Blood Pressure

[BamaCrazy]

We're about to see ultra-low dose quad pills. The most impressive thing with the trials so far, no subjects have experienced any side effects typically associated with bp meds, and 100% get significant reductions in blood pressure.

It looks like these may become first line therapy for hypertension.

Less is more: potential breakthrough for treating hypertension with ultra low-dose combinations | The George Institute for Global Health

Professor Clara Chow, of The George Institute, said the results published in The Lancet were exciting but larger trials were needed to see if these high rates could be maintained and repeated.

www.georgeinstitute.org

Odd. The study was conducted 2014-2015 and the findings were published 2017. And the Quartet Project began in 2016. They did another study 2017-2020. Then a systematic review and meta analysis in 2023. But it does not look like it’s being adopted anywhere.

 

[rxzed]

Odd. The study was conducted 2014-2015 and the findings were published 2017. And the Quartet Project began in 2016. They did another study 2017-2020. Then a systematic review and meta analysis in 2023. But it does not look like it’s being adopted anywhere.

Guidelines are almost always about a decade or more behind research

 

[Sampei]

Can BP meds lose their effectiveness with time? Or if one find the correct dosage and doesn't change much in his life they should work forever?

 

[rxzed]

Can BP meds reduce their effectiveness with time? Or if one find his correct dosage and doesn't change much in his life they should work forever?

From my understanding not necessarily a reduction in effectiveness, but age can definitely change needs.

 

[Sampei]

Quad pills I wonder what they would be made off;

Arb/ace
CCB
BB
Diuretic


???

 

[rxzed]

Quad pills I wonder what they would be made off;

Arb/ace
CCB
BB
Diuretic


???

I believe so. I personally would never use a combo pill as 'one size fits all' is going to be very tricky, especially if you use AAS; I could definitely see the use for the general pop though.

 

[Sampei]

I believe so. I personally would never use a combo pill as 'one size fits all' is going to be very tricky, especially if you use AAS; I could definitely see the use for the general pop though.

Telmi + nebi + indapamide
Imho best bodybyulding combo ever
But all as separate pills

 

[BamaCrazy]

Telmi + nebi + indapamide
Imho best bodybyulding combo ever
But all as separate pills

The study used irbesartan 37·5 mg, amlodipine 1·25 mg, hydrochlorothiazide 6·25 mg, and atenolol 12·5 mg

 

[rxzed]

Telmi + nebi + indapamide
Imho best bodybyulding combo ever
But all as separate pills

I would try to add a CCB too if you could; they seem to have some unique LVH benifits from what I read. Nebivolol is especially good if your RHR increases from GLPs.

 

[Ghoul]

Odd. The study was conducted 2014-2015 and the findings were published 2017. And the Quartet Project began in 2016. They did another study 2017-2020. Then a systematic review and meta analysis in 2023. But it does not look like it’s being adopted anywhere.

I should've used a more recent reference.

Quadro is ongoing. Quartet continues to be analyzed and mentioned but I don't know what the holdup is with that one).

A single tablet with 4 blood pressure-lowering drugs can be more effective than taking 3 drugs in separate pills

Your access to the latest cardiovascular news, science, tools and resources.

www.escardio.org

The European Society of Cardiology conference late last year had a lot of news regarding combinations.

The other big news was what seems like the final nail in the coffin of the BP med timing debate, an argument seemingly going on forever:

Take it whenever, just take it.

Late-Breaking Hypertension Studies Address Medication Timing, Benefits of Combination Pills, More - American College of Cardiology

www.acc.org

 

[Sampei]

I would try to add a CCB too if you could; they seem to have some unique LVH benifits from what I read. Nebivolol is especially good if your RHR increases from GLPs.

I didn't see much effect from Nebi on the RHR increase from GLP1. Nebi can't fix vagus nerve stimulation sadly.

I would have no issue adding a CCB but they are all mostly shit (for what I have seen researching). Amlodipine is full of side effect edema and swelling of feet is one that many experience for example

 

[AlexDavis43]

Quad pills I wonder what they would be made off;

Arb/ace
CCB
BB
Diuretic


???

Getting pharma companies to cooperate and do studies on all the various combinations will be tedious. They all want triple/quad pills of their agents, while a better approach may include crossing Pharma lines.

 

[Ghoul]

Quad pills I wonder what they would be made off;

Arb/ace
CCB
BB
Diuretic


???

You nailed it, that's the quad combo.

 

[AlexDavis43]

I didn't see much effect from Nebi on the RHR increase from GLP1. Nebi can't fix vagus nerve stimulation sadly.

I would have no issue adding a CCB but they are all mostly shit (for what I have seen researching). Amlodipine is full of side effect edema and swelling of feet is one that many experience for example

Amlo seems like the worst CCB for water retention. Not recommended if on hGH.

 

[Sampei]

Amlo seems like the worst CCB for water retention. Not recommended if on hGH.

Yeah exactly I need to research if there is a much better CCB or they are all the same more or less

 

[Ghoul]

I didn't see much effect from Nebi on the RHR increase from GLP1. Nebi can't fix vagus nerve stimulation sadly.

I would have no issue adding a CCB but they are all mostly shit (for what I have seen researching). Amlodipine is full of side effect edema and swelling of feet is one that many experience for example

7% (supposedly). Probobly much lower rates of edema at the minuscule doses they're talking about

I think the problem is the newer generation CCBs aren't approved in the EU or US. It makes no sense. They've been used in Japan, South Korea, India for a long time.

Cilnipidine seems the best of the CCBs, with lowest rates of edema, and many other interesting benefits(neuropathic pain reduction), including (as someone else pointed out to me), a pretty nice drop in RHR.

 

[rxzed]

The other big news was what seems like the final nail in the coffin of the BP med timing debate, an argument seemingly going on forever:

Take it whenever, just take it.

I assume this is only for medications with a longer half life?

 

[Ghoul]

I assume this is only for medications with a longer half life?

You'll still find recommendations all over the place.

But when the ACC and ESC align on a recommendation, "Take it at whatever time works for you" sooner or later everyone follows. These are very conservative, slow moving organizations and never take a public position without strong studies supporting it.

This is from the perspective of cardiovascular outcomes. Meaning you can prioritize whatever matters to you, ie convenience, minimization of sides if that's a factor, etc, without being concerned about increasing your risk of heart attack or stroke.


We're taking about single dose a day.

I know there are older beta blockers with short half lives taken multiple times a day.

Timing of dosing of blood-pressure medication makes no difference

Your access to the latest cardiovascular news, science, tools and resources.

www.escardio.org

 

[Sampei]

7% (supposedly). Probobly much lower rates of edema at the minuscule doses they're talking about

I think the problem is the newer generation CCBs aren't approved in the EU or US. It makes no sense. They've been used in Japan, South Korea, India for a long time.

Cilnipidine seems the best of the CCBs, with lowest rates of edema, and many other interesting benefits(neuropathic pain reduction), including (as someone else pointed out to me), a pretty nice drop in RHR.

Does CCB reduce RHR like Beta-blockers?

 

[Nemesis RR]

On cycle I get an increase in heart rate and blood pressure. Wouldn’t Nebivolol be best over something like Telismarten assuming the rise in blood pressure is only 135/85 as it has been shown to lower RHR?