Re: Decrease in Blood Pressure for airlinerg after increasing Inspra dose 50%

[Guest guest]

I would consider only increasing by 25% as gaol BP at home is <135/85 and u u were close. Discuss with team stepping done amlodipine as well. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 21, 2012, at 1:29, airlinerg <airlinerg@...> wrote:

Subject: Decrease in Blood Pressure for airlinerg after increasing Inspra dose 50% Diagnosis: Hyperaldosteronism, Metabolic Syndrome, Obesity, Sleep Apnea

I made an error by averaging all my blood pressure readings for the last 3 weeks from May 30, 2012 when I had increased Inspra 50% to June 20, 2012 instead of averaging my blood pressure readings from the last few days

June 17, 2012 to June 20, 2012 after having been on Inspra for 3 weeks in order to compare my starting blood pressure to my current blood pressure. There has been a drop in blood pressure in the last 3 weeks since I increased my Inspra dose by 50%.Note: I have also taken 5 mg of Norvasc (amlodipine) for a long time, and I did not change this.

After 3 weeks of increasing Inspra 50% from 100 mg twice a day (total of 200 mg) to 150 mg twice a day (total of 300 mg,) my blood pressure

has decreased from 140/90 to 127/85 if you just take the readings from

the last few days from June 18, 2012 to June 20, 2012. That is a decrease of 9% on the systolic pressure and 5 1/2% on the diastolic pressure.

Also, after 3 weeks of increasing Inspra 50% my Renin has increased from

0.29 to 0.47 with Aldosterone steady at about 91. Therefore my ratio of Aldosterone divided by Renin has decreased from 313 to 194 which is a

119 point drop.

CONCLUSION:

I will continue the higher dose of Inspra for another 3 weeks to see if my blood pressure readings at the larger dose of Inspra are consistent over the next 3 weeks or there is a

change.

SUMMARY OF TEST RESULTS:

Here are some readings:

6/6/08 Aldosterone 35 Renin 0.1 (Ratio of Aldosterone divided by Renin (A/R) = 350)

4/2/12 Aldosterone 93 Renin 0.29 with Inspra at previous dose (Ratio (A/R) = 313)

6/14/12 Aldosterone 89 Renin 0.47 with Inspra at 50% higher dose started 5/30/12 (Ratio (A/R) = 194)

Blood Pressure May 30, 2012 140/90 began Inspra at 50% higher dose

Blood Pressure June 20, 2012 127/85 after 3 weeks of Inspra at 50% higher dose

SIGNIFICANT MEDICATION CHANGE:

On June 8, 2012 I began injecting Victoza in an attempt to achieve weight loss since my BMI is 31 at 191 pounds. My BMI would be 25 at 155 pounds. Unfortunately at 1.2 mg I had intolerable side effects of sulfur

burping and diarrhea. I will try to restart Victoza at 0.6.

QUESTION:

Is the decrease in Aldosterone to Renin ratio and decrease in blood pressure significant? Do you have any recommendations?I would like your feedback on this matter since decreasing my weight and blood pressure has been a concern.

[Guest guest]

Dr. Grim:So 25% increase would be 125 in the AM and 125 in the PM = 250 mg per day instead of 150 AM and 150 PM = 300 mg per day.What dose of Norvasc do you recommend decreasing to? I am currently on 5 mg in the PM (which is the minimum tablet.)Why should my blood pressure goal be <135/85 instead of 120/80?At 100 mg Inspra in the AM and 100 mg Inspra in the PM = 200 mg, my blood pressure was 140/90.Please reply.> > > Subject: Decrease in Blood Pressure for airlinerg after increasing Inspra dose 50% > > > > Diagnosis: Hyperaldosteronism, Metabolic Syndrome, Obesity, Sleep Apnea> > > > I made an error by averaging all my blood pressure readings for the last 3 weeks from May 30, 2012 when I had increased Inspra 50% to June 20, 2012 instead of averaging my blood pressure readings from the last few days June 17, 2012 to June 20, 2012 after having been on Inspra for 3 weeks in order to compare my starting blood pressure to my current blood pressure. There has been a drop in blood pressure in the last 3 weeks since I increased my Inspra dose by 50%.> > > > Note: I have also taken 5 mg of Norvasc (amlodipine) for a long time, and I did not change this.> > > > After 3 weeks of increasing Inspra 50% from 100 mg twice a day (total of 200 mg) to 150 mg twice a day (total of 300 mg,) my blood pressure has decreased from 140/90 to 127/85 if you just take the readings from the last few days from June 18, 2012 to June 20, 2012. That is a decrease of 9% on the systolic pressure and 5 1/2% on the diastolic pressure. > > > > Also, after 3 weeks of increasing Inspra 50% my Renin has increased from 0.29 to 0.47 with Aldosterone steady at about 91. Therefore my ratio of Aldosterone divided by Renin has decreased from 313 to 194 which is a 119 point drop.> > > > CONCLUSION:> > > > I will continue the higher dose of Inspra for another 3 weeks to see if my blood pressure readings at the larger dose of Inspra are consistent over the next 3 weeks or there is a change. > > > > SUMMARY OF TEST RESULTS:> > > > Here are some readings:> > > > 6/6/08 Aldosterone 35 Renin 0.1 (Ratio of Aldosterone divided by Renin (A/R) = 350)> > > > 4/2/12 Aldosterone 93 Renin 0.29 with Inspra at previous dose (Ratio (A/R) = 313)> > > > 6/14/12 Aldosterone 89 Renin 0.47 with Inspra at 50% higher dose started 5/30/12 (Ratio (A/R) = 194)> > > > Blood Pressure May 30, 2012 140/90 began Inspra at 50% higher dose> > > > Blood Pressure June 20, 2012 127/85 after 3 weeks of Inspra at 50% higher dose> > > > SIGNIFICANT MEDICATION CHANGE:> > > > On June 8, 2012 I began injecting Victoza in an attempt to achieve weight loss since my BMI is 31 at 191 pounds. My BMI would be 25 at 155 pounds. Unfortunately at 1.2 mg I had intolerable side effects of sulfur burping and diarrhea. I will try to restart Victoza at 0.6.> > > > QUESTION: > > > > Is the decrease in Aldosterone to Renin ratio and decrease in blood pressure significant? > > > > Do you have any recommendations?> > > > I would like your feedback on this matter since decreasing my weight and blood pressure has been a concern. > > > > > >>