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Blood Pressure Medication


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I'm in my late 50's, blood pressure has been steadily rising the last couple of years, now it's often in the range 130-150, rarely below 130. Tried losing weight and exercising, etc., not much difference. My mother, father and brother all needed blood pressure meds once they hit 60.

 

What would be the first drug to try for somebody based in Thailand? People may say "go to see a Doctor" but once 'high blood pressure' is diagnosed it seriously affects health insurance, for example exclusions for cardio-vascular conditions, or a much higher premium. I don't want that on my record at this stage. Prefer to manage it myself, at least in the early stage, using blood pressure monitor and locally purchased meds.

 

No other health issues except high cholesterol (which is controlled by statins), taking no other meds at this stage.

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I've been on Madiplot (10mg) for a number of years (prescribed by Bumrungrad Hospital).  Seems to keep my moderately high BP under control, with no side effects.  Can be bought OTC.

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Find a good Pharmacy with an English speaker

I use Anapril 5, 1 a day, 20 Baht for 10 tablets, not sure that this is a good one to start off on though as I have been told it is quite strong but search on Google for it and you will get a lot of advice including side effects and dosage (in particular max per day).

Applies to other medicines too, research first if you don't want to see doctor.

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36 minutes ago, myprivate said:

People may say "go to see a Doctor" 

 

How much do you "value" your life ?

 

36 minutes ago, myprivate said:

but once 'high blood pressure' is diagnosed it seriously affects health insurance, for example exclusions for cardio-vascular conditions, or a much higher premium. I don't want that on my record at this stage.

 

I had a heart attack over a decade ago, a stent was inserted, been on statins and blood pressure tablets ever since, no reoccurring issues. I took out private health cover here 3 years ago which also covers my pre-existing condition, that said, for $60USD a month extra, it's well worth the extra coverage.

 

You should really see a doctor and if you need a health provider quote go to AA Insurance Brokers, they shop around for you, they did for me, and for 72,000 baht per annum, I have 1.2 mil USD coverage which includes my pre-existing condition, naturally next annual renewal it will go up as I will fall into the older/next category, but hey, it's a matter of cover or no cover, money in the bank, or no money in the bank, "up to you" as they say in Thailand, now the way I see it, for 197 baht per day at the moment, I have 1.2 mil USD coverage, makes sense to me, I don't look at the BIG annual sum as that would turn most people off, but not me.

 

Edited by 4MyEgo
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Emaril 5mg,pharmacist took my blood pressure and advised this one,told me to come

back if i had any side effects.Same thing a doctor does and this advise was free.

10 pils for 8 baht.

Blood pressure is down and no side effects.

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1 hour ago, myprivate said:

Tried losing weight and exercising, etc., not much difference.

But what were the results of your attempts to lose weight and exercise? Did you get down to a healthy body weight and become fit?

 

I suggest you go to a private lab and get a complete blood workup (if you haven't) and post your numbers here. I'm not an expert but it seems to me that high BP doesn't just up and happen in a vacuum. 

 

 

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1 hour ago, brewsterbudgen said:

I've been on Madiplot (10mg) for a number of years (prescribed by Bumrungrad Hospital).  Seems to keep my moderately high BP under control, with no side effects.  Can be bought OTC.

 

+1 - I use the same & dosage ( my wife happens to be a doctor ). I think it's 17b a tablet.

Her advice is to go and see a doctor first, as they'll also do other tests to ascertain what is best for you.

 

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1 hour ago, myprivate said:

I'm in my late 50's, blood pressure has been steadily rising the last couple of years, now it's often in the range 130-150, rarely below 130.

You are taking these readings yourself at home?  Ask as I have extreme white coat syndrome which routinely kicks my home 110 up 50 points or more so never get a good reading at a hospital or even a supermarket and have had since younger than you. 

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12 minutes ago, lopburi3 said:

You are taking these readings yourself at home?  Ask as I have extreme white coat syndrome which routinely kicks my home 110 up 50 points or more so never get a good reading at a hospital or even a supermarket and have had since younger than you. 

I'm the same as you, as soon as I step into a hospital add at least 40 points to the top figure, took mine this morning as I am starting a new medicine and keeping a record for the Dr, 143/74 heart rate 85.

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16 minutes ago, Golden Triangle said:

........ keeping a record for the Dr, 143/74 heart rate 85.

I went to the hospital and used the machine 86/60.

Nurse says 'that's no good at all, do it again'

We settled on 96/60.

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go see a dr, don't take something because other people do, what are both your readings 130/??

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Have you had a full cardiac assessment? (Inc. stress test)? As presence/an]bsence of carduac disease is a factor in selecting best approach to managing hypertension.

 

Assuming no cardiac issue, the most common first line drugs for someone with no special other conditions and assuming not of African descent would be an ACE inhibitor or an Angiotensisin II Receptor Blocker.

 

Least expensive forms of these in Thailand are Enalapril and Losartan respectively. ARBs (Losaratan) as less likely to cause dry cought than ACE inhibitor (though sometimes do).

 

People of of African descent respond better to calcium channel blockers.

 

With any drug, you want the lowest dose that achieves good control so need to monitor at home.

 

Be sure to read up on contraindications, side effects and interactions.

 

 

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2 hours ago, BritManToo said:

I went to the hospital and used the machine 86/60.

Nurse says 'that's no good at all, do it again'

We settled on 96/60.

96 is a bit low but 60 is excellent according to my brother who is a senior staff nurse with the NHS

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4 hours ago, myprivate said:

I'm in my late 50's, blood pressure has been steadily rising the last couple of years, now it's often in the range 130-150, rarely below 130.

Just read your post again in slow time, anything up to 140 is just the high end of normal range, so my UK doc says, that is not the reading that worries them most its the lower (2nd reading) so called normal is 80, but higher is a problem, if your just above 60 excellent but if it drops further see a doctor, you could be in trouble. Low blood pressure causes more health problems than high, according to my UK Doc.

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6 minutes ago, foreverlomsak said:

96 is a bit low but 60 is excellent according to my brother who is a senior staff nurse with the NHS

Just did my 2nd reading at 21.30hrs, had dinner at just after 1900hrs, took my new tab, let it get to work, reading was 123/55 heart rate 73, gonna keep an eye on it for the next week, then see the Dr and let him make any adjustments he feels are necessary, feeling good.

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2 minutes ago, Golden Triangle said:

Just did my 2nd reading at 21.30hrs, had dinner at just after 1900hrs, took my new tab, let it get to work, reading was 123/55 heart rate 73, gonna keep an eye on it for the next week, then see the Dr and let him make any adjustments he feels are necessary, feeling good.

Keep a close eye 123 is well OK according to NHS data but if the lower (55) drops further stop meds immediately and see doc asap.

If it remains at 55 might be worth questioning the doc of possible consequences.

I was always told  a heart rate of 65-75 was good, you should allow at least 15 mins between mild activity and taking BP, longer for strenuous activity.

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3 hours ago, lopburi3 said:

You are taking these readings yourself at home?  Ask as I have extreme white coat syndrome which routinely kicks my home 110 up 50 points or more so never get a good reading at a hospital or even a supermarket and have had since younger than you. 

Have been known to show 130 at home and 175 at docs surgery half an hour later (same problem the white coats even though my doc doesn't wear one)

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2 hours ago, Sheryl said:

Have you had a full cardiac assessment? (Inc. stress test)? As presence/an]bsence of carduac disease is a factor in selecting best approach to managing hypertension.

 

Assuming no cardiac issue, the most common first line drugs for someone with no special other conditions and assuming not of African descent would be an ACE inhibitor or an Angiotensisin II Receptor Blocker.

 

Least expensive forms of these in Thailand are Enalapril and Losartan respectively. ARBs (Losaratan) as less likely to cause dry cought than ACE inhibitor (though sometimes do).

 

People of of African descent respond better to calcium channel blockers.

 

With any drug, you want the lowest dose that achieves good control so need to monitor at home.

 

Be sure to read up on contraindications, side effects and interactions.

 

 

Good info

Edited by Lazy Sod
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13 hours ago, Sheryl said:

Have you had a full cardiac assessment? (Inc. stress test)? As presence/an]bsence of carduac disease is a factor in selecting best approach to managing hypertension.

 

Assuming no cardiac issue, the most common first line drugs for someone with no special other conditions and assuming not of African descent would be an ACE inhibitor or an Angiotensisin II Receptor Blocker.

 

Least expensive forms of these in Thailand are Enalapril and Losartan respectively. ARBs (Losaratan) as less likely to cause dry cought than ACE inhibitor (though sometimes do).

 

People of of African descent respond better to calcium channel blockers.

 

With any drug, you want the lowest dose that achieves good control so need to monitor at home.

 

Be sure to read up on contraindications, side effects and interactions.

 

 

Thanks Sheryl, I was hoping you would post. Yes, I've had a cardiac assessment (exercise stress test) and everything is normal. Also had full medical (blood test, x ray, etc.) and all OK.

Thinking I'll try a low dose of Losaratan because I see there is also some evidence it helps with headaches, been getting a lot of tension headaches the last couple of years.

I'm currently taking only the following meds;

Daily Lipitor 10mg

Daily Nortriptyline 10mg (low dose as a headache preventer, it helps)

Occasionally a muscle relaxer (Norgesic or Tizanidine) for the tension headaches

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15 hours ago, lopburi3 said:

You are taking these readings yourself at home?  Ask as I have extreme white coat syndrome which routinely kicks my home 110 up 50 points or more so never get a good reading at a hospital or even a supermarket and have had since younger than you. 

I'm  a  white coat sufferer too. Now my doctor writes BP Manual on my appointment card, and I also show them my recent home-testing results. The hospital nurses know me anyway, so automatically get the manual apparatus ready for me when they see me arrive.

Using that machine where you insert the whole arm, I often recorded figures like 210/110, pulse 100! 

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I had very high blood pressure when I went to a laboratory for a health check. Then I bought something on the Internet so that I could measure myself. With this I discovered something strange. 

 

As soon as I drink some beer my blood pressure will go up to 170 and more and will stay there for some days. After a couple of days without any alcohol it will go down to 120 and less. I take Losartan. But if I take it or not it does not make any difference.

 

So perhaps people should try to find out what causes the high blood pressure. For this it might be a good idea to buy something so that you can measure the blood pressure yourself. It does not cost much (especially on the Internet). I paid on ebay about 600 Baht and it has been working without any problems for years. But for sure you get it on Lazada too. Buy one for the arm and not for the wrist. Take it with you to the doctor/hospital when you get it so that you can compare the readings.

 

Whenever I drink now some beers I know what will follow. Doesn't make me happy but at least I know the reason for my high blood pressure. No need to run to doctors all the time to find a treatment. 

 

 

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As Sheryl mentioned ace inhibitors are common first line BP meds. I had mentioned Lispril which is a lower priced generic of Lisinopril an ace inhibitor widely sold in Thailand. I see no reason to pay for the non generic version. 

 

https://en.m.wikipedia.org/wiki/Lisinopril

 

Not sure of the exact price but I think under 200 baht a month for 10 mg. the generic brand Lispril. 

 

 

Edited by Jingthing
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4 minutes ago, Pottinger said:

You're mad to ask such advice on ThaiVisa - see a shrink.

Yes and no.

Personally I don't see much harm in trying an ace inhibitor and checking if it works.

Also I don't see going to doctors especially in Thailand as being without risk either.

She might put you on a diuretic out of habit when an ace inhibitor would be better.

Doctors are not gods.

Yes if you need surgery you have .no choice.

The culture in Thailand among Doctors is to accept what they say without question and if you ask questions you're a trouble maker. That is very different than the western way.

Edited by Jingthing
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1 minute ago, Jingthing said:

Yes and no.

Personally I don't see much harm in trying an ace inhibitor and checking if it works.

Also I don't see going to doctors especially in Thailand as being without risk either.

She might put you on a diuretic out of habit when an ace inhibitor would be better.

He may also self-medicate for quite the wrong underlying ailment, which a doctor could pick up.

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