Blood Pressure meds (renin inhibitors) and Weightloss/Muscle Gain

[fatguy]

Hey,

A quick background... I have not seen a doctor in many years, nor have I felt a need to. I have felt more than fine most of my life. I am 28yrs old and figured I should have a regular doctor. I went for a check-up/Intro, then 3 months later went for a a full physical.... Now the story...

So I was just prescribed to try a blood pressure lowering drug by my doc. He wants me to try the lowest available dose for a month then come back and see how things are.

My Blood pressure 3 months ago was averaging in the 160-170/85-95 (peaking over 100). I was at 321lbs at the time. I dropped to 280lbs, keeping the diet clean, exercising all the time, and am getting back into my old shape from myh late teens and early 20's.

I go for the check up again, and my blood pressure is the same exact thing (possible even a tad higher).

My Blood test results are 100% normal, and even in the very good to excellent ranges in most categories. No signs of any issues.

My EKG also came back normal.

So he recommends trying a blood pressure lowering med. He gave me Tekturna which is a Renin Inhibitor and not the typical Beta or ACE blocker given. It is supposed to be better tolerated.

I have done some reading on Beta Blockers and ACE meds with respect to Bodybuilding, Fat Loss, Lean Mass gains, etc. I do not necessarily like what I have read, though there are varying bits of info on them. I have not seen any info on Renin Inhibitors in this respect.

Does anyone have any insight for use of this medication? Assuming it works, or does not work, how do I make sure I can condinue to drop weight (specifically fat of course), and build lean mass? Anyone know anything?

Any and all information would be greatly appreciated.

Thanks in advance...

 

[1blackz28]

Angiotensin 2 is one thing constricts the blood vessles and raises BP. The Renin-Angiotensin System or "chain" basicly goes like this. Renin breaks down angiotensinogen to angiotensin 1, the angiotensin converting enzyme breaks this down into angiotensin 2. A2 then constricty your blood vessels and raises you BP.

So how do you get rid of angiotensin 2? You have to break the chain at some point. Renin blocker will prevent the conversion higher on the chain where the ACE blocker will do it little farther down the chain. It basicly does the same thing stoping A2 from being produced.

Hope this helps

 

[iprimate]

Hey,

A quick background... I have not seen a doctor in many years, nor have I felt a need to. I have felt more than fine most of my life. I am 28yrs old and figured I should have a regular doctor. I went for a check-up/Intro, then 3 months later went for a a full physical.... Now the story...

So I was just prescribed to try a blood pressure lowering drug by my doc. He wants me to try the lowest available dose for a month then come back and see how things are.

My Blood pressure 3 months ago was averaging in the 160-170/85-95 (peaking over 100). I was at 321lbs at the time. I dropped to 280lbs, keeping the diet clean, exercising all the time, and am getting back into my old shape from myh late teens and early 20's.

I go for the check up again, and my blood pressure is the same exact thing (possible even a tad higher).

My Blood test results are 100% normal, and even in the very good to excellent ranges in most categories. No signs of any issues.

My EKG also came back normal.

Hypertension is asymptomatic many times. Just because you feel ok it doesn't mean that you are necessarily ok. If you have had hypertension for many years then you may have developed Left Ventricular Hypertrophy and this won't show up on an EKG and it will exacerbate your hypertension. You should get an echocardiogram (transthoracic echocardiogram or TTE) to determine whether you have any fibrosis and thickening of your left ventricle. You need to know this because it will influence how your hypertension is treated.

So he recommends trying a blood pressure lowering med. He gave me Tekturna which is a Renin Inhibitor and not the typical Beta or ACE blocker given. It is supposed to be better tolerated.

I have done some reading on Beta Blockers and ACE meds with respect to Bodybuilding, Fat Loss, Lean Mass gains, etc. I do not necessarily like what I have read, though there are varying bits of info on them. I have not seen any info on Renin Inhibitors in this respect.

Does anyone have any insight for use of this medication? Assuming it works, or does not work, how do I make sure I can condinue to drop weight (specifically fat of course), and build lean mass? Anyone know anything?

Firstly, an ACE or renin inhibitor will NOT adversely impact your efforts to lose fat and gain muscle. Your blood pressure is very high and you must lower it ASAP so you should take antihypertensives as well as shedding excess fat.

Your doctor's choice of drug and method is unorthodox and not consistent with what is generally deemed best practice (in the UK and USA). The typical course of treatment is to try you on an ACE inhibitor and if that fails to bring your BP down to the target level then add a calcium channel blocker or thiazide type diuretic. ACE inhibitors are generally well tolerated as are thiazide diuretics. Adding another drug from another class is considered more cost effective and less likely (than increasing the dosage of one drug) to cause adverse reactions.

Aliskiren (Tekturna) is a new class of anti-hypertensive drug that directly inhibits renin production. The significance of directly inhibiting renin is that it avoids the loss of angiotensin I receptor activation which leads to increased plasma renin that is seen with long-term use of ACE inhibitors and Angiotensin Receptor Blockers (ARB). Renin -- through a cascade of biochemical reactions -- indirectly caused your BP to rise. By inhibiting the formation of renin the cascade which causes the rise in BP is reduced. Aliskiren is a good drug but it is unusual as a second choice. It is best used when all else has failed. Also aliskiren can be combined with the other antihypertensives[1][2]. So if it fails to bring your BP down to the ideal BP for your age then your doctor should add a thiazide diuretic or calcium channel blocker rather than drop it altogether.

If you don't have a blood pressure monitor at home you should buy one. If you are hypertensive and at the drug experimentation stage you should be measuring your BP twice a day: AM and PM at the same time every day and keeping a log. This will give you a better indication of your BP than getting it checked every three months by a doctor (where it is likely to read higher).

Finally, don't take "super supplements" until you have brought your BP down to a normal level.

 

[machola]

great post by iprimate

here's something of interest.

Milestone Study On Blood Pressure Meds Confirmed By New Research
Main Category: Hypertension
Also Included In: Clinical Trials / Drug Trials; Stroke; Cardiovascular / Cardiology
Article Date: 14 May 2009 - 3:00 PDT

New research supports the findings of a landmark drug comparison study published in 2002 in which a diuretic drug or "water pill" outperformed other medications for high blood pressure. A scientific team including investigators from The University of Texas Health Science Center at Houston reports the findings in the May 11 issue of the Archives of Internal Medicine.

About one in three adults in the United States has high blood pressure, which, according to the National Heart Lung and Blood Institute (NHLBI), can lead to a host of health problems including heart failure, coronary heart disease, stroke and kidney failure.

The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) is the largest high blood pressure treatment trial ever conducted and compared the impact of four classes of blood pressure drugs on 42,418 high-risk patients between 1994 and 2002. High blood pressure in adults is defined as 140/90 mm Hg or above.

"We looked at data since the trial ended to make sure our message hasn't changed. And, it hasn't. Diuretic drugs work as well or better than other medications in preventing heart failure," said Barry Davis, M.D., Ph.D., study co-author, Guy S. Parcel Chair in Public Health and director of the Coordinating Center for Clinical Trials (CCCT) at The University of Texas School of Public Health.

Diuretic drugs reduce blood pressure by clearing the body of excess fluid and sodium. In the ALLHAT study, diuretic drugs were compared to angiotensin-converting enzyme (ACE) inhibitors that widen blood vessels and decrease resistance, calcium channel blockers that relax vessels by slowing the flow of calcium into the heart and alpha blockers, which also relax blood vessels.

In addition to providing superior protection against new-onset heart failure, the thiazide-type diuretic used in the ALLHAT study (chlorthalidone) was superior to the alpha blocker (doxazosin) in protecting against stroke and to the ACE inhibitor (lisinopril) in protecting against stroke in blacks. The calcium channel blocker used in the study was amlodipine.

The benefits of the diuretic drug, according to Davis, were experienced by men and women, people with diabetes and those without, people with and without normal renal function, as well as people with and without metabolic syndrome.

"Since the initial publication of the ALLHAT findings more than five years ago, many questions and some criticisms have been raised," said Jackson T. Wright, M.D., Ph.D., lead author and professor at Case Western Reserve University. "This paper reviews the initial findings in light of more detailed analyses of the ALLHAT data and data from more recent clinical trials. All confirm the initial ALLHAT findings that diuretics (in appropriate doses) remain unsurpassed in reducing blood pressure and preventing major complications of hypertension."

The researchers looked at a meta-analysis of the ALLHAT study and 28 other high blood pressure clinical studies in which patient data were combined and results compared, as well as new clinical trials including the Avoiding Cardiovascular Events Through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH).

Davis said the large meta-analysis of antihypertensive treatment trials involving 162,341 patients confirmed initial findings of the ALLHAT study in regard to the benefits of the diuretic drug. The study was conducted by the Blood Pressure Lowering Treatment Trialists' Collaboration and results were published in The Lancet in 2003.

Following the publication of the ALLHAT findings, a Heart Failure Validation Study was conducted in which all hospitalized heart failure events were re-evaluated by independent reviewers. The study concluded that thiazide-type diuretics "would seem to provide better protection" against new-onset heart failure in high-risk people with high blood pressure, the authors wrote in the paper.

ALLHAT researchers addressed concerns about the association of diuretics with new-onset diabetes and the impact of this development on heart disease. They concluded that new-onset diabetes associated with thiazides does not increase cardiovascular disease risk.

ALLHAT investigators also looked at patient trials that appeared to be at odds with components of the ALLHAT study and found that some differences could be explained by differences in study design, such as the dose of the diuretic administered. For example, in a letter to the editor published in the Mar. 12, 2009 issue of The New England Journal of Medicine, Davis indicated that doses of thiazide-type diuretics that are equivalent to those used in the ACCOMPLISH trial are less effective for the prevention of cardiovascular events than full doses of amlodipine (the other drug used in ACCOMPLISH) or doses of diuretics used in previous trials including ALLHAT.

"Evidence from subsequent analyses of ALLHAT and other clinical outcome trials confirm that neither alpha blockers, angiotensin-converting enzyme inhibitors, nor calcium channel blockers surpass thiazide-type diuretics (at appropriate dosage) as initial therapy for reduction of cardiovascular or renal risk," the authors wrote.

Other study contributors from the CCCT at the UT School of Public Health included Sara Pressel, faculty associate, and Charles Ford, Ph.D., associate professor of biostatistics. The CCCT mission is to coordinate large multi-center controlled clinical trials.

The study is titled "ALLHAT Findings Revisited in the Context of Subsequent Analyses, Other Trials and Meta-analyses" and the research was supported by the NHLBI.

 

[Kaiser]

http://www.professionalmuscle.com/f...od-test-results-how-interpret-them-guide.html

http://www.professionalmuscle.com/f...blood-pressure-meds-treatment-discussion.html

 

[fatguy]

Your doctor's choice of drug and method is unorthodox and not consistent with what is generally deemed best practice (in the UK and USA). The typical course of treatment is to try you on an ACE inhibitor and if that fails to bring your BP down to the target level then add a calcium channel blocker or thiazide type diuretic. ACE inhibitors are generally well tolerated as are thiazide diuretics. Adding another drug from another class is considered more cost effective and less likely (than increasing the dosage of one drug) to cause adverse reactions.

When my doc was going over the different options on blood pressure meds, and the difference in known side effects, it appeared that Tekturna was the most mild. It is also a simple 1 tab a day. Not that I have an issue remembering to take my pill, but once a day is easy, especially if it makes me tired and can use it at bed time. Since I am active and play for competitive hockey teams, And of course go to the gym... I did not want something that was known to make you feel crappy and lethargic when there may be a better option. Of course I choose life over activity any day, so I would learn to live with the sides if it helped my BP. We spoke about the follow up steps if after 4 weeks, this does not help.

I do not use any AAS or GH at all. The last round with that was over 5 years back.

Thanks for all the info and links. That was really a very thorough explanation. This is why I posted my queston on this board. I knew you guys would be the best help. I was spending plenty of time reading all the different meds, sides, drug interractions, patient reviews, etc. We shall see...

Please note that I am a non-smoker and non-drinker too.

Any other information or recommendations are still greatly appreciated.