Blood Pressure

Not only is it high, but the ratio is troublesome too. What's in your PWO?

Creatine 5g citruline malate 4g taurine 4g beta alanine 4g HMB 2g tyrosine 2g and collagen peptides 10g plus 50g of whey.

Probably heart failure tbh. My genetics are cursed.
 
I just got a 150/70 … isolated systolic hypertension, anyone know what drugs are best to deal with that? I don’t want to end up with diastolic hypotension.

Tbh I’m never really at my resting heart rate when I do this cause it takes hours of sitting sedentary to get there but I think even 150 one hour post workout and consuming a non-caffeine PWO is way too high.

Diastolic has stayed down but systolic has crept up again despite my 6 hours a week cycling and lowering my TRT even further. I’m not currently on any BP med because it was OK for a while.

Approx age? This is usually the result of stiffened arteries (how are your lipids?) or kidney dysfunction.(causing water retention).

Latest guidelines say to treat immediately with 2 drug combo.

For isolated systolic hypertension (ISH) 2025 America College of Cardioligy guidelines:

“If SBP ≥140 mmHg: treat as Stage 2 hypertension — start two first-line medications unless contraindicated.”

We know from experience CCB, ARBs, and Diuretics’s are the most effective for ISH and all considered to be first line.

Telm and Ciln are exceptionally effective with isolated systolic.

Personally, unless you have other heath problems (and you should def check your kidney function if you haven’t recently), I’d start with 40mg Telmisartan and 10 mg Cilnidipine (only from India fortunately), or if Ciln not an option 5mg Amlodipine. If above 135 after two weeks increase Telm to 80 or Ciln to 20 (imo better to increase Ciln).

If you’re still above 130 after 6 weeks you should add Indapamide 1.25mg,

You can get combo Telm/Ciln, or Telm/Ciln/Indapamide tabs. Once you’ve established what works, combo tablets are the way to go.
 
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Approx age? This is usually the result of stiffened arteries (how are your lipids?) or kidney dysfunction.(causing water retention).

I’m 31 - eGFR is decent in range but not great. Lipids are in range but only just.

I will start telmisartan now since I have it.

HCT is high too and I am having heart palpitations a lot.

Pisses me off because I am only on 150mg TRT.
 
I’m 31 - eGFR is decent in range but not great. Lipids are in range but only just.

I will start telmisartan now since I have it.

HCT is high too and I am having heart palpitations a lot.

Pisses me off because I am only on 150mg TRT.
Naringin supplements will lower hematocrit.
 
Currently taking 40mg daily Telmisartan. Coming off of a 600mg test cycle. Haven't pinned any test for one week.

Moving to a cruise, will start trt in a week. Also running 2mg Reta a week.

Never had high BP until about midway through the cycle. Hoping this comes down and I don't have to add more drugs but not liking the current numbers.

Anyone have any thoughts? Weight training fine days a week. HIIT cardio three times a week. Hydration is solid.

PXL_20251025_161611628.webp
 
Currently taking 40mg daily Telmisartan. Coming off of a 600mg test cycle. Haven't pinned any test for one week.

Moving to a cruise, will start trt in a week. Also running 2mg Reta a week.

Never had high BP until about midway through the cycle. Hoping this comes down and I don't have to add more drugs but not liking the current numbers.

Anyone have any thoughts? Weight training fine days a week. HIIT cardio three times a week. Hydration is solid.

View attachment 356869
Do you have Cilnidipine on hand?
 
Do you have Cilnidipine on hand?
It's actually in the mail from India. Should be here in a week or so. I was hoping it will soon drop after the cycle and I could save them for the next blast but that hasn't happened yet. Assuming I still have elevated test levels though.
 
It's actually in the mail from India. Should be here in a week or so. I was hoping it will soon drop after the cycle and I could save them for the next blast but that hasn't happened yet. Assuming I still have elevated test levels though.

Increase telm dose.
Monitor potassium levels.
 
I’m 31 - eGFR is decent in range but not great. Lipids are in range but only just.

I will start telmisartan now since I have it.

HCT is high too and I am having heart palpitations a lot.

Pisses me off because I am only on 150mg TRT.
Do you have blood tests to post showing the actual numbers?

Do you ever donate blood?

Is the 6 hours of cycling on a bicycle, outside, or is this in a gym indoors on a machine? Do you get your heart rate up (or monitor it), elevated for a long time during your cycling?
 
Currently taking 40mg daily Telmisartan. Coming off of a 600mg test cycle. Haven't pinned any test for one week.

Moving to a cruise, will start trt in a week. Also running 2mg Reta a week.

Never had high BP until about midway through the cycle. Hoping this comes down and I don't have to add more drugs but not liking the current numbers.

Anyone have any thoughts? Weight training fine days a week. HIIT cardio three times a week. Hydration is solid.

View attachment 356869

Haven't pinned any test for a week basically equals still on cycle. Did you add a lot of body weight on cycle?

Would you consider adding some longer cardio, like getting your heart rate elevated for 20-30 minutes, like on a stair master or elliptical or on a bicycle, outside?

I saw you mentioned reta, so I have to ask about your body fat levels and whether you are reducing them consistently week to week.

Raise the telmisartan to 80, since you have it. Watch your blood pressure as the testosterone leaves. Control your estrogen until you get to TRT- consider waiting 2-3 weeks to resume TRT, and, when you do, consider keeping your levels at 120mg a week or less.

Definitely consider some longer cardio, though.

If you are higher body fat, then get it down.

As for reta and heart rate, there is this post to consider.

 
Do you have blood tests to post showing the actual numbers?

Do you ever donate blood?

Is the 6 hours of cycling on a bicycle, outside, or is this in a gym indoors on a machine? Do you get your heart rate up (or monitor it), elevated for a long time during your cycling?

6 x 1 hour cycling on my bike outside with HR between 130 and 150 with a sprint or two up to 170 for under a minute sometimes.

I haven’t donated.

All these things are a little bit too high:

HCT 58%
Test 47.8
Est 243
Albumin 54
Creatinine 116
LDL 3.36
HDL 1.44 (in range, for info)
RBC 6.06
 
6 x 1 hour cycling on my bike outside with HR between 130 and 150 with a sprint or two up to 170 for under a minute sometimes.

I haven’t donated.

All these things are a little bit too high:

HCT 58%
Test 47.8
Est 243
Albumin 54
Creatinine 116
LDL 3.36
HDL 1.44 (in range, for info)
RBC 6.06

That LDL is only acceptable by standards that were outdated by the time they were released. If longevity, and “healthspan” are things you want to pursue getting that way down, by 50%+, or more if your over 40, should be on your to do list.
 
That LDL is only acceptable by standards that were outdated by the time they were released. If longevity, and “healthspan” are things you want to pursue getting that way down, by 50%+, or more if your over 40, should be on your to do list.

So get on a statin right away? I can’t imagine any dietary change being able to give me a 50% reduction considering that it’s already a healthy pescatarian diet with zero fast food. Only thing might be I drink a bit too much, like a bottle of wine a week.

I wanted to avoid the polypharmacy approach of taking 15 different medications every day but to be honest it looks like I’ll have to if I want to have healthspan.

Should I get ApoA and ApoB tested?
 
So get on a statin right away? I can’t imagine any dietary change being able to give me a 50% reduction considering that it’s already a healthy pescatarian diet with zero fast food. Only thing might be I drink a bit too much, like a bottle of wine a week.

I wanted to avoid the polypharmacy approach of taking 15 different medications every day but to be honest it looks like I’ll have to if I want to have healthspan.

Should I get ApoA and ApoB tested?

The LDL target is determined by where you fall in the Risk hierarchy. Green is the LDL “target” for each risk level:

European Society of Cardiology guidelines

IMG_3154.webp

Regardless of what formal “SCORE” risk calculators determine, PED use puts you in the “High” or “Very High” risk category for cardiovascular disease. If you have a family history of heart attacks or strokes you’re definitely “Very High” risk. If that’s the case you’d qualify for intense cardiologist testing and treatment to reduce your risk factors.

You’re correct, diet can only shift lipids 15 (.4 mmol) points, 20 (.5 mmol) in rare cases. (Outside of a few genetic outliers that I’ll leave out for simplicities sake).

The risk of polypharmacy, essentially trying to limit side effects and controlling for the risk of unknown interactions is understandable. However, modern meds are far more targeted than previous generation pharmaceuticals, so there’s a much lower risk for either of those issues. In fact, it’s entirely possible for most people to avoid negative side effects (and benefit from health improving side effects) by choosing the correct meds.

Ezetimebe, the lowest risk most benign lipid drug, is a non-statin that reduces the ability of cholesterol to be absorbed by the intestines. Put simply, the liver produces 85% of cholesterol, dumps it into the intestines, and then it’s reabsorbed, Eze blocks some of this.

Eze will reduce your LDL by about 20%. Not enough but if this is all you’re willing to do, it’s certainly going to help.

Outside of special cases (kidney failure or serious liver disease), the ONLY statin I recommend is Pitavastatin. PITA might as well mean “pain in the ass” because so few doctors are familiar with it, and fewer willing to prescribe it. Until recently, it was a very expensive ($500/mo) statin reserved for those who tried every other statin and suffered terrible side effects. Now it’s a cheap generic.

It not only has the lowest risk of side effects, it offers other health benefits like improved insulin sensitivity.

Unless you have a cooperative doctor, you may need to get it from Indian suppliers. There are single pill combos with both. The fact is most people do fine with Rosuvastatin, a very cheap commonly prescribed statin, and I’m sure your doctor would prescribe that (you’re within statin prescribing range by EU treatment guidelines), but if you’re statin phobic like I was, knowing you’re using the safest, most modern statin developed specifically to avoid any sides is comforting.

Pita will lower LDL by about 45%, with Eze 60-65% reduction total. That will put you comfortably at the level where no further plaque will accumulate, and systemic inflammation will drop significantly. This is great for longevity, even beyond cardiovascular health, extending to joint protection, cognitive health, mood, etc.

If you could get a PCSK9 inhibitor (Repatha, once every two weeks injection) you could get into plaque regression range, removing some of the soft plaque you’ve already accumulated, but I know that’s a stretch in the EU.

This is a long term investment in your health.

You should get Lp(A) “lipoprotein A” measured if you can. This is a genetically determined risk factor that might indicate you’re at much higher risk than your LDL indicates and would warrant much more aggressive testing and treatment.

Also, HS-CRP is an important factor in the development of cardiovascular disease.

The rest, HDL, ApoB is good to know, but LDL and Lp(A) represent 95% of risk. If LDL is low enough <40 (1.2 mmol) risk is so low nothing else matters very much for cardiovascular disease.

If you can get a “Calcium Score”, you’d have a good sense of how far along the damage is, which like Lp(A) could push you into a higher risk group and qualify you for more Testing and a PCSK9 inhibitor.

IMG_1924.webp
 
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Currently on 40mg pharma telmisartan with BP 120/90, as coming down to a cruise **with crushed e2 at 8pg/ml**. Not sure if thats the cause of the diastolic rise but have read it could be. Beta blockers have 0 effect on HR (resting between 85-95 with an increase during gym that stays elevated 30-45 mins post at around 105) oand diastolic currently. Lipid panel not great, slightly out of range by 4 pts on ldl(104) , hdl was 36 trigs 170 so started ezetimibe 10mg last week.

Would anyone recommend adding amlodipine as I have it on hand (pharma) for the diastolic, or am I at risk for further pushing down of systolic in a negative low range?

Also ordering the telma-cip combo as we speak for future runs from india.
 
Currently on 40mg pharma telmisartan with BP 120/90, as coming down to a cruise **with crushed e2 at 8pg/ml**. Not sure if thats the cause of the diastolic rise but have read it could be. Beta blockers have 0 effect on HR (resting between 85-95 with an increase during gym that stays elevated 30-45 mins post at around 105) oand diastolic currently. Lipid panel not great, slightly out of range by 4 pts on ldl(104) , hdl was 36 trigs 170 so started ezetimibe 10mg last week.

Would anyone recommend adding amlodipine as I have it on hand (pharma) for the diastolic, or am I at risk for further pushing down of systolic in a negative low range?

Also ordering the telma-cip combo as we speak for future runs from india.

You don’t mention dose, but 10mg Amlodipine would bring you to approx 110/80. No risk of hypotension. You may feel slightly weaker for a couple of days until you acclimate to the lower pressure.

114/82 if using 5.

2 weeks for full effect.

10-15% risk of edema.
 
You don’t mention dose, but 10mg Amlodipine would bring you to approx 110/80. No risk of hypotension. You may feel slightly weaker for a couple of days until you acclimate to the lower pressure.

114/82 if using 5.

2 weeks for full effect.

10-15% risk of edema.
Dose of amlodipine? If so I believe they are 10s. Cruise just started at 150mg/wk. the main reason other than obviously lowering bp for health concerns is the fact I need to bring e2 up while eq clears over the next few weeks, so was going to try 1-2.5mg ment pulses to bring e2 up gradually without (hopefully) raising bp drastically. I cant do that now with an already high diastolic.

Does amlodipine work that effectively to bring bp down to 110/80 immediately? Or are you saying once full effect reaches
 
Dose of amlodipine? If so I believe they are 10s. Cruise just started at 150mg/wk. the main reason other than obviously lowering bp for health concerns is the fact I need to bring e2 up while eq clears over the next few weeks, so was going to try 1-2.5mg ment pulses to bring e2 up gradually without (hopefully) raising bp drastically. I cant do that now with an already high diastolic.

Does amlodipine work that effectively to bring bp down to 110/80 immediately? Or are you saying once full effect reaches

That’s max effect reached at 2 weeks. Half by 5 days.
 
You don’t mention dose, but 10mg Amlodipine would bring you to approx 110/80. No risk of hypotension. You may feel slightly weaker for a couple of days until you acclimate to the lower pressure.

114/82 if using 5.

2 weeks for full effect.

10-15% risk of edema.
Do you think Ciln helps with edema from GH? (Assume telmi + ciln)

Or if you're on a low dose and Telmi 80mg keeps your BP low enough, adding Ciln won't add anymore bloat reduction?

Wondering if 80mg telmi alone is fine on trt + low dose GH, or if I should try 40mg telmi + 10mg ciln, etc.
 
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