I'm switching to telmisartan from lisinopril (need advice)

side effect wise I would go Nebivolol, from every thread or article I have searched online studies and ppl all report less side effect from nebivolol and even more benefit then Amlodipine

The only thing is Nebiv is a beta blocker. And those carry some risks that bp lowering calcium channel blockers don't.

I'll be honest, I don't even know what RHR is a concern. From what I read, it seems they don't treat those with meds until it hits 100, but so could be mistaken.
 
The only thing is Nebiv is a beta blocker. And those carry some risks that bp lowering calcium channel blockers don't.

I'll be honest, I don't even know what RHR is a concern. From what I read, it seems they don't treat those with meds until it hits 100, but so could be mistaken.
explain those risks, because nebivolol is HIGHLY selective beta blockers, not the usual BB
 
AI response:

When comparing valsartan, telmisartan, and other ARB (Angiotensin Receptor Blocker) medications for their impact on athletic performance, there are some differences worth noting:

1. Telmisartan:
- Has shown the most promise for potential benefits in athletic performance.
- Some studies suggest it may improve exercise capacity and endurance.
- Its long half-life (24 hours) provides consistent blood pressure control during exercise.
- May have beneficial effects on metabolism and muscle function.

2. Valsartan:
- Generally neutral effect on athletic performance.
- Shorter half-life may result in less consistent blood pressure control during extended exercise.

3. Other ARBs (e.g., losartan, irbesartan):
- Generally neutral effects on athletic performance.
- Some studies suggest losartan might have slight benefits for muscle strength in certain populations.

Research highlights:

1. A study published in the journal "Hypertension" (2012) found that telmisartan improved exercise capacity in patients with hypertension more than other ARBs.

2. Another study in "Circulation Journal" (2013) suggested telmisartan might enhance endurance performance by activating PPAR-gamma, which affects metabolism.

3. Research in "Medicine and Science in Sports and Exercise" (2016) indicated that telmisartan might help maintain muscle mass during periods of inactivity.

4. A comparative study in "Journal of Hypertension" (2014) showed telmisartan had more favorable effects on exercise tolerance compared to valsartan.

While these findings are promising, it's important to note that the primary purpose of these medications is to manage hypertension.

Also, it's crucial to remember that while some ARBs might not hinder athletic performance, they don't necessarily enhance it in individuals without hypertension. The observed benefits are often in the context of managing hypertension, which itself can impair athletic performance if left untreated.
Telmisartan has its downsides (especially sensitive people) - its effect on histamines is negative. It increases the release of histamine. It blocks the enzyme Dao. I am one of them, even at a dosage of 40 mg it gives such side effects as dizziness, chest spasm, facial flushing after histamine products. And there is mild agitation or anxiety. After cancellation and addition of antihistamines, all symptoms go away instantly. I am not a doctor, but I advise sensitive people to switch to Valsartan.
 
But today Azilsartan is the best option.

It's stronger at the same dose, but unless you can't reach ideal BP otherwise Telm has a longer half life, some metabolic benefits as a PPAR agonist, and much cheaper. Also, Azil is more biased toward systolic reduction and it seems a lot of us need more diastolic than systolic reduction.
 
It's stronger at the same dose, but unless you can't reach ideal BP otherwise Telm has a longer half life, some metabolic benefits as a PPAR agonist, and much cheaper. Also, Azil is more biased toward systolic reduction and it seems a lot of us need more diastolic than systolic reduction.
Telmisartan has many side effects for me personally. I don't like its dizziness effect, I don't like its histamine side effects. I don't like that it is metabolized in the liver. And Azilsartan has all the advantages and doesn't have all these side effects. Also Azilsartan reduces blood pressure in two positions.
My friend was experiencing all these side effects from telmisartan and his doctor prescribed Azilsartan and now he is happier than ever.
This is in no way propaganda. This is the case when telmisartan does not suit me.
 
Telmisartan has many side effects for me personally. I don't like its dizziness effect, I don't like its histamine side effects. I don't like that it is metabolized in the liver. And Azilsartan has all the advantages and doesn't have all these side effects. Also Azilsartan reduces blood pressure in two positions.
My friend was experiencing all these side effects from telmisartan and his doctor prescribed Azilsartan and now he is happier than ever.
This is in no way propaganda. This is the case when telmisartan does not suit me.

Luckily we have, perhaps more than for any other condition, a huge variety of effective meds for hypertension to work around individual sensitivities.

FYI Azil is also metabolized by the liver and considered more hepatoxic than Telmisartan, though both are very low risk in that regard Telm is preferred in cases of liver impairment.
 
Luckily we have, perhaps more than for any other condition, a huge variety of effective meds for hypertension to work around individual sensitivities.

FYI Azil is also metabolized by the liver and considered more hepatoxic than Telmisartan, though both are very low risk in that regard Telm is preferred in cases of liver impairment.
How is it metabolized?
Azilsartan is a prodrug (azilsartan medoxomil) that is rapidly converted to the active form in the intestinal wall.
Minimal liver metabolism, with major excretion occurring in feces and urine.
Does not accumulate, even in people with mild to moderate liver impairment.
Does not affect major enzyme pathways (e.g. CYP450), meaning it does not interfere with other drugs.

Why it is better for the liver:
Telmisartan and losartan are partially metabolized in the liver.
Azilsartan - involves the liver less and has almost no effect on enzymes.
This makes it a safe choice for “hormonal background”, taking oral medications, sports, HRT and anabolics.

this is what i found. i don't know how true it is. for me it was important to get rid of the side effects of telmisartan. it helps me keep my blood pressure down very well but my patience has run out)))
 
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