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Blood Pressure Issue

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lovetosing

Active Member
Relationship to Diabetes
Type 2
Haven't been on site for a very long time due to my apparent 'excellent control' of type 2!! (not being smug honest) But have been told that "people with diabetes are more at risk of stroke/heart attack" and that diabetics should maintain a blood pressure of no higher than 130/80. I always understood that figures over 140/90 were considered high and am rather perplexed to now be told that as my pressure is over 130/80 I need to take an ace inhibitor called ramipril. I agreed to take this (have only taken it for two weeks) and already have a nasty irritating cough which is apparently a side effect. I feel that I am a victim of over generalisation regarding the statistics quoted at me which I feel may apply more to people who are less in control of diabetes and perhaps considered obese and as I now feel less healthy than without Ramipril I wonder if anyone has similar experience and could add to my knowledge.
 
Hiya, lovely to hear from you again, and well done on keeping good control! 🙂

If you have the cough then you should report this straight away to your GP. There are lots of alternatives available that may suit you better. I also had a problem with ramipril and was changed to something called candesartan,which is a different class of medication and doesn't give me any side-effects. For this reason, I am happy to take it, even though my BP is generally good.

It's a judgement call I think with these borderline cases, where you might just be above the desired range. I'm not normally one for taking pills, but this is one I don't mind as keeping good BP is very important, even if you are well-controlled generally. This is because our microvascular system is more at risk than those without diabetes, so the doctors aim for a higher standard of BP control to try and offset the effect of diabetes. They also get an extra payment for patients who get a tick in the BP box, so it's not all altruistic (if you are a bit cynical!).

Do you have a home BP monitor? I find it useful to be able to measure my BP at home because it is always higher when I get it done at the GP's due to 'white coat syndrome' - having it taken officially actually raises it! 😱 I got a cheap Omron M2 Basic Upper Arm Blood Pressure Monitor and take my BP once or twice a day. When I showed the numbers to my GP she was happy not to increase my medication. You may find you don't really need the meds if your BP is fine outside of the surgery!
 
A cough with Rampril is well known I was on Rampril and got a cough, went to the docs a couple of weeks ago and like Northerner was put on Candesartan back this week to see how its working. well done on keeping control of your Diabetes
 
I used to have very high blood pressure but it was brought down to something like 130/90 with the use of tablets, ramipril being one of them. What I don't like about it is its tendency to irritate the feet by constricting the capilliaries but apparantly all the class of drug called Ace Inhibitors may do this.

I stopped smoking and my BP fell to 125/80 and now I am losing weight I am down to something like 120/75. Hopefully I can ditch the BP drugs soon.

The reason why they want you to improve from 140/90 to 130/80 is because as a diabetic they want you to have a bit of extra leeway. Have they put you on statins too?

Because diabetes interferes with your normal blood chemistry, you are more likely to get fatty deposits on the inside of your blood vessels. If you are 130/80 and this starts to happen, they should spot the rise before or by the time it gets to 140/90 where it is still more or less safe and there is more time to do something about it. If you maintain it at 140/90 and something happens, everyone is chasing around trying to get things done quickly. It is just a safety margin.

I got a Lloyds Pharmacy BP monitor which is a copy of the Omron M2 and is approved by the British Hypertension Society.
 
I'll echo Yorksman's comment about weight. When I was very fat, I was on 80mg of Lisinopril (another ACE-inhibitor) plus Bendroflumethiazide (a diuretic). After saying goodbye to the first 4 stone, the diuretic was stopped and at the 5 stone point my Lisinopril dose was halved. Latest BP 114/80.

I've never suffered the coughing side-effect with Lisinopril - it might be worth asking the doctor whether it's worth a go with that one, or Captopril. (Different drugs within the same class can have different effects, as I found with statins.) If you're not asthmatic, Beta-blockers might be a suitable alternative BP treatment.
 
BP advice

Very many thanks for your replies esp to Northener. I do have a home BP monitor and my BP today is 133/87. I am particularly grateful for the support regarding Ramipril because I will now tell my GP about the cough etc and see if he offers to put me on the alternative. I always feel that quality of life is key in health aspects because stress only makes things worse. The cough and indeed what I feel may be extra tiredness that the Ramipril is causing are making me feel less healthy than before, despite the BP issue. Hopefully a different med will solve these probs.
thanks again.
 
Not faced this myself, but I think there are a number of ACE's you could try - and if all give you the ACE cough, you could be offered one of the (more expensive I think) ARBs
 
The trouble with coughing is, it puts up your blood pressure, so not much good there. I'm on Carvedilol which seems to work well.
 
UPdate

Not seen doc yet as Bank Holiday weekend was a no no. As I do have a home BP monitor can keep track and yesterday 133/87 now today 144/92 (not so good) so I can see I probably do need a med of some kind. I do think the coughing and side effects of ramipril if anything have made me feel generally worse and possibly the BP is up because of that. Will report what the doc says.
 
lovetosing said:
Not seen doc yet as Bank Holiday weekend was a no no. As I do have a home BP monitor can keep track and yesterday 133/87 now today 144/92 (not so good) so I can see I probably do need a med of some kind. I do think the coughing and side effects of ramipril if anything have made me feel generally worse and possibly the BP is up because of that. Will report what the doc says.
Click to expand...

Out of interest, what dose of ramipril are you currently on? I started at 2.5mg and it was only when they increased it to 5 that I started to get side-effects. I think they try to get you up to 10mg usually, but that was obviously a no-no for me 🙂
 
Im on Losartan, and suffer no side effects (I got rashes on ramapril)... Possibly another option
 
BP and on and on

Going to doc thisafternoon. But the dosage I was put on was only 2.5 and I am STILL coughing even though I haven't taken it for about 3 days (I got so fed up I haven't waited for the doc to say I can change it, but I wont tell him that!) oh and by the way I do have a home BP monitor as I mentioned. Your answers are very helpful by the way and well written !
 
lovetosing said:
Going to doc thisafternoon. But the dosage I was put on was only 2.5 and I am STILL coughing even though I haven't taken it for about 3 days (I got so fed up I haven't waited for the doc to say I can change it, but I wont tell him that!) oh and by the way I do have a home BP monitor as I mentioned. Your answers are very helpful by the way and well written !
Click to expand...

If you are coughing at the lowest dose - and even when you've stopped it! - then I would say you definitely need to be on something else! Good luck at the doc's 🙂
 
I had the cough with rampril. I went to the doctor who changed me to telmisartan.

Advice given by a friend who is a nurse says there are a number of excellent blood pressure medications, it is a case of trial and error about getting the one that is right for you. Rampril is the first one most people are tried on and the medics will work through the list until they find the one that works for you.
 
I started coughing with Ramipril and the doc put me on Losartan, which has not caused any problems. However, I do also take a few other things to thin my blood and keep my BP down and control angina etc ( Clopidogril and Bisoporol). All this helps to keep my BP down to around 120/68 on average these days.

I do check my BP at home, I use an Omron M10-IT which links to my PC - good machine. Bought from Amazon for about ?30.
 
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