High blood pressure from pred.

I've only been on the hctz for 3 days. The theory is that diuretics relax the vascular system.. I cannot take beta blockers with reactive airway disease -they cause bronchial construction.

Then you are probably right about the suddenness - you probably already had raised BP and there is whitecoat syndrome as someone else has mentioned. If you have vasculitis then that can lead to raised BP and it is possible that the pred will reduce it as the inflammation reduces.

No, you can't take betablockers with airway disease but there are other BP meds besides them, I just said what I'm on. Diuretics aren't usually given to relax the vascular system as far as I know - they remove excess fluid so the existing system can cope with the reduced fluid volume. 

eileen.

My stepson is a pharmacist and when I started on pred about 3 years

ago he was very concerned.  Also not happy when I told him I was on

a diuretic HCTZ for BP,,,,,,he told me that pred leeches calcium out of your  bones and the diuretic washes it away.....have you ever heard that particular concern?  I stopped taking it and started plant based

calcium with vit d and k.   Hard to know what to do on a regular

basis as some new side effect or problem pops up on a regular

basis......PMR   BLAH!!!!!  Pardon any typos....I'm scheduled

for cataract surgery on Wed. and don;'t see really well....

Hi Eileen

Do you have any sources of research that describe how PRM can affect the heart or be related to atrial fibrillation. My doctor and nurse practitioner don't seen to think there is any connection, but I would like to know if it is the prednisone or the PRM causing my symptoms.

This might fit the bill:

Abstract 19559: Risk of Atrial Fibrillation is Increased in Patients with Autoimmune Vasculitis: A Population-Based Cohort StudyRowlens M Melduni; Mohammed N Nazmul; Shreyasee Amin; Bernard J Gersh; Kent R Bailey; Stephen S Cha; Leslie T Cooper; James B Seward; Hon-Chi Lee

PMR is almost certainly an autoimmune vasculitis.

Or this

Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases.Seferović PM1, Ristić AD, Maksimović R, Simeunović DS, Ristić GG, Radovanović G, Seferović D, Maisch B, Matucci-Cerinic M

Again, it is a rheumatic disease with autoimmune origins.

My a/f is definitely NOT due to pred, it had started long before I was given pred, but pred can also cause new-onset a/f:

"A daily dose of at least 7.5 mg of prednisone equivalents was associated with a six-fold increase in risk of new onset atrial fibrillation, Cornelis S. van der Hooft, M.D., and colleagues, of Erasmus University Medical Center reported in the May 9 issue of theArchives of Internal Medicine.

Moreover, the increased risk was "found in patients with and without asthma/COPD", the authors wrote.

There was, however, no observed increase in the risk of atrial fibrillation among patients treated with low or intermediate doses of corticosteroids."

It is commonly known that RA leads to an increased rate of a/f and I did ask a rheumy about it and did it also apply in PMR. I got the dismissive response of "The incidence is increased in the age-group anyway". That wasn't actually what I asked - I wanted to know if the rate is higher in the PMR/GCA population than in the general population - but I assume no-one has looked at the question. 

Every so often I find myself spitting feathers as I hear of people (mostly who should know better) dismissing a question with "there's no connection". Tell me you don't know, that's fine, or you don't think so - but don't ever categorically rule it out unless you KNOW there is cast-iron proof. 

Thanks for the references Eileen. My blood pressure has been climbing steadily since I started prednisone (20mg last May, down to 13 now), but the increase in heart rate and fluttering heart with shortness of breath is new. Weight gain of 15lbs might be a factor, but it is so difficult to tease out cause and effects.

It doesn't matter WHAT is causing anything - it needs investigating and managing if appropriate. Atrial fibrillation, any arrythmia, poses a risk if ignored. Weight gain might be a factor - it is a risk factor for a/f, in cobination with Type 2 diabetes even more so - but that doesn't mean that you say, it's your weight, full stop. You attempt to reduce the weight gain - but if the a/f is there, you at the very least put the patient onto anticoagulant therapy. It shouldn't be ignored.

Faye, my pressure is high at home when I am relaxed. I never had "white coat". It was always 114/70 or thereabouts in the office; this hypertension started while on pred; it was not high when I had Untreated PMR.

Now you know that's not your problem.....  My pressure went

up a little when I started on pred but not signifigantly......

I`m exactly the same....once went to doc`s my BP went to 200/120....it caused him to remove his glasses!...but it became reasonably lower after 3 attemps.  taking it at home it was....145/90...perhaps they should wear floral coats not white

I had a cataract removed yesterday and the doc that puts patients

to sleep was very concerned even though I had a letter from my

primary doc of l7 years about my "white coat".  I had a log book with months and years of readings I have taken at home and wish the medical profession could accept that there is such a problem.  I'm

on two kinds of blood pressure meds but still have the same

problem..  It's such a strange business.  However the  cataract

surgery was very sucessful.....when I looked at TV it was like

The Wizard of Oz.....went from black and white to color.   Couldn't

believe the blue tones.....one down and one to go.  

I didn't know you could see so much difference so quickly - what a good result.

They happily accept "white coat syndrome" here - like alot of other things...

You kind of don't realize what you are not seeing until you see

again.  It comes on gradually.  I can read without glasses at all

but will need the left eye done also.  It's rather miraculous that

they can save your sight instead of going totally blind the way

it used to be before some genius came up with this surgery.

They put a lens in your eye which makes it like new again.  I

will have to have reading glasses but can live with that.

As for the "white coat" I try not to let it upset me and make

things worse.  My doc understands and accepts it....

You were put to sleep?  For some reason I always thought cataract surgery was done under local anaesthetic.

Yes I gather that - people having a fit at the state/colour of the curtains "Why on earth did you let me choose those..." sort of thing.

I'd actually LIKE to develop cataracts - the thought of only needing reading glasses is very seductive  

there is a anesthetiologist (spelling) that puts you under briefly

and the eye doc does a block of some kind on the eye.   The

nurse said they give you propofol (same med that killed Michael

Jackson) after block is done they bring you out of sleep.

You are sedated somewhat but aware....everyone has always said

"you don't feel a thing"   however, I did.  He kept putting Lidocaine

on my eye.   Not the most pleasant procedure I've ever had.

One more thing I thought of.....they ask you if you are

claustrophobic or think you might panic and if so you have

the option of being put to sleep for the procedure.   I didn't want

to have to go through the waking up process and hopefully just

get it over with as soon as possible.  It's not bad and no one

should dread it.  The whole process takes about l5 to 20 minutes

to take out the cataract and put the lens in place....

Very interesting.  I kind of hope I don't have to experience it myself, but who knows what the future will bring....