Re: Who are you?

[Guest guest]

I was on Micardis 160 and lisinopril 20. They excluded diuretic, since my sodium was 126.

Before that I was taking Micardis/HCT 80/25.

This combination of Micardis +lisinopril was presribed by both nephrologist and endocrinologist. Do you say that it's a dangerous combination? In the time I also was on clonidine 20, but I tried to get rid of it for 3 months, since it almost killed me.

Now I am on Micardis 160 and eplerenone 50. I just made my PCP prescibe eplerenone for me and stopped lisinopril. I am much better. I don't get it! I am a better doctor than my endocrinologist and nephrologist ? :-)

Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 11:24:24 PMSubject: Who are you?

We almost Never give both an ACE and and ARB in US. Which diuretic are you on?

Then it's strange, since both this groups seem working for me. My renin plasma activity is 0.36.

To: hyperaldosteronism Sent: Sat, February 5, 2011 8:33:33 PMSubject: RE: Re: 39 yr old WM with HTN slightly low K and no adrenal mass

OOPS! sorry, Dr Grim said rennin, I confused rennin with cortisol: about ACE & A2RB not working.

Max.

61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq

>Dr. Grim explained that using ACE or A2RB you try to block cortisol that PA patient already does not have and hence aldo/cortisol ratio goes up causing bp goes up. I didn't read that and it's a point! My aldo is low and my cortisol is high. So, we are different!

[Guest guest]

What’s the scoop on ACEI & ARB combinations causing harm?

(Picked up by the media: CBC, CTV, Globe & Mail, etc. Jan 16, 2009)

We have had a few questions today (Jan 19, 2009) on the media concerns raised regarding ACEI & ARB combinations leading to increased harm. A warning was released from the Heart and Stroke Foundation of Canada.1 This information appears to be based on the recent 2009 hypertension guideline recommendations (CHEP).2 The concerns largely come from results of the ONTARGET trial published in 2008. Previous trials also offer some information on possible harm versus benefit. In this Q & A, we are briefly summarizing some of the related information. The ONTARGET trial summary was included in our Hypertension Trials chart from Oct 08, which was included in our 7th Edition Drug Comparison Charts book. Guideline comments and related information from our book is included below.

Quick note:

• ACEI+ARB combinations often offer no additional outcome benefit, but increased adverse effects when used solely for hypertension. (Limited benefits noted in select patients with nephropathy or heart failure.) • If choosing either an ACEI or an ARB, in someone who tolerates both: consider extensive outcome evidence (especially cardiovascular) and lower cost with ACEI. ARBs generally equivalent at high dose. Target ACEI doses for HF & Post-MI generally towards the higher end of the dosage range if tolerated.

more...:

Max.

61M L adenoma by NP59 scan. High aldo not low renin. med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

I was on Micardis 160 and lisinopril 20. They excluded diuretic, since my sodium was 126.

Before that I was taking Micardis/HCT 80/25.

This combination of Micardis +lisinopril was presribed by both nephrologist and endocrinologist. Do you say that it's a dangerous combination? In the time I also was on clonidine 20, but I tried to get rid of it for 3 months, since it almost killed me.

Now I am on Micardis 160 and eplerenone 50. I just made my PCP prescibe eplerenone for me and stopped lisinopril. I am much better. I don't get it! I am a better doctor than my endocrinologist and nephrologist ? :-)

Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

[Guest guest]

ACE+A2RB Combo Adverse Effects:

1.1. Combination therapy does not reduce the primary outcome to a greater extent compared to ramipril alone

2. Higher rates of adverse events:

-hypotension related, including syncope

-renal dysfunction

Ref.:

[PPT]

ONTARGET

Max.

61M L adenoma by NP59 scan. High aldo not low renin. med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

I was on Micardis 160 and lisinopril 20. They excluded diuretic, since my sodium was 126.

Before that I was taking Micardis/HCT 80/25.

This combination of Micardis +lisinopril was presribed by both nephrologist and endocrinologist. Do you say that it's a dangerous combination? In the time I also was on clonidine 20, but I tried to get rid of it for 3 months, since it almost killed me.

Now I am on Micardis 160 and eplerenone 50. I just made my PCP prescibe eplerenone for me and stopped lisinopril. I am much better. I don't get it! I am a better doctor than my endocrinologist and nephrologist ? :-)

Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

[Guest guest]

It is a combo not recommended. Esp since both don't work in PA. All you can expect to get are side effects. CE Grim MDI was on Micardis 160 and lisinopril 20. They excluded diuretic, since my sodium was 126. Before that I was taking Micardis/HCT 80/25. This combination of Micardis +lisinopril was presribed by both nephrologist and endocrinologist. Do you say that it's a dangerous combination? In the time I also was on clonidine 20, but I tried to get rid of it for 3 months, since it almost killed me. Now I am on Micardis 160 and eplerenone 50. I just made my PCP prescibe eplerenone for me and stopped lisinopril. I am much better. I don't get it! I am a better doctor than my endocrinologist and nephrologist ? :-) Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol. To: hyperaldosteronism Cc: Clarence Grim Sent: Sun, February 6, 2011 11:24:24 PMSubject: Who are you? We almost Never give both an ACE and and ARB in US. Which diuretic are you on?Then it's strange, since both this groups seem working for me. My renin plasma activity is 0.36.To: hyperaldosteronism Sent: Sat, February 5, 2011 8:33:33 PMSubject: RE: Re: 39 yr old WM with HTN slightly low K and no adrenal mass OOPS! sorry, Dr Grim said rennin, I confused rennin with cortisol: about ACE & A2RB not working. Max.61M L adenoma NP59 Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq>Dr. Grim explained that using ACE or A2RB you try to block cortisol that PA patient already does not have and hence aldo/cortisol ratio goes up causing bp goes up. I didn't read that and it's a point! My aldo is low and my cortisol is high. So, we are different!

[Guest guest]

good echo in here.CEACE+A2RB Combo Adverse Effects: 1.1. Combination therapy does not reduce the primaryoutcome to a greater extent compared to ramipril alone2. Higher rates of adverse events:-hypotension related, including syncope-renal dysfunction Ref.:[PPT]ONTARGET Max.61M L adenoma by NP59 scan. High aldo not low renin. med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}I was on Micardis 160 and lisinopril 20. They excluded diuretic, since my sodium was 126. Before that I was taking Micardis/HCT 80/25. This combination of Micardis +lisinopril was presribed by both nephrologist and endocrinologist. Do you say that it's a dangerous combination? In the time I also was on clonidine 20, but I tried to get rid of it for 3 months, since it almost killed me. Now I am on Micardis 160 and eplerenone 50. I just made my PCP prescibe eplerenone for me and stopped lisinopril. I am much better. I don't get it! I am a better doctor than my endocrinologist and nephrologist ? :-) Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.

[Guest guest]

Many, many thanks.

Natalia Kamneva, 66 Russian F with adrenal adenoma, HTN and low renin , low aldosteron and high cortisol, K=3.4.

To: hyperaldosteronism Sent: Mon, February 7, 2011 8:31:36 PMSubject: RE: Who are you?

ACE+A2RB Combo Adverse Effects:

1.1. Combination therapy does not reduce the primary outcome to a greater extent compared to ramipril alone

2. Higher rates of adverse events:

-hypotension related, including syncope

-renal dysfunction

Ref.:

[PPT]

ONTARGET

Max.

61M L adenoma by NP59 scan. High aldo not low renin. med combo #75={Spiro=100, Amlo=10, Indap=2.5, Ramip=5, Metf=1000, Prav=40, Feno=67, K.cl=120 mEq}

I was on Micardis 160 and lisinopril 20. They excluded diuretic, since my sodium was 126.

Before that I was taking Micardis/HCT 80/25.

This combination of Micardis +lisinopril was presribed by both nephrologist and endocrinologist. Do you say that it's a dangerous combination? In the time I also was on clonidine 20, but I tried to get rid of it for 3 months, since it almost killed me.

Now I am on Micardis 160 and eplerenone 50. I just made my PCP prescibe eplerenone for me and stopped lisinopril. I am much better. I don't get it! I am a better doctor than my endocrinologist and nephrologist ? :-)

Natalia Kamneva 66 Russian F with left adrenal adenoma, HTN, low renin, low aldesteron and high cortisol.