Blood Pressure

[egonormical1010]

I have to take a combo of valsartan and norvasc. Each one by itself didn’t help much, but the two combined brought me down to 120/80. My bp had gotten out of control during Covid. Like 170/100.

Just adding a little more data to the thread.

 

[malfeasance]

Any sides? Do they affect your workouts or daily life or your ability to hike across the Rocky Mountains and kill an elk?

 

[FlyGuy3232]

Have you considered less "watery" compounds?

I believe you said above that you're on Test and Deca (which is an awesome stack) but maybe for someone that struggles with BP its not the best.

What about T and Mast or T and Primo?

I'm about to start a 400 T, 200 Deca, 500 Primo cycle mostly because I had a hard time with bp on my last T + Deca cycle.

I seem somewhat prone to BP going up with water retention.

 

[malfeasance]

Have you considered less "watery" compounds?

I believe you said above that you're on Test and Deca (which is an awesome stack) but maybe for someone that struggles with BP its not the best.

What about T and Mast or T and Primo?

I'm about to start a 400 T, 200 Deca, 500 Primo cycle mostly because I had a hard time with bp on my last T + Deca cycle.

I seem somewhat prone to BP going up with water retention.

Of course I have! But I weigh 236 pounds, and I am trying to add size to do better in competition in 2021. No offense, FlyGuy3232, as I appreciate the suggestions, but the cycles you suggest are not likely to get me much past where I am currently.

This is, right now, the largest I have ever been, and I am trying to exceed that by a significant margin so that I can diet down to a decent stage weight with much more size than last time. Although I won last time, I am looking to move up a level in competition. Frankly, I do not have the size for it yet, really not even close, especially in the legs. I could still win my age category, but I was hoping to do well in the open class, and right now I would be fifth place or worse, middle of the pack, judging by the competition that has shown up in the last few years, if I don't make some substantial changes.

I do appreciate you taking the time to consider my situation and post, though, so thank you.

 

[malfeasance]

I came across this chart in my files. I thought it would be interesting for anyone considering ARB or ACE drugs. Does anyone use an ARB+ACE combo?

View attachment 141656

You might want to read this, as it seems to be bad for the kidneys to do an ACE and an ARB.

ACE inhibitors and ARBs: One or the other—not both—for high-risk patients - PMC

The combination of an ACE inhibitor and an ARB reduces proteinuria, but leads to worse renal outcomes

www.ncbi.nlm.nih.gov

Renal dysfunction was highest in dual therapy group​

Patients in the combination therapy group had higher rates of renal dysfunction than either the ramipril group (13.5% vs 10.2%, NNH=30, P<.001) or the telmisartan group (10.6%), despite a decrease in proteinuria among those on dual therapy. Patients taking the 2-drug combination also had higher rates of hyperkalemia.

 

[malfeasance]

I have to take a combo of valsartan and norvasc. Each one by itself didn’t help much, but the two combined brought me down to 120/80. My bp had gotten out of control during Covid. Like 170/100.

Just adding a little more data to the thread.

I have been considering amlodipine at 5 mg before throwing in the towel on my bodybuilding hobby.

Do you mind sharing your dosages of each?

ANY side effects or negatives from this regimen?

Did it bring you down pretty quickly or did it take a long time?

Any special instructions?

I did read a study comparing 160 mg valsartan to 80mg telmisartan, and the valsartan was very much more effective at lowering blood pressure than telmisartan.

 

[Bumpygooch]

You might want to read this, as it seems to be bad for the kidneys to do an ACE and an ARB.

ACE inhibitors and ARBs: One or the other—not both—for high-risk patients - PMC

The combination of an ACE inhibitor and an ARB reduces proteinuria, but leads to worse renal outcomes

www.ncbi.nlm.nih.gov

Renal dysfunction was highest in dual therapy group​

Patients in the combination therapy group had higher rates of renal dysfunction than either the ramipril group (13.5% vs 10.2%, NNH=30, P<.001) or the telmisartan group (10.6%), despite a decrease in proteinuria among those on dual therapy. Patients taking the 2-drug combination also had higher rates of hyperkalemia.

Hmmmm, perhaps this is the study that frightened me to begin with, maybe I posted the wrong study on page 2. Good timing, I was looking at small dosing lisinopril or propranolol. I think I’ll blood dump some blood and keep running 40mg telmisartan and see what happens. PS, if you want to drop your BP significantly and quickly, crash your blood sugar. I was 90-105/50 all night last night, but, pulse was 95-100.

 

[egonormical1010]

I have been considering amlodipine at 5 mg before throwing in the towel on my bodybuilding hobby.

Do you mind sharing your dosages of each?

ANY side effects or negatives from this regimen?

Did it bring you down pretty quickly or did it take a long time?

Any special instructions?

I did read a study comparing 160 mg valsartan to 80mg telmisartan, and the valsartan was very much more effective at lowering blood pressure than telmisartan.

Yeah, of course. The valsartan is 320mg with 12.5mg of HCTZ. I take one of those.

The amlodipine is 5mg and I take 2 of those for a total of 10mg.

I work nights and I just take the combo before I leave the house. By the 3rd day of taking both my bp had returned to normal.

I’m 6’1 and 250ish lbs now. I also take Adderall everyday (prescribed) but that doesn’t seem to raise it any higher than it already was on the days I didn’t take it. The only side effect I have from the bp meds is occasional forearm cramps (I drive for a living).

 

[malfeasance]

Hmmmm, perhaps this is the study that frightened me to begin with, maybe I posted the wrong study on page 2. Good timing, I was looking at small dosing lisinopril or propranolol. I think I’ll blood dump some blood and keep running 40mg telmisartan and see what happens. PS, if you want to drop your BP significantly and quickly, crash your blood sugar. I was 90-105/50 all night last night, but, pulse was 95-100.

Just FYI, propranolol is not an ARB. That study is about combining ACE inhibitors with an ARB.

 

[malfeasance]

Yeah, of course. The valsartan is 320mg with 12.5mg of HCTZ. I take one of those.

The amlodipine is 5mg and I take 2 of those for a total of 10mg.

I work nights and I just take the combo before I leave the house. By the 3rd day of taking both my bp had returned to normal.

I’m 6’1 and 250ish lbs now. I also take Adderall everyday (prescribed) but that doesn’t seem to raise it any higher than it already was on the days I didn’t take it. The only side effect I have from the bp meds is occasional forearm cramps (I drive for a living).

HCTZ causes me to "lock up" with cramps. Working my chest? A portion of my chest will contract and look like a chunk was taken out of it. Or my arm will curl up and be stuck, or my abs, or most likely, my calves, which is the most frequent when working legs. I just cannot tolerate diuretics.

But, hey, at least we know I am not abusing diuretics to get dry for the stage! I would be cramped up on every pose.

Thanks for sharing so much information with us.

 

[Bumpygooch]

Comparison of the Efficacy and Safety of Different ACE Inhibitors in Patients With Chronic Heart Failure: A PRISMA-Compliant Network Meta-Analysis - PMC

Supplemental Digital Content is available in the text

www.ncbi.nlm.nih.gov

Interesting study on ace inhibitor efficacy I came across while looking at them. Last sentence of the abstract just turned me off on lisinopril.

 

[malfeasance]

That's a pretty damning sentence.

 

[FlyGuy3232]

Of course I have! But I weigh 236 pounds, and I am trying to add size to do better in competition in 2021. No offense, FlyGuy3232, as I appreciate the suggestions, but the cycles you suggest are not likely to get me much past where I am currently.

This is, right now, the largest I have ever been, and I am trying to exceed that by a significant margin so that I can diet down to a decent stage weight with much more size than last time. Although I won last time, I am looking to move up a level in competition. Frankly, I do not have the size for it yet, really not even close, especially in the legs. I could still win my age category, but I was hoping to do well in the open class, and right now I would be fifth place or worse, middle of the pack, judging by the competition that has shown up in the last few years, if I don't make some substantial changes.

I do appreciate you taking the time to consider my situation and post, though, so thank you.

Fair enough.

What about upping the dose of drier compounds and pour on the watery stuff only the last few weeks with orals or faster acting esters?

 

[Ferenor]

A little update from me. I always measured my bp upon waking, and today got told that it's not fine because of the cortisol spike. Today I did measure my bp 45 min after waking up and I was very happy to read a 125/68 result, tested three time because I wasn't believing what I saw. Only 80 mg Telmisartan for me.

 

[Bumpygooch]

Finally able to get myself to the donation center to dump. BTW, your pulse has to be under 100bpm, didn’t know that. Went right from the gym and wife pissed me off in the interim, had to wait 20 minutes. BP came in at 120/80, which had to be wrong, wasn’t under 135/75 in a couple days. Came home and had a couple 120/75, 115/70 readings. Woke up this morning and right back to 135/75. Now I’m puzzled.

 

[malfeasance]

Yeah, of course. The valsartan is 320mg with 12.5mg of HCTZ. I take one of those.

The amlodipine is 5mg and I take 2 of those for a total of 10mg.

I work nights and I just take the combo before I leave the house. By the 3rd day of taking both my bp had returned to normal.

I’m 6’1 and 250ish lbs now. I also take Adderall everyday (prescribed) but that doesn’t seem to raise it any higher than it already was on the days I didn’t take it. The only side effect I have from the bp meds is occasional forearm cramps (I drive for a living).

Thinking about trying this minus the HCTZ (can't tolerate even low doses of diuretics for some reason).

80 mg of telmisartan is not keeping my BP down as cycle continues. 143/91, way too high

 

[malfeasance]

Or maybe it is similar to add amlopidine to the telmisartan:

Telmisartan plus amlodipine in patients with moderate or severe hypertension: results from a subgroup analysis of a randomized, placebo-controlled, parallel-group, 4 x 4 factorial study - PubMed

Telmisartan plus amlodipine provides effective BP lowering at all clinically relevant doses (up to -26.5 mm Hg SBP), and almost 9 out of 10 patients may achieve DBP control. Peripheral edema is up to 59% less when telmisartan 40 mg is used in combination with amlodipine 10 mg compared with...

pubmed.ncbi.nlm.nih.gov

26.5 mm hg lowering of the systolic

They do mention some percentage of amlopidine patients having edema.



Thoughts?

 

[malfeasance]

I have to either find something that works or give up bodybuilding. 143/91 is bad for the body, bad for the kidneys, bad for the heart

 

[malfeasance]

Ordering amlopidine besylate, but I would like to hear opinions.

This randomized 4 x 4 factorial study determined the efficacy and safety of telmisartan (T) plus amlodipine (A) in hypertensive patients. Adults (N=1461) with stage 1 or 2 hypertension (baseline blood pressure [BP]: 153.2[12.1]/101.7[4.3] mm Hg) were randomized to 1 of 16 treatment groups with T 0, 20, 40, 80 mg and A 0, 2.5, 5, 10 mg for 8 weeks. In-clinic BP reductions were greater with combination therapy than respective monotherapies. The greatest least-square mean systolic/diastolic BP reductions were observed with T80 mg plus A10 mg (-26.4/-20.1 mm Hg; P<.05 compared with both monotherapies). BP control was also greatest in the T80-mg plus A10-mg group (76.5% [overall control] and 85.3% [diastolic BP control]), and BP response rates >90% with this combination. Peripheral edema was most common in the A10-mg group (17.8%); however, this rate was notably lower when A was used in combination with T: 11.4% (T20/A10), 6.2% (T40/A10), and 11.3% (T80/A10).

Results of treatment with telmisartan-amlodipine in hypertensive patients - PubMed

This randomized 4 x 4 factorial study determined the efficacy and safety of telmisartan (T) plus amlodipine (A) in hypertensive patients. Adults (N=1461) with stage 1 or 2 hypertension (baseline blood pressure [BP]: 153.2[12.1]/101.7[4.3] mm Hg) were randomized to 1 of 16 treatment groups with T...

pubmed.ncbi.nlm.nih.gov

 

[malfeasance]

Telmisartan is the longest acting of all ARBs with a half-life of 24 hours [15] and has been shown to reduce CV risk [16], leading to an indication for the reduction of CV morbidity in patients with manifest atherothrombotic CV disease (history or coronary heart disease, stroke, or peripheral arterial disease) or type 2 diabetes mellitus with documented target organ damage [15]. When combined with the CCB, amlodipine, additive BP lowering is evident, compared with the individual monotherapies [17, 18].

Efficacy of Telmisartan Plus Amlodipine in Nonresponders to CCB Monotherapy - PMC

Hypertensive patients unable to reach blood pressure (BP) targets with antihypertensive monotherapy may be switched to a combination of two medications with complementary modes of action for improved treatment response. This post hoc analysis pools ...

www.ncbi.nlm.nih.gov