Heart Disease and Hormones

Posted By Tony on April 28, 1999 at 17:42:12

I have idiopathic dilated cardiomyopathy.  I'm 31 years old. Male. EF of
15%. No symptoms - active.  Only difference now is that meds have dragged
me down somewhat.  Heartrate at diagnosis was a minimum of 120BPM (which
is why I went to the doctors).  Heartrate now on current meds is 95-100
in a non-exercise active state, 80-85 at dead rest on back.  BP 90/50
Meds are 100mg Coreg, 20/25 Zestoretic, 20Mg Zestril, 50mg Aldactone
(Spiro), 40mg Lasix, 10MeQ Potassium, 325mg aspirin, 100mg CoQ-10, & a
multivitamin (all total per day).
Up until Dec 98, my Coreg was 25mg per day.  On the basis of a second
opinion by a specialist, it was raised to 100mg (and the Spiro was
added).  For the first couple months, my energy level was WAY down.  I
had experienced this with increases in the Coreg previously (from 12.5
to 25), albeit on a smaller scale.  I waited it out, and it has gotten
better.  I still can't do significant treadmill exercise as before (say,
2 miles at a fast walk).  However, I have learned what I should and
shouldn't do, and I just don't exhaust myself too much.
My questions are:
  Is it reasonable to expect that a higher dose of Coreg this high will
give me better results than say, 50mg?  I only ask because a) this much
Coreg, while I have gotten used to it, still causes muscles to ache more
than lower doses, and b) the first time I tried to fill my perscription
at the pharmacy, the pharmicist needed verification to dispense that
dosage - said it was higher than the recommended dose.  If there is
a reasonable expectation that it will be more effective than 50mg, then
I feel the inconveniences I described as worth it.  If not, then I'm
gonna lower it.
  The second question revolves around HRT and heart disease.  I have read
several studies that seem to indicate that benefits have been shown in
female patients with heart disease that take estrogens (these are
primarily post-menopausal women).  Some studies show an increased risk
in the first year of heart related episodes, and decreased risk
thereafter.  Some show no benefit.  Most show a decrease in lipid levels.
  I understand that Aldactone, an anti-androgen, is given to work in
conjunction with ACE inhibitors, thus lowering blood pressure.  
  My question is this:  Ignoring the normally unwanted side-effects that
HRT regimens would have in a male, is there any medical opinion, studies,
or anecdotal evidence that would show a benefit of HRT towards heart
disease?
  Is there any correlation between testosterone levels and vascular constriction?
Thanks.











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