Discussions that mention lotrel

High & Low Blood Pressure board

[QUOTE]Beth says:After switching meds, my doctor told me that my lisinopril dosage was too strong.

That sounds like postural hypotension or else FRANK hypotension. If your BP is lowered that dramatically with an ACE inhibitor then you can consider yourself very much in the norm: a classic RENIN type hypertensive.

My mention of the fact that ACE inhibitors and ARB's do NOT work was directed only at the minority subclass of SALT SENSITIVE hypertensives...around 25%.
[QUOTE]my quote:But when it works it works VERY well for salt-sensitive hypertensives (who coincidentally don't get much use from ARB's and ACEI's.)

If I, an extreme SALT SENSITIVE, take a dose of lisinopril, captopril, or enalapril there is no BP lowering, only coughing; if I take an ARB, my BP actually goes UP.

Everybody gets the benefit from HCTZ which as I said works slowly to remove enough water Lasix, chlorthalidone or some of the stronger diuretics"> but we SALT SENSITIVE HYPERTENSIVES get a LARGE BP drop from diuretics and they work far better than any other drug class for us. In fact, for myself the only other class that works AT ALL, and not so well, are the beta-blockers but they are too fraught with quality of life life diminishing side effects.

An alternative name for SALT SENSITIVES is LOW RENIN HYPERTENSIVES (so there's little point in taking any drug that lowers RENIN (and angiotenin and angiotensin-2.)

Because doctors are generally misinformed about the types of hypertension, we salt sensitives get VERY poor treatment plans because we aren't the norm. We would be OK IF doctors followed the VERY simple guidelines and began with a diuretic, but NOOOOO (in the words of the immortal John Belushi,) they get paid by the drug companies to prescribe pricey drugs like Norvasc and Lotrel, the bevy of patented ARB's, and now, CADUET. For some well explained reason, doctors RESIST and IGNORE the very clear guidlines which are TO START WITH DIURETICS, presumably because they don't get kickbacks for prescribing HCTZ and furozemide...sad situation for some of us.