Hi Docs,
I have been taking Lisinopril 10mg for about 3 years now for my essential hypertension. My BP had been fine until about 6 months ago when it looked high again at my physical, so my PCP had me come back in today for lab work and to recheck. They measured it this morning twice: 131/75 and 140/80. When I first started taking Lisinopril, my BP had been in the 135-145 / 80-90 range. For reference, I am a 32 year old male, 6’2" and currently 198 lbs and 33 3/4" waist. At my physical last year everything came back normal on my lipid panel and on my CMP. As far as I know, my blood pressure is the only thing that is abnormal.
I have an appt with my PCP next week to talk about this, but I’m wondering what this may mean for me in terms of training/getting jacked. I’m concerned that I’m back over 130 systolic consistently despite taking my Lisinopril every day and being what seems like a healthy weight. Do you think it’s just not a good idea for me to gain weight long term to get jacked? Am I better off maintaining weight instead? It seems like it’s not in the cards for me to gain significant size, but maybe I am making too much of this relationship. Prior to this summer I had been doing BBM templates for a couple few years, mainly powerlifting and powerbuilding templates. Since then I’ve been doing the bodybuilding template because I want to focus on hypertrophy. I have no interest in competing in anything, so I’m training for health and aesthetics.
I also wanted to see if you thought there was anything in particular I should look at as far as lifestyle that might be helpful, e.g. sodium intake, cardio, etc. Obviously I will discuss with my doctor as well, but I wanted to get your thoughts.
It sounds like your training and body composition are in a good place right now (although I’d want to confirm you’re meeting/exceeding physical activity guidelines in general). On the dietary front, we’d want to make sure you’re consuming a diet high in vegetables/fruit and fiber, and avoiding excessive alcohol intake. On the medical front, I’d want to screen you for sleep apnea via the STOP-BANG Questionnaire (and ensure you’re getting adequate sleep in general), ensure your thyroid function was normal, and ensure you aren’t using NSAIDs regularly for aches and pains, as these can raise blood pressure.
Finally, I’d also want to check your blood pressure outside of the context of the medical clinic, in case there is an element of “white coat syndrome” at play. Sometimes physicians will order something called Ambulatory Blood Pressure Monitoring (ABPM) to evaluate for this. If, after all this is addressed, you are proven to have persistent high blood pressure, then there may be some genetic aspects at play, and medication may be the only remaining way to get it controlled. This is sometimes the case – fortunately 10 mg of lisinopril is a very low dose, and you have plenty of room to safely increase the dose if needed. If that is the situation you end up in, I would probably advise against aggressive weight gain.
I’m not even sure if I meet all the physical activity guidelines. Obviously I am exceeding the strength training recommendations, but I’m not sure about the rest. I do 20-30 minutes of LISS 1-2x per week and average 8-9,000 steps/day. Pre-pandemic I was averaging 11-12,000 steps/day. Dietary- I’d say my fruit/vegetable and fiber intake are a little lower than they should be. My Fitness Pal shows I was in the 20-25g of fiber per day in December and January during my cut. I rarely drink alcohol, or use NSAIDS- although I did take ibuprofen the last 2 mornings because I woke up with headaches. Can they raise blood pressure acutely, or is it just from chronic use?
I just looked at the STOP-BANG Questionnaire and it looks like I’m intermediate risk (Male, >16 inch neck, hypertension). I feel like my sleep is pretty good. I get a solid 7 hours of sleep (that’s actual sleep, not laying in bed) and very rarely feel tired during the day.
I do have a blood pressure machine at home, my doctor had me use it before I originally went on lisinopril. It was pretty consistent with what I was getting elsewhere (doctor’s visit, blood donation, biometric screening, etc). I haven’t used it since then, though.
Just to be clear, what would you consider aggressive weight gain?
I just looked at the STOP-BANG Questionnaire and it looks like I’m intermediate risk (Male, >16 inch neck, hypertension). I feel like my sleep is pretty good. I get a solid 7 hours of sleep (that’s actual sleep, not laying in bed) and very rarely feel tired during the day.
Sounds like you’re unlikely to have significant OSA.
I rarely drink alcohol, or use NSAIDS- although I did take ibuprofen the last 2 mornings because I woke up with headaches. Can they raise blood pressure acutely, or is it just from chronic use?
I wouldn’t expect a significant acute effect of these meds (although I would expect an effect from acute pain itself).
Just to be clear, what would you consider aggressive weight gain?
There’s no consensus definition here, so just use a ‘common sense’ type definition of an aggressive bulk. If you choose to gain weight, it should be done slowly while monitoring your waist circumference to ensure you aren’t adding inches to your waist just as quickly as you’re adding pounds on the scale, as well as monitoring your blood pressure.