This is not a PUMP question exactly...but diabetes realted.

I was in to see my GP yesterday and my BP always rises when I go to the Dr (white coat symdrom). Here I sit at home, BP is 106/78. Yesterday afternoon at the Dr it was 135/88. Go figure.

Because of that, my dr wanted to add another BP med for me. I already take Altace, and she added Coversyl. Seems strange to me that she now has me on 2 ACE inhibitors!? Seems like a duplication to me!? Anyone else on 2 different ACE inhibitors as medication therapy??

Not exactly on two ACE inhibitors.  But, my doctor does have me on Vasotec (ACE inhibitor) twice daily plus Norvasc (Calcium Channel Blocker).

Aaron

I can see through literature it is common to combine an ACE inhibitor and an ARB...

My doseage is small, so the 30 days will not harm me to be on two ACE inhibitors --> I will go with it, and double check on the follow up appointment.

Do you have albuminuria or have you had it at all in the past? I've often seen Perindopril (conversyl) prescribed as a preventative against diabetic nephropathy...

I had protein last year with one 24hr collection - and started altace right away. Since then, no protein, but the Canadian guidelines want the diastolic BP value under 70 (that is agressive!!!) and mine is mid 70's - so my nephrologist wanted another BP type med to help stop the progression - knowing it is in the very very early stages with no current protein present.

Research shows it is used preventatively, my pharmasist was surprised to see me on two BP meds - but I told her why I was taking them, and they are not for BP as much as for prevention of nephropathy.

Interesting tho...I appreciate the responses!

Wow, I've been taking Altace for the past 4 or 5 years for the same white coat problem you mentioned. I was "normal" at home, at school, everywhere else. Doc said it was good preventative anyways, so it's still prescribed. Is that why you all take it?

Yes that is exactly why I am on it....they all figured with a slight BP rise (they want mine below 110 / 70) and for the preventative side.....I track mine at home, and it is always 10 - 15 points higher at the office! White Coat Symdrome...

Wow,

I've been on AVAPRO? for a few months now. Haven't really seen much change in BP. I didn't know it should be that low???

Also, does anyone take Statins? What have you found that is the most gentle? It seems like Zocor and Prevachol make me Nauseated....in the morning.



Jake

I know my doc, back then, mentioned he wanted my BP even below what is considered normal. So he prescribed the altace mainly out of concern for the more delicate vessels in the eyes and kidneys.

Jacob, I am also taking Lovastatin for a slightly elevated cholesterol, that I got only one time. Always been in normal range except when I happened to be on the Atkins diet and one of the cholesterols, forget which, was slightly elevated. Been taking it ever since, again for preventative measures as I was told. I don't feel any side effects at all, almost like taking a daily vitamin.

Is your medication treating very elevated cholesterol levels?

Jake,
I think the recommendation for diabetics in the US is 120 / 80. I am taking 10 mg of Altace for BOTH preventative measures against complications and to keep my BP within range.

I also take Lipitor. Do you take your statin after dinner? That was the suggestion from my doctor. Maybe on a full stomach it would not make you nauseated.

I was back to the Dr today - brought up my concern about the secone ACE inhibitor I was put on last month.

Sure enough, I was right. I was supossed to have been started on an ARB, but it was a miscommunication between the nephrologist and my GP. SO today, I started Avapol which is an ARB, and the second ACE inhibitor is gone off my list. I am looking avapol up on the web, and already it shows beneficial for kidney protection for people with diabetes.

Interesting.....