150mg Losartan?

[Outforawalk]

After having a heart attack back at the start of March, I haven’t had much in the way of follow up but recently had a call from the Cardiology Pharmacologist.

My GP switched me from 10mg of Ramipril a week after leaving hospital due to an allergic reaction, Covid was just kicking off so I was switched to a trouble free 25mg of Losaratan.

The CP said that was “virtually a placebo” and asked me to double it three weeks ago then increase to 75mg and have my kidney function checked. All is fine.

I spoke to him again today and he now wants me to increase by 25mg a week until I am taking 150mg following which he’ll check kidney function again. His reasoning was to give me the best prognosis by giving me this maximum dose to aid full recovery of my heart muscle given my age (42). I am wary of such a high dose, just wondering whether anyone else has had similar advice or experience.

[MichaelJH Heart Star]

Whilst 10mg is the maximum dose for Ramapril, Losartan has wo maxima. These are 100mg for treating hypertension and 150mg for heart failure. As people approach the maximum dose of a blood pressure medication multiple therapies are usually considered. As you mention your heart muscle I wonder if you have a degree of heart failure. If you have not been told this you should give the Cardiology Pharmacologist a call to clarify.

[Outforawalk in reply to MichaelJH]

Thanks Michael, heart failure has never been mentioned either by discharge letter, rehab team, pharmacologist or GP but certainly worth checking.

Both the GP and pharmacologist have mentioned Losartan conditioning the heart muscle during recovery.

BP is also fine, has been steady at 120/70 even on low dose losartan and has come down further as losartan dose increases, as has my restivn heart rate. Pharmacologist wants to reduce bisoprolol as losartan dose increases.

[Shandiom]

Hi,

I too had a heart attack at 40 in August completely out of the blue and it is overwhelming the amount of medication that is given to you. I developed a cough with the ramipril so a couple of weeks ago was put on candesartan (2mg).

Personally I really don’t like the idea of having to take high doses of medication for the rest of my life but on the other hand if they explain why it’s needed (and that particular high dose) at least that can put your mind at ease.

If you are concerned in any way I would just call to ask.

Donna 😃

[Petosmum]

I had a heart attack in January at the ago of 46. I recently moved and have had excellent care since moving, I was basically ignored in my previous area. My cardiac nurse explained that they try and get the dose as high as possible to give the heart maximum protection. I've got some dead heart muscle so she said it's extremely important in my case, couldn't be that? I don't think age is an issue as that was barely mentioned when I saw her last.

[Outforawalk in reply to Petosmum]

Thank you yes that sounds very similar, the scans I had before I left hospital showed some scarring although at that stage nobody could tell me how much it would or wouldn’t affect me.

[Petosmum in reply to Outforawalk]

I'll be honest, it hasn't affected me at all. Well, physically at least, mentally is another issue altogether although I'm getting such great care now, even that is improving.

[Outforawalk in reply to Petosmum]

Very similar here, physically wary but fine. Changing meds when everything has been ok gives me a little cause for concern. Exercising, working etc all normal. Mentally 🤯 but try to keep it positive.

[Petosmum]

I was told I was lucky to survive so am doing my best to live a full life now. That also involved moving home a little bit under 300 miles north of where I was living lol. It's been worth it though, I love where I am and can't imagine living anywhere else.