Severe Regurgitation and Blood Pressure

[NorthVanJosh]

Hi all,

I'm currently awaiting surgery via Bentall procedure (should be in a month). I know that I have severe regurgiation and my high blood pressure is what led me to discover that I'm apart of the BAV club.

Lately I've noticed that my BP has gone from an average of 155/62 to an average of 170/65. So far no one I've talked to has really seemed concerned with these numbers all citing that its because of my regurgitation and I should be in a normal range once I'm fixed up.

I'm wondering if people who also have had severe regurgiation had these kinda numbers before surgery? I called my surgeon to let him know about my increase and they told me to get checked up with my family doctor to make sure my vitals are ok so I'm seeing my family doctor tomorrow. Just wondering if I should be making a bigger fuss than I am with these high readings, and possibly get on some medication before surgery.

Thanks!

 

[Lisa from LJ]

I've had high blood pressure since I was a teenager, both the 22 years when I had severe regurgitation and 26 years post surgery. It runs in my family. Your type of high blood pressure is called isolated systolic hypertension because only your top number is high. That can be due to valve disease, among other things. The problem with medication in your case is that you don't want your bottom number to drop.

 

[Lucker]

Hi, I found this article interesting. Elite athlete with at least moderate AR and a severely dilated left ventricle had normal BP. Could it be, that his normal BP was from his meds?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10157104/

 

[Teapotimus]

I've had severe regurgitation for at least 4 years at this point, probably much longer. Since I started having my blood pressure checked and taking it myself at home it's been pretty perfect at 115 - 120/60-65, no medications.

 

[Deidra]

I had moderate/severe regurgitation for 5 years prior to my surgery 2 weeks ago. My blood pressure was always somewhat elevated during that time. At the doctor's office it was usually around 150/90 and at home it was more like 130/70. I was put on Losartan 50mg/daily to control the blood pressure, and possibly reduce inflammation/necrosis in my dilated aorta, which there is some limited evidence for.

My cardiologists have attributed it to the fact that your heart has to pump much harder than usual to actually get enough blood to the rest of your body in the setting of regurgitation, which increases systolic BP (the top number). Stress and worry can also increase systolic BP.

Important to keep in mind that white-coat hypertension is very common and can make really big differences in BP. Have you taken measurements at home? Or are these only from the doctor's office?

 

[NorthVanJosh]

Important to keep in mind that white-coat hypertension is very common and can make really big differences in BP. Have you taken measurements at home? Or are these only from the doctor's office?

Yeah these are all measurements at home.

Went to doctor today and had around the same readings (165-170/62-64). He wants to look at my blood work before prescribing me anything. Mentioned that he doesn't want the bottom number to drop too much or else I'll likely be fainting. So he's only is going to give me something if he sees a cause outside my crappy valve, since that appears to be the only cause for the high BP and it'll hopefully be lower post surgery. Says while its high its not overally critical but would like to see it down a bit before surgery so we'll see what happens!

 

[Teapotimus]

Just had my annual exam with my primary care doctor a few days ago. BP was 110/60, presumably my regurgitation is still severe with a 44% regurgitant fraction.

 

[BAV]

How are you feeling with your severe regurgitation? Do you have any stenosis?

I just crossed over into severe and I'm in the process of getting surgery scheduled.

Best of luck to you!

 

[Teapotimus]

How are you feeling with your severe regurgitation? Do you have any stenosis?

I just crossed over into severe and I'm in the process of getting surgery scheduled.

Best of luck to you!

I feel fantastic, I have another thread on here about my very non-standard presentation of BAV and how it's going.

I was diagnosed with severe stenosis a few years ago, it's been improving steadily and I am now moderate by gradients and mild by AVA. Similarly my regurgitation has begun to show improvements as well, but it's still in the severe range as of March, but I did see a significant reduction in my regurgitant fraction. I've also had regression of LVH and symptoms over these last few years.

 

[NorthVanJosh]

How are you feeling with your severe regurgitation? Do you have any stenosis?

I just crossed over into severe and I'm in the process of getting surgery scheduled.

Best of luck to you!

No stenosis just the regurgiation. These days I'm feeling pretty crappy. Got no energy any more and the simpliest of walks are putting me out of breath. Also my chest feels like someone is lightly grabbing/squeezing my heart. My surgery is hopefully in 2 weeks though!

 

[Lisa from LJ]

I feel fantastic, I have another thread on here about my very non-standard presentation of BAV and how it's going.

I was diagnosed with severe stenosis a few years ago, it's been improving steadily and I am now moderate by gradients and mild by AVA. Similarly my regurgitation has begun to show improvements as well, but it's still in the severe range as of March, but I did see a significant reduction in my regurgitant fraction. I've also had regression of LVH and symptoms over these last few years.

What's causing the improvement?

I didn't have the same problem. My mitral valve was damaged when I had rheumatic fever at 14. I always felt good even though my heart function was continuing to decline. My doctor once said that I was the healthiest appearing severely ill patient he had! He noted that my heart had adjusted to poor performance, which is why I had an extremely high EF. I was the one who finally pushed for surgery. It had been 22 years of them saying I'd need it soon, and I just wanted to get it behind me. Once they did the cath, both the Cardiologist and Surgeon said that my heart was much worse than the other tests indicated and it was good that I'd pushed.

 

[Teapotimus]

What's causing the improvement?

I didn't have the same problem. My mitral valve was damaged when I had rheumatic fever at 14. I always felt good even though my heart function was continuing to decline. My doctor once said that I was the healthiest appearing severely ill patient he had! He noted that my heart had adjusted to poor performance, which is why I had an extremely high EF. I was the one who finally pushed for surgery. It had been 22 years of them saying I'd need it soon, and I just wanted to get it behind me. Once they did the cath, both the Cardiologist and Surgeon said that my heart was much worse than the other tests indicated and it was good that I'd pushed.

When I was diagnosed (well re-diagnosed but that's another story), I began a complete overhaul of my life. Exercise routine, supplementation, and fasting/diet/autophagy. I've written about it here, although I may try to make a really comprehensive post some time including my results in chronogical order.

What specifically is causing the improvement? I can't say, I'm just a guy with a couple of engineering degrees, no medical education.

All I know is I have a few years of various tests showing a linear improvement in my valve function and overall heart health. For example my peak gradient was 78 in the beginning, it's now 40. I had evidence of LVH on echo and ekg, now I don't. I scored a higher MET score on a recent stress test than my first one. My regurgitant fraction was 15% lower on my second cardiac MRI than my first etc..