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  • ARB's, Thiazides and Beta Blockers a safe combo?

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    Old 04-22-2005, 06:00 PM   #1
    Autumn1
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    ARB's, Thiazides and Beta Blockers a safe combo?

    What started out as Diovan 80, has turned into Diovan 160 with a diuretic, and now added to that, Atenolol 25 mg twice a day. This is due to
    high readings 180/105 in the office (I swear it's white coat).
    A home monitor and one brought home from the doctor's office show's
    normal ranges. All tests, lab and treadmill are normal. I know my
    problem is the extra weight and I'm trying to work on that.
    Do Beta Blockers and ARB's work together? I thought they were different
    classes of meds.

     
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    Old 04-23-2005, 05:15 AM   #2
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    It's a decent combo.

    If you don't mind the effects of the beta blocker and can see yourself taking it long term, you could drop the ARB (Diovan) for a month or two and record your numbers. Best would be a WITH week and a WITHOUT month or two. You might not be getting much contribution from it and it's too expensive to take if it's not carrying it's weight.
    (Also, in my book of BP meds. FEWER is BETTER!)

    I've never tried beta-blockers and ARB's TOGETHER, but separately I find that the beta-blockers lower BP MUCH more than my ARB...but then that's MY response. The only way to find yours is to experiment.

    Last edited by Lenin; 04-23-2005 at 05:17 AM.

     
    Old 04-23-2005, 08:21 AM   #3
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    The trouble with ARBs is what Lenin says; they don't do that much in most cases. And I'm thinking of following his advice and experimenting with droping mine. Based on my own experience and my education from reading various posts, the only other thing you might do is substitute a CCB for the beta blocker. But the CCB is more expensive and you've already started with the other. Everything depends on
    you handle the beta blocker side effects.

    Let me ask this question: What are the merits of substituting Taurine for a diuretic?
    Does it work as well?

     
    Old 04-23-2005, 08:40 AM   #4
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    My diuretic is part of the Diovan pill. 12.5. It is included and to be honest, since I've been on it over the past several months, I have seen my
    cholesterol numbers rise.

    I think at this point I will take the 25 mg Atenolol twice a day only, start walking and keep track of my numbers. I feel doctors are too quick to keep adding more meds.

     
    Old 04-23-2005, 09:35 AM   #5
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    Quote:
    Originally Posted by pal7778
    The trouble with ARBs is what Lenin says; they don't do that much in most cases. And I'm thinking of following his advice and experimenting with droping mine.
    Each one of us reacts differently to blood pressure meds, because of our different lifestyles, environments, diet, metabolism, etc. There are MANY different factors that influence how a particular medicine will function within our bodies.

    I've been taking an Arb, Avapro, for a couple of months. It's had a significant effect on lowering my blood pressure from the first time I took it, all without side effects. To say that I am excited about the addition of Avapro to my medical regimen, would be an understatement.

    I take Avapro along with several other blood pressure medications.

    I've taken about 16,000 blood pressure readings over the past seven years, and I chart my readings by hour, by week and by month. I especially like the chart that shows the average hourly changes in my blood pressure during a certain range of dates. This one page chart, of hourly averages, shows me the effect, of the changes to my blood pressure medicine regimen, over the hours of a day over a period of time, and helps me to change the schedule of my meds so that I can get maximum benefit from my blood pressure meds.

    The positive effects of Avapro, on lowering my blood pressure, has been authenticated, for me, by my blood pressure charts. This just goes to show that, what is poison to one person might be pleasure to another.

     
    Old 04-23-2005, 11:04 AM   #6
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    Even though I don't have your data, I'm all for Avapro--as far as I can tell the absolutely harmless, side effect-free bp medicine. It's just not powerful enough
    in my case; my guess is it lowers my bp about 10-15 systolic for me, which, sad to say, is not enough. If I were a doctor, I'd recommend it as the first drug to try to about everyone, and certainly the drug to mix with any other one.

     
    Old 04-23-2005, 12:00 PM   #7
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    Quote:
    Originally Posted by pal7778
    It's just not powerful enough in my case; my guess is it lowers my bp about 10-15 systolic for me, which, sad to say, is not enough.
    Only 10-15 points?! That's quite a bit. Sounds like your BP is too high, if 10-15 points is not enough.

    Based on the 542 readings, since I started taking Avapro two months ago, Avapro has lowered both my average Systolic and my average Diastolic about 4 points. The standard deviation remained basically the same, showing that the normal blood pressure range was also lowered consistantly with the lowering of the readings.

    I was surprised that it didn't lower the Systolic more than the Diastolic, but at my age, with my heart problems, perhaps I can't squeeze much more out of my blood pressure.

    Quote:
    If I were a doctor, I'd recommend it as the first drug to try to about everyone, and certainly the drug to mix with any other one.
    I agree. Arbs are the result of hundreds of millions of dollars of research, development and testing, by some of America's best scientists, over many years. To me, Arbs represent a significant medical discovery.

    But....... unfortunately, it is only one piece of a very complex hypertension puzzle.

     
    Old 04-23-2005, 03:02 PM   #8
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    I took avapro the max dose a few years ago, and it didn't budge my bp, I was given verapamil to take with it but the swelling in my legs was aweful not to mention the exercise intolerance, so I stopped the verapimil and took lotrel, despite this my pressure barly budged, was too way to high (200/100's)

    now I am on torprol, 100 mg(did lopressor years ago and it made me tired so that is why I quit it the first time) and the fatigue is starting to be very noticable, but my pressure is hardly budging, I mean it went down some but still way to high 174/94 today.

    I am not going any higher so the doctor will just have to recommend something else, but I can't imagine trying to be on avapro with torprol, (you didn't get any side affects at all from avapro?) I know for me it tore up my insides the dirrehea and stomach cramps were aweful.

    RR

    Last edited by dreamer89; 04-23-2005 at 03:03 PM.

     
    Old 04-24-2005, 04:33 AM   #9
    pal7778
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    Sadly 10-15 was not enough, which is why I take Tiazac too. The combo gets the job
    done, but that's a lot of medicine. The other thing about ARBs worth mentioning is that they can tend to protect your kidneys and heart from unintended effects of the "heavy lifting" CCBs (or, I guess, beta blockers).

     
    Old 04-24-2005, 04:55 AM   #10
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    pal,

    From the studies of irbesartan even the 10-15 mmHg drop is higher than the manufacturer touts:
    Quote:
    The seven (7) studies of irbesartan monotherapy included a total of 1915 patients randomized to irbesartan (1900 mg) and 611 patients randomized to placebo. Once-daily doses of 150 to 300 mg provided statistically and clinically significant decreases in systolic and diastolic blood pressure with trough (24 hour post-dose) effects after 612 weeks of treatment compared to placebo, of about 810/56 and 812/58 mmHg, respectively. No further increase in effect was seen at dosages greater than 300 mg. The dose-response relationships for effects on systolic and diastolic pressure are shown in Figures 1 and 2.
    And that's higher than most of the other ARB's get.

    On the taurine. Like most amino-acid supplements touted by the vitamin industry, much is claimed, little is proven. I remain "from Missouri" on free amino acid supplementation (after wasting a fortune on arginine and ornithine...when I was younger and more gullible)
    When a supplement is claimed to "cure everything" (like taurine is on the sellers' websites) I find that it usually cures nothing. I doubt that it will do the job of a diuretic it replaces, but nothing tells the tale better than experimentation...and they CLAIM it acts as a calcium channel blocker
    On the OTHER hand large doses of amino acids might be expected to behave with some diuretic properties but what an expensive way to get a diuretic.

    Last edited by Lenin; 04-24-2005 at 05:08 AM.

     
    Old 04-24-2005, 05:17 AM   #11
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    Quote:
    Originally Posted by pal7778
    Sadly 10-15 was not enough, which is why I take Tiazac too. The combo gets the job done, but that's a lot of medicine.
    I am on a calcium channel blocker, an ace inhibitor and on Avapro. I have experimented with each one, and have found out that each one has a lowering effect on my blood pressure. So I guess I am stuck with taking three blood pressure meds.

    If I come into contract with something that causes a significant jump in my blood pressure, I have also found that a nitro, under my tongue, will bring the blood pressure down, and keep it there for quite a while.

    When I adjust my medicine schedule and doses, I will take many readings over a few weeks period, in order to determine the net effect of the change. Without my numerous BP readings, and charts and statistics, I would not know how to determine the effectiveness of the changes that I have made.

    I wonder what people with hypertension did before the availability of PCs?

    Best of luck finding out what combinations work best for you!

     
    Old 04-24-2005, 11:01 AM   #12
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    Quote:
    Originally Posted by beerzoids
    I am on a calcium channel blocker, an ace inhibitor and on Avapro.
    Hi Beerzoids,

    I am also on an ACE (Altace) and an ARB (Benicar HCT). My doctor is talking about adding a CCB. May I ask which one you take? Does taking all these meds cause you any serious side effects? Another thing, you mentioned nitro for a quick lowering. My husband has those. He said they make him very dizzy. I have clonidine for that purpose but I want to get off of them.
    I am jealous of your Marlins!
    Thanks,
    Cass

     
    Old 04-24-2005, 11:42 AM   #13
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    There's a slight gotcha mixing ACE's and ARB's. Combining the two is good. However, adding a beta blocker to the mix leads to worse outcomes. The reason is unexplainable. But, it shows up in studies. So, pick 2 between ACE, ARB and BB. But, not all threee.

    Pal

     
    Old 04-24-2005, 12:06 PM   #14
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    I have heard that mixing the three causes a problem and that's why I have been trying to wean off the atenolol. I have run into problems there because I understand it's also bad to be on a beta blocker and clonidine. When I get down to a low dose of atenolol I get rebound hypertension and anxiety so I tried to wean off the 1/2 of .1 mg of clonidine and got up to 188/90 last night.
    What to do next, I don't have a clue and neither do any of my docs. Last night I took 25mgs of atenolol and about 3/4 of the clonidine .1. Today my BP is 115/74. I didn't take any Altace today.
    I am really losing my trust in the medical professionals who get us hooked on these drugs with no way to get off them. They just keep adding meds upon meds with no results.
    I can't find any one who can tell me which to try to get off of first.
    Sorry for the ranting.
    Cass

     
    Old 04-24-2005, 05:11 PM   #15
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    Re: ARB's, Thiazides and Beta Blockers a safe combo?

    Quote:
    Originally Posted by CASSIEBEL
    Hi Beerzoids,

    I am also on an ACE (Altace) and an ARB (Benicar HCT). My doctor is talking about adding a CCB. May I ask which one you take? Does taking all these meds cause you any serious side effects?
    Hello Cass!

    For blood pressure, I am on the ACE- Quinapril (Accupril) which just became generic. Much cheaper now! I am also on the CCB, Verapamil, which is also not expensive. The ARB- Avapro, however, is quite expensive. OUCH!

    I am also on other heart meds.

    The meds cause a mild dry skin problem on my hands, memory and concentration problems. Other than that, I do not think that I experience any other problems with the meds.

    Quote:
    Another thing, you mentioned nitro for a quick lowering. My husband has those. He said they make him very dizzy.
    Sorry to hear that they make him dizzy. Has he ever tried to take only a half of a nitro under the tongue? He might have to use a magnifying glass to split the tiny pill. Of course, if he is using it for chest pains, I wouldn't split it.

    I went for years only using nitro for chest pains. Then I found out that it would bring my blood pressure down fast, but only for about 30 minutes. Since I've been on the diet that we are on, I've noticed that the nitro can bring my blood pressure down for an hour or more.

    Quote:
    I have clonidine for that purpose but I want to get off of them.
    Are you having a bad reaction to the clonidine? I thought that it was working for you.

    I have read quite a few notes here about clonidine. It seems to be quite effective for those that are using it. I've been thinking of trying it myself, but I keep forgetting to ask my doctor.

    Quote:
    I am jealous of your Marlins!
    Thanks,
    Cass
    We lost today, 2 - 1. Almost pulled it out in the bottom of the 9th. They play next in snowy Colorado. Should be interesting.

    How's your team doing? Off to a slow start? Any snow up there?

     
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