Thread: Monotherapy
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Old 12-18-2004, 06:17 AM   #1
Lenin Lenin is offline
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Monotherapy

My goal is monotherapy for hypertension. I've been on all the drug classes at one time or another and have settled on an ARB + HCTZ. That give me very good control, perhaps too good. (Of course in a doctor's office I still set off fire and smoke alarms when attatched to his rig.)

I am trying for either monotherapy or "natural" means to continue control. I've taken my weight down 20 pounds this year to a fine "fighting weight" and have cut drinking to near zero and have recorded an average BP of around 120/80 for many months.

I flipped a coin this weeek to see what I'll give up as a trial in my goal to monotherapy. So today is my third day without hydrochlorothiazide. BP good last night in spite of a miserable 2 pound water weight gain (2399 calories wouldn't) have done that. Yesterday 1995 calories and another 3 pounds gain. I'm noticeably edematous (and miserably) with 5 extra pounds of water even causing visible creases in my wrist. I'm SURE my BP will be high all day. I took the Cozaar very early to see if the Angiotensin blocking will help relieve SOME of the bloat.
I've gone this route before and it usually takes 5 days to blow the water off in a "brisk diuresis" (peeing all day) implying the body has stabilized.

Question:
Does anybody have any insight into the mechanism of this HORRIBLE rebound effect?

I'm almost tempted to switch back on the 50 mg. HCTZ and drop the ARB but I really want to see which will give me the better monotherapy for at least a two week trial of each...maybe a month would be more valid. I'm also VERY curious what kind of a rebound the ARB will have since I've been seeing references to increased renin production to compensate for Angiotensin-2 diminishment. That burst of extra renin running around with no blockade must be fun!

Last edited by Lenin; 12-18-2004 at 09:40 AM.