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Suggest Treatment For High BP With Polycythemia Vera
Question: I have polycythemia vera and my neutrophils are always high on the lab tests. My blood pressure has been extremely high and the heart dr. just continues to give me more meds. I want to know why I can't get the BP down and if it could be connected with the high neutrophils? I want to treat the base problem-- not the symptoms. The hypertension has been ongoing since XXXXXXX 2011 when they put in a pacemaker. Thank you.
Brief Answer:
Cilnidipine
Detailed Answer:
Hi
XXXX
Polycythemia vera is a rare blood disorder in which there is an increase in all blood cells, particularly red blood cells. The increase in blood cells makes the blood more viscous (thick), leading to strokes or tissue and organ damage.
The disease itself causes high blood pressure.
I will advise phlebotomy for you which is a a procedure that involves removing blood from the body. Initially this must be done frequently, often every week, but once enough blood has been removed to deplete the body's iron stores, necessary to make blood quickly, it does not need to be done as often.
I will advise also Cilnidipine for you.
It is a latest calcium channel blocker.
The medication acts by blocking action at N-type calcium channel dilates both arteriole & venules as a result the pressure in the capillary bed is reduces. The accumulated fluid in the tissues flows back to veins & thus Cilnidipine minimizes the incidence of pedal edema.
Cilnidipine controls hypertension for 24 hours with once daily dose. Cilnidipine has enhanced lipophilicity leading to prolonged antihypertensive effect correlated with occupancy of the binding site. In 24 hour clinical assessment, once-daily administration of cilnidipine (5–20 mg) produced BP reduction for 24 hour period. This indicates that once-daily cilnidipine exerts a sufficient and prolonged reduction of BP.
Hope i have answered your query
Regards
DR De
Cilnidipine
Detailed Answer:
Hi
XXXX
Polycythemia vera is a rare blood disorder in which there is an increase in all blood cells, particularly red blood cells. The increase in blood cells makes the blood more viscous (thick), leading to strokes or tissue and organ damage.
The disease itself causes high blood pressure.
I will advise phlebotomy for you which is a a procedure that involves removing blood from the body. Initially this must be done frequently, often every week, but once enough blood has been removed to deplete the body's iron stores, necessary to make blood quickly, it does not need to be done as often.
I will advise also Cilnidipine for you.
It is a latest calcium channel blocker.
The medication acts by blocking action at N-type calcium channel dilates both arteriole & venules as a result the pressure in the capillary bed is reduces. The accumulated fluid in the tissues flows back to veins & thus Cilnidipine minimizes the incidence of pedal edema.
Cilnidipine controls hypertension for 24 hours with once daily dose. Cilnidipine has enhanced lipophilicity leading to prolonged antihypertensive effect correlated with occupancy of the binding site. In 24 hour clinical assessment, once-daily administration of cilnidipine (5–20 mg) produced BP reduction for 24 hour period. This indicates that once-daily cilnidipine exerts a sufficient and prolonged reduction of BP.
Hope i have answered your query
Regards
DR De
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
I don't know how to upload the lab reports. Auto Seg Neutrophil was 76.2. Platelets were 930; HGB 14.5; HCT 47.7; RBC DW 18.1. The MCHC was 30.4; MCH 25.8; MPV7.0; auto lymphocyte 13.0. I also have severe itching-- particularly in the arms and legs which lasts from two to four hours. The severe itching is not daily, but is beginning to be more frequent.Do you advise dropping the other BP meds; ie, Losartan, hctz and clonidine and taking only the cilnidipine?
The blood doctor does keep track of when I need a phlebotomy.
The blood doctor does keep track of when I need a phlebotomy.
Brief Answer:
hydroxyzine
Detailed Answer:
Hi
For severe itching on your arms and legs i would recommend oral medication hydroxyzine which is an antihistaminic thrice daily for 5 days and then can be taken as per need basis.
Once you undergo phlebotomy automatically your blood counts will come back to normal.It will also reduce your itching and blood pressure.
If you have no more clarifications then rate the answer and close the thread.
Regards
DR De
hydroxyzine
Detailed Answer:
Hi
For severe itching on your arms and legs i would recommend oral medication hydroxyzine which is an antihistaminic thrice daily for 5 days and then can be taken as per need basis.
Once you undergo phlebotomy automatically your blood counts will come back to normal.It will also reduce your itching and blood pressure.
If you have no more clarifications then rate the answer and close the thread.
Regards
DR De
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Prasad
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