Safest medication to treat high blood pressure?

[ReSTART]

Don’t suggest supplements please, I need something that works. I’ve already tried supplements and they only help a tiny bit.

 

[ecstatichamster]

Losartan and other ARBs

 

[ReSTART]

Losartan and other ARBs

You think ARB is safer than ACEI, CCB and thiazides diuretics?

I don’t know about ACEI or CCB but thiazides have been around the longest so they should have the most safety data?

Thiazides best first choice for hypertension

www.cochrane.org

 

[AntiPUFA]

No pharmaceutical drugs are safe I think but.

ARBs increases plasma angiotensin II while ACE-I lowers it. I would go for perindopril.

 

[ecstatichamster]

Dr Peat has spoken favorably about the ARBs because they have anti inflammatory effects.

 

[ReSTART]

Dr Peat has spoken favorably about the ARBs because they have anti inflammatory effects.

ARB and thiazide diuretics seem the safest. The stuff with ARBs and COVID is interesting

 

[mostlylurking]

Optimizing my husband's natural desiccated thyroid prescription medication via a good endocrinologist improved his hypertension so well that he was able to get off his prescription Lisinopril completely. Lucky for me because he was a raging maniac on that stuff. He no longer has high blood pressure.

 

[bawild]

I have not seen reductions in BP using taurine (2g/day), Mg Gly (350mg/day), theanine (500mg/day), progesterone/pregnenalone/DHEA/androsterone or acetazolamide (as a CO2 promotor and diuretic). Losartan does not have an immediate effect on me but is reported to take a few weeks. The alpha and beta anti-adrenaline drugs work immediately in my case (prazosin, propranolol and/or clonidine). My plan is to use losartan in parallel with prazosin and propranolol and slowly back-off these in about 4 weeks to see if the losartan alone can get me near 120/80. Walking 6 miles/day and lowering fat intake. No change in salt intake at the moment.

 

[ThinkPerceive]

I've just looked into this, looking at long-term mortality with HBP meds. It's shocking how many meds do reduce blood pressure - yay - but also cause people to DIE sooner. Not yay.

I'll dig out the paper(s) addressing this, but it looks like a combination of Losartan and Amlodipine is very good and are both easy to have prescribed. Both reduce mortality on their own, and the combination has a greater effect. There are slightly better results with another added medicine (I forgot the type offhand - it's in the paper), but that medicine is more specialized (used for those who've already had heart attacks) and might be harder to get prescribed.

I had a horrible reaction to Amlodipine a few years ago. I started at 10mg, and it caused such severe central sleep apnea or such low blood pressure the result was similar: I'd wake up gasping desperately for air, after not breathing at all for a very long time. I could have freaking died! But I'm trying it again at 2.5mg, and so far no problems. My sister takes Amlodipine 5mg (I think) and hasn't had problems with it (she was also taking Atenolol - it also increases mortality - and it was looking into that that renewed my research into the others)

I normally take Losarten (having informed my doctor that hydrochlorothiazide was one of the worst - that stuff has clearly been shown in increase mortality), and I'm hoping that adding Amlodipine will both decrease my pressure a little further (Losartan on its own wasn't quite getting there) and not kill me in the process.

I'm not as cynical about medicine and doctors as many are. But I do notice that for certain subjects (salt, estrogen, blood pressure meds) it's as if they just read off a pamphlet check list and not think about what they are prescribing. They just keep going because they just keep going. Hydrochlorothiazide should have been pulled years ago - yet it's still a go-to medicine. The upside to their "pamphlet" approach is that doctors seem less committed to one over the other, and are open to requests for alternatives.

Salt btw doesn't seem to be a problem. Yes it'll boost BP in the short term (thus the concern over it), but long term the impact is negligible. A global meta-study showed that countries with higher salt intake tended to live longer. They didn't account for different local diets just total salt, but I imagine if it was about the rest of their diet the global trend would be more random.

High blood pressure is a big concern in my family. My grandfather had a stroke at 64, my mother, cousin and sister all tend to have very high blood pressure. My dad needed a double bypass (though unlikely related to the others). The upside is that at least we don't typically get cancer.

 

[Mastemah]

Losartan. Take time, read up. Your dose will typically be smaller than prescribed

 

[Perry Staltic]

ACE inhibitors deplete zinc. Haven't read the same for ARBs.

 

[Doc Sandoz]

Don’t suggest supplements please, I need something that works. I’ve already tried supplements and they only help a tiny bit.

Dr. Peat has said ACE inhibitors, ARBs and Ca channel blockers which lower blood pressure "stabilize the living state of the cell" probably by working on the inflammatory system. "The way they are explained isn't very illuminating, but they are actually protecting cells against high estrogen, high lactic acid, deficient sugar and CO2." (Butter Living Podcast - Fertility Pregnancy & Development at 1:00:20)

Does anyone have a fuller explanation for exactly how these drugs are protecting from inflammation, i.e., by what mechanisms?

​

 

[ReSTART]

Optimizing my husband's natural desiccated thyroid prescription medication via a good endocrinologist improved his hypertension so well that he was able to get off his prescription Lisinopril completely. Lucky for me because he was a raging maniac on that stuff. He no longer has high blood pressure.

I have to optimise my thyroid too.

I've just looked into this, looking at long-term mortality with HBP meds. It's shocking how many meds do reduce blood pressure - yay - but also cause people to DIE sooner. Not yay.Hydrochlorothiazide should have been pulled years ago - yet it's still a go-to medicine. The upside to their "pamphlet" approach is that doctors seem less committed to one over the other, and are open to requests for alternatives.

You think thiazide diuretics are harmful?

Dr. Peat has said ACE inhibitors, ARBs and Ca channel blockers which lower blood pressure "stabilize the living state of the cell" probably by working on the inflammatory system. "The way they are explained isn't very illuminating, but they are actually protecting cells against high estrogen, high lactic acid, deficient sugar and CO2." (Butter Living Podcast - Fertility Pregnancy & Development at 1:00:20)

More people discontinue calcium channel blockers due to side effects than ACEs and ARBs.

 

[ThinkPerceive]

You think thiazide diuretics are harmful?

There have been several articles suggesting that. Here's one:

Error - Cookies Turned Off

onlinelibrary.wiley.com

I'm NOT a doctor, so I'm going by articles like these.

 

[yerrag]

Lowering BP isn't easy. Too many variables. It takes a lifetime of research just to figure out mine, and I'm still halfway through it.

Ray Peat endorses many bp lowering drugs, and I think it is because of the futility of lowering it naturally. And the only way I know he has recommended lowering bp is by the use of vitamin k2, which works if you fit that that profile, whatever that profile is. It hasn't worked for me.

Ray even recommends the use of ARBS as an ACE II inhibitor for COVID. And it's especially said to be useful for people who have hypertension. But I have very high hypertension, and I don't take any prescription medication for it. And I'm not even affected by COVID. I just go out and about, but I wear masks only because everyone else is and it's the law where I'm at.

However, I don't live in the US and I'm not scared of not having healthcare insurance. If I were in the US, I may be forced to take bp lowering drugs because if I don't show my healthcare insurance provider that I have low blood pressure, I won't get a good plan or my plan may become more expensive. In the Philippines, I may not even get a plan. I don't think I'm any more healthier if I show low blood pressure, simply because I'm taking drugs to lower it.

The drugs just hide the symptoms. It doesn't fix anything. It doesn't keep my blood vessels from bursting from the high bp. It doesn't destoy my kidneys either, contrary to what medical experts say. I even believe taking high bp medication accelerates the destruction of kidneys. in 20 days year of steadily increasing bp, my serum creatinine values stay the same. Yet the funny thing is my glomerular filtration rate (GFR) keeps decreasing and I should be alarmed because clank clank I am in chronic kidney disease territory.

But why is my GFR that low? Because the medical complex calculates my gfr based on my serum creatinine and my age. Guess what? I'm not getting any younger, and so my gfr keeps getting lower - and it's solely because of the stupid formula being used to calculate my gfr.

I think as much as Ray Peat likes living natural and eating natural, his endorsement of high bp medications is a step backward. I think it's maybe due to the fact that it is very hard to fix high bp, and he could easily be sued for suggesting ways to lower bp without the use of prescription drugs.

I view bp the same way I view heart rate. It's that way because the body thinks it's best that way. Why isn't the heart rate as high as you'd like it? It's because, first of all, high heart rate isn't always good, what if your heart isn't pumping efficiently and that is why the heart rate is that high? But let's say you aren't aware that is the case, and your heart rate is low, should you go see a doctor so he will prescribe you a drug that will increase your heart rate? If the answer is no, then why are you taking a bp drug that's making you lower blood pressure?

Why aren't you working on finding the cause and fixing the cause? What if you have a bad case of oral infection that you don't know about? Would taking bp lowering drugs fix that infection?

 

[ReSTART]

@yerrag my BP isn’t super high unlike you, but it’s always above 120/80.

What exercise do you think is best for lowering BP? About an hour of low stress exercise, walking, swimming?

Maybe with thyroid and exercising everyday, I won’t need medication.

If I did, I’d probably choose ARBs, they’re more selective and seem safer than ACEs. A lot of people stop the calcium channel blockers because of side effects and I don’t know about thiazide diuretics. There may be a good reason why they’re not prescribed as much as newer medications.

I’m going to try low dose clonidine for sleep, maybe that will be enough for my blood pressure.

 

[yerrag]

If the cause is low CO2, modifying breathing to conserve CO2 will make CO2 available for vasodilation, and that will lower BP. The reason for low CO2 is poor sugar metabolism. So you have an immediate fix, but it leads you to a likely cause, which you can set out to fix.

The immediate fix is to practice Buteyko or to use Resperate to modify your breathing. But you're just adapting your breathing behavior to compensate for poor sugar metabolism. The real fix I'd to improve sugar metabolism, improving blood sugar control, but usually I find that it comes as a result of having low PUFA fatty acids in your blood, having enough potassium stores, having enough CO2 in your blood (a circular logic, which is why there are vicious cycles that need to be broken), having enough oxygen transport in your blood, having enough thyroid, and cytochrome c oxidase.

If that doesn't work, then it's more deep-seated. But you start with that.

 

[ThinkPerceive]

Lowering BP isn't easy. Too many variables. It takes a lifetime of research just to figure out mine, and I'm still halfway through it.

Ray Peat endorses many bp lowering drugs, and I think it is because of the futility of lowering it naturally. And the only way I know he has recommended lowering bp is by the use of vitamin k2, which works if you fit that that profile, whatever that profile is. It hasn't worked for me.

Ray even recommends the use of ARBS as an ACE II inhibitor for COVID. And it's especially said to be useful for people who have hypertension. But I have very high hypertension, and I don't take any prescription medication for it. And I'm not even affected by COVID. I just go out and about, but I wear masks only because everyone else is and it's the law where I'm at.

However, I don't live in the US and I'm not scared of not having healthcare insurance. If I were in the US, I may be forced to take bp lowering drugs because if I don't show my healthcare insurance provider that I have low blood pressure, I won't get a good plan or my plan may become more expensive. In the Philippines, I may not even get a plan. I don't think I'm any more healthier if I show low blood pressure, simply because I'm taking drugs to lower it.

The drugs just hide the symptoms. It doesn't fix anything. It doesn't keep my blood vessels from bursting from the high bp. It doesn't destoy my kidneys either, contrary to what medical experts say. I even believe taking high bp medication accelerates the destruction of kidneys. in 20 days year of steadily increasing bp, my serum creatinine values stay the same. Yet the funny thing is my glomerular filtration rate (GFR) keeps decreasing and I should be alarmed because clank clank I am in chronic kidney disease territory.

But why is my GFR that low? Because the medical complex calculates my gfr based on my serum creatinine and my age. Guess what? I'm not getting any younger, and so my gfr keeps getting lower - and it's solely because of the stupid formula being used to calculate my gfr.

I think as much as Ray Peat likes living natural and eating natural, his endorsement of high bp medications is a step backward. I think it's maybe due to the fact that it is very hard to fix high bp, and he could easily be sued for suggesting ways to lower bp without the use of prescription drugs.

I view bp the same way I view heart rate. It's that way because the body thinks it's best that way. Why isn't the heart rate as high as you'd like it? It's because, first of all, high heart rate isn't always good, what if your heart isn't pumping efficiently and that is why the heart rate is that high? But let's say you aren't aware that is the case, and your heart rate is low, should you go see a doctor so he will prescribe you a drug that will increase your heart rate? If the answer is no, then why are you taking a bp drug that's making you lower blood pressure?

Why aren't you working on finding the cause and fixing the cause? What if you have a bad case of oral infection that you don't know about? Would taking bp lowering drugs fix that infection?

Some good points, but I don't think agree that the "body thinks it's the best way". Bodies have a LOT of moving, complex parts, that work amazingly well at least to survive and procreate. But for the vast majority of our species' existence we were done by 35 so. What happens after that - why our bodies break down and how - wasn't part of our evolutionary past. It just didn't matter - if a 65 year old like me keeled over from cardiovascular disease or some other growing imbalance.

After 50 or so we are pretty much on borrowed time, and unnatural medicine can keep us running well enough when "naturally" we'd be long gone.

I don't respond to K2 either. Nor to just about every other "Peaty" substance I've tried. Except for a few notable exceptions, I'm like teflon to that stuff. The evidence is that the right medicines do more than just hide symptoms - they actually extend life. I'm all for that.

 

[yerrag]

Some good points, but I don't think agree that the "body thinks it's the best way". Bodies have a LOT of moving, complex parts, that work amazingly well at least to survive and procreate. But for the vast majority of our species' existence we were done by 35 so. What happens after that - why our bodies break down and how - wasn't part of our evolutionary past. It just didn't matter - if a 65 year old like me keeled over from cardiovascular disease or some other growing imbalance.

After 50 or so we are pretty much on borrowed time, and unnatural medicine can keep us running well enough when "naturally" we'd be long gone.

I don't respond to K2 either. Nor to just about every other "Peaty" substance I've tried. Except for a few notable exceptions, I'm like teflon to that stuff. The evidence is that the right medicines do more than just hide symptoms - they actually extend life. I'm all for that.

I don't know where you get your evidence. Especially on life span. As for your thinking that medicine expends life span, what kind of life are you talking about? The city life you live in lacking good nutrition? I would agree if that is the life you are referring to.

 

[ThinkPerceive]

I don't know where you get your evidence. Especially on life span. As for your thinking that medicine expends life span, what kind of life are you talking about? The city life you live in lacking good nutrition? I would agree if that is the life you are referring to.

OK apologies for having an opinion. I'll leave you to your "natural" fetish.