I'm switching to telmisartan from lisinopril (need advice)

So if you say 140/80…. Could be changed with lifestyle choices perhaps?

Possibly, and that's where they always recommend things start, unless diastolic is over 100, since that pretty much guarantees organ damage at a rapid rate.

However, unless you're a grossly obese, sedentary smoker, I don't think there's enough in the way of changes that would get 140/80 to 120/70 fast enough to warrant the accumulating damage going on with that BP.

I'm not cutting back on salt and meditating for an hour every day in the hopes it'll come down to a healthy level in a year or two.

With your blood vessels stretched by that BP, the endothelial layer has all sorts of "cracks" opened up that cholesterol can get shoved under adding to the deadly plaque that squeezes your pipes shut and finishes most of us off. Realizing that's going on continuously lit a fire under my ass to slow or stop that process asap.

Then there are "micro strokes", seemingly symptomless, that cumulatively add to our brain's degradation that's attributed to "normal aging". The same goes for the micro vessels rupturing in our eyes over the time we have high BP.

My outlook on BP changed completely after hearing a panel of leading "Preventive Cardiologists" (have you had the privledge of being treated by one of these? Me neither. Commoners get the cardiologists that primarily treat the damage after the fact).

Anyway, they were doing their annual review of the latest data and developments, and at one point they dropped all the highly technical talk and discussed how frustrating it is that people don't realize how much benefit there is in simply taking a single pill to get your BP into an ideal range. The vast majority of the population has uncontrolled hypertension. Even primary care docs don't take it as seriously as they should despite knowing better. Basically, they were talking about the great new BP meds coming but said, essentially, "we have everything we need, right now, for 98% of the population to maintain ideal BP with no to minimal sides"

When I saw the updated flowchart I linked above today, I laughed, because since last time they added a major emphasis on a "one pill" solution.

At the panel, they pointed to a recent study that determined people were 70% more likely to stick to BP meds if it was a single pill. (and how generics should be forced to "look" the same for the same meds, as a color change on refill leads to 30% of patients stopping the drug within a month, if the shape changes 40% dropping out, if both change something like 65-70% of people stop taking their lifesaving BP med.).
 
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Just stop the lisinopril and start the Telmisartan the next day, and yes you can take it with 5mg daily cialis. It does not affect creatine. If 40mg isn't enough then increase the Telmisartan to 80mg.
 
So if you say 140/80…. Could be changed with lifestyle choices perhaps?

Here are the latest American Heart Association guidelines regarding your BP:

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And recommended treatment:

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So like everything else, you'll have to weigh the potential downsides of following this advice, vs the potential benefits. .
 
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What about for high RHR? I'm currently running 500mg test and 6iu HGH. RHR has gone up to 79bpm and I can't get it to go down. Currently I'm using 20mg telmisartan and BP is perfect. I may not even need the telmisartan. I was reading nebivolol can lower RHR. I ordered nebivolol and hctz. Not sure which I'll try yet but I didn't even think s about amlodipine.

Let me revise my post. I was looking at the risk of your tachycardia in isolation, and the best treatment for it, along with mild BP.

Considering metoprolol has some anti-androgenic effects, nebivolol would be my choice too. Also to be clear, they both open blood vessels to a degree, but most of the BP reduction comes from the heart rate slowing, slightly increasing the risk of a stroke or heart attack.
 
Let me revise my post. I was looking at the risk of your tachycardia in isolation, and the best treatment for it, along with mild BP.

Considering metoprolol has some anti-androgenic effects, nebivolol would be my choice too. Also to be clear, they both open blood vessels to a degree, but most of the BP reduction comes from the heart rate slowing, slightly increasing the risk of a stroke or heart attack.
Yes sir, systolic BP hovers at 120 without telmisartan. 110-115 with telmisartan. My resting heart rate was 60-65 before trt and went to 65-70 when I started trt. Running this higher dose and HGH it's just gone up even more. Thank you for the info! Helps a lot
 
Yes sir, systolic BP hovers at 120 without telmisartan. 110-115 with telmisartan. My resting heart rate was 60-65 before trt and went to 65-70 when I started trt. Running this higher dose and HGH it's just gone up even more. Thank you for the info! Helps a lot

Great BP, especially on gear, hope you lock that in for life!
 
Most importantly, this can't be emphasized enough:

For best long term health outcomes, 120/70 is the most well substantiated target BP for the vast majority.

It's the lowest hanging health protection measure you can take, with the biggest bang for the buck by a long shot in terms of low effort/high reward. So stick with the trial and error until you find something that gets you to target with no intolerable sides. After that it's one daily pill that you usually don't have to change for years or decades.

With BP meds in general when initiating treatment or changing dose or compound:

It takes 2 weeks to reach the maximum; stable reduction in BP.

It takes a month for the body to acclimate, and side effects to subside (the ones that will subside). Fatigue, occasional light dizzyness, and water retention in the extremities are the most common initially experienced with almost all BP meds until things stabilize. Many people give up prematurely and end up living with "the silent killer" instead. Reassess after a month.

If you're not getting there with 40mg Telmisartan, or any monotherapy BP med, the best strategy is not to increase the dose, which increases the risk and severity of side effects, but to switch to combination therapy of two low dose meds that reduce BP using different mechanisms.

For instance, instead of increasing Telmisartin from 40mg to 80mg, use generic Twynsta, a combination of Amlodipine (a calcium channel blocker) and Telm (An angiotensin blocker) at 5mg Amlodipine / 40mg Telmisartin. That combo has less likelihood of sides than 80mg Telm (or 10mg Amlodipine) while resulting in significantly more BP reduction than either med used alone at double the dose.

All of the "-artan" ARB class BP meds offer advantages and disadvantages. Telmisartan offers more visceral fat reduction, while Valsartan has a more positive effect on libido and sexual function, for instance. Telmisartan improves muscle function, Valsartan improves aerobic performance. They're both banned PEDs in sports, BTW.

I've tried Amlodipine / Telmisartan which increased hair loss for me, so switched to Amlodipine / Valsartan, and not only did the hair loss stop, I love the way the way it makes me feel. That was completely unexpected.

Both one pill combos, 5/80 Twynsta and 5/160 ExForge (the Aml/Valsartan combo brand name) brought me from 160/93 to a rock solid 120/70. (fyi ignore the dosages of different drugs even in the same class. 80mg Telm and 160mg Val are roughly equivalent for instance, there are charts that show equivalent doses to guide you when switching).

If you haven't already, get a home monitor, they're cheap, and keep an eye on your BP closely when trying a new BP med.

Finally, while Telm is widely available from UGL suppliers, it's not difficult to find any of the combo meds from India pharma and easily acquireable in the US with a quick $40 telemedicine call and just telling the provider you had been on (FILL IN BP MED HERE), it was working, but you lost your insurance, and need a prescription so you can get back on it. Use GoodRx to find the pharmacy with cheapest price before the appointment.
why do you think telmi caused hairloss?
in what way does ami/valsartan make you feel?

I was prescribed metropolol, had to take 25mg extended release for a few years, brought me from 90 RHR to 75. i went off it last year but now ive tripled my test dose and its going to increase.

metropolol works, and has anxiety reducing effects, but i think it did caused my metabolism to slow down and got rid of like helpful anxiety that would cause productivity. I think it made me lazy and possibly less happy.

What should I take? I think my heart rate will end up being too high for a calcium channel blocker to be very effective, but i dont want to be back on metropolol.

Nebivol?
 
why do you think telmi caused hairloss?
in what way does ami/valsartan make you feel?

I was prescribed metropolol, had to take 25mg extended release for a few years, brought me from 90 RHR to 75. i went off it last year but now ive tripled my test dose and its going to increase.

metropolol works, and has anxiety reducing effects, but i think it did caused my metabolism to slow down and got rid of like helpful anxiety that would cause productivity. I think it made me lazy and possibly less happy.

What should I take? I think my heart rate will end up being too high for a calcium channel blocker to be very effective, but i dont want to be back on metropolol.

Nebivol?
Nebivolol is a beta blocker similar to metoprolol, same drug class just newer. I used it a long time ago and it made my have zero motivation, killed any anxiety I had which was great, but basically couldn't get excited about anything either. Had to stop taking it and have been on Telmisartan since.
 
Did you try magnesium for reducing blood pressure?
I started with supplementing with 2 g of magnesium daily and it reduced my blood pressure from 140/90 to 120/80 in matter of 10 days...
I know it doesn't answer your question but just food for thought.
 
Nebivolol is a beta blocker similar to metoprolol, same drug class just newer. I used it a long time ago and it made my have zero motivation, killed any anxiety I had which was great, but basically couldn't get excited about anything either. Had to stop taking it and have been on Telmisartan since.
exactly how i felt. anxiety was gone but i didnt give a fuck. it does affect dopamine apparently. im taking clen now and i think its stimulating similar receptors hopefully brings me back to how i was lol.
 
exactly how i felt. anxiety was gone but i didnt give a fuck. it does affect dopamine apparently. im taking clen now and i think its stimulating similar receptors hopefully brings me back to how i was lol.

Great, i just ordered some. Hope i don't get the zero motivation sides :oops:

Nebivolol, a cardioselective beta-1 adrenergic receptor antagonist, has been studied for its effects on dopamine levels and related neuropsychiatric conditions.

Effects on Dopamine

Parkinson's Disease Model:
A study on MPTP-induced Parkinson's disease in mice demonstrated that nebivolol has beneficial effects by increasing dopamine levels in the brain. This effect is attributed to its antioxidative and anti-inflammatory properties, which help prevent the loss of dopaminergic neurons. The study suggests that nebivolol may increase dopamine either by preventing the loss of dopaminergic neurons, enhancing dopamine synthesis, or reducing dopamine metabolism by monoamine oxidase (MAO)

Vasoconstriction and Dopamine Interaction:
Another study examined the effects of nebivolol on arteriolar reactions to various agents, including dopamine. It was found that nebivolol did not modify the arteriolar vasoconstriction induced by dopamine, indicating that nebivolol does not directly interfere with dopamine-induced vasoconstriction in this context

Neuropsychiatric Effects
Beta-Blockers and Neuropsychiatric Side Effects:
Beta-blockers, including nebivolol, can cross the blood-brain barrier due to their lipophilic nature. This property allows them to interact with central nervous system receptors, potentially leading to neuropsychiatric side effects such as fatigue, depression, and cognitive changes. However, these effects are heterogeneous and difficult to measure in clinical trials

Conclusion
Nebivolol appears to have a complex interaction with dopamine, particularly in the context of neurodegenerative diseases like Parkinson's. It may increase brain dopamine levels through antioxidative and anti-inflammatory mechanisms, although it does not affect dopamine-induced vasoconstriction. The neuropsychiatric effects of nebivolol, like other beta-blockers, are significant and warrant careful consideration in clinical use.
 
Thanks for all the answers and suggestions. 3rd day on telmisartan since I switched from lisinopril. Too early to conclude anything, lisinopril was quick acting and telmisartan needs time I guess.

I really gotta start my cut and lose 10 pounds as that helps too.

I also get essential stuff like this from pharmacy. I don't trust ugls for serious stuff like anastrozole and bp meds. Where I live if you know how to talk it's not hard to convince pharmacists that you need it.

Goal for now is to stabilize in the 130's like I did on lisinopril. Then in the meantime lose 10 pounds all the way to 220lbs mostly through losing body fat. 120's would be awesome. Currently in the 140's zone. Diastolic is always fine and now is actually in the 60's since starting meds. Pulse is good too 70-80 max. Even before meds I only suffer from isolated hypertension (systollic too high).

Later on if that doesn't help then TRT dose and nothing more I guess.
 
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Thanks for all the answers and suggestions. 3rd day on telmisartan since I switched from lisinopril. Too early to conclude anything, lisinopril was quick acting and telmisartan needs time I guess.

I really gotta start my cut and lose 10 pounds as that helps too.

I also get essential stuff like this from pharmacy. I don't trust ugls for serious stuff like anastrozole and bp meds. Where I live if you know how to talk it's not hard to convince pharmacists that you need it.

Goal for now is to stabilize in the 130's like I did on lisinopril. Then in the meantime lose 10 pounds all the way to 220lbs mostly through losing body fat. 120's would be awesome. Currently in the 140's zone. Diastolic is always fine and now is actually in the 60's since starting meds. Pulse is good too 70-80 max. Even before meds I only suffer from isolated hypertension (systollic too high).

Later on if that doesn't help then TRT dose and nothing more I guess.

You have isolated systolic hypertension, a sign your arteries have lost flexibility ("hardened arteries").

You should probably be under a doctors care for this as there's usually an underlying cause that you'd be better off getting resolved before it gets worse. You don't have to mention the AAS use if that's stopping you from getting care, they'll be looking for other things like diabetes and organ damage, not hormones.

Monotherapy with a single BP med is not ideal for this, your diastolic will keep going down out of proportion your systolic.

IMG_8290.jpeg

 
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[

You have isolated systolic hypertension, a sign your arteries have lost flexibility ("hardened arteries").

You should probably be under a doctors care for this as there's usually an underlying cause that you'd be better off getting resolved before it gets worse. You don't have to mention the AAS use if that's stopping you from getting care, they'll be looking for other things like diabetes and organ damage, not hormones.

Monotherapy with a single BP med is not ideal for this, your diastolic will keep going down out of proportion your systolic.

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k2 to clear out the calcium fix to help this?
 
k2 to clear out the calcium fix to help this?
Another case where I end up sounding like a nut, but here goes.

There is no "reversal" of calcification, yet. That's the bad news.

The good news is you're barely in the isolated systolic hypertension range. It gets worse with age. Eventually most people over 75 have it.

The gooder news is that there's ample evidence there are GLP receptors in blood vessels of all types that, when activated, slow or stop further calcification.

The goodest new of all, possibly, is this. We know for certain as of several months ago GLPs not only stop the harmful changes (remodeling) of atrial tissue in the heart, when activated GLP receptors can reverse this process and the heart reverts to an earlier, better functioning state. It's possible, though not proven, it can do the same for arteries via a similar process. We know blood vessel walls are densely packed with GLP receptors.

The link between calcification (hardening) and low levels of naturally produced GLP hormone has been known for a while:

 
Another case where I end up sounding like a nut, but here goes.

There is no "reversal" of calcification, yet. That's the bad news.

The good news is you're barely in the isolated systolic hypertension range. It gets worse with age. Eventually most people over 75 have it.

The gooder news is that there's ample evidence there are GLP receptors in blood vessels of all types that, when activated, slow or stop further calcification.

The goodest new of all, possibly, is this. We know for certain as of several months ago GLPs not only stop the harmful changes (remodeling) of atrial tissue in the heart, when activated GLP receptors can reverse this process and the heart reverts to an earlier, better functioning state. It's possible, though not proven, it can do the same for arteries via a similar process. We know blood vessel walls are densely packed with GLP receptors.

The link between calcification (hardening) and low levels of naturally produced GLP hormone has been known for a while:

Possible reversal of calcium deposits in the arteries with repatha. Esp when LDL goes below 40
 
Possible reversal of calcium deposits in the arteries with repatha. Esp when LDL goes below 40

At the least it looks like it can clear plaque before it calcifies. I had forgotten about this, it's a whole new class of meds.

I read a paper that said widespread reduction of lipids with GLP use made it "prime time" to follow that up with these PCSK9 inhibitors to clear out plaque and reduce chance of heart attacks even further.
 
Another case where I end up sounding like a nut, but here goes.

There is no "reversal" of calcification, yet. That's the bad news.

The good news is you're barely in the isolated systolic hypertension range. It gets worse with age. Eventually most people over 75 have it.

The gooder news is that there's ample evidence there are GLP receptors in blood vessels of all types that, when activated, slow or stop further calcification.

The goodest new of all, possibly, is this. We know for certain as of several months ago GLPs not only stop the harmful changes (remodeling) of atrial tissue in the heart, when activated GLP receptors can reverse this process and the heart reverts to an earlier, better functioning state. It's possible, though not proven, it can do the same for arteries via a similar process. We know blood vessel walls are densely packed with GLP receptors.

The link between calcification (hardening) and low levels of naturally produced GLP hormone has been known for a while:

so whats your stance on cholesterol? I saw some stuff about how we are wrong about blood cholesterol, atleast as far as LDL goes, and i think the indicator is VLDL? I lowered my LDL from 130 to 75 in 3 weeks of 10mg eitzimbe.

So what GLP do i take and how much?
 
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