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   Went to GP and she insists on only one drug - please advise. (High & Low Blood Pressure board)

21st October 2004
At least out of the visit I got a referral to get an echocardiogram and 24 hours BP monitor. My BP was 154/98. I told her that my Avalide wasn't bringing it down and that I took my BP meds in the morning at 6:00 and that's the lowest I could bring it down with that med in 3 hours. Ridiculous.

Anyway, I urged her to let me try the same one my Mom and Husband use - Lisinopril at 20mg. Has anyone used that and not had any complications?
25th October 2004
girlofsteel,

It all hinges on whether you get "the cough" or not. If you do, it's unlikely you will be able to bear it more than a month or so.

If you like it, maybe you should consider the additional avalide a waste of money because the two drug classes are similar...basically one blocks ACE production and the other blocks attachment. Something like lisinopril and separate HCTZ might be a better choice.
(The Avalide provides HCTZ)

Bet you cough though...non coughers seem to be in the minority!
25th October 2004
Quote from zip2play:
girlofsteel,

It all hinges on whether you get "the cough" or not. If you do, it's unlikely you will be able to bear it more than a month or so.

If you like it, maybe you should consider the additional avalide a waste of money because the two drug classes are similar...basically one blocks ACE production and the other blocks attachment. Something like lisinopril and separate HCTZ might be a better choice.
(The Avalide provides HCTZ)

Bet you cough though...non coughers seem to be in the minority!

Actually, the two classes are not all that similar.

The ACE inhibitor does two things. It reduces angiotensin II (a vasoconstrictor) and increases bradykinin (a vasodilator). Both of these actions reduce blood pressure. However, this very same bradykinin is what causes the cough. Therefore, the folks who have the cough are probably the same ones who are most likely getting the best BP results from ACEIs. Also, since the body has other (non ACE) means of producing angiotensin II, they are not very efficient at this mechanism.

ARBs exclusively block the actions of angiotensin II. Bradykinin remains at the same level. Therefore, no cough. And, no blood pressure lowering effects from this mechanism either. However, they are much more effective at reducing the vasoconstriction effects of angiotensin II. So, they only reduce BP by one mechanism. But, they do it with greater efficiency.

Pal
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