from ACE to ARB, is the ARB not working?

[Mountainrain]

My ACE inhibitor--Coversyl--was effectively controlling my BP in the last six weeks I was using it, but I could not tolerate the cough that came as a side-effect. I switched to Atacand six days ago. My cough is gone but my diastolic went up again to 90 and my systolic is hovering around 130s. Does this mean that the ARB is not as effective as the ACE? Pre ACE. my BP would go as high as over 100 and over 140.

What are other experiences switching from ACE to ARB?

Thanks!

[flowergirl2day]

Mountainrain,

How come you are not on a diuretic? Both ACE inhibitors and ARBs are much more effective when combined with a diuretic. Those are standard antihypertensive medication combinations.
In this combination, a lower dose of your ACE inhibitor might have been sufficient. The lower the dose of medication, the fewer its side effects...

Maintaining a good blood pressure control often means experimenting with antihypertensive medications until the right combination is found and target blood pressure achieved. I would start with an addition of a diuretic. The use of ACE inhibitors or ARBs combined with a diuretic has been shown to result in similar blood pressure reductions. Both of these drugs can be equally effective in lowering blood pressure.

Good luck!

flowergirl

[Mountainrain]

Thanks Flowergirl. Your response is helpful. What I was really asking is if my hbp is under control with the ARB. I guess that 130/90 is still high. I will be going to my doctor in a couple of weeks and I'll see what he will give me to take with Atacand. It is really too bad I coughed so badly with Coversyl because my BP had already gone down to 125-130/80-85.

[flowergirl2day]

Mountain,

By the time you go see your doctor two weeks from now your blood pressure readings could be even better! It might take more than just six days of consecutive use for this drug to reach its maximum effectiveness.
You should aim for a lower blood pressure, especially the diastolic.

take care!

[bethsheba]

Originally Posted by flowergirl2day

Mountainrain,

How come you are not on a diuretic? Both ACE inhibitors and ARBs are much more effective when combined with a diuretic. Those are standard antihypertensive medication combinations....

Flowergirl,

Although they may be standard antihypertensive medications, combining a diuretic with an ACE or an ARB does not apply to all diuretics, ACE inhibitors, and ARBs. It clearly states on some of the ACE inhibitors that under certain circumstances, they should not be combined with diuretics, and if the patient was on diuretics, the patient should stop taking the diuretic for a period of time before starting a new medication.

Also, the appropriateness of diuretics is dependent on the health history of the individual. People who have a health history of postmyocaridal infarction or chronic kidney disease, for example, are not good candidates for diuretic treatment.

Bethsheba