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What Can/Cannot Be Used to Reduce BP?
Apr 25, 2005

40yr old male w/AIDS for 12yrs. Had a stroke at age 30. Currently on a regimen of Truvada, Ziagen & Sustiva. Experiencing elevated BP for several months (155/120-avg.). Beta blockers causing insomnia and withdrawn. Now being given HCTZ which is causing weight loss and not lowering BP enough. Given this med regimen, what can or cannot be used to medically lower BP in this patient? Thank you.

Response from Dr. Henry

There can be a wide range of responses to blood pressure meds from person to person. Calcium channel antagonists, angiotensin-converting enzyme inhibitors, angiotension II receptor blockers, alpha-adrenergic antagonists, and central adrenergic agents are classes of BP meds that can be safely be effective in certain patients. Most of those meds are OK to use with a Sustiva based regimen. In addition there are a range of beta-blockers that can be tried as well as a wide range of doses for HCTZ that can be tried. Due to the wide range of possibilities it can be hard for an HIV specialist to optimize the individual choice so I often refer to a BP specialist to get help with fitting the regimen to the patient. KH

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