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Old 05-22-2007, 01:54 PM   #1
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Lenin, Cozaar HCTZ Question

Hi Lenin,

I know you are a big fan of diuretics, so I pose this question. I have been taking Cozaar for 3 months with limited success (145-150/90-95) Doc added Metoprolol 12.5 mg (baby dose) worked a little, then dropped my heart rate into the 40s. Quit the BB and started HCTZ, 12.5 mg. After taking it for 10 days now, it seems to be giving me modest results, but noticed that last night I actually got a 118/72 reading twice in the same evening. The only thing I could think was that I had worked pretty hard that day and probably sweated, plus had a couple of beers (more diuretic). Is this just an anomaly, or does it take several days for those to work? Today I am at 140/90 on 2 readings.

Regards, Brenden.

 
Old 05-23-2007, 06:13 AM   #2
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Re: Lenin, Cozaar HCTZ Question

Editor,

It takes several days for HCTZ to remove enough water to show a good BP effect. But when it works it works VERY well for salt-sensitive hypertensives (who coincidentally don't get much use from ARB's and ACEI's.)

I'm glad it did the trick. Now that you are at "dry weight" you should continue getting nice low numbers.

If ED becomes a problem, you can try Lasix with less damage to erections.

When you have a blood test, make sure your sodium levels remain high enough...mine always fell (with 50 mg. HCTZ/day.)

 
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Old 05-23-2007, 10:49 AM   #3
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Re: Lenin, Cozaar HCTZ Question

Quote:
Originally Posted by Lenin View Post
Editor,

It takes several days for HCTZ to remove enough water to show a good BP effect. But when it works it works VERY well for salt-sensitive hypertensives (who coincidentally don't get much use from ARB's and ACEI's.)
Although I do not know how long it took to initially bring my pressures under control with hctz (I didn't have a monitor at that time), my weight loss due to water loss was immediate, if I recall correctly. I would also like to point out that despite being salt sensitive, it was very difficult for me to stay hydrated on this medication and others should take precautions to stay hydrated to avoid problems.

I would also challenge your comment about salt sensitives not getting "much use from ARB's and ACEI's". The ACE I took (lisinopril) was too effective for me as I experienced symptoms of overdose on 10-20 mgs.

Per our mantra here on the boards, everybody responds differently to meds.

Bsheba

Last edited by bethsheba; 05-23-2007 at 10:51 AM. Reason: punctuation

 
Old 05-24-2007, 05:25 AM   #4
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Re: Lenin, Cozaar HCTZ Question

Quote:
The ACE I took (lisinopril) was too effective for me as I experienced symptoms of overdose on 10-20 mgs.
What were those symptoms?

Last edited by Lenin; 05-24-2007 at 05:25 AM.

 
Old 05-24-2007, 06:02 AM   #5
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Re: Lenin, Cozaar HCTZ Question

Lenin,

I was unable to sit up from a lying position in bed due to extreme dizziness, ongoing light headed feeling during the day, fainting/passing out with little or no warning.

After switching meds, my doctor told me that my lisinopril dosage was too strong.

Bsheba

 
Old 05-24-2007, 09:06 AM   #6
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Re: Lenin, Cozaar HCTZ Question

Greetings,

Thanks for the responses. To continue, the following evening after the good reading evening, I got another 2 good readings, 127/77. Again, though, this happened after the consumption of 2 beers. Beer has never had the effect of reducing my BP before. Red wine a little, but never beer. I am wondering why. My daytime readings are around 135-145/85-88.

Yesterday while taking a break at work, I experienced quite a spell of light headedness along with PVC's. I normally get PVC's, but never had this much light headedness with them. I was going to head home, but considered the traffic....so I went to the ER and of course got panicky, hot, etc.

EKG, bloodwork, etc. all came back fine. My electrolytes were normal. Was sent home with a Holter monitor and am supposed to return it this evening.

As for HCTZ, I never responded too much with it alone, but it does seem to help the Cozaar out. Lisinopril was the most effective med for me; 125/75 or lower on 10 mg. a day. But alas, horrible stomach cramps.

Regards, Brenden.

 
Old 05-25-2007, 04:41 AM   #7
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Re: Lenin, Cozaar HCTZ Question

Quote:
Beth says:After switching meds, my doctor told me that my lisinopril dosage was too strong.
Beth,
That sounds like postural hypotension or else FRANK hypotension. If your BP is lowered that dramatically with an ACE inhibitor then you can consider yourself very much in the norm: a classic RENIN type hypertensive.

My mention of the fact that ACE inhibitors and ARB's do NOT work was directed only at the minority subclass of SALT SENSITIVE hypertensives...around 25%.
Quote:
my quote:But when it works it works VERY well for salt-sensitive hypertensives (who coincidentally don't get much use from ARB's and ACEI's.)
If I, an extreme SALT SENSITIVE, take a dose of lisinopril, captopril, or enalapril there is no BP lowering, only coughing; if I take an ARB, my BP actually goes UP.

Everybody gets the benefit from HCTZ which as I said works slowly to remove enough water <but probably should have added "as compared to Lasix, chlorthalidone or some of the stronger diuretics"> but we SALT SENSITIVE HYPERTENSIVES get a LARGE BP drop from diuretics and they work far better than any other drug class for us. In fact, for myself the only other class that works AT ALL, and not so well, are the beta-blockers but they are too fraught with quality of life life diminishing side effects.

An alternative name for SALT SENSITIVES is LOW RENIN HYPERTENSIVES (so there's little point in taking any drug that lowers RENIN (and angiotenin and angiotensin-2.)

Because doctors are generally misinformed about the types of hypertension, we salt sensitives get VERY poor treatment plans because we aren't the norm. We would be OK IF doctors followed the VERY simple guidelines and began with a diuretic, but NOOOOO (in the words of the immortal John Belushi,) they get paid by the drug companies to prescribe pricey drugs like Norvasc and Lotrel, the bevy of patented ARB's, and now, CADUET. For some well explained reason, doctors RESIST and IGNORE the very clear guidlines which are TO START WITH DIURETICS, presumably because they don't get kickbacks for prescribing HCTZ and furozemide...sad situation for some of us.

Last edited by Lenin; 05-25-2007 at 04:52 AM.

 
Old 05-25-2007, 12:41 PM   #8
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Re: Lenin, Cozaar HCTZ Question

Quote:
Originally Posted by Lenin View Post
Beth,
That sounds like postural hypotension or else FRANK hypotension.
Yes, Lenin, that's exactly what an overdose on lisinopril is--too much or too strong of medication which causes low blood pressure which results in lightheadedness or fainting. Overdose. Fainting and lightheadedness are listed as symptoms of overdose on some meds sheets--other med sheets simply list low blood pressure as a symptom of overdose. Cause and effect.

[removed]

Bsheba

Last edited by mod-anon; 05-25-2007 at 10:31 PM. Reason: be polite on these Boards.

 
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