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Old 10-29-2004, 06:38 AM   #10
Palamedes Palamedes is offline
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Re: How Much Do Meds. Bring B/P Down???

Quote:
Originally Posted by zip2play
As a rule, the drugs that give LARGE changes in BP are:
Diuretics...results can be HUGE in the salt sensitive population
But, but, but... a majority of the population has a high renin response. In a person with an overactive renin system, diuretics will actually INCREASE BP.
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Beta Blockers...some of those suckers can knock your BP socks off and of course this class is rife with horrid side effects
True, they actually antagonize the renin system as well.
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ACE inhibitors...potent but less than the first two.
Not necessarily true for everbody. In the high-renin population, these are very effective.
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Very Small benefits:
Angiotensin Receptor Blockers (ARB's)...usuallly in the realm of 10 points systolic, 6 diastolic
Calcium Channel blockers...same small reduction.
ARB's usually seem to be slightly less effective than ACE inhibitors. CCB's work very well in the same folks who are salt sensitive. They are a poor choice for the high-renin population unless this action is blocked with an ACE or ARB.
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ARB's were developed because everybody COUGHED from the ACE inhibitors so these work less well with less hacking.
Really, ARB's and ACEI were studied back in 1970's. Teprotide was the first ACEI studied. And, saralsin was the first ARB. See:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=651128&dopt=Abstract
Quote:
Calcium Channel blockers were developed to treat heart failure and angina...not hypertension; same for beta-blockers. But since doctors NEVER met a high priced drug they didn't like, they get prescribed for hypertension...and headaches...and rhythm disturbances...and soon, probably for TEETHING problems
I haven't read up on the history of CCB's. And, I don't feel like researching this morning. So, I'll take your word for it.
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The only drugs developed SOLELY to fight hypertension were the thiazides and the ACE inhibitors (Vasotec and her hacking sisters.)
And, the ARBs.

Pal