MPN Voice
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Ace inhibitors and Hydroxy

Does anyone have experience of using ACE inhibitors alongside hydroxycarbamide and low dose aspirin? I have been taking Amlodipine to control blood pressure but it is losing its effectiveness and even doubling the dose doesn't stop the increase. I have been told that ACE inhibitors may be a better solution, but before I approach my GP I would appreciate any experience you may have with ACE inhibitors.

Many thanks

John (ET & JAK2)

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Hi John, I have ET JAK 2posative and on Hydroxycarbamide, EC Asprin, Thyroxin, and ACE inhib Zetril lisinopril 5mg, have taken for many years with no problem other that a slight cough, which most of the ACE inhibitators can give you, not everybody gets the cough, my twin sister takes the Same drug and does not have a cough, but they are an amazing drug keeps my blood pressure well regulated, so I put up with the cough as it is not there all the time.

They are a well tolerated blood pressure tablet used by many people.

Jean

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Thanks Jean. That's good to know

John

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I have PV and high blood pressure too. I'm on 5000mg Hydroxycarbamide weekly. I don't believe the PV and BP relate medically, however, as I'm JAK2+ve, the high blood pressure predated the PV by many years and is possibly an inherited condition compounded by work, family life and butter!

I started with daily Amlodipine 5mg (calcium channel blocker) and that rose quickly to 10mg. Neither brought my blood pressure down adequately and they were added to, first, by ACE inhibitor) Perindopril 2mg, then 4mg, again with little significant effect. After a while the diuretic Indapamide, 2.5mg, was added and Perindopril raised to 8mg. Not related directly but typically prescribed is a statin, Atorvastatin which I have at 20mg daily.

This is about as much BP control as I can take, apparently, but, from figures typically 155/105 I'm down to being consistently around 120/70. I've suffered no significant side effects other than the slightly annoying dry cough first thing in the morning.

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Thanks for the reply. In terms of causes I'm not doing too bad, I've given up work (retired), the kids have grown up and left home.......but I've still got some way to go to give up the butter! 😁

It looks like we all respond in different ways, so I will just have to suck it and see, but its good to know that there is no barrier to using ACE inhibitors with Hydroxycarbamide.

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When I went to the Living with MPNs event I made a note from one of the speakers that there were two main types of blood pressure tablets. Of these, it was my understanding that the speaker was saying that ACE inhibitors would be preferrable/advantageous for those with a MPN.

I was interested because I may need to start treatment for blood pressure myself, so I have not experience as yet!

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Thanks Bluetop. I was also at Living With MPNs but I completely missed that. That's good to know. My daughter, who is a doctor but not a hematologist, thought ACE inhibitors would be beneficial, but I wanted to check with the MPN community first. There is usually someone here who knows the answer 😊

John

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From my notes, it was Prof Barbui. He was talking about the reginaicin(Spelling?) system which, according to my notes, reduces the production of red cells. This reginaicin system is found in ACE inhibitors and therefore less hydroxycarbamide might be needed.

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That's great. Thank you very much. I must admit I sometimes had difficulty in following his accent and as he mentioned red blood cells I suspect his topic was PV, whereas I was focusing on ET.

Thanks again

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John, John here;

I take 4 different BP meds to keep mine under control. I have non-specific high blood pressure, runs in the family. I am on Lisinopril, Amlodipne, HCTZ, and spironolactone to keep it under control. My potassium levels are normal and I an on Hydroxyurea. JAK2 Positive.

Good luck!

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