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Old 08-23-2005, 05:28 AM   #1
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*Paul HB User
HBP Meds

Hi all,
Been on BP meds for some time now. I went to see the doc yesterday about an annoying cough the Ace-I i am taking is giving me. The doc thinks i should be taking a combo of meds to control my BP and now i have been advised to take 2mg of Perindropril (Ace-I) and 50mg of Atenolol (Beta-B). On both packets it advises to take both in the morning.

My question is whether i should be taking these meds together or staggering when i take them.

Many thanks
Paul

 
Old 08-23-2005, 02:18 PM   #2
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Palamedes HB User
Re: HBP Meds

Quote:
Originally Posted by *Paul
Hi all,
Been on BP meds for some time now. I went to see the doc yesterday about an annoying cough the Ace-I i am taking is giving me. The doc thinks i should be taking a combo of meds to control my BP and now i have been advised to take 2mg of Perindropril (Ace-I) and 50mg of Atenolol (Beta-B). On both packets it advises to take both in the morning.
Huh? What is your doc doing about the cough? Adding atenolol certainly isn't going to improve that situation. Also, what is your BP both at the doctor and at home?
Quote:
Originally Posted by *Paul
My question is whether i should be taking these meds together or staggering when i take them.
It really doesn't matter. You might want to experiment. I still don't think you should be adding until you have a stable first drug.

Coughing aside, did the perindropril actually reduce your BP? If so, a switch to an ARB is in order. If not, perhaps replacing it with a diuretic makes sense.

Pal

 
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Old 08-23-2005, 06:03 PM   #3
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Re: HBP Meds

First of all Pal is right about the cough. It will only get worse so you may as well take care of it now.
As for the meds, I take both ACEI (altace) and a beta-blocker (atenolol) and it really doesn't matter how you arrange the dose. I've taken mine every way you could imagine. I've taken them at the same time and 12 hours apart, they always work the same. Presently I'm taking the ACEI in the am and atenolol at night.
ARBs work well with beta blockers too and they usually don't cause a cough.
Cass

Last edited by CASSIEBEL; 08-23-2005 at 06:04 PM.

 
Old 08-24-2005, 12:02 AM   #4
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Re: HBP Meds

Hi, thanks for the responses.

I used to take 25mg Atenolol which was increased to 50mg. I then changed to 2mg Perindropil which was increased to 4mg. I went back a couple of days ago about the annoying cough. My docs view was that i just a little bit on the high side still, she suggested a combi. It was her view that 2 lows doses of varied meds may work better than 1 med on its own. She has agreed that i return to her in 3 weeks to see if my BP is lower and also to see whether my cough has stopped on a lower dose of the ACE-I. It has only been 2 days and i still have the cough.

It seems as though all the meds i have taken in the past bring me to a certain level and never any better no matter what meds and what dose i take.

Without meds i was around ave. 155/90 max 185/105

With meds (no matter what) ave 142/82 max 158/95

My doc wants to see readings around 130/80 with the combi.

Regards
Paul

 
Old 08-24-2005, 04:23 AM   #5
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Re: HBP Meds

Quote:
Originally Posted by *Paul
I used to take 25mg Atenolol which was increased to 50mg. I then changed to 2mg Perindropil which was increased to 4mg. I went back a couple of days ago about the annoying cough. My docs view was that i just a little bit on the high side still, she suggested a combi. It was her view that 2 lows doses of varied meds may work better than 1 med on its own.
I have to disagree with your doc here - especially when we are talking about ACEI's. If you lower the dose of the ACEI so that it alleviates your cough, you have most likely lowered it below having any therapeutic benefit. If you are coughing on an ACEI, the drug needs to be changed. Plain and simple.
Quote:
Originally Posted by *Paul
She has agreed that i return to her in 3 weeks to see if my BP is lower and also to see whether my cough has stopped on a lower dose of the ACE-I. It has only been 2 days and i still have the cough.

It seems as though all the meds i have taken in the past bring me to a certain level and never any better no matter what meds and what dose i take.

Without meds i was around ave. 155/90 max 185/105

With meds (no matter what) ave 142/82 max 158/95

My doc wants to see readings around 130/80 with the combi.
Have you tried a diuretic? An ACEI works great when combined with a diuretic. You can also try a low sodium diet. It works just as well as a diuretic - especially when you are on an ACEI or ARB.

Pal

 
Old 08-24-2005, 05:39 AM   #6
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Re: HBP Meds

Thanks Pal,

I am still coughing as bad as ever, so the Ace-I will have to go. After discussing it with the doc the other day, she did explain that we would give the lower dose of Ace-I ago for 3 weeks. If the cough doesn't get better she will combine something else with the Beta- Blocker, she didn't really go into details of what she will prescribe.

It is only day 2 but i have to admit my BP has gone down to around 130/80, which i am really impressed with; whether it will rebound back up to 141/85 i will just have to see.

Regards
Paul

 
Old 08-24-2005, 06:34 AM   #7
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Lenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB UserLenin HB User
Re: HBP Meds

Paul, You're not getting a great deal of help from the beta-blocker either. I think the ideal combo for you might be an ARB plus a DIURETIC.
For monetary sense, I think a trial with JUST a diuretic first might be advisable. ARB's are expensive and if you are a classic case of a "salt-sensitive" hypertensive (low-renin-hypertensive), a diuretic may be all you need. If that doesn't do the trick, then you can add the ARB.

A fairly good clue for whether a person is a salt-sensitive hyper is poor response to ACEI's, ARBS, and to a degree, beta-blockers.

P.S. I have read several times that the ACEI cough is NOT dose dependent.

Last edited by Lenin; 08-24-2005 at 06:38 AM.

 
Old 08-24-2005, 10:15 AM   #8
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Re: HBP Meds

I agree, if perindopril makes you cough, you should change to an ARB or try a different ACEI. I coughed my head off on Lotrel, but I don't cough on captopril.

 
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