Use of ACE for increased BP

Have egfr of 33 without urine protein or abnormal labs. BP borderline for about 6 months. Is an ACE Inhibitor safe for me to control my BP? I eat a plant based diet, no smoking or diabetes and have normal BMI. Any ideas?

[Bassetmommer NKF Ambassador]

Djguy,We are not able to say if a drug is good for you or not. This is a question you should ask your doctor about all medicines. It let's them know you are doing your homework, which you should by looking up you drugs on line or talking to a pharmacist.

[Hidden in reply to Bassetmommer]

Thanks!

[Skeptix]

Has your borderline BP been established via spot checks in surgery/home? I did a 24 ambulatory recently and dropped a good 10 points compared to my home checks ( taken on a good machine and averaged out over months ).

Be worth a few double checks before plunging for a medication.

You say borderline for 6 months? A bit more exercise or other non-pharma BP adjustment? ACE is, I gather, pretty benign for a pharma. But that's not saying very much if you take the view that steering clear of pharma is your best bet. I'm sure if you googled ACE you'd find a whole host of reasons not to start on it.

It wouldn't be unusual for ACE to raise your potassium, for instance. So something not yet out of spec (serum potassium) could become out of spec due to ACE and then what? More pharma to control that? And off on the merry pharma dance we go.

Run from pharma. Run fast! If you at all can

No protein at all? No microalbumia? Wierd maaan

(BTW, you have got an abnormal lab. Your creatinine must be elevated to have an eGFR of 33 :))

[Hidden in reply to Skeptix]

Thanks!

[RoxanneKidney in reply to Hidden]

Yeah, check your diet and workout first before popping a pill. I so agree.

[userotc in reply to Skeptix]

I agree with you and Roxanne to avoid meds, where possible. Hopefully mum's nephro will continue along that vein if her protein continues to rise and hits a particular figure eg 2g/24h nhs.uk/Livewell/Kidneyhealt.... He's previously disregarded ACE Inhibitors for BP reason only.

My own research indicates higher protein is more likely with a single kidney like mum eg niddk.nih.gov/health-inform...

[RoxanneKidney]

The ACE and ARB are supposed to have protective benefits for the heart as well as the kidneys. There are plenty of studies regarding this. If potassium is an issue then an directic can be prescribed with them. Probably should be anyway, if you are retaining any fluids...not good for the heart.

[Marvin8 in reply to RoxanneKidney]

ACEs and ARBs are iffy if your BP is normal and you're not leaking significant protein in your urine. My doctor wanted to prescribe the lowest dose ARB, but became wishy-washy after seeing no protein in my urine and normal blood pressure. If I was a med taker, I'd be on an ARB, but I don't like taking meds if I don't have to.

[Skeptix in reply to RoxanneKidney]

"The ACE and ARB are supposed to have protective benefits for the heart as well as the kidneys. There are plenty of studies regarding this. If potassium is an issue then an directic can be prescribed..."

There you go right there: Dr. Feelgood prescribing away like billy-o. There surely is a pill for every ill!

[RoxanneKidney in reply to Skeptix]

Haha. Ikr. But we gotta do what we gotta do.

[Hidden]

Thanks! That’s the odd thing. I have no edema anywhere and never had. Don’t really want to take a medication for BP. I have not ridden my bicycle in a few days owing to rainy weather. And my anxiety increases my BP each time I take it. I’m worried for nothing I believe.

[kellyscats1]

My son.. a type 1 diabetic with normal bp and seeing a good endocrinologist has him on low dose ARB to protect the kidneys. I am on ARB and titrate my medication to keep pb normal,,somedays i half it.. if get too low i skip.. depends on diet exercise and so many things.. I titrate all my meds.. works well for me anywayand Oh.. 6 months ago my EGFR was down to 36... today it was back to 46.. other labs good.... just follow practical diet... not ocd about it.. no salt or meat.. I love animals and do not eat them.. I love jelly beans and as i am not diabetic i can eat wit moderation.. do not drink coffee or soda and avoid high potassium foods but i am human and if i go out for good Mexican food i will partake with a clear conscience..and big smile

best of everything... stress is bad for the body..

Kelly

[Hidden in reply to kellyscats1]

Thanks!

[Partner20]

Just an outside-the-box non-pharma suggestion. Look up the Wim Hof breathing exercises for lowering BP. This worked like a dream for my partner who had just been told to go back on BP meds and really didn't want to. Worth a try, anyway!

[PecanSandie]

I took losartan-HCT (I believe it's an ARB) and I think it might have contributed to my kidney problems. My egfr went down to 33. In general losartan is supposed to help the kidneys but there have been studies that show that this isn't always the case. I discussed this with my doctor and she took me off losartan and put me back on metoprolol. Since I switched my egfr has crawled up to 38, but I cannot say for sure it had anything to do with the change in meds since I had other med changes during this time period (such as adding calcitriol and furosemide).

[Ziggydoodah in reply to PecanSandie]

I was on Losartan. It caused me really bad joint pain, to the point I could hardly walk. My gfr was 48 and had been stable for almost a year and I was on 25mg. My consultant was on holiday and his assistant put me on 75. One month later my gfr had plunged to 33. He swiftly reduced it. I no longer take Losartan. My hair was also shedding badly. Not a fan of this medication.

[sparkie88]

Check with your Dr you have to check your labs. ACE may help to protect your kidneys if you have diabetes but may have uncomfortable side effects if your potassium is high it is not recommended but if you have high BP it may not help to reduce without another drug or a diuretic.

[Tolmezzo]

Im not a doctor and you must speak your doctor before taking any drugs. However I can confirm ACE inibitors are one of most commonly used drugs in renal desease. Side effects could be creatinine and potassium moderate increase hugely compensated by reno protection effects.

[whats]

My GFR went from 23 to 45 when my doc cut my ARB inhibitor in half and took me off a diuretic. I just looked up ARB/ACE inhibitors and understand better why. Still Science says they are "reno-protective" overall, in terms of long-term benefit.

[whats]

...And the GFR dip reverses easily (just want to add)

[Sophiebun11]

Have you tried any alternative things to lower BP like yoga? The Amer. Heart Assoc. recommends it for lowering BP. You can check on the PubMed website. Good luck.

[kellyscats1]

Often the losartan is combined with hydrochlorothiazide when.. and that can be hard on the kidney s it is a diuretic.. i personally keep em separate and only take the diuretic if i have a little ankle swelling once a month or so,,,