Unusually high blood pressure

[Guest ANCY]

The last couple days I have had a drastic change in blood pressure, "normal" for me is swinging between 50s/20s to 110s/80s with occasional excursions to 150s/100s. The last few days I've been between 135/103 to 173/125, mostly staying at the high end of that. Trouble is we can't seem to identify a cause and it seems that the clonidine is becoming less effective or maybe even raising it. We think there may be a possibility it's the Levaquin and doxycycline I'm on, but I've been on them for months and we haven't changed them. On Thursday morning it sure seemed like an allergy thing because my face was flushed and itchy and having hay fever kind of symptoms going on so I took benadryl in addition to the clonidine. Helped with the itchiness and puffy watery eyes but blood pressure remained high.

We came close to going to the ER last night but my blood pressure came down to 140/106 so we decided to at least put it off till morning and reevaluate. I am having headaches, pounding in my head, ringing in my ears, and feeling weak as a result of the blood pressure. 

Has anyone had such a drastic change spontaneously? How long did it last? What did you do about it? 

Thanks so much for reading and replying!

[haugr]

I had some wild swings like that.  My worst lasted about a day and a half, but usually they only lasted a few hours.

In my limited understand, there are a couple of ways that your body raises it's blood pressure.  The first is the kidneys activating the renen-angiotensin-aldosterone system when blood flow is low (typically when you're dehydrated).  The second is from an activation of the sympathetic nervous system which happens when you are stressed, but also is activated by the brain as a way of increasing its blood supply.  When my wild swings were happening that put my blood pressure dangerously high, I'm pretty sure it was from a combination of all of those.  

Clonidine will suppress the brain's activation of the sympathetic nervous system.  It definitely helps me, but I still have had some crazy spikes when while on it.  I actually got into a pretty strange cycle where I was on too much clonidine which led to some terrifying symptoms (bradycardia, chest pain, etc) and the fear from those symptoms activated my sympathetic nervous system more than what the clonidine was suppressing.  I was also on too much sodium supplementing at the time.  All of this caused high blood pressure spikes even while on a high dosage of clonidine.  Since it was somewhat counter intuitive it really stumped my doctor.  It took a while to get the dosage of everything right, but I eventually did.  One thing that helped me a ton was adding losartan as a second blood pressure medicine to suppress the renin-angiotensin-aldosterone system.  An anti-anxiety medication has been beneficial too.

Clonidine won't help much though if the source is not from the brain - like if a person has a pheochromocytoma.

[Guest ANCY]

Thanks so much for explaining all that. I know a lot more about low blood pressure than high lol! I'm sorry you've had to deal with the swings, glad you figured it out. I'm going to get in touch with my cardiologist Monday and ask them about trying something different. Today I tried not taking the clonidine after I got to 163/119 and my blood pressure came down slightly on its own. We are starting to really think that the clonidine is somehow pushing it uoghrr or at the very least a medication is affecting my bp. Obviously keeping a close eye on things and we'll go to the ER if we get to that point before Monday.

[p8d]

I had spikes, not that high but they were worrisome to me and my PT.  In the end I increased methyldopa and lowered my fludricortisone dose and salt.  All of these helped.  I think lowering the fludricortisone helped most.  My neurologist and cardiologist said not to worry/go to the ER until it hit 180/110 but I prefer it 130s-140s/80s.  It took me about three or four months to figure it all out.

[Guest ANCY]

Thanks p8d for sharing. We did go up on my florinf a couple weeks ago, maybe its hitting late. My cardio also didn't seem worried about 160s/110 but did have me start the clonidine to try and alleviate the headaches associated with it. Aim to talk with cardio tomorrow I might just go ahead and ask about the methyldopa.

Today has been kind of weird, started with 163/113 and then dropped to 62/40. I think the drastic swings bother me the most, also makes it hard to treat either of them. Apprehensive about taking the midodrine or clonidine... Eventually did take the midodrine but only got it up to 79/37.

[p8d]

Yikes, Ancy,  those are serious swings.  I really like methyldopa, it doesn't drop my bp like clonidine did.  It's so frustrating when things change suddenly and you have to spend months working out a new med regime.  Please let us know what the cardio says.

[yogini]

I would definitely ask your doctor a lot of questions. You can also google and research the side effects of florinef and do some searches on the forum, because many people have similar stories. Your experience sounds like mine when I increased my dose too high and had to taper off.     Florinef takes a couple of weeks to kick in.  Headaches and high BP are definitely indicators that your dose may be incorrect.  I would be concerned about taking midodrine with high BP and ask your doctor specifically whether it is ok to miss a dose of midodrine when your bp is high.  

[Guest ANCY]

Thanks for your input. I have not yet heard back from my cardio in regards to my bp. Going to try them again today. I am not sure it's the florinef alone, I've been on it for years, and an even higher dose of florinef before and right now I'm still having lows. I do not take the midodrine when my bp is high. Trouble is that I'm dropping so drastically and low enough that I HAVE to treat. (50-60s/30-40s)  I do have a lot of leway in regards to meds, otherwise I'd be calling them every other day. The unusual part is that I'm going so high. 

[yogini]

Try your pharmacist if your doctor isn't responding.  And separately make an appointment with your dr if he doesn't respond by phone. Things can change and if your BP is suddenly going high at times, I think it is important to reconsider the dosing on any meds that increase your BP.  If it recently started up after increasing your dose, then the change in dosage is something important to think about.  

I am not a doctor at all, but I also really didn't understand why your doctor was giving you clonidine to counter the florinef. That seems unusual.

[Guest ANCY]

Thanks, we are discussing options. Its less urgent now as my BP has steadily been dropping and avg around 80/50 now. Something we thought was unrelated was my allergies which have been going haywire but that has calmed down as well so thinking the two may be related. We have yet to identify what I was reacting to however we believe it is environmental not pharmaceutical as I haven't started anything new. I'm allergic to pollen, grass, horses and cats that we know, not sure exactly how I've been exposed though as I haven't spent any time outside recently. Its a bit of a puzzle lol!

As for the florinef and clonidine that's because clonidine is short acting and has been successful for months treating my random infrequent highs. When I started it I had been managing at a stable dose of midodrine and florinef and we believed the bp highs were related to uncontrolled pain.