Resistant Hypertension

[rfgh20]

Never had hypertension before starting Zytiga. BP and pulse rate. increased. Taking 5mg prednisone a day. MO reluctant to increase. Can't find study to back up increasing prednisone. Fair BP and pulse rate control on bisoprolol, losartan and amlodipine. Doing so well on Zytiga, really rather not change it. Continue as I am or increase prednisone?

[tango65]

You have an excess of aldosterone caused by zytiga.

Increasing the dose of prednisone could resolve the situation.

Other possibility is to start treatment with eplerenone (inspra) a drug which blocks the aldosterone receptors.

Once the aldosterone receptors are blocked the sodium and water retention will be also reduced leading to a resolution of the hypertension

[mrscruffy]

Not exactly science here but i was in the same situation. Added cardio to my workout and am now cutting back on BP meds

[rfgh20 in reply to mrscruffy]

I've done cardio and resistant training for years. I think should increase prednisone but I'm trying not to be my own doctor.

[Tall_Allen]

This is an article about the study. Show it to your oncologist:

prostatecancer.news/2019/06...

You can achieve the same low mineralcorticoid excess, low rate of hypertension, no hypokalemia, and reduction in ACTH with 5 mg prednisone twice a day (P5 bid) or by switching to 0.5 mg dexamethasone once a day (D0.5qd). The table shows the other differences.

[rfgh20 in reply to Tall_Allen]

I have no swelling, potassium WNL, no increase skin pigmentation. Just hypertension and tachycardia. Thanks for the reference.

[Tall_Allen in reply to rfgh20]

You don't have to have every known side effect.

[tango65]

Perhaps, this article could help you to make a decision to discuss eplerenone with your doctors

ncbi.nlm.nih.gov/pmc/articl...