Blood Pressure

I agree to a certain extent. For example if you have high BP take a medication. If you know your cycle will create conditions that cause high BP get in front of it and take a medication. But I don’t agree with taking medications you don’t need. Your liver and kidneys have a crucial role in metabolizing and excreting medications and are vulnerable when taking excessive amounts of medications.

Can you clarify what you mean by a drug you don't "need"?

If someone's taking a drug presumably there's a purpose they have in mind.
 
Yea. Your hematocrit, cholesterol and Apo B are concerning. Have you thought about adding Ezitimibe to your Rosuvastatin instead of increasing Rosuvastatin? Or staying at 10mg and adding Ezitimibe? I’m on 10mg Rosuvastatin and 10mg Ezitimibe and my total cholesterol is around 75-80. Off cycle I drop the Ezitimibe.
Yeah, I’ve read multiple posts from you and others on the forum about stacking Ezetimibe with Rosuvastatin, but honestly didn’t think I’d need it.

But I’ve already messaged PCT and I’ll be adding it to my next order - appreciate the tip!

I was actually planning to add anavar for the last 6 weeks of the cycle… but after seeing those labs I was like, “Not this time, buddy. Not this time.”
 
Yeah, I’ve read multiple posts from you and others on the forum about stacking Ezetimibe with Rosuvastatin, but honestly didn’t think I’d need it.

But I’ve already messaged PCT and I’ll be adding it to my next order - appreciate the tip!

I was actually planning to add anavar for the last 6 weeks of the cycle… but after seeing those labs I was like, “Not this time, buddy. Not this time.”

If you're going to use a statin, imo Pitavastatin is hands down the best, with an ultra low side effect risk, and like Telm is for BP, a long list of health benefit bonuses. It also raises HDL modestly, and counteracts AAS induced HDL reduction for an even better HDL improvement than you'd otherwise see if using steroids,

The only downside is it's not quite as strong at reducing lipids vs other statins for the worst cases.

It's the go to cholesterol reducer (along with ezetimibe), considered the only "healthy statin" by the life extension crowd, who try to get LDL below 50, where data shows clearly lower cardiovascular risk.

It's been around for a decade, and only recently became generic. Many docs still remember when it required insurance preauthorization due to high expense, so don't bother. It was reserved for patients who had to use a statin, but couldn't tolerate sides. Only about 2% of statin prescriptions are for Pitava, but I presume that's gong to change fast now that it's much cheaper.
 
Can you clarify what you mean by a drug you don't "need"?

If someone's taking a drug presumably there's a purpose they have in mind.
That is not always the case. Some members experiment and take medications that might provide some type of advantage or benefit in the gym. Hell, there was a member here whose Coach recommended he take Telmisartan in the absence of high BP because of the endurance benefits. Some decide 80 is too high of a RHR and start taking Nebivolol in the absence of high BP. Pharmaceuticals should only be used to address a health condition and not used solely for the potential performance enhancements they might receive.
 
But I’ve already messaged PCT and I’ll be adding it to my next order - appreciate the tip!

Dont bother getting Ezetimibe on its own.
Ask for Bempesta EZ.

Ezetimibe is $4 for a strip of 10.
Bempedoic acid is $7 for a strip of 10.
Both serve to lower LDL.
Bempesta EZ is (Bempedoic acid + Ezetimibe), $5 for a strip of 10.

You can stick to Rosu 5. There's not much benefit going to 10.
 
Dont bother getting Ezetimibe on its own.
Ask for Bempesta EZ.

Ezetimibe is $4 for a strip of 10.
Bempedoic acid is $7 for a strip of 10.
Both serve to lower LDL.
Bempesta EZ is (Bempedoic acid + Ezetimibe), $5 for a strip of 10.

You can stick to Rosu 5. There's not much benefit going to 10.
Thanks, man - tons of useful info here. I’ll go ahead and add Bempesta EZ then.

This thread’s been full of unexpected gold - really appreciate it!
 
Totally agree - that’s why I’ve added Telmisartan and Ivabradine during this cycle, but only for the duration of the blast.

I also bumped up Rosuvastatin from 5mg to 10mg since my recent labs weren’t looking great.

Honestly, I’m a bit surprised how rough this cycle has been in terms of side effects and overall health, even though liver and kidney values are still perfect.

Starting to think I might need to take a proper break after this one.
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Go donate some blood
 
Saw this today.
First combo pill approved in US.

The polypill (Widaplik) — formerly known as GMRx2 — contains three separate drugs for treatment of high BP: telmisartan, an angiotensin receptor blocker; amlodipine, a calcium channel blocker; and indapamide, a thiazide-like diuretic.

The polypill is available in three doses and is the first triple combination to be FDA-approved as initial therapy in patients who may need multiple drugs to reach their BP goals, according to a company press release.

The company stated it plans to launch the polypill in the U.S. in the fourth quarter of 2025.

 
Saw this today.
First combo pill approved in US.

The polypill (Widaplik) — formerly known as GMRx2 — contains three separate drugs for treatment of high BP: telmisartan, an angiotensin receptor blocker; amlodipine, a calcium channel blocker; and indapamide, a thiazide-like diuretic.

The polypill is available in three doses and is the first triple combination to be FDA-approved as initial therapy in patients who may need multiple drugs to reach their BP goals, according to a company press release.

The company stated it plans to launch the polypill in the U.S. in the fourth quarter of 2025.


About fucking time. The evidence of triple, and quad, different mechanism of action BP meds increasing effectiveness far above larger dose mono therapy has been clear for over a decade, while reducing side effects significantly.

India has had just about every triple, and now some quad, combos imagineable for several years now.

The problem is in India 2, 3, or 4 generics in a single pill is still a generic, and usually cheaper than the already cheap separate tabs. In the US it becomes a patent protected name brand for 15 years, and goes from 50¢ per dose as separate generic tablets, to $20 / dose as a name brand single tablet option.
 
Saw this today.
First combo pill approved in US.

The polypill (Widaplik) — formerly known as GMRx2 — contains three separate drugs for treatment of high BP: telmisartan, an angiotensin receptor blocker; amlodipine, a calcium channel blocker; and indapamide, a thiazide-like diuretic.

The polypill is available in three doses and is the first triple combination to be FDA-approved as initial therapy in patients who may need multiple drugs to reach their BP goals, according to a company press release.

The company stated it plans to launch the polypill in the U.S. in the fourth quarter of 2025.

It’s too bad they went with Amlodipine. But that’s progress.
 
About fucking time. The evidence of triple, and quad, different mechanism of action BP meds increasing effectiveness far above larger dose mono therapy has been clear for over a decade, while reducing side effects significantly.

India has had just about every triple, and now some quad, combos imagineable for several years now.

The problem is in India 2, 3, or 4 generics in a single pill is still a generic, and usually cheaper than the already cheap separate tabs. In the US it becomes a patent protected name brand for 15 years, and goes from 50¢ per dose as separate generic tablets, to $20 / dose as a name brand single tablet option.

What I'm really curious to see is how much it'll be post launch.
Great for compliance, but if insurance won't cover then nobody will use it :rolleyes:
 
What I'm really curious to see is how much it'll be post launch.
Great for compliance, but if insurance won't cover then nobody will use it :rolleyes:

I have a "Cadillac" policy, very generous, and even they won't pay for brand name combos when two generics are the same medication for 95% less.

I've wondered who their customers are when the generics cost $8/month and the name brand combo is $600 (like twynsta or exforge, the Telm and Valsartan combos with amlodipine).

But yeah, compliance is definately improved, and we know with BP meds 50% already stop using them within a year, rising to 80% of its multiple tablets. Hell, even I prefer a single tablet even though I know it makes no difference. Something psychologically more pleasant to down one tiny tab, vs 3 large ones.
 
It’s too bad they went with Amlodipine. But that’s progress.

Every reference to Amlodipine reminds me of how factors that have nothing to do with best outcomes deny access to everyone in the US where almost everything is available (if you can pay for it).

You literally have to step outside the bounds of the law, which most won't do, to avoid known side effects from Amlodipine when a safer, more advanced, all around better drug is easily accessible in a third world country.

Millions of people needlessly suffer a worse quality of life and "just have to live with" edema from amlodipine as an unnecessary tradeoff in order to prevent heart attacks or strokes.
 
Do you guys have any tips on treating isolated systolic hypertension? I take 5mg nebivolol and 80mg telmisartan while on cycle (take the 5mg nebivolol year round, have a family history of high blood pressure). Even with the blood pressure meds , my hematocrit and rbc in range and drinking plenty of fluids sometimes I’ll check my blood pressure mid day and my systolic will be anywhere from 145-175 while my diastolic is always mid 60’s. My blood pressure is usually perfect in the morning , sometimes it will be 130/60 but usually my systolic won’t be above 125 when I first wake up. Just wondering if anyone’s had a similar situation, I have to go back through and read this thread so if it’s already been talked about I do apologize.
 
Do you guys have any tips on treating isolated systolic hypertension? I take 5mg nebivolol and 80mg telmisartan while on cycle (take the 5mg nebivolol year round, have a family history of high blood pressure). Even with the blood pressure meds , my hematocrit and rbc in range and drinking plenty of fluids sometimes I’ll check my blood pressure mid day and my systolic will be anywhere from 145-175 while my diastolic is always mid 60’s. My blood pressure is usually perfect in the morning , sometimes it will be 130/60 but usually my systolic won’t be above 125 when I first wake up. Just wondering if anyone’s had a similar situation, I have to go back through and read this thread so if it’s already been talked about I do apologize.
Have you had labs recently? Electrolyte imbalances, high or low potassium, dehydration and some BP meds can cause isolated systolic hypertension. Telmisartan can cause potassium levels to get out of range.
 
Do you guys have any tips on treating isolated systolic hypertension? I take 5mg nebivolol and 80mg telmisartan while on cycle (take the 5mg nebivolol year round, have a family history of high blood pressure). Even with the blood pressure meds , my hematocrit and rbc in range and drinking plenty of fluids sometimes I’ll check my blood pressure mid day and my systolic will be anywhere from 145-175 while my diastolic is always mid 60’s. My blood pressure is usually perfect in the morning , sometimes it will be 130/60 but usually my systolic won’t be above 125 when I first wake up. Just wondering if anyone’s had a similar situation, I have to go back through and read this thread so if it’s already been talked about I do apologize.

You can search for pulse pressure on this board.
Some of the ARBs hit systolic more than diastolic, so maybe you can switch to those instead. I also face the same issue, tho not as wide a range as yours..
 
Have you had labs recently? Electrolyte imbalances, high or low potassium, dehydration and some BP meds can cause isolated systolic hypertension. Telmisartan can cause potassium levels to get out of range.
Yes potassium was in range on my last set of labs , I’ve been watching my potassium intake since increasing telmisartan to 80. Drinking 6-7 liters of water daily
 
You can search for pulse pressure on this board.
Some of the ARBs hit systolic more than diastolic, so maybe you can switch to those instead. I also face the same issue, tho not as wide a range as yours..
I’ll look into that , appreciate it man !
 
Using 40mg tel, 2.5 neb and 10mg cilnidipine, still can’t seem to get under 140/75. One issue is I have the regular cuff and my arm is over 20”, so, I realize that could be a factor.
 
Using 40mg tel, 2.5 neb and 10mg cilnidipine, still can’t seem to get under 140/75. One issue is I have the regular cuff and my arm is over 20”, so, I realize that could be a factor.

If it's not the cuff, and it could be, most resistant BP responds to (and the guidelines call for) the addition of a diuretic. That said, I'd titrate the Cilnidipine to 20 before resorting to that. Telm to 80 is an option, but I think Ciln is the preferable of the two to increase, That's what I needed to get the rest of the way down, Keep your diastolic from dropping below 65 though.
 

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