I finally decided to measure my blood pressure day before yesterday and was very disappointed to see that it's gone up again (ca. 152/90). So, unfortunately, it looks like it's back to the hydrochlorothiazide (HZ hereafter) for me--at least until major aerobic exercise can be undertaken again (spring, God willing).
I was initially pretty discouraged about this: I make serious efforts at being fit and active, my diet is good, my cholesterol levels are immaculate, and my heart rate is generally low (registered about 63 when I was measuring my blood pressure). All the most evident causes of hypertension are lacking.
But I've developed a theory that perhaps a major factor in my heightened blood pressure is chronic insomnia. I haven't blogged much about this but a health issue that's dogged me over the last decade and more is chronic intestinal discomfort--something I've been seeing various medical professionals about since 1998. No diagnosis so far.
One of the effects this intestinal distress has is to make sleep difficult and generally very fitful. So, for days, weeks, and months on end I'll not get a decent night's sleep. It can, I think, cause major stress when your body cannot, over long periods of time, get the kind of rest it needs to rejuvinate.
I think what's happening with me is that my body rarely goes into deep sleep, where you really become sort of dead to the world. Many, many nights I never get beyond the R.E.M. stage of sleep, since the discomfort in the abdominal area ensures that I have plenty of nightmares and dreams involving tension all night. Believe me, I have had many mornings when I've gotten out of bed thinking "that's the sort of night you wouldn't wish even on your worst enemy." It's not rest I'm getting on these nights, but some kind of torture session.
The point I'm making, as might be obvious, is that I suspect this restlessness and sleeplessness may be a major contributing factor to my high blood pressure. It's just a theory for now, of course, but it makes sense to me.
Furthermore, I decided some months ago to ask my doctor to prescribe a sleep aid in hopes that it might relieve the insomnia and perhaps help lower my blood pressure. At first I tried amitriptyline, which seemed not to be very effective and additionally had the undesirable side-effect of making me feel very groggy the day after I'd taken it. Next, ambien (zolpidem is the generic name and is the name of the one I was eventually prescribed) was recommended. It did definitely help me to sleep through the intestinal distress and did not seem to have lingering after-effects, so I used it with some regularity for a few weeks. With regular use, however, I found that it began to effect my moods very negatively: the day after I'd take it I would be prone to fits of anger and feelings of aggression.
Long story short, I recently decided to stop taking zolpidem except in extreme circumstances (i.e., sleeplessness lasting a few days). Which brings me to the present blog entry and the high blood-pressure readings I got the other day. Is there a connection between stopping the sleep aid, which has resulted in a return of insomnia problems, and my recent elevated blood-pressure reading? I just can't say for sure . . .
Anyway, I've resigned in the near term to the reality that I'll have to go back on HZ. In fact, I've already taken it for the third day now. And I did feel some immediate relief from some of the headachiness and other symptoms.
This time, however, I'm going to experiment with cutting down to a quarter of a tablet (ca. 6 mg.) to see how that goes. And I think I'll not take it on strength-training days (Mondays and Fridays) since those are the days, at this time of year, when I'm pushing myself pretty hard physically. And I've already blogged about how HZ and rigorous exercise do not mix well in my experience. I'll doubtless be posting on how this works out.
ADDENDUM: while researching blood pressure on the 'net I came across this article, which offers support to my idea that my insomnia could be a contributing factor in my heightened blood pressure:
Question
Sleep deprivation: A cause of high blood pressure?
Is it true that sleep deprivation can cause high blood pressure?
Answer
from Sheldon G. Sheps, M.D.
Possibly. Recent studies suggest that sleep deprivation may increase the risk of high blood pressure (hypertension).
An October 2007 study in the medical journal Hypertension suggests that women who routinely sleep fewer than seven hours a night may have an increased risk of developing high blood pressure. The study followed 10,300 adults between the ages of 35 and 55 for five years. When compared with women who typically slept seven hours each night, women who slept six hours a night were 42 percent more likely to develop high blood pressure. Women who routinely slept no more than five hours had a 31 percent higher risk. The study didn't show a relationship between sleep deprivation and high blood pressure in men.
A May 2006 report also published in Hypertension further suggests that long-term sleep deprivation increases the risk of hypertension. Researchers analyzed data for 4,810 participants, who were between the ages of 32 and 86 years old. Among participants between the ages of 32 and 59 years, those who slept less than six hours a night had more than double the risk of high blood pressure than did those who slept more than six hours a night. This association was not significant in participants older than 59 years.
According to some researchers, people who sleep for only short periods — less than six hours a night — increase their average 24-hour blood pressure and heart rate. Over time, this may lead to persistent high blood pressure. (emphasis added)
Additional studies are needed to better understand the role of sleep deprivation in high blood pressure. But these studies suggest that increasing the amount and quality of sleep may play a role in the treatment and prevention of high blood pressure.
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