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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Dizziness And Arthritic Pain After Taking Medication For White Coat Syndrome?

I have recently ( about 6 weeks now) been put on Karvezide 300mg/12.5mg to lowere my blood pressure, usually 160/95, age 70(female) I also take Lisinopril 20mg, Lipidil145mg,Ezetrol 10mg, Lyrica 75 mg twice daily, and Somac 40mg, as well as Mobic 15 mg. My Blood pressure has dropped dramatically to between 140/74 (highest) to 121/61 (lowest). This has been taken twice a week before getting up out of bed first thing in the morning. However I have been experiencing the following, Dizziness on bending down , and most recently a lot of Arthritic type pain in my ankles, knees and lower legs. This can occur mostly after lying on the couch at night , watching TV, or at bedtime, or even after a walk. I am a very fit 70 year old and partake in either a walk, exercise program , weight bearing class, Age Strong class, 5 out of 7 days per week. I am 170cm tall and weigh 67kgs. The Dizziness worried me initially, ( I have had an attack of Vertigo last year) however this is more Postural dizziness, but it is the aches and pains in my legs that are concerning me most now. My Doctor told me to keep a record for 6 weeks of my blood Pressure, twice a week as directed before rising and to go back to see him then. I suffer from White Coat Syndrome . I am about to do that in the next week or so but would like to have some more information myself prior to this appointment. Hoping you can assist, Thank you.
Thu, 25 Jun 2015
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Cardiologist 's  Response
As you suspect, their is a fair chance that the giddiness is due to postural. I will suggest you measure blood pressure while sleeping and than 30 sec to 1 min of suddenly getting up. See what is the fall in pressure. The arthritic pain may be due to hyperuricamia, which is seen commonly this hydrochlorthiazide, a component of your b BP medication. The same may cause change in balance of electrolytes which may cause muscle ache. Importantly would like to draw your attention that you are taking both lisinopril (ace inhibitor) and ibresartan (arb) , which according to present guidelines is contraindicated ie. Should not be given, just discuss it with your doctor on next visit. Presently do not change your position suddenly, even when you get up from bed post sleep, sit for a minute with legs dangling and than get up. I would suggest you to review your meds with your doctor or us. Regards
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What Causes Dizziness And Arthritic Pain After Taking Medication For White Coat Syndrome?

As you suspect, their is a fair chance that the giddiness is due to postural. I will suggest you measure blood pressure while sleeping and than 30 sec to 1 min of suddenly getting up. See what is the fall in pressure. The arthritic pain may be due to hyperuricamia, which is seen commonly this hydrochlorthiazide, a component of your b BP medication. The same may cause change in balance of electrolytes which may cause muscle ache. Importantly would like to draw your attention that you are taking both lisinopril (ace inhibitor) and ibresartan (arb) , which according to present guidelines is contraindicated ie. Should not be given, just discuss it with your doctor on next visit. Presently do not change your position suddenly, even when you get up from bed post sleep, sit for a minute with legs dangling and than get up. I would suggest you to review your meds with your doctor or us. Regards