Discussions that mention cozaar

High & Low Blood Pressure board


I had been taking Lasix (40-40) and Cozaar (50-50) in two doses a day 12 hours apart.

I got a little tired of swelling with water and then deflating on a twice a day routine. It was laughable...
Besides, my main reason for switching from HCTZ to Lasix was sexual and the Lasix didn't treat me any better.
I got GOOD numbers usually under 120/80 on both.

So I decided to lose the diuretic and TRY Cozaar alone...a disaster. After a week of this my systolic was consistently in the 150's and worse, I've had a couple bouts of angina (long steamroom, and racing the rain, and yesterday's elliptical workout.)

SO today I began a NO DRUGS MONTH, well no BP drugs to be exact. Today's workout was an almost pleasant 35 minutes at 80% of maximum heartrate...no chest discomfort. I tried to get BP while working out but that't too much for my tester to do right.

I really think that my results on ONLY Cozaar were worse than nothing at all and may actually precipitate angina. I haven't a clue why (but you can bet that I'll search for a good reason! :D)

I feel quite good today, better than usual!
The other day you mentioned that you were salt sensitive. You also say Cozaar doesn't help much. I am thinking you might be a low-renin hypertensive. Although low-renins are traditionally black, whites (esp from Mediterranean heritages) can also be low-renin. Low-renin folks do not respond well to ARBs, from what I understand.

I can't figure out whether I am low renin or not. I seem to be at least a little salt sensitive, but my ARB Diovan seems to be working on me. On at least some occasions I can get my SBP down to the 105 range (rarely), but usually closer to 111-116. Who knows.

To what degree are you salt sensitive? In other words, if you took your BP before and after a salty meal, what kind of difference might you expect?

Nick
Last night surprised me.
I had an afternoon with a GREAT aerobic workout... in the evening I monitored my BP closely and got readings of:
6PM...154/87...74BPM
8PM...147/79...70 BPM
10PM..150/74...65 BPM

Not good, but tolerable for the first day of the trial. I had this jumpy nervous feeling in the middle of my chest with frequent missed beats and pre-beats. A little disconcerting. But this morning I am fine. Seems there are withdrawal symptoms with losartan which I've been taking for 8 years. It feels precisely like an overabundance of catecholamines...just what I might expect.
In any case, the BP numbers WITHOUT Cozaar are no worse than WITH ONLY Cozaar.

My bodyweight is remaining low and it's been a week since I've had any diuretics. This makes me very happy.

npp,
On your question about what happens before and after a salty meal, I think I must say very little UNTIL hours have passed by and I've drunk enough water to start puffing up...then it can soar 20 points systolic. Usually I see the effect the next day.
I can't take Cozaar without HCTZ for more than 4 days without "bloat city".

Good luck to you, though.
Tamsin,
I am amazed that ANYONE can take an ARB without a diuretic. "Bloat City" is a good way to put it. Perhaps a PURE low Renin-type hyspertensive can get away with it but for any salt sensitives, monotherapy with a diuretic is FAR more effective than monotherapy with an ARB.

Brad,
[QUOTE]What did you mean by "diuretics taking their toll, or rearing their ugly head after years of use"? Have they increased your blood glucose levels?

Erectile Disfunction with both Lasix and HCTZ; low serum sodium ALWAYS with thiazide. ED is already improving!:D It's been a HARD morning! ;) Blood glucose may have slid up into the 90's from the 80's over the years but I never get any fasting readings over 100 so no diabetes worries.


[QUOTE]that when I tried the 4 day withdrawal from altace, (which I actually went > 4 days w/o angiotension blocking or angiotension receptor blockers) I lost probably 7 pounds
That effect is quite startling isn't it? I've been eating rather heavily for the last copuple days and my weight is staying down...amaxingly, even salty canned soups aren't causing the normal "bloat city."


Electrolytes:
On thiazides (50 mg./day) for decades, I got consistently low sodium readings even while eating tons of salt. It was the primary reason for the switch to Lasix (loop) and it worked in that my sodium remained normal. With the Lasix I took KCl which replaced lost potassium. My main problem with Lasix was the efffect of NO sodium depletion. To amplify, on HCTZ, I lost sodium and water which STAYED lost til I had excess sodium, thus a dose on Monday might last several days if I ate carefully.
With LASIX, I lost water copiously (unsalty water I might add...I checked!:D) for 4 hours but then put the water right back after 6 hours...then another Lasix and the same round-Robbin. I got sick of this silly routine. I conjectured that HCTZ removes salt and it's cocomitant water and Lasix removed only water.

Is anything sillier than that Bloat-Deplete-Bloat-Deplete nonsense that goes on with Lasix in a single day?


[QUOTE]I do wonder though if you ALSO have lowered your salt intake? I wonder how long you will remain edema free? Will your system readjust and let you bloat up again?
I have not lowered my salt intake...probably >3 grams a day (I should check.) I am beginning to think that the years and years on diuretics were both causing and curing my edema. I think I MAY be finding that my body is able to regulate electolytes far better if I DON'T try to "help" with diuretics. I've been so long with diuretics that I almost cannot remember my life without them.

BP Readings yesterday:
4PM: 152/82...62 BPM
10PM: 147/82...58 BPM
11PM: 146/88...54 BPM

Each number is the median of three readings.
"Edginess" in chest has disappeared.
I'm amazed that my heart rate had decreased...is it possible thatCozaar was RAISING it a bit?? :confused:
Anyway...all good. I AM hoping that systolics gets down a bit without salt restriction...I love my Chinese and Indian dinners. All I ask is a 139 average.


Nice day to you!
Yet my cardio wants me to take the just the Cozaar, because I was becoming hypokalemic on too much HCTZ.

Well, what I really need is to find the right dosage of HCTZ that works, with the right level of supplementation. Looks like I have to do that on my own, though. It appears to be too much trouble for him.
Tamsin,

Of couse, any ARB is potassium sparing but ever so slightly so. I think a far better approach for somebody who gets hypokalemia from HCTZ (or Lasix) is just to supplement KCl. It costs almost nothing compared to the ARB's and gets right to the heart of the problem.
THe prescription sized "horse pills" at 10 Meq provide more than 800 mg. potassium and are taken daily.



My Test
My numbers yesterday were better:
5PM: 142/82 (70 BPM)
6PM: 146/83 (73 BPM)
8PM: 138/79 (67 BPM)
10 PM: 144/83 (58 BPM)

I can live with numbers like these if I can get them with no drugs, and they are getting a little lower as time goes by.

Thing that surprised me was the occasional "jumpiness" mid chest. I wasn't expecting any withdrawal effects from Cozaar, but they are a real thing. It's been 6 days and things are settling back to normal. Magnesium seems to have helped a lot.