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

[Sampei]

FYI, in line with the most recent evidence of long term good health outcomes, 120-129/70-79 is now considered "Elevated" and consideration of treatment should start in that range. So if raising nebivilol gets you below that (and you're not passing out), it's actually preferable

New ESC Guidelines on BP and Hypertension Shift Treatment Targets Lower

The recommendations, based on STEP, CRHCP, and ESPRIT data, are now more in line with US guidance.

www.tctmd.com

yes but is nebivolol a good drug for reducing HR?
My bp now is 110-115/65-70 with telmi 40 and nebivolol 2.5mg on cycle
problem is HR is still 98-100

 

[Ghoul]

yes but is nebivolol a good drug for reducing HR?
My bp now is 110-115/65-70 with telmi 40 and nebivolol 2.5mg on cycle
problem is HR is still 98-100

I know this is an unsatisfactory answer, but the reasons there are so many beta blockers (around 10) still being produced and sold is because they all have characteristics that make them "better" for some and not others. For instance, Nebivolol significantly increases nitrous oxide. This lowers blood pressure a little by relaxing tiny blood vessels (and makes your dick work better). But what if you have high heart rate without high BP? That could be a problem, even causing a stroke. Then you'd want a more selective Beta blocker that doesn't lower BP. See what I mean?

In plain english, if it gets the job done, and doesn't cause you side effects, than that's the right one for you. Any that were clearly inferior options because something better became available have been taken off the market because no one would choose those.

See how 5mg works for you, and while you could go to 10mg, the general guidance for BP related meds is it's preferable to switch than go to max dose of a particular drug. So if 5mg doesn't lower heart rate enough, either you try 10mg and see if sides are tolerable, or switch to one of the many other options at that point and see if that's more effective and again, doesn't induce side effects.

 

[Sampei]

I know this is an unsatisfactory answer, but the reasons there are so many beta blockers (around 10) still being produced and sold is because they all have characteristics that make them "better" for some and not others. For instance, Nebivolol significantly increases nitrous oxide. This lowers blood pressure a little by relaxing tiny blood vessels (and makes your dick work better). But what if you have high heart rate without high BP? That could be a problem, even causing a stroke. Then you'd want a more selective Beta blocker that doesn't lower BP. See what I mean?

In plain english, if it get's the job done, and doesn't cause you side effects, than that's the right one for you. Any that were clearly inferior options because something better became available have been taken off the market because no one would choose those.

See how 5mg works for you, and while you could go to 10mg, the general guidance for BP related meds is it's preferable to switch than go to max dose of a particular drug. So if 5mg doesn't lower heart rate enough, either you try 10mg and see if sides are tolerable, or switch to one of the many other options at that point and see if that's more effective and again, doesn't induce side effects.

can you suggest me other drugs specifically targeting HR?
so I can start reading on them, less they reduce the BP the better, as the BP is very good right now and don't need it lower.

 

[iris]

See what I mean?

Hello.
Better today or are you still a hormonal so and so?

Please answer and do not pretend you haven't read this, or I am going to flipping hate you forever.
Since everyone already does, you don't need this, too.
So.....

 

[Ghoul]

can you suggest me other drugs specifically targeting HR?
so I can start reading on them, less they reduce the BP the better, as the BP is very good right now and don't need it lower.

Well what you're asking for is the most "cardioselective" beta blocker, that specifically blocks adrenaline receptors in the heart without affecting other receptors. Nebivolol is actually the strongest EXCEPT for the vasodilation from the nitrous oxide it increases.



Bisoprolol is the next most cardioselective beta blocker, but does not open blood vessels.



A new drug might bring on new sides though (or not), and unless slightly lower BP is a problem for you, personally I wouldn't switch.

Beta blockers for cardiovascular conditions: one size does not fit all - bpacnz

bpac.org.nz

 

[Sampei]

thanks man, you really dumbed it down for me. Gonna stay on 40telmi and try 5mg nebi and hopefully I can tackle this damn High HR

Well what you're asking for is the most "cardioselective" beta blocker, that specifically blocks adrenaline receptors in the heart without affecting other receptors. Nebivolol is actually the strongest EXCEPT for the vasodilation from the nitrous oxide it increases.

View attachment 295585

Bisoprolol is the next most cardioselective beta blocker, but does not open blood vessels.

View attachment 295586

A new drug might bring on new sides though (or not), and unless slightly lower BP is a problem for you, personally I wouldn't switch.

Beta blockers for cardiovascular conditions: one size does not fit all - bpacnz

bpac.org.nz

 

[Ghoul]

Hello.
Better today or are you still a hormonal so and so?

Please answer and do not pretend you haven't read this, or I am going to flipping hate you forever.
Since everyone already does, you don't need this, too.
So.....

I feel better in the company of curious. intelligent people.

Even if they disagree, which I actually welcome so I can improve my knowledge by being challenged, it's done respectfully, thoughtfully, and not the knuckle dragging proudly ignorant kind.

Nothing personal with you, the whole mob gets put on mute when that happens.

 

[Ghoul]

thanks man, you really dumbed it down for me. Gonna stay on 40telmi and try 5mg nebi and hopefully I can tackle this damn High HR

Thanks for the opportunity to get out and refresh my knowledge on this topic, If I were in your position, that's exactly what I would do. 80mg Telma will probably bring your BP down too much, while the Nebiv will just bring it closer to ideal, and hopefully get your heart rate where it should be. Remember it'll take a few weeks to settle in at the new dose, so be patient with any minor side effects as they may resolve in that time.

 

[iris]

I feel better in the company of curious. intelligent people.

Even if they disagree, which I actually welcome so I can improve my knowledge by being challenged, it's done respectfully, thoughtfully, and not the knuckle dragging proudly ignorant kind.

Nothing personal with you, the whole mob gets put on mute when that happens.

No problem.
Glad to know you are OK, that's all.
thanks