BP induced damage to organs

[tonyperkis]

How is BP induced damage to the liver, kidneys quantified? Can I tell if high BP is affecting my liver and kidneys by looking at AST/ALT, bilirubin, BUN, creatinine? Or does the damage caused not really have a quantifiable marker?

 

[TNH]

Scarring of the kidneys might not show on any blood work at all, you would have to do a kidney biopsy to see if there was damage. I don't know know what would cause a health care professional to ask for something like that either.

 

[BigEnough]

Ultrasound will tell you.

 

[alpha6164]

High blood pressure does not affect the liver directly. The major organs that are affected by high BP are heart and kidneys. Period. Getting a 2D echocardiogram of the heart is the only way to check for signs of damage such as cardiomegally, leaking valves, etc. Your kidney damage will not show up on ultrasound or imaging until way way way late in the disease when there is no turn around. The bottom line is that if you have high BP just know that YOU ARE CAUSING DAMAGE.

You dont need any proof. It is like smoking a cigarette. Every single one you light up causes damage. It is the cumulative effect that year after year that eventually breaks the horse's back. So the lesson here is to get your BP checked frequently particularly if you are on a cycle and if you are over 130/80 then you need to do whatever to bring it down. That is all folks

 

[1bigmofo]

How is BP induced damage to the liver, kidneys quantified? Can I tell if high BP is affecting my liver and kidneys by looking at AST/ALT, bilirubin, BUN, creatinine? Or does the damage caused not really have a quantifiable marker?[/Q

liver panel, cbc/bmp...should give u an indicator. If they come back elevated then a cardiologist can asess BP issues. I'm not undestanding though, do u have high BP? If you do that is what i would address first.

 

[Amazon Doll]

Alpha, you are a real asset to this board!

 

[tonyperkis]

How is BP induced damage to the liver, kidneys quantified? Can I tell if high BP is affecting my liver and kidneys by looking at AST/ALT, bilirubin, BUN, creatinine? Or does the damage caused not really have a quantifiable marker?[/Q

liver panel, cbc/bmp...should give u an indicator. If they come back elevated then a cardiologist can asess BP issues. I'm not undestanding though, do u have high BP? If you do that is what i would address first.

my BP is 140-145/85-90 on cycle and 130/80 off. i daily supplement with coq10, fish oil, and a baby aspirin. wouldn't mind getting on BP meds but don't want to do so without doctor supervision

 

[E.J.]

Tony, u are high and should get a script from a md and be monitored periodically. A few months back I was running 160 systolic. Benicar has brought it down into the 130's. Def schedule an appt. htn over time will def damage ur kidneys, as alpha has explained above. Good luck.

 

[Ashop]

How is BP induced damage to the liver, kidneys quantified? Can I tell if high BP is affecting my liver and kidneys by looking at AST/ALT, bilirubin, BUN, creatinine? Or does the damage caused not really have a quantifiable marker?

Uncontrolled BP can damage internal organs thats why it so essential to monitor.

 

[alpha6164]

Alpha, you are a real asset to this board!

Thank you

 

[alpha6164]

my BP is 140-145/85-90 on cycle and 130/80 off. i daily supplement with coq10, fish oil, and a baby aspirin. wouldn't mind getting on BP meds but don't want to do so without doctor supervision

Your BP is definitely considered high. There are more studies that show that even 130 is considered high on the systolic side. Any of the ace inhibitor type drugs such as lisinopril or ARBII blockers such as Benicar would be awesome particularly because you are on AAS. They have extreme kidney protective properties. 10-20mg of lisinopril would do wonders and they are the type of BP meds that do not crash your BP so there is no risk of like going to 80/50 for example like some BP meds.

 

[tonyperkis]

Your BP is definitely considered high. There are more studies that show that even 130 is considered high on the systolic side. Any of the ace inhibitor type drugs such as lisinopril or ARBII blockers such as Benicar would be awesome particularly because you are on AAS. They have extreme kidney protective properties. 10-20mg of lisinopril would do wonders and they are the type of BP meds that do not crash your BP so there is no risk of like going to 80/50 for example like some BP meds.

Alpha what is your opinion on self medicating bp meds? Ie running lisinopril at 10-20mg/day

 

[prudhoe2006]

Alpha what is your opinion on self medicating bp meds? Ie running lisinopril at 10-20mg/day

Why would you self medicate especially something like BP meds. Just go to the dr and tell him someone suggested what alpha just did but let them take control of it since they are a dr. I know there's a few Dr's here as well but they will also know what other types of meds your on id leave out the aas btw. But u see them in a regular basis

 

[alpha6164]

Alpha what is your opinion on self medicating bp meds? Ie running lisinopril at 10-20mg/day

Believe it or not i try not to even self medicate and still ask my best friend/business partner who is also a physician. There is a famous saying "A doctor that treats himself has a fool for a patient "

The bottom line is that you always want someone to be aware of what you are taking. Having said all that lisinopril at 10mg daily is about 10x safer than any of the crap most guys take on this board including myself So the lisinopril at 10mg a day is something that you take, take your BP daily, after 30 days get a complete metabolic panel to make sure things are ok and you should be fine.

And although i never make direct recommendations here since this is the internet, you always have me here to help you out

 

[Techner]

Great info. Which BP is the one to measure? I've heard you need to check it first thing when u wake up? Then i am almost every time fine. If i measure when i am active (walking, doing routine) then my systolic goes up to 145. My diastolic is around 80 all the time.

 

[Amazon Doll]

There is a reason to self medicate:

If you don't have health insurance but plan on getting it self pay, you don't want high bp on your medical records. You also don't want to let your high bp to continue to screw up your heart and kidneys. So in this case there are 2 good reasons for "do it yourself" doctoring.

I take care of myself and rarely go to the doctor. When my back goes out now, instead of spending $150 at the doctors office when it becomes acute, I do alternating heat and ice thrapy after giving myself a 40Mg shot of depo-medrol. I bought the 30mh vial for fourty bucks and it will last years. I also did what doctots won't doand that is learn how to prevent my bacl from going out in the first place. No doc or chiro would do that for me.

I treat my own low thyroid and get regular blood test to see I am in range and adjust accordingly. While I am getting bloodwork to vheck my thyroid I get a gull workup amd make Sure everything is running right

Last year I had a re-occurring cold, every 3-4 Weeks I would get sick again. After this happening 4 times and getting so bad I was needing to miss work (something I can't afford, I went to the doctor and was prescribed antibiotics.. Everytime I came offI would get sick again. After 4 doctor visits, all they would do would be try a different antibiotic. So I tell the doc "all yoi are doing with these low doses is teaching that germ to be resistant to one more drug, soon it will be resistant to 6 different antibiotics. How about we stop doing the same thing over and over that doesn't heal me, and all the while I am getting sicker and sicker?" I haf enough of the clowns when inder their care I became so ill I was bedridden for 6 Weeks. I took my care in my own hands and ordered the appropriate antibiotics and tan 2 different ones for 3x the normal lenghth and the sneaky little bastards were killed off for good!

I save hundreds every year and keep my medival records clean so when I can afford health insurance, certain medical issues are not denied nor will I get denied insurance or pay a higher rate.

So yea........I'm all for self care!

 

[tonyperkis]

all, thank you for your responses. nice to have so much experience/intelligence chime in on this thread. since ive adjusted some lifestyle changes (quitting copenhagen, upping cardio), i think it's prudent to try some low dosed lisinopril for awhile, get bloodwork and assess

 

[kylho]

I'm an Advanced Practice Nurse with over 10 years in the ICU & OR, and I'd have to disagree w/ some of the advice you've been given. Simply put, yes you can get a very good idea of your kidney function by the simple blood test called a BMP, or a CMP. Either test will give you your BUN & creatinine level. Your creatinine level is more indicative of kidney function overall. An elevated BUN alone is usually associated w/ dehydration. A normal creatinine level is b/w 0.7 - 1.3. Generally speaking for an adult male, if you see a creatinine at 1.7 and above, you are having kidney problems. I say generally speaking b/c if you have a elderly woman for example, w/ a creatinine of 1.4, this very well may be indicative of renal (kidney) impairment. However, if you are talking about a younger adult male, specifically one who has a higher degree of muscle mass, a 1.4 may be totally normal for him. So before any health care professionals chime in and say, "1.7 is too high", what I'm saying is in my clinical experience for adult males like the ones on this site, I would start to get concerned w/ a creatinine around 1.7. Anything above that requires more extensive testing.

As far as BP goes, below you'll find the guidelines from the National Institute of Health

Normal BP
Systolic - Less than 120
And
Diastolic - Less than 80

Prehypertension
Systolic 120–139
Or
Diastolic 80–89

High blood pressure
Stage 1
Systolic 140–159
Or
Diastolic 90–99

Stage 2
Systolic 160 or higher
Or
Diastolic 100 or higher

Prehypertension is usually treated by first working on behavioral changes such as, lowering your sodium level (you want >2gms/day), increasing aerobic activity, consuming a diet high in fruits and vegetables (atleast 5 portions/day), don't smoke, and limit your alcohol intake. This doesn't mean that you wouldn't be prescribed an antihypertensive agent if your prehypertensive, but usually making the above behavioral changes can bring your BP within normal limits.

Above someone suggested Lisinopril or Benicar for elevated BP. First of all I would say, look at the standards set up today. I would not be prescribing anti-hypertensive medications for someone w/ a systolic BP in the 130's. There's no need, and its too risky. Secondly, Lisinopril absolutely can drop your pressure, and I'm one of those it happened to. My BP on a cycle was 140's over 90's, so I decided to take 5mgs of Lisinopril - considered a very low dose. Just 5mgs and my pressure dropped to the low 80's over 50's - consistently for a good 5-6 hrs, and that was just 5mgs. And consistently in my clinical practice I've seen pts drop d/t Lisinopril. Most MD's, or health-care practitioners specifically place BP limits when prescribing Lisinopril, such as do not administer if SBP <120 or diastolic <70. So stating that Lisinopril has no risk of "crashing your pressure into the 80's over 50's" is just wrong. It happened to me personally as well as many, many others.

If you do choose to use a BP medication Lisinopril is a good choice, but Benicar is not near as commonly used as a first choice antihypertensive agent. Benicar is actually used more cautiously in patients w/ renal impairment, and it many times can cause severe gastointestinal issues. Besides this it is still under patent which means there are no generics and thus the cost is much greater. There are many generics which work via the same method w/ the same results for 1/10th the cost.

The best way to accurately assess your REAL BP is to take it at the exact time every day, preferably in the morning. True hypertension is an elevated BP - consistently! Your body increases your BP during stress, working out, at work, etc., but that can be totally normal. To get an accurate assessment for your doctor or for yourself, take your BP everyday at the same time for atleast 10 days, and write it down. If its consistently within the range of being pre-hypertensive (as above) then first work at decreasing your sodium - that usually helps a lot. If your not doing any cardio, or little, increase it.
Follow the behavioral advice as above. If its consitently in the 140/85 range, I would then look into anti-hypertensive medication. Although, if you do have diabetes or know renal (kidney) impairment, then the range would be 130/80 - this is when you should be looking into ant-ihypertensives.

Elevated BP does not directly effect your liver, so I wouldn't concern myself w/ that in this respect. However, if you want to check your liver function, then yes you would check your SGOT (AST) & SGPT (ALT). As many know here, these elevate many times w/ cycles, so don't be suprised. They also increase d/t muscle breakdown, so if you check your liver function I would take off from training for several days prior to the blood test to get an accurate result.

Hope this helps!

 

[kylho]

Your BP is definitely considered high. There are more studies that show that even 130 is considered high on the systolic side. Any of the ace inhibitor type drugs such as lisinopril or ARBII blockers such as Benicar would be awesome particularly because you are on AAS. They have extreme kidney protective properties. 10-20mg of lisinopril would do wonders and they are the type of BP meds that do not crash your BP so there is no risk of like going to 80/50 for example like some BP meds.

I don't mean to contradict you here b/c I know you've been around a lot, but a lot of this doesn't make sense. Where are there studies that show that 130 systolic is considered high? Maybe your reading different journals then I am. 130's are considered pre-hypertensive, or others call it the beginning of normal-high, but its not considered high in the sense that you would be giving anti-hypertensives for it.

Secondly, where are you getting that Benicar has "extreme kidney protective properties"? The exact opposite is true. Check their website, 'Benicar and Benicar HCT may cause serious side effects, these include .... kidney problems, which also may get worse in people w/ kidney disease'.

Lastly, where do you get that Lisinopril will "not crash your BP so there is no risk of going to 80/50?" I mean even as an undergrad nurse 12-13 years ago I knew better then that. You state your a physician, yet almost every MD who prescribes that medication in the clinical setting gives parameters on giving the medication such as, 'don't give if SBP<120 or DBP<70.' I described w/ my own use of only 5mgs of Lisinopril and my pressure dropped from 140's/90's to 80's/50's - and that was just w/ 5 mgs. Your supposed to be a MD/physician and these are your recommendations?? Sorry but it just doesn't make any sense.

 

[alpha6164]

I don't mean to contradict you here b/c I know you've been around a lot, but a lot of this doesn't make sense. Where are there studies that show that 130 systolic is considered high? Maybe your reading different journals then I am. 130's are considered pre-hypertensive, or others call it the beginning of normal-high, but its not considered high in the sense that you would be giving anti-hypertensives for it.

Secondly, where are you getting that Benicar has "extreme kidney protective properties"? The exact opposite is true. Check their website, 'Benicar and Benicar HCT may cause serious side effects, these include .... kidney problems, which also may get worse in people w/ kidney disease'.

Lastly, where do you get that Lisinopril will "not crash your BP so there is no risk of going to 80/50?" I mean even as an undergrad nurse 12-13 years ago I knew better then that. You state your a physician, yet almost every MD who prescribes that medication in the clinical setting gives parameters on giving the medication such as, 'don't give if SBP<120 or DBP<70.' I described w/ my own use of only 5mgs of Lisinopril and my pressure dropped from 140's/90's to 80's/50's - and that was just w/ 5 mgs. Your supposed to be a MD/physician and these are your recommendations?? Sorry but it just doesn't make any sense.

I am sorry to have to say this but what is an Advanced Practice Nurse? Are you talking about a Nurse Practioner ARNP? I have never heard of such a title as you give yourself. No matter what 2yrs of nursing school does not equal 8yrs of medical school and residency. We are operating on different levels. Nurses have their jobs and physicians have their roles. I dont tell my
nurses how to start an IV and my nurses dont tell me what therapies to use.

You are correct about one thing that we are not reading the same journals. One of the early signs of renal damage is micro protein in the urine. The use of ACE inhibitors and ARB blockers help significantly. Here are a few articles that agree with what i am saying as far as ACE inhibitors and ARBs being renal protective. I can post 20 more if you like. Just ask. If you read the studies, they also mention how ARBs are even better tolerated than ACE inhibitors to address one of your other points.

**broken link removed**


Renal protection with angiotensin receptor... [J Nephrol. 2011 Sep-Oct] - PubMed - NCBI

http://www.diabeticmctoday.com/HtmlPages/DMC1004/PDF%20FILES/dmc1004_Barnett.pdf





You said it yourself 120/80 and under is normal. 120-130 is pre-hypertensive. If it is not normal then it is abnormal. There is no way around it. If it was considered normal then it would be under the NORMAL heading. You are right that with my normal patients (NOT ON GEAR) i would recommend life style changes, sodium reduction, etc etc but with someone that cycles several times a year and off gear their BP is 130 and on gear is 140 or greater, no amount of sodium reduction is going to reduce that BP. HCTZ is the usual drug written for initial diagnosis of hypertension but gain this may apply to the general population. One thing a smart physician and practioner does is to not treat everyone with the same cookie cutter type treatments. We have to evaluate every single person on their own clinical case and what is different about their case. A younger healthy male that is on gear that already has a BP of 140 most of the year because he cycles a few times a year would not benefit from HCTZ. It may actually be detrimental that the dehydration from HCTZ may cause worsening of renal function. In that patient i would always recommend a low dose ace inhibitor or ARB blocker.


I hope i didnt come across too harsh. But you have 2 posts on here and you came across very aggressive so i had to make sure i address your points. No hard feelings i hope.