BP high with every period, normal in between

[becj86]

Hi,

I ended up in the hospital again yesterday with my BP at 190/100 (right arm) and 143/85 (left arm). Right arm went down to 123/85 and left remained the same, so they discharged me with a script for an ACE inhibitor I can't take when breastfeeding despite confirming that I'm breastfeeding three times... They did ask DS' age and seemed to think it would be fine because he's 6 months. Anyone know why that might be?

We are yet to discover the cause of these incidents (have now had three periods of time with scary-high BP, each starting 1 day before my period and ending ~day 3 or 4) but have cleared kidney function and brain aneurysms from the list of concerns. No doctor will believe that there could be a link between menstrual cycle and high BP. It is not a psychological thing as my cycle is totally unpredictable (never been regular in my life).

Anyone got any ideas of what more I can tell the doctor to get to the bottom of this issue? Any ideas on a specialist I could be referred to? I had pre-eclampsia and HELLP syndrome at the end of my pregnancy but they have always ruled out post partum pre-e because its more than 6 weeks PP when its happening. I still get the nasty headache with the high BP and I do swell but the swelling is a gradual thing and its not pitting oedema.

If anyone has any ideas, I'd be really grateful.

[blythe]

I wonder if they think that after 6 months your babies get less breastmilk and more of their nutrients from babyfood? I know that wasn't the case for me, though, and if it's not for you either I'd call back. It might be that in your case an ACE inhibitor is the only option, but it seems like there are tons of bp meds and quite a few of them are safer for breastfeeding.

What kind of doc are you seeing now? Can I ask what part of the country you're from? We can't share doctor names on the forums but if someone has suggestions for you they could use the private messaging.

Those high spikes sound scary to not-a-doc me, I hope we can help you find more questions and specialists to ask!

[becj86]

He's still taking 5 or 6 decent milk feeds in 24hrs and is in the middle of a growth spurt... The 'dont use for BFing mothers' clause says particularly not to use while feeding a premie or a newborn after saying not to use at all if breastfeeding. An ACE inhibitor is definitely a likely medication for me in the future with my kidney condition, etc. but my GP didn't want to put me on it without me seeing a kidney specialist (can't get in to see one til mid-December). I'm in North Qld, 1.5hr to Mackay and 3hr to Townsville. The kidney guy I can see earliest is my mum's one - I have to fly to Brisbane and drive to Toowoomba to see him. The waiting list for the kidney specialist in Mackay is so long they can't even give me an indication of what month I'll be able to get in.

The prescription was from the emergency doctor who did speak to my GP about it before prescribing and I have a follow up next week. Today (day 3 of period) my BP is back to normal, so I'm really not sure that daily BP meds is the best idea for me - worried it'll drop my pressure too much and I'll end up blacked out - not good when I'm caring for my son by myself all day and sometimes for 4 days without anyone else in the house when my husband is away on call for work. Right arm is still higher than left arm which is a bit odd, can indicate an aneurysm but they ruled that out based on the right arm BP lowering when I sat in the hospital bed for a few hours...

I didn't get the script filled due to the pharmacist's info on not breastfeeding while taking it. I don't think high BP for a few days every 4-5 weeks is enough to warrant stopping breastfeeding, especially when its normal (110/70 range) in between times. I wonder if maybe I should be seeing what my hormones are doing and if that could be affecting things. It seems so very strange that the spikes are only happening with my period but its every time since I had my son.

[caryn]

Chronic hypertensives are supposed to react more to progesterone spikes - I wonder if that could be what you're seeing?

Here's an Experts discussion: http://www.preeclampsia.org/forum/viewt ... 40&p=58309

[becj86]

Quite possibly it is related to the progesterone... at least that gives me something to suggest to the doctor when I see her to follow up after my visit to emergency. She is the one who was adamant that there cannot possibly be a connection between hormones and BP though, so I'll need luck and some data on my side.

I don't want to take daily BP meds until we figure this out - 2.5mg/day Tritace is not going to do much when BP is 190/100 but it could drop BP too low when I'm currently normal which is most of the time.

I will have a chat to doc about whether I go on a progesterone contraceptive and BP meds to get it all on an even keel and have a more effective contraceptive method than we currently use... I've just never been a fan of hormonal contraceptives.