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Old 12-22-2004, 09:53 AM   #16
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Re: Monotherapy

Quote:
Originally Posted by Lenin
I really am beginning to suspect the necessary rationale behind the development of HYZAAR.
The rationale behind ACEI/ARB + diuretic was discovered long before these drugs were brought to market. Here's one of my favorite experiments from 1978:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=372606

If you look at the data, you'll notice that the ACEI or the ARB did just a little by itself. And, sodium depletion did just a little by itself. But, sodium depletion plus an ACE or ARB had huge drops.

Pal

 
Old 12-23-2004, 06:28 AM   #17
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Re: Monotherapy

I'll have to take that piece by piece; it would have helped if I had seen it BEFORE my first dose of chlorpheniramine maleate to clear my head. Right now, it's "Through a Glass Darkly."
I was surprised that they had the ARB saralasin as early as 1978.

Thanks, it's a rich article that seems to imply that the ARB-diuretic combo was "made in Heaven." I look forward to an in-depth study (oh those poor morphined dogs with catheter implanted pressure guages in their hearts )

Last edited by Lenin; 12-23-2004 at 06:36 AM.

 
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Old 12-25-2004, 12:03 PM   #18
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Re: Monotherapy

Hey Pal,

There seems to be a stong implication here that ACE and ARB method drugs don't do much except in the presence of salt deprivation.
Quote:
These systemic and coronary vasodilator effects of teprotide and saralasin, however, were not observed in normal dogs on a regular sodium diet
from the abstract.

The study seems to be talking AROUND that inevitablility...it's a tough day, so I could be getting the "wrong end of the stick."

This I found the most intersesting (from page 880):

Quote:
Teprotide produced no systemic hemodynamic effects
in normal dogs, suggesting that the reninangiotensin
system plays no important role in maintaining
arterial blood pressure in dogs on a regular
sodium diet. In contrast, arterial blood pressure
increased transiently in normal dogs during saralasin
infusion, probably because of the partial agonist effect
of saralasin. These results also indicate that neither
agent has primary vasodepressor effects in normal dogs
,
and that the vasodilation produced by both agents in
sodium-depleted dogs probably is related to the high
angiotensin II level. Nevertheless, it may still be
possible that a primary drug-induced vasodilation may
occur during sodium depletion.
That implies you almost must have BOTH together, i.e., ain't HYZAAR a good idea. Another implication might explain why ACE's and ARB's alone aren't wonder drugs.

P.s. the article, while excellent STILL gives me a headache!

Last edited by Lenin; 12-25-2004 at 12:23 PM.

 
Old 12-31-2004, 06:56 AM   #19
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Re: Monotherapy

After 2 weeks of trying to get BP control with losartan monotherapy, I have concluded that I cannot. The best I can do is to get numbers averaging about 140/90. Two nights ago I got consistent 160/100...that was with split dosage of 100 mg daily total.
Little difference between 50 and 100 mg. daily total.

I added back 50 mg. thiazide (50 HCTZ +50 losartan[Cozaar]) and I've shown consistent readings hovering around 115/76.

I'll continue with both drugs for a week and then kick the Cozaar for 14 days and see what I get with JUST the thiazide. If satisfactory, that's where I'll stay; if NOT, then I plan to try 50 mg losartan- 25 mg HCTZ and see what that gives me. (I guess that's the Hyzaar formulation.)

Last edited by Lenin; 12-31-2004 at 06:57 AM.

 
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