Reducing bp meds

[lettingoffsteam]

Hi folks, As I've posted before I was diagnosed with extremely high blood pressure in March 2019 and immediately put on 10mg amlodipine and 5mg ramipril.Well I lost a lot of weight through diet changes and made some lifestyle adjustments and my medication has been reduced.For the last few months my bp has been very low, around 102/65 on 5mg of each drug so it was decided to drop my dose again.This coincided with my discharge from the cardiologist to GP care.My GP decided to reduce ramipril to 2.5mg as 5mg is as low as it goes for amlodipine.Then the cardiologist wrote and said just quit the amlodipine.But we had already started 2.5mg so kept it up.Well no change to my bp...still low.Today the GP said try 1.25mg ramipril with the amlodipine.My problem is I have left ventricular hypertrophy or a thickened left side of my heart and the ramipril is meant to help keep that down or even reduce it.Is that dose high enough? Now I know that no one can give medical advice but who out there is on 1.25mg ramipril and what for?

[MichaelJH Heart Star]

Amlodipine is a CCI (calcium channel inhibitor). There are a number of other CCI's available. Whilst Amlodipine gave me oedema Diltiazem (another CCI) did not. I don't know the dosages available for the various CCI's so am unsure of possible alternatives. Maybe chat with your pharmacist before your GP as they tend to be more up to speed.

[lettingoffsteam in reply to MichaelJH]

Thanks Michael.

[Thecyclist]

Hi, well done you! Congratulations on getting it down on your own, you must be really pleased!

I am still in the losing weight phase, I did put on a few kilo's during lockdown but I have been conscientiously losing weight since May, and have dropped the pre lockdown weight now, still another 10 kg (stone and half) to go though until I am at my ideal wight. Your success does give me the motivation to keep going as it clearly makes a difference!

On the subject of the LVH and Ramipril, I would say that by the very nature of you now having "normal" BP will mean your heart is not having to work as hard and therefore you are not working the muscle so hard, which should I assume lead to a reduction in the thickening? Only way to tell would be to have another Echo done.

I think as long as you are in normal BP ranges you are doing your best and any meds will help as long as they keep BP normal. I don't think the meds in themselves stop the thickening, its them working as they should and allowing your heart and system to not work as hard that would reduce the LVH.

As always though best speak to the Doctor.

Keep up the great work though, and congratulations again!

[lettingoffsteam in reply to Thecyclist]

Good to hear from you and well done on the weight loss.What you say makes a lot of sense so perhaps I'm overthinking it.Will keep you updated.👍