Abdominal Aortic Aneurysm Stent Graft-Induced Hypertension Appears to Self-Correct Eventually

 

Blood Pressure Range Table for older men

Blood pressure range table for older men.

Hi folks,

You can generate some useful information (data) by monitoring your heart rate and body weight each day, or at least once per week. If you know your usual resting heart rate, any deviations can warn you of potential health issues. I find that my resting pulse will increase in frequency by as many as five to ten beats per minute if I am over training (back off) or going down with a cold or other illness (rest and plenty of fluids).

In 2010, I received an abdominal aortic aneurysm (AAA) stent graft, which both saved my life and caused my resting blood pressure to jump from it’s normal 130/80 to 220/120, a dangerous state of hypertension. To cut a long story short, this condition was controlled using a combination of exercise and a cardiologist-prescribed angiotensin converting enzyme (ACE) inhibitor, Lisinopril. Here are the data I posted on this previously.

Effects of exercise and Lisinopril on FitOldDog's AAA stent-induced hypertension.

Previously posted data on the impact of exercise, and an ACE inhibitor with and without alcohol, on my blood pressure.

A cardiologist recently recommended that I double my dose of Lisinopril, because my blood pressure profile exceeded a magic formula of (Systolic+Diastolic)/2 less than 100. I don’t like potted formulae, which are based on statistical averages, and I’m not a statistic, I’m me. For a number of reasons, including a weird problem at the Lake Placid Ironman that caused me to DNF (did not finish), and a state of hypotension (100/60) whilst visiting a doctor for tick-borne fever a few weeks ago, I decided to start monitoring my blood pressure again. It was sitting at 135-140/75-85, pretty well in the normal range. Then I wondered if it would go up again if I were to stop my ACE inhibitor. I ceased taking the drug two weeks ago and my blood pressure has remained unchanged. Today it was 137/77, within the normal range.

It would appear that my body has adapted to my AAA stent graft, vindicating my view of the probable cause of this stent-induced hypertension being a bounce back wave from the rigid stent graft interfering with baroreceptor function in the aortic arch region, and not impaired renal function (the party line). Our bodies have a tremendous ability to adapt and seek their (note I say their, not the population average) set point for thousands of key variables, one of which is blood pressure.

I’ll stay off of Lisinopril, and keep you posted if my blood pressure starts to climb. Monitoring key physiological variables can be highly person-specific, including blood pressure in my case, blood sugar for a diabetic, thyroid hormones for those with certain endocrine conditions, and so forth. In my opinion, this is all part of any program of safe exercise for better health, especially as I sure don’t want to take any pharmaceuticals that I don’t need.

All’s well that ends well!

-k @FitOldDog

 

Comments

  1. That’s cool about your bp returning to normal. However, I still don’t think of you as normal.

  2. I’m perpendicular to the plane (in oblate spheroidal space) when I am standing up with good posture, so at those times I’m normal with respect to some kind of fractal average or ideal approximation of the surface of planet Earth from time to time. -kevin

  3. Strange, after a few glasses of mead celebrating a new granddaughter I seemed to shift from perpendicular to said plane exactly 90 degrees and it was observed that I was parallel to said plain. I cannot confirm this as I seem to lack recall.

  4. Makes me feel like having a beer! -kevin

  5. My father had an AAA stent put in 2 months ago, and he also is now experiencing hypertension that his primary doctor cannot figure out. Did you cardiologist or vascular surgeon ever concur that your hypertension was stent-induced? Does your stent reach up to the renal arteries at all? (My dad’s doesn’t, so that’s why the surgeon doesn’t think it is causing the hypertension.) Thanks for any insight you can give.

  6. Hi Faith, I am sure that the stent graft induced the hypertension. My suspicion is that a bounce back wave, due to altered compliance in the distal aorta (which means changes in pressure flow due to an elastic stretchy vessel being replaced by a rigid wall) resulted in a bounce back wave that ‘confused’ the baroreceptors in the aortic arch (one part of a system that detects and results in regulation of blood pressure), leading to hypertension. The system was confused by the stent. This probably does not occur in all cases and the fluid dynamics will vary from one case to another. I failed to find ANY cardiologists who would discuss this with me intelligently, even though a research engineer in Ireland predicted such a stent-induced hypertension. My hypertension has finally self-adjusted, which I expected, and that would not occur if the underlying problem was kidney damage. Your Dad needs to try Lisinopril (10 mg 1x/day), as that fixed it for me, but I combined it with intense exercise, which also brings down BP (I provided data on by blog demonstrating this). Don’t expect the cardiologists to believe it is not renal dysfunction. Your doctor must be great as he/she admits to doubt – I hate to say this, but I am yet to meet a cardiologist with any apparent knowledge of fluid mechanics, and who will listen. Go to the hypertension category of this blog and you’ll find the whole story, which I reported as an ‘Adverse Event’ to the FDA. Read my blogs on this issue (5 or 6) and get back to me with more questions.
    Finally, get your Dad’s blood pressure down ASAP – it’s dangerous. What is it? Mine was about 140/80 before the stent, and 220/120 two weeks after the stent (and they say it wasn’t the stent that did it).
    Excuse me ranting, but they wouldn’t listen, EVER. Surgeons tend to know nothing of the function of the cardiovascular system, and cardiologists are worse because they think they do.
    I look forward to hearing that you’ve fixed your Dad’s BP, and any data would be much appreciated. Sorry my writing is so technical, but some of it is hard to translate, and I’ve got to sleep now. I can rewrite if you need it – what is your training and that of your Dad, as it will help me to know when we communicate?
    Boy! I didn’t know I was still so heated about this.
    Kind Regards,
    Kevin aka FitOldDog

    PS for my own legal safety I have to say that I do not provide medical advice, and you should consult your physician.

  7. Well done Kevin!
    System thinking applied.
    I will forward this article to my father. He did some research by his own using internet resources and got results that are similar to what I wrote on your blog.
    M.

  8. Mistake….similar to what YOU wrote on your blog.

  9. Kevin, I have been reading your writings since finding you on the facebook AAA site. My husband had a stent put in on November 8th of this year. His bp was always normal. 120/80 sometimes a little lower. He went back to surgeon 3 wks after surgery complaining of a severe pain in his left side. When the nurse took his bp she said that it was a little high. We asked how high, surprised as his is always low. She said 197/102! I about fell off of the chair. When the surgeon came in, she really didn’t address the high bp, but was more concerned over the pain, which she couldn’t explain and said that she had never heard of it before. She sent him for another ct scan and blood work told us if everything came back normal we needed to see our primary. Everything came back normal so went to primary. He put him on meds for bp and sent us to another dr for hypertension. He sent my husband for a renal flow test and an echo. Both came back ok. Primary has had to up his meds twice now to get his bp down. My husband monitors it daily and it is up and down, but not as high as it was in the beginning. He has had a headache since two weeks after the surgery also. If not a full blown headache he has pressure. Still has side pain occasionally. Primary says that if you take the surgery out of the equation then there is no reason his bp should have went up. The surgeon just says she doesn’t treat hypertension. I am hoping that like you, his body will adjust and it will go back to normal on its own. Thanks for all of your research.
    Dawn

  10. Hi Dawn, good to hear from you and I’m glad your husband has you as an advocate. The attitude of the medical profession to AAA stent-induced hypertension is remarkable in it’s absence. I know they listen to what I’m saying (I track the traffic sources), but they ignore me, personally. That is why I finally filed that adverse event report with the FDA. They managed to piss me off. I found that exercise (and I mean exercise) reduced my blood pressure consistently, but it needed the ACE inhibitor to bring it into a safe range. It took over a year to self-correct, and if the hypertension was due to renal problems it would never have occurred (once again, my reports are ignored). I find that cardiologists and surgeons are the worst for sticking their heads in the sand (or somewhere else) on this, and spouting the party line. Very frustrating, but that’s to be expected. My recommendation is that your husband buys a decent wrist BP monitor and start collecting data. Try beets. Try meditation. Try whatever to bring it down, as he doesn’t want to have a stroke.
    If I can help in any way, please let me know, and thanks so much for telling me about this. I think that it is a problem for a subset of people due to a bounce back wave from the rigid stent (reduced local compliance) to the baroreceptor system (probably in the aortic arch, and possibly elsewhere), but until the research is done it should be listed as a risk factor and treated accordingly, not ignored. How odd life can be sometimes.
    Well, it is time to wish you Happy New Year as I’m about to sleep through it.
    Kind Regards,
    Kevin

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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.