Optimal Blood Pressure we Should Target? Systolic Under 110 or 100?

Thanks for your reply, Ive implemented many of these already! I recently lost over one hundred pounds but my BP hasnt budged.

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Very good recommendation Kandice.

Either potassium chloride, magnesium chloride.

A replacement salt product, such as “LO SALT” is one of many brands, look around. This is a premixed product having potassium chloride, sodium chloride, magnesium carbonate, potassium iodide. ¼ tsp is approximately 510mg of sodium, ¼ tsp of the “lo salt” product is approximately 170mg of sodium.

I know this about lo salt as I have used/do use this product on and off.

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Thank you @Joseph.

I bought Morton Lite Salt recently. It’s similar to the product you mentioned. I haven’t tried it yet because I need to finish my regular salt first, which takes a long time since I use so little these days.

I really like salt and well seasoned food. It just wouldn’t be the same… must look into this salt replacement, but I highly doubt that it would be enjoyable for me to live longer if the food wouldn7T taste good. :sweat_smile:
Would taking potassium supplement help?
I read somewhere that also SGLT2 inhibitors aka canagliflozin and empagliflozin reduce BP. Has someone any experience with this?

You’ll be surprised how flexible the taste buds are and they will get used to new flavors over time.

When I first started to reduce sodium, I found the foods bland and not very tasty. But after a while, I got used to it and now I can eat plain veggies with no salt added. In fact, now I find some of what I used to consider normal tasting foods (such as restaurant foods) too salty.

Another strategy would be to use other flavor agents, such as vinegar and spices, instead of salt.

The same thing happened to my taste buds for sugar. I try not to eat artificially sweetened stuff (e.g. candy) and only eat natural sweet foods (i.e. fruits). Now when I eat candy, I find it way too sweet and prefer the natural sweetness of fruits.

Potassium supplements can only provide very low amounts (I think must be less than 100mg) because too much potassium can cause problems. So it’s not recommended to take potassium supplements.

However, potassium from foods should not be a problem. Generally fruits and veggies are high in potassium, so eating more of those can help. Read nutrition labels to see the potassium content of foods. You can also Google high potassium foods - there are lots of them.

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I don’t know about SGLT2 inhibitors’ effects on BP, but there is some indication that higher blood sugar can increase BP. Hence my recommendation of don’t eat too much.

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I just started empagliflozin 12.5mg (half a 25mg Jardiance tab) a day. My BP is currently all over the place from 150 over 90 on first measurement to 128 over 83 on the second. I’m hoping empagliflozin will help. I’ll keep my rapa diary updated with any updates.

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SGLT2 inhibitors do indeed have a BP lowering effect because they act as diuretics (pull extra water out along with glucose through the urine i.e “osmotic diuresis”).

Another concern with lowering BP “too much” is decreased perfusion of blood and oxygen to coronary arteries and other organs. So it’s not just decreased perfusion to the brain resulting in syncope/fainting, it’s concern about perfusing the heart and kidneys, especially in let’s say an older person who already has calcification of arteries and a limited ability to dilate those vessels to increase oxygen delivery when blood pressure and hence flow has decreased. Decreased perfusion can actually exacerbate plaque development, from what I’ve read. It clearly seems to be better to start early and keep BP in that optimal range for prevention, but I’m not so sure about lowering it down so low late in life would always be a good idea for treatment.

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I tried telmisartan a few weeks ago, and it seemed to make me feel tired/foggy headed even at a low dose of 10mg. I’ll probably try it again in case I was feeling tired for other reasons, given its potential health benefits and the fact that I’d like to get down to consistently less than 115 or so systolic. To date, my BP med of choice is nebivolol – all the benefits of older beta blockers but virtually none of the side effects thanks to its vasodilating properties (a result of enhancing vascular nitric oxide release).

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At least in my case empagliflozin lowered both blood sugar (5-10 points) and sodium levels, along with BP (from 125/90 to 110/75) and my sodium levels are now low, so I will need to add salt back to my diet eventually (to avoid weakening of muscle control : low sodium causes more deaths from slip and fall than high sodium causes deaths from Cardiac problems). I just started on 10mg/day a month ago!

Loss of sodium (along with sugar) is a known side effect of most SGLT2 inhibitors and possibly the main cause of the lower BP.

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I just started 20 mg daily of telmisartan. Is this dose too low to impact blood pressure? Anyone on the 20 mg dose and seen results?

Inspired by this thread I bought a high end BP monitor. My key observation so far is the vast range of measurements across the day. I’ve had as high as 129/86 and as low at 97/65.

In the UK they take your BP when you go for your 5 year health check up. One measurement in 5 years literally shows nothing!

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I would not say inspired, but can understand you @Maveric78 :sweat_smile:
I ordered one on Amazon as well :face_with_open_eyes_and_hand_over_mouth: I usually measure mine when i get to a my parents’s house or randomly when I go to pharmacy few times a year. But this topic got me thinking and I almost started to believe I need BP medication. So might not be all good in knowing all the metrics and recommendations. My husband calls it midlife crisis and says I should buy myself a Porsche or sometling like normal people do, get a lover or a hobby. :flushed: :rofl:

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Is telmisartan your only BP medication? I also take 20 mg in addition to 50 mg/twice/day of labetalol. Combination works well.

FWIW

Consider adding/taking oral Minoxidil as this would effect lowering BP and possibly increase hair growth.

Oral minoxidil was originally marketed /still is marketed as a BP medication

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I’m on 20mg qd telmisartan; lowered my bp from mostly in the mid-to-upper 120’s to mostly mid 110’s. My MD likes SBP under 120! I’m 78. No ill-effects.

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yes. Just started telmisartan yesterday (20 mg). Just curious what to expect.

Works gradually. Don’t expect results immediately.

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From my experience telmisartan is a very “gentle” medication. I have been taking 80 mg for years and my SBP only occasionally drops to less than 110. Of course, it’s very individual! I have never experienced side effects from the medication.

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My wife once accidentally ingested 10 tablets of 80mg Telmisartan, because they came in the same style blister pack (during a Covid shortage, the normal dispensed Telmisartan was not available) as the Rapacan 1mg tablets!

We called Poisson control in a panic but they said you basically cannot overdose on Telmisartan : it just blocks the BP raising signal sent out by the kidneys, even with 100% blockage you won’t get low blood pressure, unless you have some other condition unrelated to Telmisartan.

That means with Telmisartan (and other ARB’s) you are trading off high blood pressure against elevated levels of waste products in the blood, since the kidney should only try to raise BP if it cannot keep up with its dialysis load with normal BP. So monitoring blood creatinine and Uric acid levels is probably more important if taking an ARB. Also avoid other kidney weakening medication like diuretics and chronic NSAID use at the same time as ARBs. Using all 3 (ARB + diuretic + NSAIDs) at maximum dosage levels can actually result in kidney failure.

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