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Thread: high Blood pressure and diving

 


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    high Blood pressure and diving

    I was wondering how many others have high blood pressure and dive. Are you on any specific meds for it?

    I was told at one point some medications are not compatible with diving. I'm made to wonder if this was the doc trying to sell a new drug or if he was telling the truth. I was told I HAD to take Diovan. I am currently on Lisinopril as its cheaper than the other medication. I switched to it after last diving season.
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    Lisinopril is an ACE inhibitor. One of the common side effects of ACE inhibitors is a cough. A more serious side effect is inflammation of the lining of the respiratory tract. Such pulmonary side effects are not good for a diver. If you have these side effects, then it would be best to change to a different class of anti-hypertensive med. That being said, physicians often prescribe ACE inhibitors to divers. ACE inhibitors are a much better choice than beta-blockers, which decrease exercise tolerance.

    Diovan is the brand name for valsartan, an angiotensin receptor blocker (ARB). I'm not aware of any side effects that would make ARBs inappropriate for scuba divers. Common side effects for valsartan include headache and dizziness. FYI, there's a combo formulation of Diovan with the loop diuretic HCTZ. Divers on HCTZ should take care to stay well-hydrated, as the loop diuretic can cause dehydration if fluids aren't replaced.

    Yeah, I can see why Diovan would cost more than lisinopril for you. I think a reasonable approach is to stick with lisinopril for now, assuming that it controls your hypertension without any of the previously mentioned side effects. You don't really need to take Diovan. If that's what your physician told you, did he/she give an explanation as to why?
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    I had a huge problem with the Lisinopril cough in the beginning, I've been on it a while now and the only time I cough is at night usually as I lay in the bed reading or on the computer before bed. I rarely cough during the day anymore.
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    Quote Originally Posted by Savaaha View Post
    I had a huge problem with the Lisinopril cough in the beginning, I've been on it a while now and the only time I cough is at night usually as I lay in the bed reading or on the computer before bed. I rarely cough during the day anymore.
    Hmmm. Is the night cough the reason your physician wanted to move you away from the ACE inhibitor? FWIW, it's pretty standard to move a patient to an ARB if the ACE inhibitor elicits coughing. It sounds to me like your physician was being pretty reasonable. As you found out, though, the downside is that ARBs are much more expensive than ACE inhibitors.

    Have you tested whether breathing dry scuba tank air elicits coughing? I would definitely do a test-dive in my living room prior to attempting any real diving while on lisinopril.
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    I was on the Diovan last dive season, and to save money switched to lisonopril. When I was 1st on it I coughed like hell but he told me with in 3-4 months the cough would stop. It has for the most part, only and rarely at that do I have a coughing spell at night.

    I did some pool time on saturday and had no problem breathing the tanked air. I think this Sherwood reg I have now will also help and according to the LDS it has a pair of metal pieces in it to help prevent drying out of my mouth.
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    I have high blood pressure (really high actually). I have been taking Cardizim and Benicar HCTZ for a few years now (one AM and one PM) and have not had any problems. I am carefull about hydration, but I was before the HCTZ. I tried lisinipril but the cough drove me nuts. There are alot of BP meds out there, many have been arround long enough to be less expensive generics. You are getting some good advice here, hopefully TSandM will chime in, or you should PM her. She is a doctor and very experienced diver, she won't lead you astray.
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    Ive been on both Carizim and Benecar in fact was on benecar before the doc put me on diovan.

    I may give her a PM if she doesn't post here. Im feeling better about staying on what Im on since I don't have the cough like I did before. Generic for this is only 4.00 so its very cost effective.
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    Quote Originally Posted by Savaaha View Post
    I did some pool time on saturday and had no problem breathing the tanked air. I think this Sherwood reg I have now will also help and according to the LDS it has a pair of metal pieces in it to help prevent drying out of my mouth.
    That's encouraging should you insist to stay on lisinopril.

    It sounds like this is going to be an informed decision on your part. You know what is at risk. If you have a coughing fit underwater, how manageable do you think the situation will be?

    I realize that you are saving a significant amount of money by going with the ACE inhibitor...but you are assuming a greater amount of risk. I'm assuming that you had no cough and good blood pressure control while on Diovan.

    Sorry I couldn't be more helpful. IMO, I think your physician is giving you good advice.

    FWIW, management of hypertension is very much an art. Side effects help physicians rule out the use of certain classes of drugs in a given patient. The patient might also have another medical condition that influences drug choice, e.g., hypertensive Type II diabetic on ACE inhibitor (may slow progression of kidney disease).
    Ear Equalization problems? Check out Dr. Kay's Ear Lecture for Divers.

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    Bubble, you have been a great help. Its good to have people to bounce things off of.

    If need be I am more than willing to switch. When it comes to health stuff I definitely have experience. I am 17 yrs post liver transplant and have had HBP the entire time. Ive stayed alive and in fair shape because I do listen to my doctors. I posted to see if anyone else dove while on lisinopril and to see if there was a possibility it was feasible. The doc who said I should be on it never really explained the why, just said it was a better choice if I was going to be diving. Hes no longer at my clinic so I cannot ask him.

    If I stayed on the lisinopril I think I could handle a coughing spell should one happen, I cant imagine it being worse than vomiting at depth, which I happened twice in 1 day and was able to deal with without surfacing(Really bad day at the destin jetties).
    I may go ahead and be on the safe side and go back to Diovan for the diving season, Im just hating the idea if readjusting to lisinopril a 2nd time.
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    Quote Originally Posted by Savaaha View Post
    Ive been on both Carizim and Benecar in fact was on benecar before the doc put me on diovan.
    Why did your doctor switch you from Benicar to Diovan? They both belong to the same drug class (ARBs) but likely have different drug kinetic profiles.

    Did you mean to write Cardizem instead of "Carizim"?
    Quote Originally Posted by Savaaha View Post
    If need be I am more than willing to switch. When it comes to health stuff I definitely have experience. I am 17 yrs post liver transplant and have had HBP the entire time. Ive stayed alive and in fair shape because I do listen to my doctors. I posted to see if anyone else dove while on lisinopril and to see if there was a possibility it was feasible. The doc who said I should be on it never really explained the why, just said it was a better choice if I was going to be diving. Hes no longer at my clinic so I cannot ask him.
    The side effect profile for ARBs appears to be better than other anti-hypertensive meds, particularly ACE inhibitors. The whole airway issue with ACE inhibitor-induced coughing is troubling. That's probably what the doctor was referring to. I know for a fact, however, that there are divers who successfully take ACE inhibitors...but AFAIK they don't fall into the minority population who get the cough.

    In the 1990s, there were a handful (not many at all) of published cases of liver toxicity in patients taking ACE inhibitors. Obviously, this isn't an issue for you or else you would have been symptomatic and your bloodwork would have shown increased liver enzymes. Just something to be aware of.
    Quote Originally Posted by Savaaha View Post
    If I stayed on the lisinopril I think I could handle a coughing spell should one happen, I cant imagine it being worse than vomiting at depth, which I happened twice in 1 day and was able to deal with without surfacing(Really bad day at the destin jetties).
    I may go ahead and be on the safe side and go back to Diovan for the diving season, Im just hating the idea if readjusting to lisinopril a 2nd time.
    Yeah. I can imagine that it would be tough to deal with all of that coughing all over again when dive season was over. I am also aware of the significant cost difference in the two meds. In a perfect world, we wouldn't have to choose between personal safety and saving money. It's a difficult situation.
    Ear Equalization problems? Check out Dr. Kay's Ear Lecture for Divers.

    What would you do? ScubaBoard has a "What if...?" series geared for beginner divers.

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