BP meds - determining goals per med

[burpee]

Hello,

As a "newly medicated" HBP patient I contiune to look for a "best practice" of diet, exercise and medication for healthy living.

I was started on 5mg of Enalapril a month ago. After reporting my BP readings to my doctor after 2 weeks, he suggested upping the dosage to 10mg per day. My unteated BP was often reaching 150/90. 5mg per day produced many 140-145/80-85 readings, with few dipping to 130s/70s...

10mg per days is resulting in 130s/70s. But these are "best case" early morning readings, many afternoon, and a few PM readings produce 140/80s.

I'm still a little confused - concerned, that I didn't get a better, or more dramatic result. I've cut-out all alcohol, and eliminated salty, indulgences.

Now, I'm wondering how much of BP drop is from diet change and whether the Enalapril is really doing "that much" to contribute to the drop.

After reading the entire "dosing" instructions for Enalapril, I'm also concerned about how quickly I may be needing a "mainstream" or heavy dose to manage my BP.

To any of the "technical types" outhere in the know --is there such a thing as drug tolerance to an ACE-inhibitor? Isn't ACE inhibtion strictly a "chemical reaction"? Are there organelle that develop in response to the drug to synthesize additional enzymes?

In other words, should I be hesitant about future dosage increases and accept slightly higher BP over aggressive medication. Is 2 weeks, too short of a time period to review what effect 10mg is producing?

Thanks.

[Lenin]

burpee,

There is DEFINITELY a tendency to delop a resistance to the effect of ACEI's but I think it takes a great deal more time than you've been on it.
I'll look up what the manufacturer claims to get in his tests, wait a sec :!
Cannot believe it??? I checked online and 2 old PDR's and neither list ANYTHING on the expected BP loweing for Vasotec. I can't BELIEVE a number like that isn't reported. Is it really THAT bad ?? As I recall, all it did for/to me was make me cough.

Anyhow, alternative methods to produce Angiotensin 2 from other sources develop over time and make the ACE inhibition less effective.

I think it's best to ignore best and worst readings, just try to vary the time of testin a lot and then look at ONLY the average to determine efficacy of your treatment. Yes, 2 weeks is FAR to early to consider changing dosage; a month or even two is wiser.

(I'll keep looking for the expected enalapril effect on BP.)

[zuzu8]

I have a Cleveland Clinic print-out on Enalapril/Vasotec sitting in right front of me and it says:

..." It may take several weeks before you feel the full effect of this medication....."

Lenin is right...give it a little more time.

zuzu xx

[burpee]

Well, your comments don't sound to encouraging. But, since I'm not experiencing any side-effects - I guess have little to complain about.

The "point" of my post was that it seems I'm getting very little result from the medication in spite of the fact that I exercise and improved my diet.

Where would I be if quit avoiding chips and salty foods and start drinking regularly? Five point drop?

I guess the tone of my posts is the root cause of my BP problems in the first place...... :-)

Thanks.

[rigel434]

IIRC, most folks' BP isn't controlled by only one medication. Took a diuretic and ACEI for me to get under control. I'm very fortunate with side effects- basically don't have any from 25 mg chlrothalidone and 20 mg lisinopril daily. I did get the ACE cough but that thankfully passed (was driving me nuts) after a few days.