Question about ARB's vs ACE's

[suki1724]

I've tried almost every ARB and cannot tolerate any of them. My Dr. wants me to try lisinopril and I'm wondering if it's worth it? I thought that ARBs were "better" versions of ace inhibitors? Is it possible to be able to tolerate an ace inhibitor if you can't tolerate the ARB's?

Susan

[bethsheba]

suki

I experienced overdoses (later confirmed by my doctor) when taking 10mg (I think) of lisinopril. Looking back, a smaller dose might have been ok. (I have been on a total of 5 different meds and lisinopril and norvasc seemed to have the least serious side effects for me).

If you've read the package insert (before buying the med) and decide to go ahead and try it, I would recommend starting on the lowest dose possible. In the past couple of years, I've suspected that the reason some of us are having problems with our pressures is that our meds are too strong...I'm not going to go into this here except to say that starting off at a lower than needed dose may not hurt. You can always increase the dosage if need be.

Bethsheba

[flowergirl2day]

Hi,

I thought that ARBs were "better" versions of ace inhibitors? Is it possible to be able to tolerate an ace inhibitor if you can't tolerate the ARB's?

Beth has plenty of good advice. To answer your other question: Angiotensin receptor blockers and Angiotensin converting enzyme inhibitors are two different medications.

Angiotensin II causes muscle contraction and narrowing of blood vessels, which results in high blood pressure.

Angiotensin receptor blockers (ARBs) block the action of Angiotensin II, causing the blood vessels to dilate. This causes a reduction in blood pressure.
Angiotensin converting enzyme inhibitors (ACE Is) prevent the effects of Angiotensin II by stopping the production of this enzyme.
So the mechanism of action is different in each of these antihypertensives.

It is possible to tolerate one and not the other. Happens all the time. I cannot tolerate ARBs (have tried two so far) but am OK on a max. dose of an ACE. Some people cannot tolerate ACE at all while they have no problem with the ARBs. The only way to tell if they are right for you is by trying them. Make sure your doctor is aware of your medical issues (they are contraindicated in certain conditions). Do you have problems tolerating the ARBs? What problems, if you don't mind me asking? (I cannot tolerate them either so am curious)

Good luck,
flowergirl

[suki1724]

Thanks for the information. I wasn't really sure if they were two different drugs or just slighty different.

My biggest problem with the ARB's is really severe lower back pain. I made it the longest on cozaar (about 1 1/2 months) but the pain got so severe that it was hard to even walk. I just tried atacand and by the fourth day on it I had the same pain.

We are going to the beach for spring break next week and I'm not sure if I should try the lisinopril now or wait until we get back.

I think that I wasn't given an ACE initially because I have asthma and ACE's can cause coughing? I'm running out of things to try, though.

Susan

[suki1724]

Beth,

I always start with half of whatever I'm given for a few days - if I feel O.K. at that point, I go ahead and increase it to the regular dose. I agree that sometimes these dosages are a little high for some of us.

Susan