Update after switching from spiro to Inspra 5 weeks ago

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(Husband Tim finally diagnosed with PA (no renin, high ARR and aldosterone, very low K for years) after 5 years on 6 different BP meds in October 2010.)After successfully starting spiro 100mg daily and DASHing and getting off all other BP/K meds, Tim's BP was maintaining around 120-130/78-90. Unfortunately, he started to develop gynocomastia so we switched over to Inspra 100mg daily at the end of January. The gynocomastia has stopped getting worse and I think it's beginning to resolve but his BP is averaging 150's/90's now. I called the hypertension specialist in Toronto and left a message re: the need to likely increase the Inspra, maybe double it. He'll likely get back to me early next week. He's going to suggest one of two things I think: He'll either double the Inspra or he'll leave the Inspra dose the same and add back the amlodipine as a once daily dose ?2.5-5mg.Any input as to the best approach would be most appreciated. Tim DASHes quite well now and never gets up in the night to pee anymore. We have come to check his weight daily and actually log it more regularily than his BP. It is amazing how much body weight can fluctuate in someone with PA. A small cheat with salt can easily add 3 lbs. of water and a big cheat (went to Jamaica for a week) added a whopping 10 lbs. of water which he easily shed within 4 days of returning home. Any one else track their weight to guage their fluid volume?Take care,

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Thanks for the update nicely detailed. Remind your HTN EXPERT that the usual dose of inspra needs to be 2x the Spiro but never hurts to start lower. If cost is aProblem can try the other stuff. Can upload Tom's DASH SUCCESS STORY to our files. Also invite your dr and his other PAs to the site. Did u take him my evolution article?Aldo does not cause water retention. It causes Na retention and water follows. Tiped sad Send form miiPhone ;-)May your pressure be low!CE Grim MDSpecializing in DifficultHypertension

(Husband Tim finally diagnosed with PA (no renin, high ARR and aldosterone, very low K for years) after 5 years on 6 different BP meds in October 2010.)After successfully starting spiro 100mg daily and DASHing and getting off all other BP/K meds, Tim's BP was maintaining around 120-130/78-90. Unfortunately, he started to develop gynocomastia so we switched over to Inspra 100mg daily at the end of January. The gynocomastia has stopped getting worse and I think it's beginning to resolve but his BP is averaging 150's/90's now. I called the hypertension specialist in Toronto and left a message re: the need to likely increase the Inspra, maybe double it. He'll likely get back to me early next week. He's going to suggest one of two things I think: He'll either double the Inspra or he'll leave the Inspra dose the same

and add back the amlodipine as a once daily dose ?2.5-5mg.Any input as to the best approach would be most appreciated. Tim DASHes quite well now and never gets up in the night to pee anymore. We have come to check his weight daily and actually log it more regularily than his BP. It is amazing how much body weight can fluctuate in someone with PA. A small cheat with salt can easily add 3 lbs. of water and a big cheat (went to Jamaica for a week) added a whopping 10 lbs. of water which he easily shed within 4 days of returning home. Any one else track their weight to guage their fluid volume?Take care,

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That's what I meant when I said a small salt cheat causes increased fluid volume.

When I brought the Evol. of PA with us to Toronto, the doc said he had already read it from another patient years earlier! He seems to have a very good understanding of PA, thank goodness.

Thanks for the input Dr. Grim.

n hyperaldosteronism , Clarence Grim wrote:>> Thanks for the update nicely detailed. Remind your HTN EXPERT that the usual dose of inspra needs to be 2x the Spiro but never hurts to start lower. If cost is a> Problem can try the other stuff. > > Can upload Tom's DASH SUCCESS STORY to our files. Also invite your dr and his other PAs to the site. Did u take him my evolution article?> > Aldo does not cause water retention. It causes Na retention and water follows. > > Tiped sad Send form mi> iPhone ;-)> > May your pressure be low!> > CE Grim MD> Specializing in Difficult> Hypertension> > On Mar 11, 2011, at 2:05 PM, regnnicole regnnicole@... wrote:> > > (Husband Tim finally diagnosed with PA (no renin, high ARR and aldosterone, very low K for years) after 5 years on 6 different BP meds in October 2010.)> > > > After successfully starting spiro 100mg daily and DASHing and getting off all other BP/K meds, Tim's BP was maintaining around 120-130/78-90. Unfortunately, he started to develop gynocomastia so we switched over to Inspra 100mg daily at the end of January. The gynocomastia has stopped getting worse and I think it's beginning to resolve but his BP is averaging 150's/90's now. I called the hypertension specialist in Toronto and left a message re: the need to likely increase the Inspra, maybe double it. He'll likely get back to me early next week. He's going to suggest one of two things I think: He'll either double the Inspra or he'll leave the Inspra dose the same and add back the amlodipine as a once daily dose ?2.5-5mg.> > > > Any input as to the best approach would be most appreciated. Tim DASHes quite well now and never gets up in the night to pee anymore. We have come to check his weight daily and actually log it more regularily than his BP. It is amazing how much body weight can fluctuate in someone with PA. A small cheat with salt can easily add 3 lbs. of water and a big cheat (went to Jamaica for a week) added a whopping 10 lbs. of water which he easily shed within 4 days of returning home. Any one else track their weight to guage their fluid volume?> > > > Take care,> > > > > > > >>