I had a patient call concerned because she was having the "I'm gonna pass out" light headed feeling as she stands up from a sitting position. I asked her if she was on blood pressure medication and if she had any other changes recently. She was on Norvasc and had lost 60 pounds over the last few months. Bingo! We have a winner!
There is a lack of awareness for patients that significant weight loss will make major decreases in your blood pressure. This is especially important to know if you are on a blood pressure medication. As your weight and blood pressure goes down you will need to communicate with your physician and monitor your blood pressure. When blood pressure goes too low there can be complications far worse than falling down or passing out when standing up from a sitting position. Imagine if this happened while you were working with dangerous machinery or driving a 2000lb death machine, I mean automobile. Imagine if it dropped so low that you died from a chamber of the heart collapsing or got brain damage from lack of blood oxygenating the brain....crap, gonna get hate mail for that alarmist comment...
Reliable studies over several years have proven one significant finding in weight loss:
1kg = 1mmHg
For every 1 kilogram (2.2 pounds) of weight lost your blood pressure will drop approximately 1mmHg or one point on your reading. This correlation means that patients can see measurable results with only a 10 pound weight loss. As weight and blood pressure drop your blood pressure medications will need to be adjusted. Patients on multiple drug therapy can be dropped to single drug therapy and patients on single drug therapy can have their dose reduced. With enough weight loss and a good weight maintenance lifestyle change most patients can be MEDICATION FREE!
The added bonus: with significant weight loss in Type 2 diabetics we also see less insulin resistance and better beta cell function, which allows them to get off insulin and reduce their other medications and in many patients the same MEDICATION FREE status is achievable!
Another added bonus: with significant weight loss and better eating habits the same reductions can be seen in LDL and triglycerides with increases in HDL (the good cholesterol) and the same MEDICATION FREE status can be achieved by most cholesterol patients!
Long gone will be the days of patients bitching and moaning about taking multiple drugs and spending a lot on ever-climbing copays! Oh wait, reality check, this America... The land of high fructose corn syrup, ever present salty & sugary snacks, and a drive thru eatery on every other street corner! Optimism, I lay thee to rest. Say high to Jesus and Budda for me! I hear they throw great parties, I mean seriously, water into wine...How awesome is that?!
Please let your patients know the wonderful benefits of weight loss and healthy eating. Please let them know how to properly monitor their blood pressure at home at least on a weekly basis with any dietary and workout combo so they know to contact you when they are probably going to need that medication change to prevent any complications. And please only use optimism for them because making those changes should be done slowly and permanently. Slow and steady always finishes the race!