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

[Supertrain]

Trying again with SesameCare in an hour.
$29 for video visit with Costco discount.

Success. $29 for Seasamecare + $50 for 90x Telmisartan 80mg and Tadalafil 5mg (used goodrx for discount but CVS was $2 cheaper on their own discount).
$79 for 180 days of meds.
Now I could repeat with goodrx because I have a current script. Basically same price.

But Seasamecare wouldn’t refer me for a coronary artery calcium scan. Oh well. Open to suggestions on how to get a CAC coronary artery score CT scan.

 

[Ghoul]

Success. $29 for Seasamecare + $50 for 90x Telmisartan 80mg and Tadalafil 5mg (used goodrx for discount but CVS was $2 cheaper on their own discount).
$79 for 180 days of meds.
Now I could repeat with goodrx because I have a current script. Basically same price.

But Seasamecare wouldn’t refer me for a coronary artery calcium scan. Oh well. Open to suggestions on how to get a CAC coronary artery score CT scan.

Go to Mdsave. They're like GoodRx for diagnostic procedures:

https://www.mdsave.com/t/imaging-radiology

Go to "Cardiac Imaging" / Calcium Score

Find the facility you want to use.


Go to CallOnDoc:

Online Doctor for Diagnostic Imaging | CallonDoc

Talk to one of our many highly trained online doctors and easily get the diagnostic imaging you need today!

www.callondoc.com

Pick "CT Scan" $50 to get a prescrip.

Tell them your Dad had a heart attack in his 40s, your grandmother too...so you just want to stay on top of things.

You can get a CT Angiography if you want to go all the way. They'll use contrast dye and get a completely. accurate picture of not only calcified plaque, but the soft plaque buildup in all the critical vessels. It's about 2.5x the cost of a Calcium Score CT.

This scan replaces a lot of the older cardiac diagnostics, like stress tests, EKG, and Echocardiogram. It's so good my insurance covers it without a deductible IF you schedule it before they start using the battery of older, money making tests a lot of places still use by default.

 

[Supertrain]

Go to Mdsave. They're like GoodRx for diagnostic procedures:
…
Go to CallOnDoc:
…
You can get a CT Angiography if you want to go all the way. …

Thanks for the recommendations on finding a CAC scan location - I found it was cheap and much closer to me using radiologyassist.com ($88 one hour away vs $195 three hours away from mdsave.com; though mdsave was cheaper for the CCTA scan at $480 vs $456, but still too far away).

This website has a helpful description of CAC compared with CCTA, and here’s an AI summary of that comparison:
“CAC (Coronary Artery Calcium) test measures calcified plaque in coronary arteries, providing a risk score for heart disease. It's quick and suited for asymptomatic patients with risk factors.

CCTA (Coronary CT Angiography) offers detailed images of coronary arteries, showing plaque, blockages, and blood flow. It's used for patients with chest pain or unclear test results.

Choose CAC for risk assessment in asymptomatic individuals or when considering statins. Opt for CCTA if experiencing symptoms, need detailed diagnosis, or have inconclusive results from other tests.

CAC is faster and focuses on risk, while CCTA provides more comprehensive information for diagnosis and treatment planning.”

 

[Millard]

I'm going to preface this by saying research in this area is thin, and what I'm going to present is based on what I've extrapolated as a layman, piecing together data from disparate sources. It's worth noting however, that Valsartan has long been banned by several sports anti-doping bodies.

I think the distinguishing "performance enhancing" characteristic of Valsartan is its ability to maintain lowered Central Systolic Pressure during exercise.

Thank you for this and the references ^^^

The research is really thin when it comes to athletic performance. Sadly, it seems it's only WADA that is interested in this type of research (for the purpose banning them in athletes). I really wish it was a more active area.

I think it's clear that sartans/ARBs have a advantage over most other anti-hypertensive meds in terms of their effect on athletic performance (and any improvement in sexual performance even a better bonus!) At the very least there doesn't appear to be negative effects and very likely only positive effects. (I included below the excellent table from the paper you shared with me.)

I still don't see convincing evidence that valsartan is clearly superior to other sartans when it comes to athletic performance variables. It would be great to have a study with a direct comparisons. Maybe there are? I haven't looked. Does anyone know?

BTW, do you know which athletic organizations ban sartans? I know WADA added telmisartan to their "monitoring list" but were removed after a few years without being added to the Prohibited List.

 

[Supertrain]

I still don't see convincing evidence that valsartan is clearly superior to other sartans when it comes to athletic performance variables. It would be great to have a study with a direct comparisons. Maybe there are? I haven't looked. Does anyone know?

AI response:

When comparing valsartan, telmisartan, and other ARB (Angiotensin Receptor Blocker) medications for their impact on athletic performance, there are some differences worth noting:

1. Telmisartan:
- Has shown the most promise for potential benefits in athletic performance.
- Some studies suggest it may improve exercise capacity and endurance.
- Its long half-life (24 hours) provides consistent blood pressure control during exercise.
- May have beneficial effects on metabolism and muscle function.

2. Valsartan:
- Generally neutral effect on athletic performance.
- Shorter half-life may result in less consistent blood pressure control during extended exercise.

3. Other ARBs (e.g., losartan, irbesartan):
- Generally neutral effects on athletic performance.
- Some studies suggest losartan might have slight benefits for muscle strength in certain populations.

Research highlights:

1. A study published in the journal "Hypertension" (2012) found that telmisartan improved exercise capacity in patients with hypertension more than other ARBs.

2. Another study in "Circulation Journal" (2013) suggested telmisartan might enhance endurance performance by activating PPAR-gamma, which affects metabolism.

3. Research in "Medicine and Science in Sports and Exercise" (2016) indicated that telmisartan might help maintain muscle mass during periods of inactivity.

4. A comparative study in "Journal of Hypertension" (2014) showed telmisartan had more favorable effects on exercise tolerance compared to valsartan.

While these findings are promising, it's important to note that the primary purpose of these medications is to manage hypertension.

Also, it's crucial to remember that while some ARBs might not hinder athletic performance, they don't necessarily enhance it in individuals without hypertension. The observed benefits are often in the context of managing hypertension, which itself can impair athletic performance if left untreated.

 

[readalot]

@Ghoul I want to recognize the incredible amount of effort you have put into this thread. The word that comes to mind is prolific. Not many have the interest, aptitude, and bandwidth to do this. Obviously you enjoy learning and research. A job well done (or in this case above and beyond the call of duty) should be recognized.

AI has a ways to go before it will catch up to you.

Thanks for all the effort.

 

[Millard]

1. A study published in the journal "Hypertension" (2012) found that telmisartan improved exercise capacity in patients with hypertension more than other ARBs.

2. Another study in "Circulation Journal" (2013) suggested telmisartan might enhance endurance performance by activating PPAR-gamma, which affects metabolism.

3. Research in "Medicine and Science in Sports and Exercise" (2016) indicated that telmisartan might help maintain muscle mass during periods of inactivity.

4. A comparative study in "Journal of Hypertension" (2014) showed telmisartan had more favorable effects on exercise tolerance compared to valsartan.

Thanks! Did you happen to save the citations?

 

[Jaxino]

Not sure if I should've posted in male health section of the forum, but here this thread will get more attention.

So, I have been using lisinopril for a month now and it works well. It got my blood pressure from 150's/80 down to 130's, but it makes me a bit dizzy especially when driving. I take it at night and it still is kinda problematic. So therefore I read about telmisartan and heard many stories from you guys which made me want it even more.

My stats are 230lbs and about 14-16% body fat range, I plan to drop to 220 (100kg) or even a bit lower mainly through losing a bit more body fat, but I will lose some overall size. I take 250mg TU weekly, I planned to drop to 200mg, but right now I want to lean out on it and get a pro photoshoot of my body. So a bit more enhanced look "fake natural" like them social media followers say. Then later on I will see how my health does if it says no, then I will consider TRT at 150-160mg/week. Health is more important, but I want to balance it with looks and strength. Do things more moderately than I used to.

My main questions are:

-How should I switch from lisinopril 20mg to 40mg telmisartan? (My last pill was last night june 22nd, today is 23rd mid day, I'm thinking of skipping the dose today and start on 24th to let the half life of lisinopril clear)

-I hear it helps to flush extra water retention, does it interfere with creatine? I like creatine and it makes me fuller and stronger, I don't gain too much weight on it maybe 5-6lbs max.

-Can I combine it with say 5mg cialis daily?

-Should I avoid anything on it? Obviously alcohol only on holidays and I don't smoke or vape, so I guess apart from one smallest red bull can a day, I don't do any other toxic stuff.

-Anything else should I know before starting?

I would start by supplementing 1-2g magnesium daily (Magnesium Oxyde)
This should help you with BP
5-10mg Cialis are good for overall health
I won't switch to Lisinopril, take 80mg Telmisartan.

But on 250 Test you shouldn't have that high BP.

I would try what I have stated, magnesium is great for everything and everyone of us training burns it like nothing, if nothing works then it's time to go to your doctor and do more exams.

 

[Supertrain]

Thanks! Did you happen to save the citations?

1. Telmisartan improving exercise capacity:
Sato A, et al. "Telmisartan, an AT1 Receptor Blocker, Improves Endothelial Function and Exercise Capacity in Patients With Mild to Moderate Hypertension." Hypertension. 2012;60(4):967-73.
DOI: 10.1161/HYPERTENSIONAHA.112.196352

2. Telmisartan enhancing endurance performance:
Feng X, et al. "Telmisartan Enhances the Skeletal Muscle Microcirculation and Endurance Performance in Middle-Aged Mice." Circulation Journal. 2013;77(7):1833-41.
DOI: 10.1253/circj.CJ-12-1351

3. Telmisartan helping maintain muscle mass:
Burks TN, et al. "Losartan Restores Skeletal Muscle Remodeling and Protects Against Disuse Atrophy in Sarcopenia." Science Translational Medicine. 2011;3(82):82ra37.
DOI: 10.1126/scitranslmed.3002227

(Note: This study is actually about losartan, not telmisartan - AI screw up here - mistakenly stated earlier.)

4. Comparative study of telmisartan and valsartan on exercise tolerance:
Ekholm M, et al. "Telmisartan Improves Absolute Walking Distance and Endothelial Function in Patients With Peripheral Artery Disease." Clinical Research in Cardiology. 2014;103(5):354-62.
DOI: 10.1007/s00392-014-0663-9

 

[FunkOdyssey]

4. Comparative study of telmisartan and valsartan on exercise tolerance:
Ekholm M, et al. "Telmisartan Improves Absolute Walking Distance and Endothelial Function in Patients With Peripheral Artery Disease." Clinical Research in Cardiology. 2014;103(5):354-62.
DOI: 10.1007/s00392-014-0663-9

What is going on with this one? The DOI links to a study about yoga and meditation. Searching the title of the study, you find a study from 2010 about telmisartan, that doesn't include valsartan at all.

 

[readalot]

What is going on with this one? The DOI links to a study about yoga and meditation. Searching the title of the study, you find a study from 2010 about telmisartan, that doesn't include valsartan at all.

AI probably got distracted watching those YouTube "yoga" vids.

 

[Supertrain]

What is going on with this one? The DOI links to a study about yoga and meditation. Searching the title of the study, you find a study from 2010 about telmisartan, that doesn't include valsartan at all.

I have to blame the claw.AI for that mistake. Thanks for checking in more detail, this has been a really thoughtful discussion. Has anyone found any other studies related to this?

 

[Supertrain]

Thanks @Ghoul - started Telmisartan and Tadalafil, my BP is now consistently at or under 120/75.
My PCP wouldn’t RX Telmi because my BP gets significantly lower post exercise. But most of the time I was over 135/85. Now even post workout I’m just right.

 

[Stamkos]

Just read this entire thread. I will just say this is one of the most informative threads I’ve ever read on any BB forum.
Well done Ghoul.

 

[Ghoul]

Just read this entire thread. I will just say this is one of the most informative threads I’ve ever read on any BB forum.
Well done Ghoul.

Thanks man. When I intensely research topics for myself, others benefitting from that work makes it all the more worthwhile.

I spent years translating complex topics into plain English for corporate boards so they could take action. I try to do the same here.

 

[OilCarrier]

Ghoul, thank you for pointing me to this thread. I bookmarked it to read it completely at a later moment.

I am on 80 mg telmisartan year round, I take about 800 mg magnesium (which should be higher?) and 5mg tadalafil daily (amongst other things such as taurine).

Currently I am on 200 test. My bp ranges (at rest of course) between 130/80 and 115/65 at the lowest. Average is 125/75 over 25 measures.

I would have expected it to be lower, but it is roughly the same when I am on 800 test vs when I am on no test, vs when I am on 200 test.

rhr is 60-65 when not having just eaten carbs, 70 when I just ate.

Does anybody have obvious pointers for me to improve rhr and bp based on what I posted? more sprinting/cardio?

 

[Sampei]

Ghoul, thank you for pointing me to this thread. I bookmarked it to read it completely at a later moment.

I am on 80 mg telmisartan year round, I take about 800 mg magnesium (which should be higher?) and 5mg tadalafil daily (amongst other things such as taurine).

Currently I am on 200 test. My bp ranges (at rest of course) between 130/80 and 115/65 at the lowest. Average is 125/75 over 25 measures.

I would have expected it to be lower, but it is roughly the same when I am on 800 test vs when I am on no test, vs when I am on 200 test.

rhr is 60-65 when not having just eaten carbs, 70 when I just ate.

Does anybody have obvious pointers for me to improve rhr and bp based on what I posted? more sprinting/cardio?

cardio LISS even is fine, 30 minutes every day if you can. will do wonder

 

[readalot]

cardio LISS even is fine, 30 minutes every day if you can. will do wonder

115/70 about 2 hours after my zone 2 to 4 cardio sessions. 280/70 ND:TC mg/week currently. Great advice!

 

[Ghoul]

Ghoul, thank you for pointing me to this thread. I bookmarked it to read it completely at a later moment.

I am on 80 mg telmisartan year round, I take about 800 mg magnesium (which should be higher?) and 5mg tadalafil daily (amongst other things such as taurine).

Currently I am on 200 test. My bp ranges (at rest of course) between 130/80 and 115/65 at the lowest. Average is 125/75 over 25 measures.

I would have expected it to be lower, but it is roughly the same when I am on 800 test vs when I am on no test, vs when I am on 200 test.

rhr is 60-65 when not having just eaten carbs, 70 when I just ate.

Does anybody have obvious pointers for me to improve rhr and bp based on what I posted? more sprinting/cardio?

You're really in that ideal "sub 120/70" range. If you can't get to where you want RHR wise, you could switch to 40mg Telm/5mg Amlodipine.

But your BP is so good now, I'd be reluctant to mess around with second compound and potentially induce new sides.

IF your BP climbs with age though, I'd definately try the 40mg Telm/5mg Amlodipine combo tab, than switch to another "sartan" med. The Amlodipine will lower RHR slightly.

 

[Sampei]

You're really in that ideal "sub 120/70" range. If you can't get to where you want RHR wise, you could switch to 40mg Telm/5mg Amlodipine.

But your BP is so good now, I'd be reluctant to mess around with second compound and potentially induce new sides.

IF your BP climbs with age though, I'd definately try the 40mg Telm/5mg Amlodipine combo tab, than switch to another "sartan" med. The Amlodipine will lower RHR slightly.

side effect wise I would go Nebivolol, from every thread or article I have searched online studies and ppl all report less side effect from nebivolol and even more benefit then Amlodipine