Some years ago I was put on medication for elevated blood pressure, as my mother before me. I took my medication and checked my values “religiously”… All of a sudden last October I developed malignant hypertension. I was hospitalized 3 times in 3 days with values over 220, then the hospital sent me to a nephrologist. He started running tests which were all normal. The hospital put me on Clonidine but the nephrologist did not add anything while running tests. In November I had to be hospitalized again. That time the ER doctor said they were not going to release me back to the same situation and added Amlodipine Besylate. My blood pressure has been normal with one brief spike since. Problem now are medication side effects: edema of feet and legs, hearing loss from fluid retention, bloating and constipation and generally not feeling well. I had always worked full time but finally retired this March. I am very disappointed to think that after working so hard for so may years I am going to feel like this in retirement due to side effects. I have talked to my nephrologist, especially a few weeks ago when I developed hearing loss from fluid retention and found that all the side effects are cumulative. He sent me an email saying we will stop the Clonidine and Amlodipine with no adjustments or anything in their place!! My pharmacist has tried to be helpful but can’t change anything. He says Amlodipine is one of the worst meds for side effects and many patients have to stop it for something else. The nephrologist does not seem to have done any research on side effects in order to suggest alternative medications, or to offer adjustments. He seems kind and listens, but offers nothing. In fact all of my medications for this condition were prescribed at the hospital. We have few geriatric doctors in this area, and no geriatric cardiologists. My regular cardiologist who just prescribed my standard meds cancelled my appointment when I developed the spikes. I already knew he was not up to challenges…I see an adult congenital cardiologist every so often even though he tells me I don’t need him as my congenital repair and heart are fine. There are not a lot of nephrologists here, but I think there is a better one in the same group so I doubt he will see me. I am really in a dilemma because I certainly cannot risk spikes, but would hope to feel better and not risk side effects such as fluid retention causing worse problems. It has also elevated my blood glucose which I watch and control through diet and exercise. The medication had my blood pressure running as low as the low 80s over low 50s, obviously too low, which is when the edema developed and I was lethargic. Now values are good. I have found little information on malignant hypertension and had never heard of it. I will greatly appreciate any suggestions. Thank you! PS I do not have a primary care doctor because so many here will not take Medicare and the “good” ones are not taking new patients or retiring. I have been looking for some time. My neurologist even had me send records to his good friend, an internal medicine specialist and they called and said he couldn’t help me….I had endocarditis at age 5 and have some medical PTSD. Sorry to write a novel, but I am thrilled there may be some help for me!
Enjoy a nice, sunny day and go for a brisk walk, for aerobic physical activity at least 30 minutes per day. Kennedy believes this "can decrease systolic blood pressure by 4-9 points." However, even "ten minutes a day can make all the difference." When blood pressure isn’t controlled, general isometric exercise is bad. Preferred cardiovascular exercises include: walking, running, cycling, and swimming.
Stress hormones constrict your blood vessels and can lead to temporary spikes in blood pressure. In addition, over time, stress can trigger unhealthy habits that put your cardiovascular health at risk. These might include overeating, poor sleep, and misusing drugs and alcohol. For all these reasons, reducing stress should be a priority if you're looking to lower your blood pressure.
Bananas are one great source of potassium, but there are other tasty ways to get your fill. Potatoes actually pack more potassium than the yellow fruit (and you might be surprised to learn there are plenty of other health benefits of potatoes, too). Sweet potatoes, tomatoes, orange juice, kidney beans, peas, cantaloupe, honeydew, and dried fruits like prunes or raisins are other good sources. In all, you should aim to get 2,000 to 4,000 mg of potassium a day, Van Horn recommends. 

The causes are most often some combination of clogged “pipes” and excessive salt in the diet. Lifestyle changes, such as appropriate diet and exercise, are among the most effective treatment strategies for high blood pressure. Relaxation, meditation, and otherwise “taking it easy” are not effective solutions, as valuable as such strategies may be for your psychological well-being.

Meditate or take slow, steady deep breaths to calm the nervous system, relax and your dilate blood vessels. Breathing exercises help calm your sympathetic nervous system and your fight-or-flight response. This technique also encourages blood flow to your body’s tissues and causes your diaphragm to move up and down, which eases blood flow to your heart.
Ask your doctor if low-fat or nonfat milk is better than whole milk for you. Whole milk can lower blood pressure better than low-fat or nonfat milk, but there may also be risks. Whole milk contains Palmitic acid, which, according to some studies, can block internal signals responsible for relaxing blood vessels. As a result, your blood vessels stay constricted and your blood pressure remains high.[7]
I totally agree with you that we should not rely on medication for high blood pressure. End of the day, high blood pressure is a symptom that our body requires immediate attention. The kidneys work extremely hard to send out the “signal” to us and what we did is to pop a high blood pressure pill to suppress the signal. With this medication, our body has to work even harder to send us another signal. No wonder over the long run people who are suffering from high blood pressure needs an additional pill for deteriorating kidneys. Our body is fully capable of healing itself without us realizing it. I strongly encourage high blood pressure sufferers to listen to this and say goodbye to high blood pressure once and for all:
“I always recommend that people find something that they enjoy doing to stay in shape. For example, line dancing, walking outside, and riding a bike are all good ways to get active,” says Scott Parker, a health and fitness trainer and a national spokesperson for #GoRedGetFit — an online fitness challenge for women hosted by the AHA and Macy’s. “It’s also important to find other people you like doing the activity with, because that helps you stick with it.”
Diabetics often have lower recommendations for blood pressure, the maximum normal value being seen as 130/80-85. However, it’s questionable whether it’s a good idea to medicate your blood pressure levels down to those values. Diabetics can probably stick to approximately the same upper limit as people with heart disease: 140/90 (according to new studies and expert comments, as well as the latest recommendations from the American Diabetes Association, ADA).
If you are in this 130/80 range, reducing your blood pressure can help protect you from heart attack, stroke, kidney disease, eye disease, and even cognitive decline. The goal of the new guidelines is to encourage you to treat your high blood pressure seriously and to take action to bring it down, primarily using lifestyle interventions. "It is well documented that lifestyle changes can lower blood pressure as much as pills can, and sometimes even more," says Dr. Fisher.
Thank you so much for your highly informative article on hypertension for seniors–the best one that I have read. Presently, my wife, age 78, weight 98 lbs., height 4′ 11″, has been on a 4 m Atacand (brand name) per day for close to ten years now. Healthwise, I was concerned about its side effects on her. Pricewise, it is a very, very costly drug and our plan now requires her to pay a newly required deductible of $350 before reaching a new copay that has also become more expensive as well. She does not smoke or drink. Her family doctor has suggested that she switches to a generic brand Atacand but she prefers not to risk with its poorer bioavailability. Is such a preference valid? Are there any benefits in a generic that would outweigh its bioavailability constraint? Is there any alternative brand name drug that would offer her a good transition? Thank you kindly again for sharing the above highly informative, useful, and rare article regarding hypertension for seniors. I’d look forward to your reply with great appreciation–if I may.
SJH provides a full range of care facilities including 16 acute care hospitals, home health agencies, hospice care, outpatient services, skilled nursing facilities, community clinics and physician groups. All of our hospital and home health entities are accredited by the Joint Commission. In our award-winning facilities, SJH maintains a "continuum of care," matched to the diverse needs of the urban centers, smaller cities and rural communities who depend on us every day.
A study published in the Journal of Bioscience, Biotechnology and Biochemistry looked at the effect that vinegar has on blood pressure if it is introduced to your diet. The results of the research showed that consumption of acetic acid (which is found in apple cider vinegar) caused a significant reduction in hypertension (high blood pressure). The research found that the acetic acid reduced blood pressure by lowering the renin activity. Renin is an enzyme which helps regulate blood pressure. I mix 1-2 tablespoons in a glass of warm water in the morning. I have found like I like Braggs ACV with the mother.
Dr. Palanismy notes that a particular form of stress reduction called Mindfulness-Based Stress Reduction has been proven in research studies to reduce blood pressure. This approach to stress reduction uses meditation, body awareness and movement such as yoga to help people better observe their experiences, instead of being completely immersed in them. This helps them take a step back in stressful situations.
Eat potassium- and magnesium-rich foods. Potassium can help regulate your heart rate and can reduce the effect that sodium has on your blood pressure. Foods like bananas, melons, oranges, apricots, avocados, dairy, leafy green vegetables, tomatoes, potatoes, sweet potatoes, tuna, salmon, beans, nuts, and seeds have lots of potassium.  Magnesium is thought to help blood vessels relax, making it easier for blood to pass through. Foods rich in magnesium include vegetables, dairy, chicken, legumes, and whole grains. It’s better to get vitamins and minerals from food, and a heart-healthy diet like the one we described above is a good way to ensure you get plenty of nutrients. However, you may want to talk to your doctor about whether taking certain supplements might help your blood pressure.
According to the American College of Cardiology and the American Heart Association, the goal of blood pressure treatment is to attain a blood pressure reading that's less than 130/80 mmHg systolic and less than 80mmHg diastolic. In general, if you have hypertension, it is likely that you will need to be treated for the duration of your life to maintain this target blood pressure. 
Seek the sun: A natural source of energy and one that keeps you healthy. A recent study found that people exposed to UV rays for a short duration experienced a significant drop in blood pressure, even before their production for vitamin D activated. This is thought to be because of the sunlight converting nitrate stored in the skin to nitric oxide—a potent vasodilator.

The right tunes can help bring your blood pressure down, according to Italian research. Researchers asked 29 adults who were already taking BP medication to listen to soothing classical, Celtic, or Indian music for 30 minutes daily while breathing slowly. When they followed up with the subjects six months later, their blood pressure had dropped by an average of 4 mmHg.


As the body increases production of an enzyme called angiotensin I-converting enzyme, or “ACE”, blood pressure increases. Pharmaceutical drugs called ACE inhibitors work by blocking the formation of this enzyme, but they have multiple side effects. Garlic contains gamma-glutamylcysteine, a natural ACE inhibitor.  This chemical, in combination with the high allicin content, gives garlic its ability to dilate arteries, thereby lowering blood pressure. I usually take one clove of garlic and remove the skin, chew well and swallow. Yes nobody wants to be around me after. You can also buy in pill form.
“Beware of the American Heart Association’s (AHA) 'Salty Six' — six popular foods that can add high levels of sodium to your diet,” says Rachel Johnson, PhD, a professor of nutrition at the University of Vermont in Burlington and the former chair of the AHA’s nutrition committee. The Salty Six include breads and rolls, cold cuts and cured meats, sandwiches, pizza, soup, and chicken.
CoQ10 is a naturally occurring enzyme. It contains antioxidants that are good for maintaining cardiac health. CoQ10 has been shown to decrease blood pressure and reduces the thickening of the heart muscle (hypertrophy). There are no known side effects of CoQ10 since it naturally occurs in the body. According to the Mayo Clinic, for the treatment of hypertension, take 60-360 milligrams daily for 8-12 weeks.
I would not recommend changing BP medications every 3-4 months just to prevent the onset of potential side-effects, but it certainly makes sense to reassess how you are doing on a BP med after a certain interval (usually after a few weeks, and then every few months or more often if the dose still needs to be refined or if there is concern about potential side-effects).
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