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Blood pressure

Question
Hello dear expert team!

I am taking the drung Candesartan plus for 10 years now. 2014 I have lost my conscious for 2 times, many investigations did really not bring results. Only a suspicon for a vasovagal syncope.
My blood pressure is now without a drug too high in the day mean, unfortunately even not a lowering in the night, either. Unfortunately I have the impression, that my blood pressure medication has side effects. Feeling rapid heart beat. I feel it often to beat hard and I am dizzy, inner disquite. Therefore I tried it for 4 weeks without medication. However 157/97 in the day mean and 144/87 in the night is too high. Longterm blood pressure in the hospital.
Which kind of substances are the best for CF patients and which are not suitable at all? I am 48 years old and weigh 77 kg, high blood pressure is in my family. My FEV1 is around 30%.
After my syncope I have already changed a lot. I drink much more and try to take less tablets like Arcoxia, azithromycin, ibuprofen, no permanent antibiotic therapy against Staphylococci, my blood values have improved much. Before, creatinin 100 to 135, now 82!
Actually I am only taking ACC 600, Vitamin D3 and acetylsalicyclic acid.
Unfortunately, the cardiologists do not see the whole human being, but rather only their special area. Just in case of CF, the situation is rather complex. I have heard about some CF patients, that they tolerate the calcium antagonists quite well, however beta-blocker are narrowing the lung. Which experience do you have as a CF doctor for many years?
My ultrasound of the heart is normal.

Many thanks for an answer.
Answer
Dear questioner,

I can conclude from your mail, that you are suffering from CF and suffer also from a high blood pressure, probably genetically caused. There is no direct correlation between CF and a high blood pressure. A CF patient can also have other diseases like everybody else, among These also a high blood pressure.
You want to know, with groups of substances are best suitable for CF patients with a high blood pressure. For this, we can unfortunately not give you a scientific proved answer. That means, that the right therapy has to be individually adjusted for you. In cases of a complicated adjustment of the blood pressure, a cardiologic consultation is necessary for a CF patient like in your case.

I can confirm, that beta-blocker can cause a narrowing of the bronchi in case of a patient with asthma or also with a chronic obstructive lung disease (COPD). Especially patients with asthma are involved by this. This should be taken into account in case of CF, as the illness is not seldom accompanied by an asthma and has paralleles to COPD. The narrowing of the bronchi, however, does not necessarily occur in a CF patient under therapy with beta-blockers, so that in case of lacking alternatives, also beta-blockers could be used.
In spite of this, it should be investigated before the usage of a beta-blocker, if an asthma is underlying in a CF patient and if other blood pressure medications could be used. Among these would e.g. be calcium antagonists, ACE blockers, AT1-antagonists and others. This should be decided together with a cardiologist. Among my patients with high blood pressure, different substances have been used (no preferences).

Best regards,
Yours Dr. Christina Smaczny
28.06.2015