Decrease in Blood Pressure after increase Inspra dose 50% from 200 mg to 300 mg

[Guest guest]

Subject: Decrease in Blood Pressure after increasing Inspra dose 50% from 200 mg to 300 mgDiagnosis: Hyperaldosteronism, Metabolic Syndrome, Obesity, Sleep ApneaI 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. I am also using the DASH diet, and I walk 1/2 hour uphill and 1/2 hour downhill 5 times a week. 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 doseBlood Pressure June 20, 2012 127/85 after 3 weeks of Inspra at 50% higher doseSIGNIFICANT 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]

Your renin going up is irrelevant because you are on inspra. I don't know if you have gotten your renin up high enough to allow the Norvasc to have a slight impact. You are on a huge dose of inspra from what I read. Although it has not been tested and approved I looked at the guidelines for HTN and the max is 100mg. ( http://www.drugs.com/dosage/eplerenone.html )

When NIH started me on Epler they told me to start at 25mg bid and if BP wasn't at goal in a week to check K and see if it was below 4.5. It was around 132/70ish so we didn't get any further but I think they were going to raise it SLOWLY or add another med if it wasn't okay. I would be worried about your potassium level. My guess is you are getting minimal effect from your Inspra and this is often because sodium level is too high. I would think urine test would be in order.

Are you being treated for OSA? Do you have diabetes, what is your glucose or preferrably HbA1C numbers? (If you get PA under control you may see glucose jump up (mine went up a whole point when I got it right w/spironolactone.)

My BP this morning was 128/67 HR 68. Eplerenone 25mg bid and I am still on the meds NIH was trying to manage with pre-MCB. (Verapamil 240 mg bid and Terazosin 5mg bid) I have not tried to titrate down those two because we are still investigating an ADx and I don't want to be ruled out due to BP.

>> Subject: Decrease in Blood Pressure after increasing Inspra dose 50%> from 200 mg to 300 mg> > 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. I am also using the DASH diet, and I walk 1/2> hour uphill and 1/2 hour downhill 5 times a week.> > 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]

What is Victorza?On Jun 21, 2012, at 1:33 AM, airlinerg wrote: Subject: Decrease in Blood Pressure after increasing Inspra dose 50% from 200 mg to 300 mgDiagnosis: Hyperaldosteronism, Metabolic Syndrome, Obesity, Sleep ApneaI 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. I am also using the DASH diet, and I walk 1/2 hour uphill and 1/2 hour downhill 5 times a week. 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 doseBlood Pressure June 20, 2012 127/85 after 3 weeks of Inspra at 50% higher doseSIGNIFICANT 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]

from drugs.com

Victoza is a diabetes medicine that helps control blood sugar levels. It works

by increasing the amount of insulin that your body produces.

Victoza is used to treat type 2 diabetes. This medication is not for treating

type 1 diabetes.

Victoza may also be used for other purposes not listed in this medication guide.

>

> > Subject: Decrease in Blood Pressure after increasing Inspra dose 50%

> > from 200 mg to 300 mg

> >

> > 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. I am also using the DASH diet, and

> > I walk 1/2 hour uphill and 1/2 hour downhill 5 times a week.

> >

> > 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]

not clear on rational for "don't want to be ruled out due to BP". Yet. So if you do very well on E and DASH. If BP and K and DM and you feel well at goal then why surgery?CE Grim MDOn Jun 21, 2012, at 10:30 AM, wrote: Your renin going up is irrelevant because you are on inspra. I don't know if you have gotten your renin up high enough to allow the Norvasc to have a slight impact. You are on a huge dose of inspra from what I read. Although it has not been tested and approved I looked at the guidelines for HTN and the max is 100mg. ( http://www.drugs.com/dosage/eplerenone.html )When NIH started me on Epler they told me to start at 25mg bid and if BP wasn't at goal in a week to check K and see if it was below 4.5. It was around 132/70ish so we didn't get any further but I think they were going to raise it SLOWLY or add another med if it wasn't okay. I would be worried about your potassium level. My guess is you are getting minimal effect from your Inspra and this is often because sodium level is too high. I would think urine test would be in order.Are you being treated for OSA? Do you have diabetes, what is your glucose or preferrably HbA1C numbers? (If you get PA under control you may see glucose jump up (mine went up a whole point when I got it right w/spironolactone.)My BP this morning was 128/67 HR 68. Eplerenone 25mg bid and I am still on the meds NIH was trying to manage with pre-MCB. (Verapamil 240 mg bid and Terazosin 5mg bid) I have not tried to titrate down those two because we are still investigating an ADx and I don't want to be ruled out due to BP.>> Subject: Decrease in Blood Pressure after increasing Inspra dose 50%> from 200 mg to 300 mg> > 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. I am also using the DASH diet, and I walk 1/2> hour uphill and 1/2 hour downhill 5 times a week.> > 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]

Before a surgeon operates they prefer BP be as controlled as possible the way I

understand it!

Why Surgery: I have a right adrenal gland that has been confirmed to be

overproducing Aldosterone and Cortisol thereby being Dxed with Primary

Aldosteronism masking Subclinical Cushing's. The current regiment of medicines

is controlling my BP and T2DM very well. I still have MDD, Flank and Testis

pain, low Testosterone and Metabolic Syndrome. Although meds. are offered as a

second choice for treating a Unilateral Adenoma, I am not convinced it is the

best - there has to be a reason all doctors but one recommend surgery first.

Let me look at my issues:

Flank & Testis Pain - May resolve over time, at least it did after 10 months on

Spironolactone.

Low Testosterone - We are unsure of the cause at this time and treating with T

patches. I suspect the Spironolactone since body hair is starting to grow

back but they say it takes at least 3 months to see real results. (Hopefully it

won't be like the boobs, I understand they are mine forever unless I go under

the knife!)

Metabolic Syndrome - an advertised effect of excess Cortisol.

MDD - I saw a Physicists on Monday and he was very impressed with my knowledge

of what excess Cortisol might be doing " North of the Neck " ! As Barb Tatro

explained here a few months ago, if you never hit the " relaxation response " you

remain in a chronic state of stress (chronically high Cortisol levels). He has

referred me to a specialist from Dartmouth who has done a lot in this area. He

has also encouraged me to continue working with the Therapists I have been

working with who does a lot with cognitive processing.

Cortisol and Alzheimer - I have recently found some studies regarding this

subject. My Dad died from complications from Alzheimer and I will do everything

I can to not follow in those footsteps! Here are a couple studies on this

subject:

http://www.ncbi.nlm.nih.gov/pubmed/18801622

Subclinical Cushing's syndrome is a potential cause of metabolic dementia and

rapidly progressive Alzheimer-type dementia.

Plasma cortisol and progression of dementia in subjects with Alzheimer-type

dementia

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1780275/pdf/nihms10895.pdf

So the short answer is I will take the risk of surgery over the risk of being in

wheel chair from complications of DM with Alzheimer! (I've always believed in

" fixing something " if I can instead of " circumventing " it!)

> > >

> > > Subject: Decrease in Blood Pressure after increasing Inspra dose 50%

> > > from 200 mg to 300 mg

> > >

> > > 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. I am also using the DASH diet, and I

> > walk 1/2

> > > hour uphill and 1/2 hour downhill 5 times a week.

> > >

> > > 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]

OK I thought you were stating that surgery would not be considered if BP and you were doing well. Both refs of interest: Comments.First paper is a hypothesis paper.Second only uses 8 am cortisol to Dx SCC. NIH would not approve today I think. I know this group well and would look for more recent data or write them for more recent data. I would worry as well about keeping BP and DM under control as it is a better correlate of dementia esp of the vascular type hard to separate from AZ.AKA DASHing.CE Grim MDOn Jun 22, 2012, at 11:10 AM, wrote: Before a surgeon operates they prefer BP be as controlled as possible the way I understand it! Why Surgery: I have a right adrenal gland that has been confirmed to be overproducing Aldosterone and Cortisol thereby being Dxed with Primary Aldosteronism masking Subclinical Cushing's. The current regiment of medicines is controlling my BP and T2DM very well. I still have MDD, Flank and Testis pain, low Testosterone and Metabolic Syndrome. Although meds. are offered as a second choice for treating a Unilateral Adenoma, I am not convinced it is the best - there has to be a reason all doctors but one recommend surgery first. Let me look at my issues: Flank & Testis Pain - May resolve over time, at least it did after 10 months on Spironolactone. Low Testosterone - We are unsure of the cause at this time and treating with T patches. I suspect the Spironolactone since body hair is starting to grow back but they say it takes at least 3 months to see real results. (Hopefully it won't be like the boobs, I understand they are mine forever unless I go under the knife!) Metabolic Syndrome - an advertised effect of excess Cortisol. MDD - I saw a Physicists on Monday and he was very impressed with my knowledge of what excess Cortisol might be doing "North of the Neck"! As Barb Tatro explained here a few months ago, if you never hit the "relaxation response" you remain in a chronic state of stress (chronically high Cortisol levels). He has referred me to a specialist from Dartmouth who has done a lot in this area. He has also encouraged me to continue working with the Therapists I have been working with who does a lot with cognitive processing. Cortisol and Alzheimer - I have recently found some studies regarding this subject. My Dad died from complications from Alzheimer and I will do everything I can to not follow in those footsteps! Here are a couple studies on this subject: http://www.ncbi.nlm.nih.gov/pubmed/18801622 Subclinical Cushing's syndrome is a potential cause of metabolic dementia and rapidly progressive Alzheimer-type dementia. Plasma cortisol and progression of dementia in subjects with Alzheimer-type dementia http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1780275/pdf/nihms10895.pdf So the short answer is I will take the risk of surgery over the risk of being in wheel chair from complications of DM with Alzheimer! (I've always believed in "fixing something" if I can instead of "circumventing" it!) > > > > > > Subject: Decrease in Blood Pressure after increasing Inspra dose 50% > > > from 200 mg to 300 mg > > > > > > 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. I am also using the DASH diet, and I > > walk 1/2 > > > hour uphill and 1/2 hour downhill 5 times a week. > > > > > > 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]

,

That's just great...thanks for posting the articles, but it didn't make my day!

My Mom died of Picks disease; a horrific form of frontal lobe dementia at 69

after 3 MI's that did not kill her. I just got cardiac genetic marker studies

back and have her gene for early MI's.

> > > > >

> > > > > Subject: Decrease in Blood Pressure after increasing Inspra

> > dose 50%

> > > > > from 200 mg to 300 mg

> > > > >

> > > > > 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. I am also using the DASH diet, and I

> > > > walk 1/2

> > > > > hour uphill and 1/2 hour downhill 5 times a week.

> > > > >

> > > > > 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]

Maggs, Then I suggest you, "Dance like no one is watching, love like you have never been hurt, sing like no one can hear you, and live like heaven is on earth"~Souza

Hopefully some of the work on the horizon will prove positive and they will come up with a less invasive way to treat. You are certainally in a good place to be keeping track of it and I would think Dr. Stratakis etal are in the best position to be aware of any emerging solutions! I'm just thankful I have a good idea what is going on so I can treat accordingly! The BEST $350 I ever spent ! (And the food and company was good too!)

.....

> > > > > >> > > > > > Subject: Decrease in Blood Pressure after increasing Inspra > > > dose 50%> > > > > > from 200 mg to 300 mg> > > > > >> > > > > > 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. I am also using the DASH diet, and I> > > > > walk 1/2> > > > > > hour uphill and 1/2 hour downhill 5 times a week.> > > > > >> > > > > > 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]

I am somewhat limited as to what I can see but I figure " where there's smoke

there's fire! " in the first reference. If they are watching it so am I and I

expect my doctors to be watching also!

Please note the second was looking at CS and not SCS so the 8am test would be

valid. I figured cortisol was cortisol and they probably didn't use SCS PTNs

because it's hard to id and often fluctuates as I understand it.

Understand I am early in my research, I will probably find other references!

Question, Who's malpractice insurance could afford to refuse to remove a tumor

when all the major studies recommend it and the PTN requests it? :>)

> > > > >

> > > > > Subject: Decrease in Blood Pressure after increasing Inspra

> > dose 50%

> > > > > from 200 mg to 300 mg

> > > > >

> > > > > 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. I am also using the DASH diet, and I

> > > > walk 1/2

> > > > > hour uphill and 1/2 hour downhill 5 times a week.

> > > > >

> > > > > 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]

VA for one as there is no malpractice insurance or do they need it. Government

has a lot of money.

> > > > > >

> > > > > > Subject: Decrease in Blood Pressure after increasing Inspra

> > > dose 50%

> > > > > > from 200 mg to 300 mg

> > > > > >

> > > > > > 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. I am also using the DASH diet, and I

> > > > > walk 1/2

> > > > > > hour uphill and 1/2 hour downhill 5 times a week.

> > > > > >

> > > > > > 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]

No controlled trials to support surgery vs medical management. Sorely needed with so much benign found by others. I have always found a lot. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 22, 2012, at 17:47, Francis Bill SUSPECTED PA <georgewbill@...> wrote:

VA for one as there is no malpractice insurance or do they need it. Government has a lot of money.

> > > > > >

> > > > > > Subject: Decrease in Blood Pressure after increasing Inspra

> > > dose 50%

> > > > > > from 200 mg to 300 mg

> > > > > >

> > > > > > 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. I am also using the DASH diet, and I

> > > > > walk 1/2

> > > > > > hour uphill and 1/2 hour downhill 5 times a week.

> > > > > >

> > > > > > 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.

> > > > > >

> > > > >

> > > > >

> > > > >

> > > >

> > >

> > >

> >

>

Reply to sender |

Reply to group |

[Guest guest]

Drs. Gordon, Stowasser, etal felt it was important enough to look at!

http://www.ncbi.nlm.nih.gov/pubmed/21778218 - Treated medically

Conclusion: Subnormal QOL scores were improved after 6 months of MT in 21 patients with BPA, but more slowly and to a lesser degree than surgical treatment had previously been shown to improve QOL scores in 22 patients with UPA.

http://www.ncbi.nlm.nih.gov/pubmed/20089615 - treated ADx

Conclusion: Unilateral adrenalectomy had positive impacts not only on blood pressure and biochemical parameters, but also on QOL, which was impaired preoperatively but significantly improved by 3 months postoperatively.

> > > > > > > >> > > > > > > > Subject: Decrease in Blood Pressure after increasing Inspra > > > > > dose 50%> > > > > > > > from 200 mg to 300 mg> > > > > > > >> > > > > > > > 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. I am also using the DASH diet, and I> > > > > > > walk 1/2> > > > > > > > hour uphill and 1/2 hour downhill 5 times a week.> > > > > > > >> > > > > > > > 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.> > > > > > > >> > > > > > >> > > > > > >> > > > > > >> > > > > >> > > > >> > > > >> > > >> > >> > > > > > Reply to sender | Reply to group |>

[Guest guest]

Mention of DASH? Really improves QO as well? Suspect not as this group has never mentioned low sodium diet in RX of PA. I will send them a note. Had hoped to attend their meeting in Sept in Brisbane to present our data. But $ held me back. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jun 23, 2012, at 9:26, <jclark24p@...> wrote:

Drs. Gordon, Stowasser, etal felt it was important enough to look at!

http://www.ncbi.nlm.nih.gov/pubmed/21778218 - Treated medically

Conclusion: Subnormal QOL scores were improved after 6 months of MT in 21 patients with BPA, but more slowly and to a lesser degree than surgical treatment had previously been shown to improve QOL scores in 22 patients with UPA.

http://www.ncbi.nlm.nih.gov/pubmed/20089615 - treated ADx

Conclusion: Unilateral adrenalectomy had positive impacts not only on blood pressure and biochemical parameters, but also on QOL, which was impaired preoperatively but significantly improved by 3 months postoperatively.

> > > > > > > >> > > > > > > > Subject: Decrease in Blood Pressure after increasing Inspra > > > > > dose 50%> > > > > > > > from 200 mg to 300 mg> > > > > > > >> > > > > > > > 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. I am also using the DASH diet, and I> > > >

> > > walk 1/2> > > > > > > > hour uphill and 1/2 hour downhill 5 times a week.> > > > > > > >> > > > > > > > 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> >

[Guest guest]

I have been given Victoza to lose weight and so far I have lost 4 pounds in about 3 weeks.My BMI was 31.Without the Victoza my A1C is 5.7 and my blood sugar is 99.> > > > > Subject: Decrease in Blood Pressure after increasing Inspra dose 50% > > > from 200 mg to 300 mg> > >> > > 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. I am also using the DASH diet, and > > > I walk 1/2 hour uphill and 1/2 hour downhill 5 times a week.> > >> > > 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]

must also be eating better?CE Grim MDOn Jun 26, 2012, at 5:00 AM, airlinerg wrote: I have been given Victoza to lose weight and so far I have lost 4 pounds in about 3 weeks.My BMI was 31.Without the Victoza my A1C is 5.7 and my blood sugar is 99.> > > > > Subject: Decrease in Blood Pressure after increasing Inspra dose 50% > > > from 200 mg to 300 mg> > >> > > 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. I am also using the DASH diet, and > > > I walk 1/2 hour uphill and 1/2 hour downhill 5 times a week.> > >> > > 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]

Victorza is for diabetes not to lose weight. Losing weight will help diabetes more than Victorza without drug side effects.So if you can get BMI down to 25 you will likely not have DM at all.But easier said than done.I have had pts lose 70 lbs on DASH. On Jun 26, 2012, at 5:00 AM, airlinerg wrote: I have been given Victoza to lose weight and so far I have lost 4 pounds in about 3 weeks.My BMI was 31.Without the Victoza my A1C is 5.7 and my blood sugar is 99.> > > > > Subject: Decrease in Blood Pressure after increasing Inspra dose 50% > > > from 200 mg to 300 mg> > >> > > 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. I am also using the DASH diet, and > > > I walk 1/2 hour uphill and 1/2 hour downhill 5 times a week.> > >> > > 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]

I have been on Victoza for 4 weeks. I have been on 300 mg Inspra for 6 weeks instead of 200 mg of Inspra (a 50% increase.)2 weeks update as of July 10, 2012 vs. March 19, 2012Weight 185 was 191 (6 pound loss in 5 weeks)Blood Pressure 126/84 was 140/90HgbA1C 5.2 was 5.9Glucose fasting 91 was 91Potassium 3.7 was 3.9Total Cholesterol 126 was 182LDL Cholesterol 66 was 105HDL Cholesterol 35 was 35Triglycerides 124 was 208> > >> > > > Subject: Decrease in Blood Pressure after increasing Inspra dose> 50%> > > > from 200 mg to 300 mg> > > >> > > > 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. I am also using the DASH diet,> and> > > > I walk 1/2 hour uphill and 1/2 hour downhill 5 times a week.> > > >> > > > 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]

Progress Update (7 1/2 weeks) for airlinerg5-30-12 Increase Inspra 50% from 200 mg./day to 300 mg./day BP 140/90 6-8-12 Start Victoza 0.6 mg Weight 191 lbs. 7-10-12 Victoza 1.2 mg BP 126/84 Weight 185 lbs. (6 pound loss in 4 1/2 weeks) (BP down 14 systolic down 6 diastolic)7-21-12 Victoza 1.0 mg BP 120/79 Weight 179 lbs. (12 pound loss in 6 weeks) (BP down 6 systolic down 6 diastolic)

> > > >> > > > > Subject: Decrease in Blood Pressure after increasing Inspra dose> > 50%> > > > > from 200 mg to 300 mg> > > > >> > > > > 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. I am also using the DASH diet,> > and> > > > > I walk 1/2 hour uphill and 1/2 hour downhill 5 times a week.> > > > >> > > > > 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.> > > > >> > > > >> > > > >> > > >> > >> >>