BP meds - calcium Vs ARBs

[Transalp]

So my typical 140/85 (over the past several years) popped up to 165/96 this year between June and July and stayed there.

GP has said age-related artery hardening (to be honest I would have assumed a more gradual increase if age related, but I digress), and put me on Amlodipine calcium blocker.

I was on the 5mg for a month and am now on the 10mg and back down to 143/91 average.

I listened to the Peter Attia podcast the other day and he said they use ARBs as their first line of defence rather than calcium blockers, especially for patients with kidney issues - my eGFR has been in the 50's & 60's for a few years now.

Anyone have any thoughts on whether I should be pushing to go on ARBs and if so, which one? I assume the Dr when I can see him (he is deigning to call me in three weeks time) will want to add something else to get the BP lower than the current 143/91.

TIA

[Happyrosie]

you might find it useful to look at what NICE (National Institute for Clinical Evidence) says about diagnosis and treatment of hypertension.

you’ve used quite a few abbreviations so it’s a bit hard to follow your thought processes without re-reading and re-reading your post.

In advance of you seeing your GP, try and see if you can discuss your medication with the pharmacist employed at your doctor’s group of surgeries (I access mine through the receptionist but different surgeries might have different ways). The pharmacist has access to your records and can help the GP make decisions. Failing that your dispensing pharmacist might be able to give you a lead.

[Transalp in reply to Happyrosie]

I’ve only used ARBs as an abbreviation? I assumed it was standard nomenclature for that type of medicine - Angiotensin II receptor blockers (ARBs)

[Happyrosie in reply to Transalp]

EGFR?

[Transalp in reply to Happyrosie]

If you don’t know what that is I can’t really help you.

Thanks for the NICE suggestion.

[Stainlessstevie in reply to Happyrosie]

I had to look eGFR up as well.

[Happyrosie in reply to Stainlessstevie]

The point I was trying to make is, where there are several abbreviations (plus a reference to someone I’ve never heard of) makes it harder to read therefore people are less likely to respond.

[Eviedog12]

Hi there, I'm on Losartan which is an ARB. It's meant to be kinder to those with CKD, yes another abbreviation, chronic kidney disease. My egfr is between 50 and 60 too. It's the rate kidneys filtrate blood to cleanse it from toxins, for those who are not aware. Losartan controls my BP very well as I had other issues with BP meds. If you're concerned, ask your GP if it's better to have an ARB.

Good luck

[PecanSandie]

It has been my experience that the only acceptable BP for my doctors is 120/80 (or less) and they kept adding drugs until I managed to achieve that. I take Metoprolol, Valsartan, Furosemide and Amlodipine and my BP is, for the most part, controlled even when at the doctor's office. Luckily my Stage 3 kidney function has remained relatively stable even with all those drugs.

[Cats4]

I developed high blood pressure in May due to Acute Kidney Injury and was prescribed Amlopidine rising from 5 mg to 10 mg whilst in hospital. My eGFR has recovered from 6 to within normal range of 65. My Renal consultant has written to my gp requesting a bp check as he wants my bp to be no higher than 130/80 and has advised that if my readings are above this rate to prescribe me with Ace Inhibitor or angiotensin inhibitor. I have to see my gp this week.

[Transalp in reply to Cats4]

My partner (sports trainer and health nut) follows Peter Attia who is a US doctor focused on longevity etc and he seemed to point to ARBs (angiotensin) being the best drug to kick off with.

Good luck with GP visit.

Nice to see the eGFR back up north of 60, mine kicks around the 55-65 although the newer 2021 eGFR calculation does seem to make things look better than the older versions. I did do a test with cystatin-c (alongside creatinine for the eGFR calculation) which reduced the number considerably.

[Cats4 in reply to Transalp]

Thanks 🙏