Q. My husband has become very worried about his blood pressure. He is 47 and a little overweight, but he gets plenty of exercise and has always been healthy up to now.
The doctor started him on enalapril, but he coughed at night and neither of us got much sleep. Lisinopril did the same thing. Then he was switched to Procardia XL (nifedipine) but we read in your column that it could be affected by grapefruit, one of his favorite foods. He’s not willing to give up grapefruit, so he is now taking Norvasc (amlodipine).
I think he works himself up so that going to the doctor makes his blood pressure high. His father died of a heart attack, so this blood pressure problem scares him.
What can you tell us about Norvasc? Should he be taking his blood pressure at home?
A. Amlodipine (Norvasc) is a calcium channel blocker somewhat like nifedipine, but it does not interact dangerously with grapefruit. Most people do well with amlodipine, but some report headaches or swelling of the legs or ankles due to fluid retention. Other possible side effects include heart palpitations, fatigue, dizziness, drowsiness, nausea or digestive upset and flushing.
White Coat Hypertension:
Your husband’s blood pressure might rise when he visits the doctor. This “white coat hypertension” which may be related to anxiety can boost blood pressure 20 points or more. Home blood pressure measurement can provide a more accurate daily assessment.
We would encourage your husband to try keeping a daily log of his blood pressure. He should vary the times he measures his blood pressure so that he can get an accurate assessment under a variety of conditions.
Were he to lose some weight, he might be able to reduce the dose of his medication or eventually eliminate it completely (under his doctor’s supervision, of course).
There are a number of non-drug approaches to blood pressure control in our Guide To Blood Pressure Treatment. Foods such as beets (and beet juice), grape juice, pomegranate juice, kefir and high-magnesium foods like nuts may all be helpful.
