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Blood Pressure Meds and HIV Meds -- Not a good mix
Feb 3, 2010

I'm in a medication rut. I've failed nearly every class of medications for blood pressure out there; some due to side effects (metabolic reactions with HIV meds, that were never known at the time), and the rest due to my body being hypersensitive which I believe is due to having taken HIV meds for so many years (I've been poz since 1988).

My cardiologist is at Mass General; and off all the places I could go, even he says he doesn't know what else to do!

Right now, they're trying me on 25mg of HCT to see if that will help - though I can tell it probably won't be sufficient.

What should I do? Surely there are others out there that have been experiencing the same problems.

The irony here, according to my cardiologist, is that people with long-term HIV are not dying of HIV anymore, we're dying from heart trouble -- high cholesterol caused by HIV drugs, etc. etc.

Many anti-hypertensive drugs have common side effects, I feel very trapped. I have hypertension on both sides of my family so at age 41, and where my pressure is going, I have to do something.

I would appreciate any advice. My docs are stumped as to what to do.

FYI, my HIV meds are currently: Reyataz, 3TC, Viread, Norvir.

Thank you!

Response from Dr. Henry

Blood pressure control can be challenging even in the general population. In many cases low (better tolerated) doses of 2-3 classes of BP meds are needed (such as a B blocker, a diuretic, and an ACE inhibitor) so mixing and matching with frequent BP checks (including regularly at home). Diet and exercise/weight loss often important to help long term control of BP. A few BP meds are tough to use in HIV+ persons on drugs like protease inhibitors (for example some calcium channel blockers). I find the health care system often frustrating, making too difficult to set regular/frequent assessments and adjustments. Secondary causes of hypertension (such as kidney or hormone problems) can complicate matters so an assessment for that possibility can be useful. KH



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