I'm trying hard to find a good balance between acceptable BP, low side effects, and reasonable cost. I simply CANNOT take ACEI's because of the extreme neverending cough. I don't like beta-blockers because I find they are antithetical to sleep, cause weight gain and constant fatigue. My experience with CCB's is 2 months of Norvasc before and after stenting...impossibly hateful. I tend toward headaches and thus verapamil is probably out...maybe nifedipine is somewhere in the cards.
So I've been testing myself to find the best therapy.
*************(Trial went just 14 days because of side possible side effects, 7 days of each dosage)
NO DRUGS...28 day trial.
Results of 120 readings (each a 3 reading average)
HYDROCHLOROTHIAZIDE ALONE.......41 day trial (77 readings averaged from 231)
I have yet to tabulate a HUGE set of numbers on a long term 50mg losartan +50 mg. HCTZ...I'll report when I can get them done.
So it seems that Cozaar alone, either at the 50 or 100 mg dose taken either once or twice a day was no better than nothing at all.
My problem, now is to decide whether to go with daily thiazide and excellent numbers or to accept the marginal numbers with no drugs. I have gout and thiazide is not a good drug for that and constantly thinking about potassium foods is annoying (part of the reason I was taking losartan..it conserves K+). Maybe if I settle on the HCTZ, I'll ask my doctor to prescribe some high dosage potassium but that's not without risks either. Possible alternative is to use the thiazides only for BP spikes or edema...it's a VERY efffective drug when used sporadically.
I have a notebook full of numbers that I should transpose into Excel or Lotus 123...tedium but I WON'T give my notebook to Doctor Quackenbush (made-up name... by Grouch Marx!). Last time he had the nerve to tear the pages out since he likes to keep EVERYTHING in his file...and in his office my BP is always explosively high (like 170/115), so I've got to go in well armed.
This will be a daunting task because I STINK at spreadsheeting and I'm seeing him next week...oh well I'll be better at Excel next week, anyway!
I'd stick with the HCTZ. The concerns about gout and potassium are outweighed, in my view, by the fact that the diuretic works for you and will extend your life. Those are good numbers you got with the diuretic.
Not surprised about the Cozaar not working well, btw- angiotensin receptor blockers are known as perhaps the least effective bp medicines.
Thanks rigel, I agree that the ARB's are gentle but weak drugs. I'm flummoxed that several people do so well on them???
I'd be tempted to agree with you on the unlikelihood of gout except that when they first put me on HCTZ 100mg. back in the early 80's, after a while of just the thiazide I started developed weird ankle, instep, and thumb pains that would slam me for a week and then go away. I hadn't a CLUE where they were coming from.
Of course over a couple years it eventualy got to crippling frank gout with the big purple toe and the whole Henry VIII routine...and you DON'T want to try 22 colchicines in one day. I've been on daily allopurinol for about 15 years now and had only one acute attack on it and NONE in well over a decade...but I still really have to worry about uric acid retention. I have a thumb that aches sporadically for years and probably always will.
So that uricosuric aspect of the losartan always appealed to me...but it's too little reason, really, to take an ineffective, expensive BP med.
So I guess you're right...daily thiazide + daily allopurinol seems AOK.
One of the reasons I'd prefer NOTHING is that the HCTZ that works so well on my BP causes me weight gain as well. My theory, that is really quite logical, is that ANYTHING that lowers BP a lot will cause you to burn fewer calories. The pump doesn't have to work as hard against a low head of pressure...and that's 24/7/365/80 (If lucky!)
For anyone who isn't a pure salt sensitive hypertensive like me, I'd say take an ACEI if you don't cough; if you DO,then TRY an ARB. If your hypertension is RENIN run, then it might help you a lot better than it does me.
For some reason which I don't understand I get excellent BP results with any beta-blocker??? but the aggravation isn't worth it. They even cause good diuresis, which really is nowhere in the literature???
Probably MY second choice would have to be be plain propranolol (non-time release)...well timed to allow me a life AROUND the drug. I did it for several years and coped. But IT caused weight gain too.
If am not mistaken I think that some diuretics are "potassium sparing".
Am I correct?
Also, maybe Verapamil might be good for you. Have you tried it ever? I know I eventually had gotten headaches from it but it did make me feel good at first. I am 49 and feel really pretty good most of the time but when I took verapamil I felt like I was in my 20's again, at least for a few days.
Also, I am gearing up (thinking heavily) hopefully to go on a fast for 6 days. But it is a BP lowering fast that involves food except for day 1.
Lots of apples for 3 days and then the last 2 days involve salt free bread, vegatables and apples.
For variety I am considering different types of apples.
Let's face it your a salt addict.. Haha just like I was. I think your numbers with HCTZ prove that they are great. I know it's hard but try the dash diet I have been doing it now for about 2 1/2 weeks and it really is working for me Also gave up coffee (drink green tea instead). I relapsed last night and went to one of our favorite bars to get my favorite "Sweet and Sweaty Wings" with homemade Blue Cheese dressing. Both were very salty tasting to me but I did get the margaritas no salt. I'ts funny I have not had much salt and it was hard at first but I did get use to it and now things that tasted normal to me before seem like someone poured the whole salt shaker in it. I am swollen today hands and face and my neck hurts like my BP is up. I took my BP just now and it said 130/78 but take note as it has been reading since the dash diet 120/68-125/75 so as you know the salt may be the key factor here. All I can say to all of us salt addicts out there you will get use to it but there is alot of prep work that goes into this diet. We have nothing but leafy greens and whole grains and fruits in our house and that is what we eat all day..Alot of herbs combat the no salt and garlic and chili pepper give it loads of flavor. Plus an added bonus here is they are loaded with anti-oxidants I have a ton of energy more now than when I drank coffee ..Lisa
I've given some thought to potassium-aparing diuretics but unfortunately the triamterene that is used is almost always packaged with thiazide so that indicates to me that triamterene alone isn't very good a t BP reduction. Unfortunately, it seems ALSO to inhibit uric acid excretion so the combo is likely to make matters worse. I'd rather pop a KCl or two every day.
I've never tried it, it slaughters my sister's head and history has told me that we react to almost all drugs the same way...same with her and diltiazem.
I mentioned nifedipine to my doctor after he said "maybe we should try a calcium channel blocker." When I said that I HATED Norvasc, he lost interest in the subject...so much for integrity!
Good luck with the FAST; I'm going on a similar FAST starting today, except mine involves a daily intake of 2,000 calories <tongue planted firmly in cheek>
Would that I could get my salt down but I MUST have convenience food at least every second day...I'm SICK of cooking everything, AND shopping, AND washing 20 pots.
I had a fair tasting SW@NSON'S HUNGRY MAN TURKEY dinner this week. Calories: 520 ...GOOD; Protein (29 as I recall)...GOOD; SODIUM: 2920 mg....WRETCHED.
And EVERYTHING is this way except for the few and far between cans of NO-SALT-ADDED veg, and they are often completely devoid of taste.
I envy your ability to do the DASH diet, I think it's a great way to eat and I could enjoy it for a week, tolerate it for a month...but then that would be IT! If I were in a HOME FOR HYPERTENSIVES where COOK made only low salt meals, I could eat like that FOREVER...but alas, I live in the Supermarket world!
We won't even TALK about the difficulty of salt control in a NEW RESTAURANT that ideally I would go to every day of my life if my finances could bear the assault.
Salt impairs kidneys over time and is the real culprit. I just started using Sea salt which has reports of actually lowering BP. The only problem is that we still have so much sodium chloride in all of our foods.
I could only wish that Sea salt was used in ALL foods. But it isn't.
Yes, you have seen the benefits of low sodium. Keep up the good work.
Thanks for the vote of confidence. It is hard but the easy part is that both my husband and I love to cook so that makes it easier on us. Plus we are doing it together. I know what you mean about the pots. I think I have it down to a science now. I put the pots into the dishwasher and that saves me. The prep work I'm like Rachel Ray (chef of 30 minute meals) in where I get all my greens after buying them and clean them all and wrap them up so that they are ready for slicing. I have yet to eat a frozen dinner that taste good to me. Soups I make myself and freeze them in batches. My hat is still off to you in trying to get yourself down to one med. The only salt I use is Sea Salt and very little.
thanks a bunch for the pat on the back. I want to live like the Okinawans do a very long and healthy life free of the issues that we Americans have..I keep trying one day at a time they say. Well off to saute some greens..Lisa
It would be so much the easier for all of us if the food companies used sea salt instead.
The salt I just ordered and recieved is very good and mild tasting. It has colored specks in it which is other minerals. As you know regular salt is 40% sodium and 60% chloride and is manufactured and heated to high temperatures. It is man made.
Here is the breakdown on THIS sea salt:
Suppossably it has many other trace minerals but in very small amounts.
This is an all natural 'realsalt'. Supposably the idea is that the other trace minerals "antagonize" the sodium chloride and is more natural to what the body requires and can actually lower and regulate BP. Nothing is added to this salt. It is in its natural form.
Have you considered OTC Diurex?
Really cheap. I am experimenting with it myself. There are also alot of other natural water pills that are supposed to work really well and not deplete one of essential potassium.
I feel that if i can lose another 20 lb my BP may be ok, but I cant seem to do it, ive been stuck in the mid - high 240's since I lost the initial 25 or so pounds when i quit taking the benicar hctz in nov
I am not salt sensitive, at least not enough to make it worth doing (only a couple points, if that), especially since when i was on a very low salt diet when i did have something with salt in it my BP spiked up really high
seems like my body just wants to run around 150/100
ive tried several natural remedies, hawthorn didnt do a thing (tried it for 7 weeks, supposedly takes 5 or 6), hibiscus tea (a natural diuretic that also mimics someother BP drugs) lowered my BP at first but quit doing anything after a couple weeks
I tried valerian root starting early this week, it really dropped my BP and it also helps me sleep thru the night, the first few days it made me really tired but yesterday & today it seems like its not doing anything, & I am gaining a little weight again - it drops my pulse from normally around 80 to mid 60's
I have been really stressed a lot the last couple days, my mom had emergency heart catheterization & had 3 stents put in, funny thing about that her dr says he is 99% sure the rediation treatment she had about 5 years ago caused it
anyway, I was wondering about the diuretics because my Dr has never had me on just a diuretic, everything he did have me on seemed like it worked for a while & then either quit working or became very erratic, plus they had nasty side effects
so i am thinking of telling him i want a certain dosage of some diuretic, see what happens, & then if i get the same results I want to tell him I want some kind of scan (renal scan, mri, whatever) to see if I have some blockage somewhere thats causeing high BP
I figure I will give the valerian another week or 2 before I do that though
Nuts, I did a HUGE post here yesterday and it's gone????
Pumper, that Diurex is Caffeine and I am so addicted to HUGE amounts of coffeee that it wouldn;t affect me one iota. I've never vbeen happy with the weak pricey natural alternatives like hydrangea, dandelion, buchu, uva ursi and the others...they just don;t work like dirt cheap HCTZ.
I did a GRAM of powdered valerian root on Friday night...NADA. I'll try 1600 mg. tonight and see if I get anything. (I'll even settle for just an uninterrupted night of sleep!)
We'll both take it for a week and compare notes.
I've been checking out the Lean Cuisine dinners. They have a new line with about 300 calories or less and less than 30% of the daily recommended sodium. I noticed this past weekend they even have individual pizza with 25% or less sodium! I will eat these when my SO is out of town and I don't feel like cooking for myself. I generally suppliment them with a large serving of frozen veggies (no salt). There are many of them I feel are pretty good, and require limited effort to fix.
This may not be low sodium enough for those on a strict low sodium diet, but I don't eat much sodium in breakfast or lunch, so I figure I am at or slightly less than the daily recommended amount for the day.