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Thursday, November 19, 2009

ACE inhibitors for early kidney damage 2

I shifted from one ace inhibitor to another as my bp raised or lowered. The cough bit people complained about I did not notice until later and as I had it too I joined in. ARBs also work. My doc being a nice guy prescribed an expensive arb that did not work. So I opted for diovan.
I resisted blood pressure meds because as a youngster I observed older people on meds and boy it seemed the meds killed them gracefully. Then I had that doc at the clinic for the poor who told me that one measure of bp was enough to prescribe. I asked if she called the patient back to see if the pressure went back to normal without the med and then take the patient off the med? Of course, few very very few make this effort. BP changes all the time, some have the white coat syndrome, or have their bp raised by some idiot in traffic. There is an automatic pressure measure devise that measures around the clock. After a week or two, you can average the scores and get a real idea of your bp instead of going on the meds after one measurement by an aide. Most of you know that at some cardiology departments they don't allow the aides to measure your bp, only the higher ups and you hope the instruments they use are adequately calibrated.

There is a history of blood pressure instruments for sale at Amazon that may tell you how normal standards were made. Was the standard truly representative of hypertension, or normal bp or low bp? Was it set to sell more bp pills? I just couldn't avoid that question!

Sometimes I wonder if the evidence truly calls for assuming diabetics are like patients who already had a heart attack and that all should be put on statins because they are diabetic? Of course, this leads to more sales of statins which is a lucrative business. Or should we treat each diabetic individually and not make collective assumptions about their heart risk?

One time ago, my bp went up and my doc wanted me on the calcium blockers. The symptoms they generate transform one into a zombie and I surely didn't want to prance about like that. I asked for a delay and sure enough my bp went down. From that day on, I learned that you have to delay and wait to see if your bp improves without meds. And I do think one should try exercise and diet before jumping into the meds. Always delay and move cautiously from one step to the other.
BY Joe

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