Re: UK guidelines for treating high blood pressure

[Guest guest]

Here over the pond I almost always start with a diuretic unless there are

special circumstances. If the first drug does not get to goal the second drug

should always be a diuretic.

Note that starting with an ACE will have no effect if one has PA or variant.

C and beta also not so good. So one should quickly identify the " drug

resistant " PAs by following their protocol.

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

Surely there must be something on diet?

You can see these at the British Hypertension Society web site I think Just

tell them you are a medical professional which you are.

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

This sounds like the same sqeuence I was put through for a decade or so

(shame on me) before a Dr. from Iran who hadn't heard " forget about

aldosterone, it is so rare) did the test.

Never mind that my pressure didn't improve, but slowly crept upward.

" It isn't an emergency " on told me. Never asked to look at my Hx. Even

the LVH didn't ring any bells wihth this guy. Just kept on with drugs,

drugs, drugs.

Dave

Helen wrote:

>

> I have recently been given the underlying information by the

> technician at the hypertension clinic and thought it would raise a

> rye smile. Note there is no suggestion of blood tests just straight

> onto the drugs...... I asked to see a dr before starting any drugs so

> that I could get blood tests done first. They are not happy about it

> but did agree after I was given a script for an ACE inhibitor and

> asked if it was gluten free. Since no one could tell me I gave the

> script back.... they did understand that.

>

> " Current UK guidelines give the following recommendations as to usual

> drugs that should be used. These recommendations are based on

> treatments and combinations of treatments that are likely to give the

> best control of the blood pressure with the least risk of side

> effects or problems.

>

> Treatment is guided by the A/CD approach as follows:

>

> If you are less than 55 years old and are not black then initial

> treatment should be with 'A' (an ACE inhibitor, or an angiotensin

> receptor blocker if an ACE inhibitor causes problems or side

> effects).

>

> If you are 55 years or older, or are black then initial treatment

> should be with 'C' or 'D' (a calcium-channel blocker or a diuretic).

>

> Then, if the target blood pressure is not reached, combine 'A'

> with 'C' or 'D' (an ACE inhibitor or an angiotensin receptor blocker

> plus a calcium-channel blocker or diuretic).

>

> Then, if target blood pressure is still not reached, combine 'A'

> with 'C' and 'D' (an ACE inhibitor or an angiotensin receptor

> blocker, and a calcium-channel blocker, and a diuretic).

>

> If a fourth drug is needed to achieve the target blood pressure,

> consider adding of one of the following:

> A beta-blocker

> Another diuretic

> An alpha-blocker "

>

> Helen in Scotland

>

>

>