QuestionQUESTION: I'm 60 and may likely need to be on blood pressure medication, but a few years ago one doctor said he would choose an ace inhibitor, another Dr. said beta blocker, and then I read that the "old reliable standby" a diuretic is the way to start. It's confusing, is there a particular one that has the least side effects? Is one type used more commonly than others in someone my age who is otherwise healthy?
ANSWER: it becomes a matter of habit and personal preference... the bottom line is you will get benefit from blood pressure lowering no matter which medicine is chosen, provided it works and you don't have side effects. B blockers tend to slow people down, I prefer ace inhib and/or diuretics.... cheap, safe. 12% of people cannot take ace inhibitors but it is always worth a try......
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QUESTION: Thanks. I read that angiotensin II receptor blockers may cause fewer side effects. Is that true, or for some reason is it not used as much?
Answerthat is true, arb's are probably tolerated a little better than ace's, but remember, only 12 % have ace side effects and the cost difference is significant... many ace's cost 4 dollars or less a month, most arb's are 50-100 dollars per month (not counting insurance); so with the benefit equal, I would always try an ace first... chances are it will work and be tolerated well.......
