Re: antihypertensive med regimen

neighbor Willow wrote:

Hypertension 16 years well-controlled, was on Diovan 320 with no side
effects, was exercising, eating whole graiins, plant-based diet with
dried and fresh fruits at same time with unsalted almonds, salads, no
oils except olive oil, no dairy fat, only fat-free milk, no red meat
or pork, only chicken, turkey in small amounts and fish in ample
amount. Good amounts of water and taking Metamucil to add fiber (have
colon polyp problem that has meant two colonoscopies last year and
another coming up soon). On Lipitor 10. BP rose to upper 150s over
90s and sometimes shot up to 180/ 102 and I sought medical attention
which led to the changing of my bp med to Diovan HCT 320/25 as well
as nuclear stress test (normal), echo (normal), Renal MRI with
contrast (normal) and endocrine workup (normal considering the
medication I'm on). Was okay until doctor decided my bp was still not
low enough (I had white coat hypertension that he insisted must be
treated with meds and added Norvasc 5 mg.) I am now unable to walk
briskly for an hour as I did before but am fatigued and slower-paced,
constipated and must take stool softener once a week to pass anything
at all, and am feeling sadness, dead inside like depression. Am foggy-
thinking much of the time. My question is whether an ACE inhibitor
might replace the Norvasc?

It could.

If so, how to taper off the Norvasc safely?

Tapering is not necessary.

And which ACE is least likely to cause cough?

They have equal likelihood.

I think the ACE
inhibitors sound like relatively good drugs and I have no signs of
kidney damage / disease right now so might I be a candidate?

Yes.

I cannot
tolerate Toprol or Toprol XL (cannot get deep breath on it, wake up
unable to catch my breath) and do not want a beta blocker. Is there
any chance I could just live with a bp of 130/85 and forget the third
agent entirely? After all, it was not so very long ago that the bp
recommendations were higher and I suspect I could lower my own bp some
more if the doctor could only accept I am nervous in medical
situations. I am interested in the VAT passages I've read here and
know my weight is 120 -- 127 (varies with scale and clothing I guess)
and I'm 5' 2" but not fit as I had six sedentary years before my
myofascial pain and fibromyalgia were diagnosed and treated. My
midsection is soft. Could that be elevating my bp?

Yes.

Sorry for such a
long post. Thank you for any helpful info!

You are welcome.

Andrew <><
--
Andrew B. Chung, MD/PhD
http://EmoryCardiology.com

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