Lisinopril

[brano77]

I had a heart attack in 2005 and a stent fitted in my right coronary artery. At the time I was put on 2.5 mg bisoprolol, 2.5mg lisinopril, 75mg apirin and 40 mg simvastatin . I am now 69 years old. I dropped the lisinopril about 5 years ago as my BP was not an issue and my GP thought it may be contributing to sinus/mucus problems. It made no difference to the sinus/mucus problem which is ongoing.

My typical BP without the linopril was on waking 90/60 and through day less than 120/80. More recently I have noticed my BP as peaking in the evening at 136/82.

As a result of this peak I reintroduced the lisinopril at 2.5 mg taken at night. Initially in the morning I was seeing a BP of typically 75/50 but this settled to 85/55 after a few days.I discussed this with my doctor who seemed surprised the low dose had any effect at all. Throughout the rest of the day my BP was typically 115/70. Then the evening peaks started recurring at greater than 130/80. I then tried taking 5mg split between morning and night. Result seems to be no evening peaks but morning BP ranging from 75/45 – 95/60. I also felt tired, found it difficult to concentrate, felt cold and generally not right.

Should I be concerned about a BP as low as 70/45 ? Should I be concerned about peaks of BP around 135/60 for short periods? The bisoprolol seems to have worked well as a beta blocker in controlling BP and heart rate but I thought that adding lisinopril to relax the the blood vessels would be an added advantage in managing BP given my age and history.

Is this a sensible approach? I feel comfortable taking 2.5mg at night but does this really have much effect? A 5mg dose at night or split between morning and night results in low BP of 75/45 and I do not feel right as noted above. Is it necessary to continue my lisinopril for several weeks before deciding on the best way forward or are 4-5 days sufficient to understand how well the medication suits me? Is there a better alternative?

I also take daily 600mg NAC for my sinus mucus problem, 200mg co-enzyme Q10, 1000mg glucosamine, 800mg chodroitrin and 1000mg omega 3 fish oil. I don’t think any of these these have any interaction with lisinopril.

I am active, not overweight and have never had any chest pains.

I would be grateful for any advice.

Thanks.

[MichaelJH Heart Star]

I am on Lisinopril but in the morning. The idea is that its peak action occurs when you are most likely to be stressed(e. g. dentist, call centre idiot, etc.)

Why not try 2.5mg on the morning and see how it goes. Maybe drop a call to your GP?

[brano77 in reply to MichaelJH]

Thanks for the reply. I presume you have noticed that the lisinopril you take has had an effect on you BP regardless of stress but that under a stressful situation your BP does not rise unduly due to the effect of the lisinopril in making the blood vessel relax and dilate. I may in future switch to a morning dose depending on how my current "trial" pans out.

[brano77]

Thanks. I remember my UK GP telling me some years ago that the lower the better for BP unless you start falling over! As I have been varying the lisinopril dosing regimes I will settle on the night time dose of 2.5mg for several days to let things stabilize, take some BP readings over a couple of days and then discuss with my GP. Have to admit that the evening readings are following several glasses of red wine!

[MountainGoat52 in reply to brano77]

My initial thought was hydration. I wonder whether this is a factir. If you are only having alcohol during an evening, then that could affect your BP. Balancing the alcohol intake with water, soft drinks, tea or coffee may help. When I get spikes, I find that I have usually had insufficient water during the day, typically when I have been driving or involved in some activity.