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So Ramipril (ACE) alone doesn't work for my blood pressure, and neither does Olmetec (ARB).? But Altace HCT (ACE + thiazide diuretic) works great.? But I'm thinking that 2.5 to 3 years on Altace HCT has given me two recent episodes of gout in my toe, and also I'm thinking maybe some of the joints in my fingers, which strangely seemed to go away after stopping Altace HCT for 2 weeks now.?
But the Olmetec doesn't seem to be doing anything for my HBP, and I have an almost constant headache because my BP is too high.? I'm going to have to go to my doctor next week and try something else.
There seem to be lots of people that need to have a diuretic as part of their ACE or ARB blood pressure pills for the pills to work to bring down their blood pressure.? I don't know what my options are if an ACE or ARB without a diuretic isin't going to work.? Does it make sense to keep trying other ACE and ARB's?
Is there another diuretic that is NOT linked to gout that I can combine with an ACE or ARB, or is there something other than an ACE / ARB that I should try next?
Ah sumguy,
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A man after my own hypertensive heart.
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About 25% of us hypertensives are “salt-sensitive” or “V-type,” meaning volume type hypertensives. Another?nomiker is “low renin hypertensives. They all say the same thing that distills down to ACE inhibitors and ARB's are of very little use becasue they control the effects of renin driven hypertension? what we ain't got.
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BUT what works for us is diuretics and they work very well. But the curse of diuretics is that the work by dumping sodium and then water from our bloodsteams and in order to keep an electrical balance urate is retained in order to dump sodium. Thus they cause gout.
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What I have found is that LASIX (furosemide), a LOOP diuretic, excretes mostly water without salt. You can test this by tasting your urine.
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What I do now for at least 10 years?is combine Lasix with losartan (Cozaar, an ARB) 4 hours later, because that dosing combo has been found to drop serum urate by 15%?Japanese research listed elsewhere on the website.
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Cozaar by itself doesn't do diddley squat for my BP, but the Lasix is amazing at keeping BP low?and if the combo at least combats the? effect of the diuretic, I'm ahead of the game and if the combo actually is uricosuric to boot then double hooray.
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By itself Lasix is thought to retain only 25% of the amount of urate that thiazide does.
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So give?cheap furosemide a shot, 40 mg. in the morning for me, and if it works, consider adding losartan. Alas the latter is still under patent and costs a lot?maybe buy 100's and split the buggers (buggers because they are teardrop shaped and hard to break evenly.)
If the Lasix alone gives you better BP control than you have ever gotten then you KNOW you are a salt sensitive, V-type hypertensiive.
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Incidentally, only losartan among all the ARB's is uricosuric.
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