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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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    Suggest treatment for fluctuating BP levels without taking Bisoprolol

Good morning. I was wondering how long does bisoprolol stay in your system. about a year ago, my doctor took one blood pressure reading 140/90 and put me on bisoprolol HCTZ. Four days prior, my OB/GYN took my blood pressure 120/70. I told my primary care doctor, but he still put me on blood pressure meds despite the fact that I told him I was extremely stressed after losing my job. At any rate, I started weaning myself off the meds after taking it for 8 months July 2010-March 2011. When I exercise, I get very good readings 101/75, 99/68, 103/76 and sometimes a little higher 121/77. Prior to being placed on the meds, my blood pressure normal range was 116-120 over 70-78. Now that I ve stop the meds, if I miss a few days of not exercising my pressure is all over the place ie (151/97, 137/86, 122/83, 115/75, 140/90, etc).
Wed, 28 Dec 2016
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Cardiologist 's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Lets first understand how blood pressure is maintained by our body, this will help you to understand your symptoms better.

Our kidney on top of them have two small glands called ADRENAL, these glands are responsible for secretion of hormones named ALDOSTERONE, CORTISOL etc.

Aldosterone along with Cortisol affects the body's ability to regulate blood pressure.It plays a pivotal role in maintaining blood pressure constant through out the day, It sends signal to organs, like the kidney and colon, that can increase the amount of sodium(sodium retains water and can increase blood pressure if there is a drop in blood pressure) the body sends into the bloodstream or the amount of potassium released in the urine.

Aldosterone is closely linked to two other hormones: renin and angiotensin, which create the renin-angiotensin-aldosterone system. This system is activated when the body experiences a decrease in blood flow to the kidneys, such as after a drop in blood pressure,and maintains the blood pressure to normal again.

My suggestion to you is to get a through check up under a ENDOCRINOLOGIST.

He would prescribe you:

A) ACTH(hormone secreted by pituitary that stimulate adrenal gland to produce hormone) stimulation test- commonly used test for diagnosing adrenal insufficiency.You would be given an intravenous injection of synthetic ACTH, and samples of blood, urine, or both are taken before and after the injection. The cortisol levels in the blood and urine samples are measured in a lab.

B) CRH stimulation test-When the response to the ACTH test is abnormal, a CRH stimulation test can help determine the cause of adrenal insufficiency. In this you would be given an IV injection of synthetic CRH, and blood is taken before and 30, 60, 90, and 120 minutes after the injection. The cortisol levels in the blood samples are measured in a lab.

C) serum renin and aldosterone levels will be done

D)MRI of abdomen can be done to rule out atrophy(injury) to adrenals

All these tests should be done in consultaion with a endocrinologist.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Rini
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