CO,
I thought u could do better than that. BTW I accept PayPal.
Port,
Thanks. I've got to study up a bit on bp drugs before my next cardio visit so I can guide him properly :) It does seem like some hospitals are pro diuretics and others are def anti and will prescribe Ace Inhibitors first. Hopefully, this is more philosophical than economical as there is no money in diuretics but much money in the more exotic bp meds.
-- Jim
Jim: Of course it your ACE isn't doing its job then you have to change, what will be your next drug of choice?
Port: Avocados
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ROFL
"BB is super RVR so either you're wrong about that, or he was not IR going into treatment or had it under control."
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Hypoglycemia is a sign of TRANSIENT hyperinsulinemia.
"so either you're wrong about that"
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Not today...LOL
Co
I'm not fool enough to become an ACE groupie but I like what I read.
It helps a bit that my cousin, who's adored me since we were little but is excessively blunt, is co-director of a cardiology/metabolic syndrome clinic and likes ACE inhibitors. (BTW, he hates that my husband is taking niacin for his cholesterol.)
He's only a specialist but at least he distrusts drug bandwagons as much as I do. Distrust runs in the family.
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In answer to your questions:
Jim: I'd be interested in anything you have regarding problems with ARBs.
Port: I remember one article about interaction with ACE, the other about ARB not as good as ACE, but useful if ACE can't be tolerated. You know I'm a lightweight but will do my best to find them. Tomorrow?
Jim: (1) What strength did you try and was it suggested to titrate up?
Port: Started with 2.5 ramipril, and increased every two or three weeks due to resistance in diastolic. 5 ramipril, now 7.5 and doctor wanted me to go up to 10 ramipril but still haven't done it. Afraid to pass out with too beautifully low systolic and stubbornly high diastolic.
Jim: (2) Any side effects
Port: Transient dry cough (a week?) but was really not a nuisance.
Jim: (3) Did it bring down your systolic and how much?
Port: December 14, 2008, 157/101; January 04, 2009, 118/87, January 30, 2009, 96/76.
I want to be at 75 diastolic but feel faint with 96 systolic.
Jim: (4) Have you tried diuretics either with it, or alone? I've read a diuretic can amplify the effects of the ACE but maybe it's just additive.
Port: I do take Ramipril with a baby diuretic to counterbalance high potassium problems with ACE; currently taking 1.25 mg indapamide, down from 2.5, due to potassium going TOO LOW! Low potassium is the pits. Very easy to fix the low, though.
Jim: Of course it your ACE isn't doing its job then you have to change, what will be your next drug of choice?
Port: Avocados
"Co, if ACE's are so much in the cardiology eye, why wasn't he prescribed one?"
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I have no idea.
Co
This is starting to turn into an interesting thread, isn't it?
I'm very thrifty. I don't even pay for studies.
Co