Has Anyone Seen a Rise in Blood Pressure Using Rapamycin?

[jakexb]

I had been taking rapamycin since August, quickly working my way up to 3mg and then staying there until over the past 6 weeks upping my dose to 6mg weekly. 2 weeks ago, I started having headaches and feeling a bit lightheaded. I stopped taking rapa the following week out of caution. The headaches and pressure and lightheadedness continued through this week along with ringing in my ears. After some googling and consulting Dr. ChatGPT I began to think this might be due to raised blood pressure. I dug out my automatic blood pressure cuff and it read 160/80! Not emergency-room level, but not at all good. And much higher than it has been for most of my life.

I am going to carefully monitor my blood pressure and stay off rapamycin at any dose for the time being. If it increases at all, I will immediately go to the doctor. If it can resolve now that I have ceased taking rapamycin, that would probably be best rather than starting treatment for something that might resolve on its own. Online sources say pressure usually resolves within 1-4 weeks. If it does not resolve or if it increases at all, I will go to the doctor.

The interaction seems to be an activation of the renin-angiotensin-aldosterone system. Here’s what our buddy ChatGPT had to say about it:

Rapamycin is known to increase the expression of the gene encoding for renin, the first enzyme in the renin-angiotensin-aldosterone system (RAAS). This increase leads to increased production of angiotensin II, which is a potent vasoconstrictor and stimulates the secretion of aldosterone. The elevated levels of angiotensin II and aldosterone result in constricted blood vessels and fluid and sodium retention, leading to increased blood pressure. Rapamycin also has direct effects on the cardiovascular system, reducing the responsiveness of blood vessels to dilating stimuli and the contractile function of the heart. The exact mechanisms of how rapamycin affects blood pressure and the RAAS are not fully understood, but the current working theory suggests that the increase in blood pressure seen with rapamycin is due to its effects on the RAAS and its direct effects on the cardiovascular system.

The exact mechanisms by which rapamycin affects the expression of the gene encoding for renin and the activation of the renin-angiotensin-aldosterone system (RAAS) are not fully understood, but it is believed to involve the mechanistic target of rapamycin (mTOR) pathway, specifically the mTORC1 complex.

I honestly don’t know if the two are related for sure, but considering that was a change and this very closely followed, I think it’s a reasonable guess.

Assuming my levels return to normal, I will consider restarting at the 3mg level and watch my blood pressure for signs of increase very closely. I’ll keep you all updated!

[Agetron]

You’re not crazy.

I was noticing elevations of a 154 to 156 over 82 to 84 way out of my normal range. WhenI was weekly dosing at 36 ng/mL This was pretty random…whenever I was getting my blood pressure taken.

And yet then, I would go and I would have a rate of 134 / 74. Maybe at my trough?

I seroously considered getting a Blood Pessure watch to monitor it 24/7 to look for a pattern.

Akso, I always have ringing in my ears a few hours after my rapa dose. Lasts a day or two.

Since lowering my rapa dose to 12 mg/mL blood pressure is back to normal on checks.
127/72.

I also had edema in ankles… that’s gone too… now that I am on lower dose.

[Emi88]

Huh…. I couldn’t say what is causing the high blood pressure… or headaches… but it could def be the rapa

I’ve been taking 5mg once per week for over a year…. I have noticed on the day that I dose that my heart rate increases…. Not crazy, but like… similar to if I drank too much coffee…. Also the day I dose I have noticed a bit of increased energy… almost like an amphetamine, but super mild…. I can sleep that night when I take rpamycin, but I definitely have more trouble falling asleep (I don’t feel tired) and I don’t sleep more than 7 hours that night….

Because of this I decide to take my weekly doses on Saturday mornings…. The increased energy helps me not be lazy on the weekend, and that way if I have trouble falling asleep at night, I don’t have to work the next day….

But I have been to the doctors a lot since starting rap…. My blood pressure is always normal, and all stats are good… but i also workout daily, and eat very healthy… I cook all my own food, and rarely eat out… never do I eat fast food….

The only time my doctor told me I had high blood pressure was years ago (before rapa) and before I got into daily gym and Meal prep habits…. (I used to eat out a lot). I learned at that time how much eating out (high salt, etc) was affecting me. Even though I was not overweight, high sodium restaurant foods were really not good for me!

Ok, back to the rapa… Even though my blood pressure isn’t affected by rapa, the rapid heart rate still happens… I’ve been taking this over a year…. The increases heart rate/energy only happens on the day I dose, and is gone by the next day…. By Sunday night I’m completely back to normal.

Increased heart rate could cause increased blood pressure… I think… I’m not a doctor… but it hasn’t cause high blood pressure for me…

but the heart rate thing on my has never gone away even after taking rapa for over a year. I’ve gotten used to it…. And it’s very mild…. But still… I don’t drink coffee on the weekends either when I dose…. I really don’t need it LOL… I kind of like the slight increase of energy rapa gives me …. And the heart rate is not enough for me to be worried, but enough for it to not go unnoticed…. My doctors have said I’m in superb health for my age, so I just keep taking the rapa….

[jakexb]

That’s interesting and I’m happy to hear it went back down when you lowered your dose. I love that you actually have blood levels too. About what oral doses create those levels for you?

[jakexb]

Yeah it doesn’t seem to be an issue for a majority of people. Considering how much I’ve heard about mouth sores, this is the first time I heard about the potential for blood pressure issues. Hopefully I can resolve this quickly and find a nice level that isn’t problematic.

[Agetron]

Thanks yes… normal as ever until I dose with rapa.Then blood pressure spikes.

I was having leg…ankle edema too. My dose was three 2mg pills (6mg total) and fresh grapefruit juice - 5 fluid ounces. Giving me about a 36 mg dose based on LabCorp test.

[LaraPo]

Interesting observation about ringing in the ears. I noticed that sometimes I have ringing in my ears but could not figure out what is the trigger. I did not connect it with Rapa, but will now watch more closely.

[pjef_pjef]

I measure my blood pressure every day and pre Rapa it was always below 115/70. With 6mg weekly with metformin + Evoo it consistently +125/75. 52 years male, very lean at 70kg and 180cm

[jakexb]

Interesting for sure! But also still an excellent blood pressure.

[tongMD]

I’m not saying that a high BP isn’t potentially concerning - one should seek medical attention quickly at extreme elevations of BP - aka “hypertensive urgency/emergency/crisis” depending on the BP elevation and/or other factors.

I’ll add though - the most important part of BP measurements is accuracy and reliability.

It’s easy to buy something that deviates >10 mmHg if one didn’t research these consumer devices beforehand. Then there is user error to consider especially if one has a nonadjustable cuff (ie too small cuffs can increase false readings a lot). Even with perfect at-home BP and perfect use, it might deviate >10 mmHg with a “validated” device. Also, BP can fluctuate throughout the day and change based on meds.

I’m not aware of any wrist-based measurements that have significant accuracy for the consumer side that is DTC - most wristwatch-based ones are complete trash - the only one I am aware of in the US with suggestive evidence of potentially “good enough” accuracy would only sell to clinics and hospitals, not consumers - also incredibly expensive at the moment.

For cuff-based monitors available for the general public - here is a validated BP cuff list:

https://www.validatebp.org/

European/international org if you wish to compare with a second source:

STRIDE BP

[jakexb]

Thank you so much for those links. Luckily my monitor (QardioArm) is in the validated list.

I wouldn’t have thought much about it, but the headache and general wooziness has been quite unrelenting over the past few days. Current plan is to give it over the weekend and if things aren’t improving, start the hall rolling to see someone.

If im really honest, part of the reason I haven’t made an appointment already is that I really really don’t want to have to admit I’ve been taking rapamycin on my own and start off as a “crazy patient”

[tongMD]

I can understand your concern. I’ll add that nobody should try to fix things themselves - it can possibly lead to accidental severe injury - ie perfusion issues from insufficient autoregulation can cause stroke, MI, or AKI as one possible potentially deadly issue.

Get medical advice quickly depending on the potential urgency. There are rapa-friendly MDs out there.

For example, any exclusion of end-organ damage requires labs and/or imaging - there can be severe issues if the appropriate amount of treatment is not pursued in time. Certain pre existing conditions can increase risk.

[pjef_pjef]

Mine is the Omron wrist BP6350, validated on the list, so I hope its quite reliable. Just did three measurements after a dinner and half a bottle of wine and its 117/71, 116/71 and 116/72 quite strange as it was higher yesterday with no alcohol. Btw I take Rapa on mondays

[jakexb]

Thank you for the advice, I really do appreciate it. I have an appointment scheduled for Tuesday and will keep an eye on the numbers in the meantime if anything gets worse.

[pollux]

Dr. B in his 2017 paper “From rapalogs to anti-aging formula” on drugs to suppress hyperfuctions recommends taking propranolol (beta blockers lowering heart rate), Lisinopril , valsartan (angiotensin II inhibitors). These are BP lowering drugs.

[Agetron]

Thanks for the suggestion - I just order the Omron #7 on Amazon at 38% off the price sale!
Will report back when it arrives in a week. Wish I had this all summer when I was getting those highs peaks from 36 mg Rapa dosses.

Will take B/P before dosing and a few hours after dose and 12 hours later. Let’s see.

[John_Hemming]

I have used Omron devices for a long time now. I record my bp on going to bed and waking up each day.

[José]

FWIW this co$t over $400.00

Blood Pressure Watch | OMRON HeartGuide Wrist BP Monitor

I keep using my $50.00 - E500

Some screen shots from my unit{the E 500] on the HBand app.

[Agetron]

I want that… a bit of sticker shock at $500. Ouch!

But yes! This is exactly what I want.
Check my B/P anytime…anywhere.

Will try my Omron #7. If these are the first… price will come down as others apoear on the market.

[John_Hemming]

I was not persuaded by the e500 figures. They may be better than the glucose. I did some comparisons, but my bp was not varying enough to test fully.