Blood Pressure

[BamaCrazy]

Thanks, I guess I should look further into it then.
When do you take it then? Morning or evening?

What about Nebivolol, it seems like the same kind of drug, that should be able to do very little harm, but a lot of good, even at low doses.
I don't want to loose any my endurance, as my training currently (injuries...) is a hybrid one at best, so I do a lot of LISS cardio of all sorts, complimenting m weak ass strength training.

TIA!

I take it at night but it really shouldn’t matter with the 24 hour coverage.

I’d try Telmisartan before considering adding Nebivolol. It’s a different type of BP med and can lower heart rate. I initially felt a hit to my endurance and some exhaustion when I started Nebivolol. It’s a decent add on at low doses only if needed.

 

[newguy2]

Personally I would not be comfortable with a systolic of 130. I believe 20mg Telmisartan will get you down below 120 within a couple of weeks. Some of the things I like about Telmisartan is I never feel any side effects and it has a 24 hour half life. So I am covered around the clock. Which is crucial for morning hypertension. Heart attacks are more common in the morning within the first few hours of waking.

I got a script from my doctor and have been taking 40mg for about 2 weeks. Just pulled a morning BP at 144/79. Not excited about that, was hoping for better results. First time taking and or needing a BP med. Running 600mg of test cycle ends in ten days. Hoping and assuming the BP will naturally drop once the cycle is over.

 

[BamaCrazy]

I got a script from my doctor and have been taking 40mg for about 2 weeks. Just pulled a morning BP at 144/79. Not excited about that, was hoping for better results. First time taking and or needing a BP med. Running 600mg of test cycle ends in ten days. Hoping and assuming the BP will naturally drop once the cycle is over.

2 weeks should be enough for you to see some reduction. But it can take up to 4 weeks to see the full effects. But 144 is highly concerning.

 

[Ateam2023]

I got a script from my doctor and have been taking 40mg for about 2 weeks. Just pulled a morning BP at 144/79. Not excited about that, was hoping for better results. First time taking and or needing a BP med. Running 600mg of test cycle ends in ten days. Hoping and assuming the BP will naturally drop once the cycle is over.

144/79 ? ? what is your bp normally?

 

[Banana Joe]

Excuse the interruption, there are important Telm side effects you should be aware of:

"Telmisartan is ...
Taken together, these pleiotropic effects mean telmisartan doesn’t just manage blood pressure, it also supports metabolic health, vascular integrity, organ protection, and mitochondrial efficiency through a combination of angiotensin blockade and PPAR-mediated cellular regulation."

PS: Take it whenever it's convenient. All that matters is that you take it consistently, at roughly the same time every day. A pill organizer can help keep everything straight (ie, "Did I already take it today??"). It takes a couple of months for the full benefit to manifest.

I am not missing the obvious by wanting to take it, after heaving read this?

I take it at night but it really shouldn’t matter with the 24 hour coverage.

I was asking based on the 1h(?) to reach peak blood serum concentration, and that I would assume my BP is the highest during my workouts.
I know it probably a wash at the end, but if nothing speaks against taking it in the morning, I would do so, because I usually train a few hours later.

I’d try Telmisartan before considering adding Nebivolol. It’s a different type of BP med and can lower heart rate. I initially felt a hit to my endurance and some exhaustion when I started Nebivolol. It’s a decent add on at low doses only if needed.

I think my RHR recently was always in the low to mid 60's. I'd check right now, but I am either too dumb to use my new cuff, or the thing broke after using it 3 times...
A friend of mine (20kg heavier, hereditary high BP) said, he only got his BP down with Nebivolol, Telmisartan alone didn't do the trick.

Leaving aside the possible regular side effects, am I likely to profit from 5mg? Wouldn't it be better to have my RHR a bit lower?

 

[Nixonnow99]

I am not missing the obvious by wanting to take it, after heaving read this?

I'm pretty sure he was fooling. Lots of positives regarding Telm for BP. I was previously on Losartan. Switched to Telmisartan due to the longer half-life. Losartan has the negative morning BP widowmaker spikes.

I was asking based on the 1h(?) to reach peak blood serum concentration, and that I would assume my BP is the highest during my workouts.
I know it probably a wash at the end, but if nothing speaks against taking it in the morning, I would do so, because I usually train a few hours later.

I take mine in the morning and feel fine for workouts. As Bama said. The longer half-life ensures it always in your system.

I think my RHR recently was always in the low to mid 60's. I'd check right now, but I am either too dumb to use my new cuff, or the thing broke after using it 3 times...
A friend of mine (20kg heavier, hereditary high BP) said, he only got his BP down with Nebivolol, Telmisartan alone didn't do the trick.

At home cuffs are notoriously inaccurate at times....just food for thought. What's your lipids profile like? Particularly LDL. Could benefit from a statin. It will reduce blood pressure by eliminating plaque buildup and rigidity in your vascular system.

 

[Banana Joe]

I'm pretty sure he was fooling. Lots of positives regarding Telm for BP.
I take mine in the morning and feel fine for workouts. As Bama said. The longer half-life ensures it always in your system.

I was joking as well, but I guess I could have made it a bit more obvious!
I will probably settle on taking it in the morning then.

At home cuffs are notoriously inaccurate at times....just food for thought. What's your lipids profile like? Particularly LDL. Could benefit from a statin. It will reduce blood pressure by eliminating plaque buildup and rigidity in your vascular system.

I *just* wrote this, could have been the response to your question too, you read my previous replies, to get more details. Last LDL/HDL was around 155/28.
About the cuff, yeah. I must read the manual again, before I blame the device. But I had an error 2x today. Not sure what I did different than the other few times.

Post in thread 'Reta Microdosing (<1.5mg) to improve lipids?'

Oct 6, 2025

Ok, to make a long story short, I will get a prescription for Pita+Ezem.

Thanks to everyone insisting on me getting myself checked!
It raised my awareness about LDL, that I didn't have before, because no doctor said it would be something he is really worried about.


I still want to know more about using Reta in microdoses, because I really want to take this supposed miracle drug.^^

• Banana Joe

• 

 

[Ateam2023]

I was joking as well, but I guess I could have made it a bit more obvious!
I will probably settle on taking it in the morning then.


I *just* wrote this, could have been the response to your question too, you read my previous replies, to get more details. Last LDL/HDL was around 155/28.
About the cuff, yeah. I must read the manual again, before I blame the device. But I had an error 2x today. Not sure what I did different than the other few times.

Post in thread 'Reta Microdosing (<1.5mg) to improve lipids?'

Oct 6, 2025

Ok, to make a long story short, I will get a prescription for Pita+Ezem.

Thanks to everyone insisting on me getting myself checked!
It raised my awareness about LDL, that I didn't have before, because no doctor said it would be something he is really worried about.


I still want to know more about using Reta in microdoses, because I really want to take this supposed miracle drug.^^

• Banana Joe

• 

Then take some low dose Reta and let us know how it goes, orrr keep posting about how you want to take it haha and what you want it to do

 

[Nixonnow99]

I *just* wrote this, could have been the response to your question too, you read my previous replies, to get more details. Last LDL/HDL was around 155/28.

Ahh crap. You definitely did list all of that this morning. My bad bro. I've been trying to keep up with this thread while at work. It looks like you've got some solid options going forward.

 

[just some dude]

my bp can’t handle high test without a calcium channel blocker. i would agree with the line of defense being ARB and then calcium channel blocker. had great success with amlopodine but cilnidipine seems to be superior

 

[just some dude]

Of course everyone's entitled to their opinion, drawn from their experience etc.

However, every set of hypertension treatment guidelines from medical organizations. which are updated based on evidence every few years, have increasingly discouraged use of beta blockers and reserve them as a last resort for treatment resistant hypertension, because of the negative consequences associated with their use(more strokes, being the primary reason).

TLDR the steps are currently in the order of:

ACE/ARB + Calcium channel blocker minimum doses.

Increase doses of one or both to maximum tolerable if bp not at target.

If still not at target, add diuretic.

Finally, if still not working add a Beta Blocker.






View attachment 313597View attachment 313601

interesting. ive always used 5mg nebivolol with 80mg telmisartan but clonidine and cilnidipine have definitely sparked my interest. very effective. reading this makes sense though, it’s not that beta blockers are outdated, they just aren’t as much as a priority on the first lines of defense anymore.

it seems you were right about doctors preferring a polypharmacy approach to cardiovascular health over hammering one pathway, and quite frankly when put into practice, it just makes sense.

as far as diuretics, i just consume more and more potassium, and less and less sodium.

 

[newguy2]

2 weeks should be enough for you to see some reduction. But it can take up to 4 weeks to see the full effects. But 144 is highly concerning.

144/79 ? ? what is your bp normally?

For most of the cycle and before that it was commonly in the 120's, low 130s here and there. Then all of a sudden it was hitting 140's, even think I was like 150/81 once and obviously kind of freaked out.

Currently taking 40mg telm and 5mg Cialis daily.

 

[BigDadd7]

...as far as diuretics, i just consume more and more potassium, and less and less sodium.

I wonder how your kidneys feel about that

 

[just some dude]

I wonder how your kidneys feel about that

overall it’s better than high sodium but yeah good reminder for me to get back on top of electrolytes

edit: yeah i see the problem now. tbh this forum already influenced me to stop demonizing reta and anti cholestrol meds, so i wouldn’t be surprised if ill stop being anti diuretics after i finish this research

 

[Lifting88]

I am not missing the obvious by wanting to take it, after heaving read this?


I was asking based on the 1h(?) to reach peak blood serum concentration, and that I would assume my BP is the highest during my workouts.
I know it probably a wash at the end, but if nothing speaks against taking it in the morning, I would do so, because I usually train a few hours later.


I think my RHR recently was always in the low to mid 60's. I'd check right now, but I am either too dumb to use my new cuff, or the thing broke after using it 3 times...
A friend of mine (20kg heavier, hereditary high BP) said, he only got his BP down with Nebivolol, Telmisartan alone didn't do the trick.

Leaving aside the possible regular side effects, am I likely to profit from 5mg? Wouldn't it be better to have my RHR a bit lower?

For me telmasartan doensnt do alot

But i was using 2.5 mg nebivolol and raise to 5mg before bed, that night i need to go out bed because my little boy calls me and i almost passt out, got dizzy and everthing turns around look me a day before it got better

After that night im very scared off nebivolol

 

[BamaCrazy]

For me telmasartan doensnt do alot

But i was using 2.5 mg nebivolol and raise to 5mg before bed, that night i need to go out bed because my little boy calls me and i almost passt out, got dizzy and everthing turns around look me a day before it got better

After that night im very scared off nebivolol

There is an adjustment period for sure. It took me 1-2 weeks on Nebivolol before I wasn’t feeling exhausted. But I take it in the morning. I felt it the most if I went to the gym within 3 hours of taking it.

 

[Banana Joe]

... I take it in the morning. I felt it the most if I went to the gym within 3 hours of taking it.

Why not take it before bed then?
3h before the gym would be around my timeframe as well.

 

[Ghoul]

interesting. ive always used 5mg nebivolol with 80mg telmisartan but clonidine and cilnidipine have definitely sparked my interest. very effective. reading this makes sense though, it’s not that beta blockers are outdated, they just aren’t as much as a priority on the first lines of defense anymore.

it seems you were right about doctors preferring a polypharmacy approach to cardiovascular health over hammering one pathway, and quite frankly when put into practice, it just makes sense.

as far as diuretics, i just consume more and more potassium, and less and less sodium.

FYI for everyone:

Since I last posted various charts etc from previous guidelines, two weeks ago the American Heart Association released their massive 2025 Blood Pressure Guidelines book. This is the uber guideline that consolidates the most solid recommendations from all other guidelines issued by major health organizations worldwide. They spent several years looking at all the latest research as well, and using an evidence based approach, updated various aspects of BP treatment. The guide itself is very interesting if you really dive into it, the "lifestyle" section alone has a lot of great info on what you can expect in terms of BP improvement from various types of exercise , changes to diet, etc. (it's not as much as you think though).

https://www.ahajournals.org/doi/epdf/10.1161/CIR.0000000000001356

Most relevant to us is that for Stage 2 hypertension, >140 Systolic or >90 Diastolic, they now advise immediately starting with medication to reduce blood pressure.



The first line treatment should a a low dose combo of 2 classes from ACE / ARB / Diuretic / CCB. Do not combine ACE/ARB.

Beta Blockers look worse and worse for outcomes as the years go by, and they advise avoiding them except for patients with chronic heart disease or heart failure.



They point out it's now clear very few people can reach healthy blood pressure on a single class of med.

For most of us without medical complications, a combo of Telm + CCB (amlodipine is most common addition in the US), is the best choice. ACE/ARB and CCB address the two most common mechanisms of hypertension, so combined they have a very high rate of effectiveness and Telm/Amlo has a low rate of sides at low doses (40/5).

Cilnidipine is the best CCB of all, but unavailable in the US and has to be bought via India Pharma, a hassle but it is cheap. For most people Amlodipine is fine, but if you start with Telm/Amlo and find it works, for the long term consider ordering some Cilnidipine or a Telm/Ciln combo. Just double the Amlodipine dose for the equivalent Cilnidipine dose.

If low dose 2x med combo still leaves you a little high, doses of one or both can be increased. If it's way off, adding third class, a diuretic, is the next step. If that's not enough it's considered "resistant hypertension" and needs a specialist to evaluate for root cause.




Seriously. if you have any questions about dealing with BP, this is the bible. Some parts are heavily technical, but a lot of its 120 pages are clear enough for a layman to understand.

It rarely gets updated, and they only do so when the American Heart Association believes there are significant changes warranted by new research. The last update was 8 years ago, and the one before that was 15 years.


PS: You'll see color coded columns labeled COR and LOE. COR is "Strength" of the recommendation (risk to benefit) and LOE "quality of evidence" for it. Per this chart:

 

[BamaCrazy]

Why not take it before bed then?
3h before the gym would be around my timeframe as well.

I get a little concerned for my liver taking all my meds at one time. So I take Telmisartan and Cilnidipine at night. And Nebivolol. Rosuvastatin and Ezetimibe in the morning.

 

[Photon]

Beta Blockers look worse and worse for outcomes as the years go by, and they advise avoiding them except for patients with chronic heart disease or heart failure.

View attachment 352822

Were beta blockers ever recommended as first line agents?