It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
^ van Berge-Landry HM, Bovbjerg DH, James GD (October 2008). "Relationship between waking-sleep blood pressure and catecholamine changes in African-American and European-American women". Blood Pressure Monitoring. 13 (5): 257–62. doi:10.1097/MBP.0b013e3283078f45. PMC 2655229. PMID 18799950. Table2: Comparison of ambulatory blood pressures and urinary norepinephrine and epinephrine excretion measured at work, home, and during sleep between European–American (n = 110) and African–American (n = 51) women
Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.
The new guidelines stem from the 2017 results of the Systolic Blood Pressure Intervention Trial (SPRINT), which studied more than 9,000 adults ages 50 and older who had systolic blood pressure (the top number in a reading) of 130 mm Hg or higher and at least one risk factor for cardiovascular disease. The study's aim was to find out whether treating blood pressure to lower the systolic number to 120 mm Hg or less was superior to the standard target of 140 mm Hg or less. The results found that targeting a systolic pressure of no more than 120 mm Hg reduced the chance of heart attacks, heart failure, or stroke over a three-year period.
In Europe hypertension occurs in about 30-45% of people as of 2013.[12] In 1995 it was estimated that 43 million people (24% of the population) in the United States had hypertension or were taking antihypertensive medication.[141] By 2004 this had increased to 29%[142][143] and further to 32% (76 million US adults) by 2017.[7] In 2017, with the change in definitions for hypertension, 46% of people in the United States are affected.[7] African-American adults in the United States have among the highest rates of hypertension in the world at 44%.[144] It is also more common in Filipino Americans and less common in US whites and Mexican Americans.[6][145] Differences in hypertension rates are multifactorial and under study.[146]
2. Take the right nutrients. Talk with your chiropractor or other healthcare professional about the wide range of well-studied nutrients that, along with dietary and lifestyle modifications, can help normalize your blood pressure. One meta-analysis found magnesium supplements could lower blood pressure. Likewise, researchers find a small but significant decline in blood pressure for people with hypertension who use fish oil. (You can get all of fish oil’s benefits combined with anti-inflammatory flax oil and GLA in our Optimal Omega.) 

These common metformin side effects also happen because metformin alters your digestive process and your nutrient absorption. Some foods/products may start tasting and smelling better to you, while others may gain an unfamiliar/unpleasant smell/taste. Patients often report a heightened sense of smell on metformin, as well as metallic taste in the mouth and while consuming certain foods. 1-5% of the patients experience taste and smell disturbances while medicating with metformin.
Nausea, vomiting, stomach upset, diarrhea, weakness, or a metallic taste in the mouth may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. If stomach symptoms return later (after taking the same dose for several days or weeks), tell your doctor right away. Stomach symptoms that occur after the first days of your treatment may be signs of lactic acidosis.
2. Take the right nutrients. Talk with your chiropractor or other healthcare professional about the wide range of well-studied nutrients that, along with dietary and lifestyle modifications, can help normalize your blood pressure. One meta-analysis found magnesium supplements could lower blood pressure. Likewise, researchers find a small but significant decline in blood pressure for people with hypertension who use fish oil. (You can get all of fish oil’s benefits combined with anti-inflammatory flax oil and GLA in our Optimal Omega.) 
Lactic acidosis is a rare but serious side effect of this drug. With this condition, lactic acid builds up in your blood. This is a medical emergency that requires treatment in the hospital. Lactic acidosis is fatal in about half of people who develop it. You should stop taking this drug and call your doctor right away or go to the emergency room if you have symptoms of lactic acidosis.

^ Roerecke, Michael; Tobe, Sheldon W.; Kaczorowski, Janusz; Bacon, Simon L.; Vafaei, Afshin; Hasan, Omer S. M.; Krishnan, Rohin J.; Raifu, Amidu O.; Rehm, Jürgen (27 June 2018). "Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies". Journal of the American Heart Association. 7 (13): e008202. doi:10.1161/JAHA.117.008202.
You may be directed to seek medical care if blood pressure readings are elevated if done as part of a community health screening. Isolated elevated blood pressure readings do not necessarily make the diagnosis of hypertension. Blood pressure readings vary throughout the day, and your primary care provider may record a different reading than the one that was measured in a screening that sent you in for care.
Normal blood pressure can differ substantially between breeds but hypertension in dogs is often diagnosed if systolic blood pressure is above 160 mm Hg particularly if this is associated with target organ damage.[170] Inhibitors of the renin-angiotensin system and calcium channel blockers are often used to treat hypertension in dogs, although other drugs may be indicated for specific conditions causing high blood pressure.[170]
AMPK probably also plays a role in increased peripheral insulin sensitivity, as metformin administration increases AMPK activity in skeletal muscle.[105] AMPK is known to cause GLUT4 deployment to the plasma membrane, resulting in insulin-independent glucose uptake. Some metabolic actions of metformin do appear to occur by AMPK-independent mechanisms; the metabolic actions of metformin in the heart muscle can occur independent of changes in AMPK activity and may be mediated by p38 MAPK- and PKC-dependent mechanisms.[106]
7. Visit your chiropractor. A special chiropractic adjustment could significantly lower high blood pressure, a placebo-controlled study suggests. “This procedure has the effect of not one, but two blood–pressure medications given in combination,” study leader George Bakris, MD, told WebMD. Your chiropractor can create an effective protocol that helps normalize blood pressure without medication or other invasive procedures.
Imagine a garden hose hooked up to a spigot. When the hose is flexible and there are no kinks in it, you can turn on the water full blast and it will flow easily through the hose. But if there’s a kink in the hose, the water doesn’t flow as well beyond the kink. And the pressure inside the hose builds up behind the kink. Or imagine there is gunk inside the hose blocking the path of the water. Your arteries are a lot like that garden hose.
Metformin is capable of affecting the level of certain hormones in the body, especially in large doses. For instance, an overdose may lead to a reduction in the blood levels of thyroid-stimulating hormones, especially if the individual has a history of suffering from hypothyroidism. It can also cause a reduction of the blood level in testosterone and luteinizing hormones found in men.

In the 19th and 20th centuries, before effective pharmacological treatment for hypertension became possible, three treatment modalities were used, all with numerous side-effects: strict sodium restriction (for example the rice diet[152]), sympathectomy (surgical ablation of parts of the sympathetic nervous system), and pyrogen therapy (injection of substances that caused a fever, indirectly reducing blood pressure).[152][158]


Metformin is not metabolized. It is cleared from the body by tubular secretion and excreted unchanged in the urine; metformin is undetectable in blood plasma within 24 hours of a single oral dose.[89][116] The average elimination half-life in plasma is 6.2 hours.[89] Metformin is distributed to (and appears to accumulate in) red blood cells, with a much longer elimination half-life: 17.6 hours[89] (reported as ranging from 18.5 to 31.5 hours in a single-dose study of nondiabetics).[116]
^ Jump up to: a b c Giuseppe, Mancia; Fagard, R; Narkiewicz, K; Redon, J; Zanchetti, A; Bohm, M; Christiaens, T; Cifkova, R; De Backer, G; Dominiczak, A; Galderisi, M; Grobbee, DE; Jaarsma, T; Kirchhof, P; Kjeldsen, SE; Laurent, S; Manolis, AJ; Nilsson, PM; Ruilope, LM; Schmieder, RE; Sirnes, PA; Sleight, P; Viigimaa, M; Waeber, B; Zannad, F; Redon, J; Dominiczak, A; Narkiewicz, K; Nilsson, PM; et al. (July 2013). "2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)". European Heart Journal. 34 (28): 2159–219. doi:10.1093/eurheartj/eht151. PMID 23771844.

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This is one of the most common metformin side effects that a lot of people tend to experience when medicating with metformin. Generally, it is expressed in chronic diarrhea. It is believed to be related to that fact that metformin prevents enterocytes (cells in your digestive tract) from absorbing certain nutrients, particularly carbohydrates, which results in upset GI tract. 53% of the patients medicating with metformin experience diarrhea.
The table shows the most recent classification (2018) of office (or clinic) blood pressure by The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH).[9] Similar thresholds had been adopted by the American Heart Association for adults who are 18 years and older,[10] but in November 2017 the American Heart Association announced revised definitions for blood pressure categories that increased the number of people considered to have high blood pressure.[11]

2. How did I get the numbers? I started with the commonly seen "Systolic/ Diastolic pairs" seen in the literature - 200/120, 160/100, 140/90, 120/80 and 90/60. From there, I interpolated and extrapolated all the other numbers. Note that these are AVERAGE relationships. For instance, instead of 140/90, your BP may be 140/100, or 140/80. Each individual will have a unique systolic-diastolic relationship. If your S/D difference varies significantly from the averages shown above, this can be helpful in assessing your particular cardiovascular condition.
Aldosterone release: This steroid hormone is released from the adrenal cortex in response to angiotensin II or high serum potassium levels. Aldosterone stimulates sodium retention and potassium excretion by the kidneys. Since sodium is the main ion that determines the amount of fluid in the blood vessels by osmosis, aldosterone will increase fluid retention, and indirectly, arterial pressure.

Physical changes: If something in your body changes, you may begin experiencing issues throughout your body. High blood pressure may be one of those issues. For example, it’s thought that changes in your kidney function due to aging may upset the body’s natural balance of salts and fluid. This change may cause your body’s blood pressure to increase.


This is one of the most common metformin side effects that a lot of people tend to experience when medicating with metformin. Generally, it is expressed in chronic diarrhea. It is believed to be related to that fact that metformin prevents enterocytes (cells in your digestive tract) from absorbing certain nutrients, particularly carbohydrates, which results in upset GI tract. 53% of the patients medicating with metformin experience diarrhea.
Damage to the heart muscle can also cause atrial fibrillation over time. Atrial fibrillation is an irregular heart rate that puts you at risk for stroke. High blood pressure can also tear the inner layer of the arteries, allowing buildup of scar tissue that attracts cholesterol debris and platelets (blood cells that form clots). Cholesterol build-up in damaged blood vessels is called a plaque. These plaques cause a narrowing of the arteries, which results in more work for the heart to pump adequate blood through the body.

The symptoms similar to symptoms of patients with hypertensive crisis are discussed in medieval Persian medical texts in the chapter of "fullness disease".[155] The symptoms include headache, heaviness in the head, sluggish movements, general redness and warm to touch feel of the body, prominent, distended and tense vessels, fullness of the pulse, distension of the skin, coloured and dense urine, loss of appetite, weak eyesight, impairment of thinking, yawning, drowsiness, vascular rupture, and hemorrhagic stroke.[156] Fullness disease was presumed to be due to an excessive amount of blood within the blood vessels.
Enlarged heart. High blood pressure increases the amount of work for your heart. Like any heavily exercised muscle in your body, your heart grows bigger (enlarges) to handle the extra workload. The bigger your heart is, the more it demands oxygen-rich blood but the less able it is to maintain proper blood flow. As a result, you feel weak and tired and are not able to exercise or perform physical activities. Without treatment, your heart failure will only get worse.
Cirrhosis of the liver is the most common cause of portal hypertension. In cirrhosis, the scar tissue (from the healing of liver injury caused by hepatitis, alcohol, or other liver damage) blocks the flow of blood through the liver. Blood clots in the portal vein, blockages of the veins that carry blood from the liver to the heart, parasitic infection (schistosomiasis), and focal nodular hyperplasia are also causes of portal hypertension.
While high blood pressure doesn’t have any distinctive symptoms in itself, there can be many associated conditions and signs that high blood pressure may be affecting your body and causing damage. When left untreated, high blood pressure can cause the following symptoms in the body, which may worsen over time. If you are experiencing any of the following symptoms chances are your high blood pressure may be placing you at risk of developing further conditions and should be addressed immediately.
The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) classification of office blood pressure (BP)a and definitions of hypertension gradeb. The same classification is used for all ages from 16 years. a BP category is defined according to seated clinic BP and by the highest level of BP, whether systolic or diastolic. b Isolated systolic hypertension is graded 1, 2, or 3 according to systolic BP values in the ranges indicated.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
Damage to the heart muscle can also cause atrial fibrillation over time. Atrial fibrillation is an irregular heart rate that puts you at risk for stroke. High blood pressure can also tear the inner layer of the arteries, allowing buildup of scar tissue that attracts cholesterol debris and platelets (blood cells that form clots). Cholesterol build-up in damaged blood vessels is called a plaque. These plaques cause a narrowing of the arteries, which results in more work for the heart to pump adequate blood through the body.
Before having surgery or any X-ray/scanning procedure using iodinated contrast, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). You may need to stop this medication for a short time for the surgery/procedure. Ask your doctor or dentist for instructions before your surgery/procedure.
^ Hemmingsen B, Schroll JB, Wetterslev J, Gluud C, Vaag A, Sonne DP, Lundstrøm LH, Almdal T (July 2014). "Sulfonylurea versus metformin monotherapy in patients with type 2 diabetes: a Cochrane systematic review and meta-analysis of randomized clinical trials and trial sequential analysis". CMAJ Open. 2 (3): E162–75. doi:10.9778/cmajo.20130073. PMC 4185978. PMID 25295236.

Generally the first sign of experiencing high blood pressure, the tension on the brain can cause a severe headache. These headaches can come in the form of just a dull throbbing to a debilitating migraine. The reason behind the headache is linked to the blood vessels in the brain, which swell due to the higher instance of blood in the system. This swelling then places pressure on sensitive areas of the brain causing pain to radiate throughout the head, in the temples and even down through the neck. Pain can be treating by taking ibuprofen or paracetamol, however these should not be taken too frequently.

^ Roerecke, Michael; Tobe, Sheldon W.; Kaczorowski, Janusz; Bacon, Simon L.; Vafaei, Afshin; Hasan, Omer S. M.; Krishnan, Rohin J.; Raifu, Amidu O.; Rehm, Jürgen (27 June 2018). "Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies". Journal of the American Heart Association. 7 (13): e008202. doi:10.1161/JAHA.117.008202.

It was withdrawn from the market in the UK and India in 2010,[140] and in New Zealand and South Africa in 2011.[141] From November 2011 until November 2013 the FDA[142] did not allow rosiglitazone or metformin/rosiglitazone to be sold without a prescription; moreover, makers were required to notify patients of the risks associated with its use, and the drug had to be purchased by mail order through specified pharmacies.[143]


Gastrointestinal upset can cause severe discomfort; it is most common when metformin is first administered, or when the dose is increased. The discomfort can often be avoided by beginning at a low dose (1.0 to 1.7 grams per day) and increasing the dose gradually but even with low doses 5% of people may be unable to tolerate metformin.[64] Use of slow- or extended-release preparations may improve tolerability.[64]
Metformin (prescribed to treat type 2 diabetes) can cause excessive gas and bloating, heartburn, headaches, a cough, muscle pain and a metallic taste in the mouth, but these side effects typically ease after a few weeks. Very rarely, metformin may cause a serious condition called lactic acidosis. Key signs include weakness, trouble breathing, abnormal heartbeat, unusual muscle pain, stomach discomfort, lightheadedness and feeling cold. You're more at risk if you have reduced kidney function, worsening congestive heart failure or are dehydrated.
Lifelong control of hypertension will minimize the risk of developing heart attack, stroke, kidney failure, blindness, and a variety of other illnesses. Unlike other illnesses in which medications are taken for only a short period of time, high blood pressure medication is usually expected to be taken for the rest of the individual's life. It is uncommon, but not rare, that significant lifestyle changes can lower blood pressure readings to normal.
^ Jump up to: a b Campbell, NR; Lackland, DT; Lisheng, L; Niebylski, ML; Nilsson, PM; Zhang, XH (March 2015). "Using the Global Burden of Disease study to assist development of nation-specific fact sheets to promote prevention and control of hypertension and reduction in dietary salt: a resource from the World Hypertension League". Journal of clinical hypertension (Greenwich, Conn.). 17 (3): 165–67. doi:10.1111/jch.12479. PMID 25644474.
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