Question: I was premature and was sick for many years. Finally, I was diagnosed with mitral regurgitation. I am 70 now, and I take two medications for blood pressure to keep my systolic in the 140's and 150's, but my diastolic is low and my pulse is good. Is there anything I can do or take?

Dr. Hibberd's Answer:

While I cannot offer you personalized recommendations, I can provide you with several pointers. Hypertension is very common and it is not unusual to need two and sometimes three medications to adequately control elevated blood pressure conditions in elderly patients. It is not associated with prematurity.

The challenge is to minimize the side-effects seen with higher doses of single medications. They are often minimized by using lower doses of multiple medications.

Drug-drug interactions are the number one reason many physicians do not encourage their patients to use non-prescription meds without their knowledge. Be sure to bring all your meds to your doctor for review, both prescription and non prescription. Some supplements contain substances that are safe for most healthy people but can be harmful for those with hypertension and other medical conditions. Since many non-prescription supplements are approved only as dietary supplements and have not been cleared by the FDA, they are not required to carry consumer warnings. When in doubt, consult a professional medical doctor.

Some patients are extremely salt sensitive, so restricting dietary sodium may be beneficial for some. This is usually in the form of a no-salt-added diet combined with a calcium-rich foods or a supplement prescribed by their physician.
Mitral valve regurgitation (leaking of the valve allowing backward flow of blood when the heart pumps to supply blood to our brain, vital organs and extremities) should be under continued review by your cardiologist. Note that many medications used for blood pressure control also have heart effects that need to be balanced against the severity of your mitral regurgitation.
Although you would like to have an ideal BP of 120/80, your 140-150 systolic readings may be required for adequate delivery of blood because of your low diastolic blood pressures. Since elevated pressures may influence your risk of heart disease, I recommend you review this with your physician and cardiologist.