[AnnieBL]

I am prescribed spiro solely for hypertension. Two years ago my blood pressure was out of control, much to the concern of our then doctor since I was already taking about five other antihypertensives. She changed the beta blocker I was taking and repeatedly increased the dose, all without much effect, and sent me to the cardiologist who suggested first trying spiro in case I had a type of hypertension that is responsive only to spiro but not to conventional antihypertensives, and if that didn't work to prescribe a calcium channel blocker. Because spiro is a diuretic it did produce some reduction in blood pressure, but not nearly enough, so she then went on to prescribe the CCB without cancelling the spiro. The CCB worked like a charm without causing the leg swelling that had resulted in my having been previously taken off CCBs, but the day before my next visit to her, she died suddenly. This was not only a tragedy (she was in her early 40s and had school age children) but left her patients in a very difficult position since there is a serious shortage of family physicians in this area (about 10% of the population are on the official waiting list). We were very fortunate to be able to sign up with a new clinic within 20 miles of us run by a nurse-practitioner (in fact two currently, since the second, formerly a cardiac nurse, is doing the equivalent of her residency). I cannot speak too highly of the NPs, but they are understandably hesitant to stop medications originally recommended by a specialist. They have been reducing the dose of four of my antihypertensives one at a time, and have changed another, in order to find out what has been causing brief, almost daily episodes of very low blood pressure and/or pulse rate. The reductions in dosage have eventually reduced the depths of the dips, but paradoxically my average blood pressure has continued to decline to levels approaching hypotension rather than hypertension - hence the further visit to the cardiologist and hence my anticipation that he may cancel the spiro. In favour of the spiro is that it does seem more effective than the terazosin (originally developed as an anti-hypertensive) that my urologist prescribes. He said this could not be so, but the literature seem to back me up. I also found that there is research that digoxin (which I also take) potentiates the action of spiro.

I looked into eplerenone (thanks for the information) but find that it has never been approved in Canada and is not available.

The jury is still out for me on GABA. It seems nearly as effective as valerian as a sleep aid, but whether it increases growth hormone production or does any of the other things that are alleged, I have no idea. No noticeable side effects.

AP

"Experience is what you have just after you needed it most"