Re: Should I add Midamor and/or Cozaar to Inspra? (Blood Test Results)

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Blood Test Results:August 29, 2005:Aldosterone, serum 22 ng/dl ( REFERENCE Adults: Supine 3-16 Upright 7-30)Renin, Pra 0.2 ng/ml/hr (REFERENCE Renin Activity: Adult Normal sodium diet: Supine 0.2-1.6 ng/ml/hr Upright 0.5-4.0 ng/ml/hr) Sodium 137 mmol/LPotassium 4.2 mmol/LChloride 103 mmol/LMay 24, 2005:Aldosterone, serum 23 ng/dlRenin, Pra 0.1 ng/ml/hrSodium 135 mmol/LPotassium 3.9 mmol/LChloride 101 mmol/L >> > > > Dear Dr. Grim and others,> > > > My blood pressure is still running 140/90 to 160/100.> > In the morning I take:> > 50 mg. Inspra> > In the evening I take:> > 50 mg. Inspra> 1 mg. Cardura> 10 mg. Lipitor> 30 mg. Cymbalta> 5 mg. Celexa> > > The manufacturer of Inspra does not recommend taking more than 100 mg. of Inspra per day. I tried Aldactone previously, but it gave me gynocomastia.> > I also take Ambien 5 mg. to sleep, and 100 mg. Provigil to stay awake as needed.> > I still use the CPAP machine every night I sleep at 7 cm pressure. Strangely, the more hours of sleep I get at night, the higher my blood pressure is the next day.> > I have lost 5 pounds and now weigh 185 and I am 5'6" so I am still 40 pounds overweight. I have possible hyperaldosteronism, definite low renin, and hyperplasia. I try to maintain a low salt diet as much as possible.> > > ___________> > Questions:> ___________> > > 1. Should I add 5 mg. Midamor to the Inspra in the morning?> > 2. Should I add 100 mg. of Cozaar?> > 3. If I do add Midamor to the Inspra, I will have to have my blood monitored because they are both potassium sparing and could make me hyperalkemic. Is this appropriate?> > 4. How often should I have my potassium checked in my blood?> > 5. Do I need any other blood tests besides to be checked for electrolytes?> > 6. Any other suggestions?>