Biologics and high blood pressure

Hi folks! It has been awhile since I have posted. I have been on three different biologics in the past year. Enbrel stopped working after 1.5 years, Humira (6 months) forget about it, Cimzia for 2 months. The Cimzia has worked leaps and bound compared to the other two but I am dealing with high blood pressure now. I am soon to be 51 and blood pressure was always in the 120 range. It spiked to the 130's and was at doctor today and it was 152. I am now on BP meds and I am scared. There is a family history of HBP in my family and my dad passed away at 55 from a massive heart attack.

I am more active since taking the Cimzia and have lost 3 pounds also. I guess it is a wait and see but I am thinking if the cimzia is causing this, I want to be off. I also have been on sulfazine for 3 years.

Any experience from any one would be greatly appreciated on this subject.

Thanks!

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The interesting thing is that I was told that my blood pressure rise was likely related to NSAID use. It sounds like your doctor is taking this seriously. Did you also talk about diet and exercise?

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I don't know whether my story is similar or not. Some common elements anyway.

Prediagnosis -- high BP (and a family history). Started BP med, BP then 120-130.

Ten intervening years, undiagnosed PsA, plenty of pain and damage. BP stable at 120-135

Diagnosis. Started Enbrel. Gradually my BP went down to consistently around 120. Nice. I was feeling better, and by last winter, was exercising and had lost 15 or 20 lb. But ... BP started creeping up.

Spring this year, fittest I've been for years, BP now consistently at about 140. Rheum decided Enbrel may be failing.

Fall, BP now 140-150, and Enbrel has pooped out. Rheum is switching me to Humira, and I'm on another BP med.

So I'm wondering whether my BP was gradually rising as Enbrel was gradually doing less and less for me. I'm moving to Humira as soon as possible, and it will be interesting to see what happens to my BP as (if) that works.

It's a puzzle, isn't it? One of the nurses suggested that my increasing pain levels could have something to do with it. Who knows. And then there is always the age factor: I'm ten years older than I was ten years ago.

Remind me to report back down the road, clipclop.

Thank you for the reply. I am stumped as my BP was always low. Am going to start valsartan tomorrow and then back to GP in two weeks. Will keep you posted.


We did, she didn't mention anything about the NSAID so she was thinking more of the biologic. Rheumy has also mentioned the BP but wasn't too concerned. I am glad I have a great GP.
Stoney said:

The interesting thing is that I was told that my blood pressure rise was likely related to NSAID use. It sounds like your doctor is taking this seriously. Did you also talk about diet and exercise?

What I didn't say is that I've been on an NSAID for, oh, at least 10 years, maybe longer. That could be a factor too.

My BP went up to the 190/100 range around 50 years old. This was 4 years before menopause and 5 years before PsA diagnosis.

I remember taking a couple different BP meds (can't remember their names) that were beta blockers. They didn't work well, and the insurance people told my doctor that the second one was actually causing some of my pain.

Now I'm on Amlodipine, which is a calcium channel blocker. I've taken it for several years now and it works wonderfully. It worked before I started Enbrel and since I've been on Enbrel--I always have a BP around 120/70. I should add my dose is only 5 mg/day.

I'm not sure why my doctor put me on a calcium channel blocker, but I'm sure glad she did!

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Grandma J, I take a calcium channel blocker (nifedipine) to help with circulation issues in my fingers and toes (Raynaud's phenomenon). I have pretty good to low blood pressure already so I have to be careful to not get up too quickly in the morning when I take it so I don't fall down!

Grandma J said:

I'm not sure why my doctor put me on a calcium channel blocker, but I'm sure glad she did!

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Amlodipine is the one I just started. So far so good.




Grandma J said:

My BP went up to the 190/100 range around 50 years old. This was 4 years before menopause and 5 years before PsA diagnosis.

I remember taking a couple different BP meds (can’t remember their names) that were beta blockers. They didn’t work well, and the insurance people told my doctor that the second one was actually causing some of my pain.

Now I’m on Amlodipine, which is a calcium channel blocker. I’ve taken it for several years now and it works wonderfully. It worked before I started Enbrel and since I’ve been on Enbrel–I always have a BP around 120/70. I should add my dose is only 5 mg/day.

I’m not sure why my doctor put me on a calcium channel blocker, but I’m sure glad she did!

I also have some things in common with your story, clipclop, and I'm just a little bit older than you.

Back in 2005, before PsA, I had a health check which put my BP around the140/90 mark. Initially the docs thought it was 'white coat syndrome' but it seemed to settle around this point and because of family history of hypertension (both parents died prematurely from connected conditions) they decided pretty early on to medicate. My PsA was diagnosed in 2012.

In spite of various medications (and I've tried a good few now but had to stop because of side effects) I am just about within acceptable levels. I seem to be one of these people with widely varing BP levels minute to minute. My absolute peak was something like 220/126 ... I can't remember exactly but I felt pretty unwell and this led to increases in doses and the addition of a diuretic. In hindsight this 'spike' corresponded to a period when I wasn't on any PsA treatment but there was a train of thought that a contributory factor was likely the leflunomide that I'd just stopped taking.

My medications are currently 25mg of atenolol (beta blocker) and 2.5mg bendroflumethazide (thiazide diuretic) in the mornings and 16mg candesartan (angiotensin II receptor antagoinist). My dose of atenolol was recently reduced from 50mg to see if this helps my psoriasis any as it is known to worsen pre-existing psoriasis ... it's too soon to tell and I will need to do a weeks BP monitoring at home to get an average to see if my BP is still ok or not. I don't think I've seen any correlation with my biologics .. I had a short 12 week stint on Humira (which didn't work) and I've now been on Simponi for 21 months.

I have put on way too much weight and that is something I'm now going to tackle. Will be interesting to see if it has any effect on my BP. I try not to worry too much about it all.

Thanks for the reply. I am going nuts as to why....sigh, just part of "growing up" I guess.

Seenie, just a forewarning. You might get a slight headache from the Amlodipine. I did every time I took it for a long time. But, it wasn't a bad enough headache to get concerned about, and I didn't take pain meds for it. Just wanted you to know.....the headache is worth it for how well it works to keep my BP down.

Interesting, janeatiu! I don't have that symptom from my Amlodipine. But my dose is so small--when the doctor first prescribed it, I said give me the smallest dose possible. She said she was giving me the dose she'd give a 90-year old, 100 lb. lady! She didn't think it would be enough for me, but it worked very well! I think doctors need to see each individual as just that, an individual, and their reaction or response to a pill should not be expected to be the same as the average person's. There are so many variables!

The other thing I think helps my BP a lot is that I take fish oil and coq10 every day, religiously. So natural and so safe--I really think they help my health as much as the BP med does!

Grandma J, the doctor and the pharmacist told me that too, so I started with 1/2 a tablet, and now I take a whole one. No headache, lucky me. I’m on 5 as well, for now anyway.

Wow, a few of us have struggled with this! Good to know I’m not the only one.

Ha! I've just remembered which BP meds caused me what problems ... I got the horrible dry tickly cough with the ACE inhibitors and the dreadful hot flushing with the calcium channel blockers.

Oh, and I mustn't forget the diuretic indapamide ... that made me very, very poorly but took the longest time and a chance mess up with my pill schedule to realise it was the cause of feeling like a zombie for 75% of every day. I'd been blaming PsA for this and it turned out to be an adverse effect to the diuretic. Who'da guessed it?

Good luck everyone. Seems this is far from an exact science.

I searched for some threads on high blood pressure and landed back here. You know, there is a lot of wisdom in some of the past conversations! I have always been on the low side 105/70 but in the last months its been creeping up to 135/85. @seenie, in this 5 year old conversation you shared a bit about your blood pressure. Did you find any decrease as pain got under control? While I’m waiting for Humira to work, my rheumy has suggested I stop using the Celebrex. It was the only thing helping my pain. Now I go day after day in a slightly worse flare than the day before. Shoulder pain is new, elbow is more common, what feels like shin splints in both legs, new and more intense foot pain and my knees are so bad I can’t get off the ground with out a prop. But it seems like pain is bringing on the high blood pressure. Not sure what to do next…The deep ache bouncing from joint to joint is really affecting my every step! The pain med that I am on is, “distractions”!

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I’m so glad you gave this thread a kick start! Lots has changed in the last 5 years: more exercise, a bit of weight loss, Humira did a great job, except I’m having some breakthrough symptoms. (The latest being dactylitis in one foot, owweeeee, now pretty much resolved.) I was able to reduce my BP meds to a fairly low dose of telmisartan, and no amlodipine. I’m off to Toronto in a couple of weeks, so there may be a change of meds in the offing for me.

You must be my fraternal PsA twin: elbow pain, and those shin-splint things, darn, they are awful, and then add intense foot pain and it’s no wonder BP is a problem for us!

Remind me, when did you start Humira? Oh, I so hope you get some relief from it.

Seenie

@Amos, to answer your question, I when pain came under good control, BP improved. So keep those fingers crossed (if that doesn’t hurt too much).

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I’ve had 3 Humira injections so I’m in my 5th week since starting. Not expecting much for another few months but maybe it will kick in sooner. Which one of us is the “evil twin”? :wink:

My dad passed away from a heart attack too, in hindsight I suspect he had developed undiagnosed psa in the last period, as a knee operation he had had had not sorted out his problem, and a few other signs. Neither of us even knew of the existence of this disease, of course, although on his side of the family many members w psoriasis. Went on a massively low carb diet and fasting and as a result at the moment although always with Cosentyx and methotrexate my bmi is now ok, since stopping steroids, and bp has gone down to last measurement at check up 100/70, down from 135 or so and 95 or so. Am on carnivore diet now, take folate and vit d and bisphophonates for osteoporosis

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Me, without a doubt. Can’t go into detail here. LOL

The bad news is that it took three months for my first biologic to kick in. Patience my friend, patience.

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