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Old 07-13-2005, 07:24 PM   #1
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Am I my best doctor?

I have prescriptions from different doctors for hydrochlorthiazimide and an Ace Inhibitor - Enalipril.

I have discovered that using a combination HCTD and the ACE gives me a better control than each or either drug by itself.

In other words, 5mg HCTD and 10mg of ACE lowers my BP more than 20mg of ACE or 20mg of HCTD.

So should I ask or tell each Doctor what I have discovered? Is it better to do a split therapy than a larger dose of an ACE?

Thanks.

 
Old 07-14-2005, 05:39 AM   #2
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Re: Am I my best doctor?

burpee,
It's better to take lower doses of each to get the desired effect. My doctor acually said to me that the recommended way to adjust dosage is to raise one higher and higher until it no longer has an effect and then add another. I didn't know whether to laugh in his face or cry!

You will ALWAYS be your own best doctor because you have more at stake and actually CARE!

 
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Old 07-14-2005, 05:57 AM   #3
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Palamedes HB User
Re: Am I my best doctor?

Quote:
Originally Posted by burpee
I have prescriptions from different doctors for hydrochlorthiazimide and an Ace Inhibitor - Enalipril.

I have discovered that using a combination HCTD and the ACE gives me a better control than each or either drug by itself.
Yep, you have discovered what scientists have known since the 1970's. See:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=372606&tools=bo t

Quote:
Originally Posted by burpee
In other words, 5mg HCTD and 10mg of ACE lowers my BP more than 20mg of ACE or 20mg of HCTD.

So should I ask or tell each Doctor what I have discovered? Is it better to do a split therapy than a larger dose of an ACE?

Thanks.
Well, for the ACE inhibitor, the difference between 10 and 20 mg will be minimal for BP lowering. However, a 10 mg dose may not last as long. ACE Inhibitors are more of an on/off type of drug. The drug is working once you get to a critical level. When this level falls below that critical level, the drug will stop working.

The diuretic has a different action. It will get in and out of your system quickly. The lasting effect from the diuretic is because it reduced your blood volume. In other words, the drug is not really in your system working for 24 hours. But, its effects are. The diuretic will tend to have more of a dose response - especially when combined with an ACE inhibitor.

You can also replace the diuretic with a low sodium diet. This has the same BP lowering effect without the potassium depleting effect of the diuretic. What I think would work the best would be to monitor your sodium consumption and take the diuretic on an as needed basis. In other words, if you were sinful with your sodium consumption the previous day, take a diuretic in the morning to flush it out. If you've been eating low sodium, skip the diuretic. Of course, no doctor will ever agree with this. But, a system like this will probably regulation your BP better than anything else.

Pal

 
Old 07-14-2005, 06:57 AM   #4
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Re: Am I my best doctor?

You should absolutely tell both your doctors about your other medicines! There have been cases of people getting all kinds of symptoms caused by excess and incompatible drugs.

 
Old 07-18-2005, 07:21 AM   #5
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Re: Am I my best doctor?

Thanks for all the comments. I'll continue to investigate the use of both drugs.

I feel like I'm a bit of BP-med "yo-yo".....

One of the mitigating factors of my life-style is prolonged exercise. Being in the mid-west and working-out in the summer completely depletes fluid reserves to the point that I'm almost hypotensive. I recently measured 115-70 after a 2hour bicycle ride.

The HCDT is too strong to take every day. And usually, I could even skip the ACE drug and still read near normal, on the day of the work-out.

It's just that - as you might guess, as soon as I eat or drink very much, my BP shoots back up.

 
Old 07-19-2005, 06:51 AM   #6
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Re: Am I my best doctor?

pal,

I like your titrating method for salt control and I use it too. Diuretics have much more BANG if they haven't been taken for a couple days,
When I told a doctor years ago that I titrate my thiazide depending on BP and salt intake he went purple...seems he wasn't taking enough medication!

Now I keep my mouth shut!

Last edited by Lenin; 07-19-2005 at 06:53 AM.

 
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