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ForumsExercise & Body CompositionCan we normalize being the slowest person at the gym — 12 month update

Can we normalize being the slowest person at the gym — 12 month update

josh_phd_bmore Sat, Oct 14, 2023 at 5:47 AM 7 replies 2,144 viewsPage 1 of 2
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josh_phd_bmore
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389
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Jul 2024
Baltimore, MD
Oct 14, 2023 at 7:12 AM#1

Just had the conversation with my cardiologist I've been waiting for. After 6 years on lisinopril 20mg for hypertension, I'm officially discontinuing it. My blood pressure has been consistently normal for the last 3 months without it (we did a trial taper starting 12 weeks ago).

TimepointBP (office avg)BP (home avg)WeightLisinopril
Pre-semaglutide148/94142/90278 lbs20mg
Month 2138/88134/86262 lbs20mg
Month 4128/82124/80249 lbs20mg (reduced to 10mg)
Month 6122/78118/76238 lbs10mg
Month 7118/76116/74234 lbs5mg (taper started)
Month 8120/78116/76229 lbsOFF

M/56. The home averages are from my Omron cuff, morning readings before coffee, average of 3 readings per session, 5-7 sessions per week. I take this seriously because my father died of a stroke at 62.

I'm going to continue monitoring daily and see my cardiologist again in 6 weeks. But this feels like a genuine turning point. One less pill.

2 17NurseKim_ATL, paul_denver
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MASHdoc_SA
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456
2,345
Aug 2024
San Antonio, TX
Oct 14, 2023 at 7:29 AM#2

Well managed taper. A few things I want to highlight for anyone in a similar situation:

  1. DO NOT stop blood pressure medications on your own. This was done under cardiologist supervision with a gradual taper and close monitoring. Abruptly stopping antihypertensives can cause rebound hypertension which is dangerous.
  2. The relationship between weight and blood pressure is well-established: roughly 1 mmHg systolic drop per 1 kg (2.2 lbs) lost. The OP lost 49 lbs, which predicts about a 22 mmHg systolic drop — and they got a 28 point drop (148→120), suggesting the semaglutide may have additional direct vascular benefits beyond weight loss.
  3. Home monitoring the way you're doing it — morning, fasted, averaged, multiple readings — is actually considered more reliable than office readings for diagnosing and managing hypertension.

Given your family history, I'd recommend asking about a coronary calcium score if you haven't had one. It's a cheap CT scan that directly quantifies arterial plaque.

21 12TrialTracker_MD, JennaRN, LabKate and 18 others
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Dr.KarenChen
VIP Member
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24,567
Nov 2023
San Francisco, CA
Oct 14, 2023 at 7:46 AM#3

Congrats. Getting off a medication you've been on for 6 years must feel incredible.

I had a similar experience — was on amlodipine 10mg for 4 years, now off it after 7 months on semaglutide. BP is consistently 118-122/72-76. My doctor said the weight loss essentially "cured" the hypertension, though he prefers the term "resolved" since it could come back if weight is regained.

25 23TomFromTexas, mike.trainer_LA, sarah_nash92 and 22 others
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BrianDallas92
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Oct 2024
Dallas, TX
Oct 14, 2023 at 8:03 AM#4

That's exactly the word my cardiologist used — "resolved." He was very clear that if I stop semaglutide and regain weight, the hypertension will very likely return. He also said that the longer I maintain a healthy weight and normal BP, the less likely that is, because the vascular remodeling that happens with chronic hypertension can partially reverse over time.

And yes, I've had a CAC scan — scored 42, which is moderate for my age. Another reason I'm staying on top of cardiovascular health.

24 19Dr.EndoEP, GraceAZ_72, carl_compliance and 21 others
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sarah_TO
Member
278
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Sep 2024
Toronto, CA
Oct 14, 2023 at 8:20 AM#5

This gives me hope. I'm on lisinopril 10mg + hydrochlorothiazide 12.5mg. 4 months into semaglutide, BP is already trending down. Going to discuss with my doc at my next visit about whether we can start reducing.

Last edited: Oct 14, 2023 at 12:20 PM
44 0DanielChem_CHI, marco_milano, pam_columbus and 41 others
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