Speaking of ACE/ARB and/or Hi-BP. My Savella (SSRI/NERI) for my fibromyalgia has been bumping my blood pressure since last year, and I had to drop from 75mg a day to 50mg a day last year (25 bid). That helped me avoid antihypertensives for persistent HTN.
Well for the past 6 weeks my BP has been back up, mostly due to the constant anxiety and stress from the pandemic that I saw coming as early as middle of February. At my doctor's office two weeks ago it was 190/102 (doubled checked at end of visit and home). Rather than accept being on something like a an ACE/ARB (RAAS inhibitor) I elected to lower my dose of Savella even further, and cut it down to 12.5mg bid while trying to lose weight. I'm down from 243 lbs to 238 lbs today.
Last week it was down to 180/90, but last night I was down to 160/82. I'm going to stay on 12.5mg BID and try to lose 20 lbs now, and get more active to deal with the increased onslaught of pain from the lower dosage. I've been avoiding NSAIDS for my chronic pain (Relafen or Naproxen) because of CoVid as well, so all I have left is Tylenol arthritis strength.
Now, some articles suggest that it may be more harmful to stop the ACE/ARB (RAAS inhibitors) in certain CoVid-19 patients until we know more. This one explains the relationship with the ACE receptors and CoVid-19.
https://www.nejm.org/doi/full/10.1056/NEJMsr2005760
Quote From the Article Summary:
"
KEY POINTS RELATED TO THE INTERPLAY BETWEEN COVID-19 AND THE RENIN–ANGIOTENSIN–ALDOSTERONE SYSTEM
- • ACE2, an enzyme that physiologically counters RAAS activation, is the functional receptor to SARS-CoV-2, the virus responsible for the Covid-19 pandemic
- • Select preclinical studies have suggested that RAAS inhibitors may increase ACE2 expression, raising concerns regarding their safety in patients with Covid-19
- • Insufficient data are available to determine whether these observations readily translate to humans, and no studies have evaluated the effects of RAAS inhibitors in Covid-19
- • Clinical trials are under way to test the safety and efficacy of RAAS modulators, including recombinant human ACE2 and the ARB losartan in Covid-19
- • Abrupt withdrawal of RAAS inhibitors in high-risk patients, including those who have heart failure or have had myocardial infarction, may result in clinical instability and adverse health outcomes
- • Until further data are available, we think that RAAS inhibitors should be continued in patients in otherwise stable condition who are at risk for, being evaluated for, or with Covid-19"
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