medications have been proven to prolong patients' lives who have your similiar condition.
Seeing that you're on lasix, i'm guessing you have pretty moderate to severe heart failure where your legs swell and fluid retains, thus necessitating you being on this medication. This is a diuretic which makes your kidneys excrete more urine to prevent fluid buildup. It also has and indirect effect at lowering blood pressure. Though this medication does not have any benefit in mortality, it does decrease the chance of fluid building up and causing you to be in the hospital.
Unfortunately, what I'm saying is for your benefit, you should continue these medications. Metoprolol, ramipril, and if you can't get ramipril, then maybe your doctor can switch you to lisinopril or enalapril (same drug class that's on the generic list) to help. If he can right norvasc as amlodipine, i think that should also be on the generic list.
The only other things nonpharmacologically you can do is like you're already saying, limit salt intake and fluid intake. For weight loss, insulin sucks because its a growth factor and can cause weight gain. As a result, for my patients, i try and get it to them that to minimize, weight gain, you're gonna have to minimize your insulin dosage. And to minimize your insulin requirements, you're gonna have to minimize your spikes in blood sugar aka minimize unhealthy carb intake.
Sorry to say, there's not going to be a simple solution for your case.
Most of the medications you were on have generics that can be bought at walmart/target for 4$ if you qualify for their program, which I think you would given you've lost coverage and you have a medical condition such as heart failure and diabetes.
Unfortunately, the reality is if you had bp in the 200's, then coming off your meds is going to cause your bp to increase, not necessarily to 200's, but possibly to 150-170's. Your goal is going to be less than 130/80 given you have heart failure and diabetes.
The consequences of not having controlled blood pressure (bp) is going to be have your heart strain harder to overcome the resistance from bp and it already consume more oxygen than it already does in its weakned state. That can lead to 1) heart attack which would further damage the viable heart muscle you have left 2) possibly put you into a decompensated state where fluid can build up in your lungs and you'll have trouble breathing. Of course this most likely wouldn't happen in a day or two, but over weeks could lead to a hospitalization. This is important because there is a correlation with how often you're hospitalized for heart failure and mortality.
More importantly, some of the medications you're on not only lower blood pressure but have been proven to decrease mortality associated with your heart failure condition. Namely, metoprolol and ramipril. Metoprolol being a beta-blocker and ramipril being an ace-inhibitor. These medications have been proven to prolong patients' lives who have your similiar condition.
Seeing that you're on lasix, i'm guessing you have pretty moderate to severe heart failure where your legs swell and fluid retains, thus necessitating you being on this medication. This is a diuretic which makes your kidneys excrete more urine to prevent fluid buildup. It also has and indirect effect at lowering blood pressure. Though this medication does not have any benefit in mortality, it does decrease the chance of fluid building up and causing you to be in the hospital.
Unfortunately, what I'm saying is for your benefit, you should continue these medications. Metoprolol, ramipril, and if you can't get ramipril, then maybe your doctor can switch you to lisinopril or enalapril (same drug class that's on the generic list) to help. If he can right norvasc as amlodipine, i think that should also be on the generic list.
The only other things nonpharmacologically you can do is like you're already saying, limit salt intake and fluid intake. For weight loss, insulin sucks because its a growth factor and can cause weight gain. As a result, for my patients, i try and get it to them that to minimize, weight gain, you're gonna have to minimize your insulin dosage. And to minimize your insulin requirements, you're gonna have to minimize your spikes in blood sugar aka minimize unhealthy carb intake.
Sorry to say, there's not going to be a simple solution for your case.
I don't think you need to regulate BP so fanatically, it varies throughout the day, so as long as you measure it at the same time once a day you should be fine. Good to see you seem to have everything mostly under control though
Facebook
Twitter