Best hypertension medecine?

[yimlitnoy]

In your opinion what is the best medicine to lower hypertension?

 

Then I will discuss with my doctor about this after you suggest some anti hypertension regimen.  I am now taking Prenolol 100Mg and Amlopine10Mg daily but my pressure simply stabilize at 145-150 each time, never to 120/80.

 

 

[Pilotman]

Lose weight, get fit, have lots of outdoor exercise, eat well. If need be, take one Kamagra or Viagra every week. You dont have to have the sex, although that helps of course, just use the med for what it was designed for.    Beats all the crap meds the medicos will give you.   Of course I am no Doctor so don't quote me as a reference, but it works for me, even the Kamagra!!  

[yimlitnoy]

Maybe you are right but on low dose.  I was once prescribed some Losartan but the pressure was going up instead of down and Calcium Channel blocker simply gives me headaches even at very low dose.  I am asking to see what is the most reducing anti hypertension prescribed medicine on this forum.

[Sheryl]

Prenolol is a beta blocker and no longer recommended for first line treatment of hypertension unless certain types of heart failure are also present.

 

Amlodopine is a calcium channel blocker (CCB) and can be used first line, so can ACE inhibitors and Angiotensin Receptor Blocker (ARB)s. Diuretics are also often used, I don't recommend them for people in Thailand as in this climate most farangs sweat a lot which increases the risk of  electrolyte disturbance, but in temperate climates are fine.

 

These 4 classes (Calcium channel blocker, ACE inhibitor, ARB and diuretic) can be combined i.e. one could take an ARB plus a calcium channel blocker. The usual practice would be to prescribe just one drug first and move to combination therapy if one drug alone did not suffice.

In Thailand ACE inhibitors are very cheap (enalapril being the most commonly presecribed) and ARBs cost more - they two classes are similar in action but ACE inhibitors sometimes cause a chronic cough which is less common with ARBs. So often an AVE inghibotor will be presecribed and, if there are problems with cough, then switch to an ARB. CCB like amlodopine can be given together with ACE inhibitor or ARB if necessary.

 

While beta blockers like prenolol are no longer recommended as first line meds, they were commonly used in the past so unless you also have a certain type of heart failure, it may be that your doctor is behind the times/not up on the latest recommendations and if so you might like to consider a change of physician. But perhaps first ask him why this specific drug.

 

 

 

the choice between Calcium channel blocker, ACE inhibitor, ARB etc is inlfuenced by soem patient specific factors such as whether ro nto also diabetic and race/ethnicity.

[yimlitnoy]

On 2/21/2018 at 5:36 PM, Sheryl said:

Prenolol is a beta blocker and no longer recommended for first line treatment of hypertension unless certain types of heart failure are also present.

 

Amlodopine is a calcium channel blocker (CCB) and can be used first line, so can ACE inhibitors and Angiotensin Receptor Blocker (ARB)s. Diuretics are also often used, I don't recommend them for people in Thailand as in this climate most farangs sweat a lot which increases the risk of  electrolyte disturbance, but in temperate climates are fine.

 

These 4 classes (Calcium channel blocker, ACE inhibitor, ARB and diuretic) can be combined i.e. one could take an ARB plus a calcium channel blocker. The usual practice would be to prescribe just one drug first and move to combination therapy if one drug alone did not suffice.

In Thailand ACE inhibitors are very cheap (enalapril being the most commonly presecribed) and ARBs cost more - they two classes are similar in action but ACE inhibitors sometimes cause a chronic cough which is less common with ARBs. So often an AVE inghibotor will be presecribed and, if there are problems with cough, then switch to an ARB. CCB like amlodopine can be given together with ACE inhibitor or ARB if necessary.

 

While beta blockers like prenolol are no longer recommended as first line meds, they were commonly used in the past so unless you also have a certain type of heart failure, it may be that your doctor is behind the times/not up on the latest recommendations and if so you might like to consider a change of physician. But perhaps first ask him why this specific drug.

 

 

 

the choice between Calcium channel blocker, ACE inhibitor, ARB etc is inlfuenced by soem patient specific factors such as whether ro nto also diabetic and race/ethnicity.

I am now taking Amlopine 10 Mg then the pressure decreases but to only 150, not enough, while the heart beat is going up to 80 bpm hence the Prenolol to reduce the heart beat to normal.  At home I usually get 130/80 while on each hospital visits to my ophthalmologist it shows higher 155/90.

 

What would be your safe suggestion to combine with Amlopine 10Mg in order to get the difficult inaccessible 120/80?

[BEVUP]

15 minutes ago, yimlitnoy said:

I am now taking Amlopine 10 Mg then the pressure decreases but to only 150, not enough, while the heart beat is going up to 80 bpm hence the Prenolol to reduce the heart beat to normal.  At home I usually get 130/80 while on each hospital visits to my ophthalmologist it shows higher 155/90.

 

What would be your safe suggestion to combine with Amlopine 10Mg in order to get the difficult inaccessible 120/80?

Read my post in High Blood Pressure

[Sheryl]

ACE inhibitors such as enalapril are often combined with amlodipine. But as explained there is some possibility the prenolol was prescribed for reasons beyond your BP so would be wise to first discuss the change with your doctor.

 

Do not fixate on 120/80. It may not be a realistic goal for you (and remember that BP is not static).

 

It is generally considered adequate in management of hypertension if the systolic (top number) can be brought down below 140 and the diastolic to under 90. Which iof course is still higher than what you currently have, so some adjustment is indicated, but don't obsess on reaching 120/80.

 

You don't mention other factors but they can play a very key role e.g. weight, smoking, exercise. If you are overweight, losing weight will bring your BP down in and of itself. So will stopping smoking, if you are a smoker, and exercise.

[yimlitnoy]

On 2/22/2018 at 7:12 PM, Sheryl said:

ACE inhibitors such as enalapril are often combined with amlodipine. But as explained there is some possibility the prenolol was prescribed for reasons beyond your BP so would be wise to first discuss the change with your doctor.

 

Do not fixate on 120/80. It may not be a realistic goal for you (and remember that BP is not static).

 

It is generally considered adequate in management of hypertension if the systolic (top number) can be brought down below 140 and the diastolic to under 90. Which iof course is still higher than what you currently have, so some adjustment is indicated, but don't obsess on reaching 120/80.

 

You don't mention other factors but they can play a very key role e.g. weight, smoking, exercise. If you are overweight, losing weight will bring your BP down in and of itself. So will stopping smoking, if you are a smoker, and exercise.

Why with 1 tab Amlodipine10 or even 1 tab Enaril 20 (Enalapril) or a combination of both in half (in trial mode), my heart rate is always increasing to 80bpm and even 92bpm while simply working on my computer...   Of course I am also watching  MSNBC American politics saga...  It could also be due to lack of sleep.  This morning I had 112/67 and 93bpm, at noon 133/79 and 77bpm, this evening 136/82 and 87bpm.

[Sheryl]

It is quite normal for both BP and heart rate to flunctuate throughout the day. You may be over obsessing about this. Unless initial reading is very abnormal there is no reason to check more than once a day. At about the same time everyday, at rest.

 

It sounds like you are experimenting with meds on your own. This is not advisable. Did you ask your doctor why beta bli ker was prescribed? If there was a cardiac reason then stopping on your own is not a good idea.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

[tonray]

10 minutes ago, Sheryl said:

It is quite normal for both BP and heart rate to flunctuate throughout the day. You may be over obsessing about this. Unless initial reading is very abnormal there is no reason to check more than once a day. At about the same time everyday, at rest.

 

It sounds like you are experimenting with meds on your own. This is not advisable. Did you ask your doctor why beta bli ker was prescribed? If there was a cardiac reason then stopping on your own is not a good idea.

 

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

 

 

 

 

I agree and those heart rates are not particularly troubling either.  and quitting beta blockers suddenly is never recommended as the rebound effect could be dangerous if there are underlying conditions. 

[yimlitnoy]

Sheryl,

The reason I am using Prenolol  is because, as you guessed well, I was prescribed 50Mg Tenormin 25 years ago when it was discovered that I had some hypertension.  In any case you have helped me a lot as always.  This year I had 5 eyes surgeries (mostly IOL anterior and posterior related) under general anesthesia, all preceded by an electrocardiogram and continuous pressure monitoring during the surgery and nothing was said about my medication.  I am only 67 and about 17 kilo overweight.  I was not running because I was told by my eye surgeon not to run but now the last surgeon has  allowed me to run which I will do starting tomorrow as Lumpini park is very near.  I measured my pression daily and make the adjustment when necessary.  However on each monthly hospital visits, it looks like that the systolic is then 145 to 155 mm Hg.

 

When I mentioned to my eye doctor about the advisable medication for hypertension, I was told to go and see a general doctor as they do not do those kind of things...  You guess the rest. 

 

Thank you for all, you are of great help in this forum. 9663 advises is quite a lot and we surely need you.

Edited February 26, 2018 by yimlitnoy

[tfc]

Magnesium Glycinate has helped me a lot in the past with severe connective tissue/fascia tension (50-60% reduction over a few days of 3 x 133mg/day) and apparently it helps with hypertension too.  There's a lot of research out there but you'll have to sort the solid from the not so solid.  I always go for a chelated form and while some like the citrate I just find that Glycinate or Biglinate suits me better.  Magnesium Oxide apparently doesn't have such good absorption.

 

The first link has some more information on that as does the second (though the second is also selling products so it's probably helpful to keep that agenda in mind).

 

https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

 

http://peoplesrx.com/the-best-kind-of-magnesium-for-you/

 

I also hear that having baths with magnesium salts is helpful and absorbs well but I've never tried it can't recommend either way.  Lastly, I'm not a doctor or in a profession where I'm wearing any kind of lab coat, so my post here is entirely anecdotal and based on my own "guinea pigging" and "broscience." 

[tonray]

15 minutes ago, tfc said:

Magnesium Glycinate has helped me a lot in the past with severe connective tissue/fascia tension (50-60% reduction over a few days of 3 x 133mg/day) and apparently it helps with hypertension too.  There's a lot of research out there but you'll have to sort the solid from the not so solid.  I always go for a chelated form and while some like the citrate I just find that Glycinate or Biglinate suits me better.  Magnesium Oxide apparently doesn't have such good absorption.

 

The first link has some more information on that as does the second (though the second is also selling products so it's probably helpful to keep that agenda in mind).

 

https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

 

http://peoplesrx.com/the-best-kind-of-magnesium-for-you/

 

I also hear that having baths with magnesium salts is helpful and absorbs well but I've never tried it can't recommend either way.  Lastly, I'm not a doctor or in a profession where I'm wearing any kind of lab coat, so my post here is entirely anecdotal and based on my own "guinea pigging" and "broscience." 

where to buy in Bangkok  ? I have been looking for a good magnesium supplement but usually only find oxide 

[tfc]

Unfortunately I haven't been able to source it in Thailand yet so I get it shipped using point to point tracking from the U.S.

 

I've found epsom salts (for baths) around (I think at Gourmet Mart, Tops and Boots/Watsons may even have it).  Apparently it has high levels of magnesium sulphate in it.  I don't have experience with this form of magnesium absorption though as I don't like baths. 

 

 

[Sheryl]

Sheryl,
The reason I am using Prenolol  is because, as you guessed well, I was prescribed 50Mg Tenormin 25 years ago when it was discovered that I had some hypertension.  In any case you have helped me a lot as always.  This year I had 5 eyes surgeries (mostly IOL anterior and posterior related) under general anesthesia, all preceded by an electrocardiogram and continuous pressure monitoring during the surgery and nothing was said about my medication.  I am only 67 and about 17 kilo overweight.  I was not running because I was told by my eye surgeon not to run but now the last surgeon has  allowed me to run which I will do starting tomorrow as Lumpini park is very near.  I measured my pression daily and make the adjustment when necessary.  However on each monthly hospital visits, it looks like that the systolic is then 145 to 155 mm Hg.
 
When I mentioned to my eye doctor about the advisable medication for hypertension, I was told to go and see a general doctor as they do not do those kind of things...  You guess the rest. 
 
Thank you for all, you are of great help in this forum. 9663 advises is quite a lot and we surely need you.

At 67 and very overweight, with long standing hypertension and apparently not having had a comprehensive physical exam recently it would be much wiser to first see a cardiologist and get at least a stress test before you start running.

The pre-op EKG you had and monitoring while under anesthesia do not serve that purpose nor rule out coronary artery disease.

Better safe than sorry...and the cardiologist canalso advise on BP meds.

Dr. Taworn Suithichaiyakul at Bangkok Christian Hospital is US trained and very good. When you call spell out the name as there is another cardiologist thete of similar name.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app

[yimlitnoy]

1 hour ago, Sheryl said:

At 67 and very overweight, with long standing hypertension and apparently not having had a comprehensive physical exam recently it would be much wiser to first see a cardiologist and get at least a stress test before you start running.

The pre-op EKG you had and monitoring while under anesthesia do not serve that purpose nor rule out coronary artery disease.

Better safe than sorry...and the cardiologist canalso advise on BP meds.

Dr. Taworn Suithichaiyakul at Bangkok Christian Hospital is US trained and very good. When you call spell out the name as there is another cardiologist thete of similar name.

Sent from my SM-J701F using Thailand Forum - Thaivisa mobile app
 

You are right and I will follow your advise.  It is time for a full checkup and another stress test, the last one was in 2004...  As you say better safe than sorry!

[Sheryl]

Dr. Taworn can also be seen at Chula after hours clinic. And check ups can be done at Chula too. St Louis is also very reasonable.