Sunday, January 25, 2009

Simvastatin, perindopril and amlodipine.? -

Why would someone be on all three? My Dad is getting these and is not very talkative on why. I ve researched these drugs and they seem to be for hypertension, cholesterol and possibly heart problems. But not being competent in this field I wondered if anyone could give me a general idea as to why someone would be on all three. I understand that the best answer will be an educated guess but it will give me a better understanding. Thanks for your time.

Jay, - I hate to differ with you, - we ve been regular Answers respondents in the past. However, I have to disagree with your comment (made several times) that quot;high blood pressure adds to the workload of the heart and arteries....quot; Please don t take offence at this, but it doesn t. That is, high blood pressure has not the slightest effect on the workload of the heart. That is, quot;the workload of the heartquot; is precisely that. It is quot;the work that the heart must performquot; and is quantifiable. One can calculate it, and it is expressible in two forms, either (1) CO x Pm. and/or (2) CO x the square of TPR. ........ Whichever way one calculates it, the answer comes out the same, and is independent of so-called quot;blood pressurequot;. That is, quot;blood pressurequot; doesn t change it, because it can t, -it can neither increase it nor decrease it. Why? - well, because everybody s resting TPR is essentially the same (about 0.02mmsHg/ml/min), and everyone s average CO at rest is about 5 litres/min, and from Darcy s Law (or The Mean Pressure Equation, or the Law of Flow, -whichever name you prefer) this means that the true Pm (central aortic Mean pressure, the actual driving pressure delivering blood out of the aortic valve) has to be 100 mms/Hg. As you can see, it matters not what systolic and diastolic pressures are, so long as their weighted mean is 100. So the cardiac workload is 100 x 5ltres, whether you take quot;blood pressuresquot; like mine (195/105) or those of a healthy young adult. As I said, please take these observations in the spirit in which I make them, and I d be most interested and grateful for any comments. Sincerely

Here is a general idea... Simvastatin (Zocor) used for cholesterol. Cholesterol builds up in the arteries and can cause a heart attack. Amlodipine (Norvasc) Helps blood pressure and chest pain thereby reducing the chance of a heart attack. Perinolpril (Aceon) Helps blood pressure and is used in patients with coronary artery disease to help prevent heart attacks. Sometimes one medication is not enough to control a patients blood pressure so doctors prescribe combinations to get results. It sounds like your dad s doctor is doing everything he can do with medication to help him.

Simvastatin is for lowering cholesterol levels. Perindopril amp; amlodipine are against hypertension being ACE inhibitor amp; calcium channel blocker respectively. It s quite normal to be on an anti-hypertensive drug and a cholesterol-lowering drug at the same time. But, I don t see why your dad has to be on 2 types of hypertensive drugs at the same time. While these drugs are often safely used together, careful monitoring of the systemic blood pressure is recommended during co-administration, especially during the first one to three weeks of therapy.

The specific functions of these drugs for which they are presecribed are - Simvastatin is used together with a proper diet to treat high cholesterol levels in the blood. Using this medicine may help prevent medical problems caused by such substances clogging the blood vessels. This medicine may also be used to prevent certain types of heart problems in patients with risk factors for heart problems . It works by blocking an enzyme that is needed by the body to make cholesterol, thereby reducing the amount of cholesterol in the blood . Perindopril is used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. Hypertension may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled . Amlodipine is a calcium channel blocker used to treat angina (chest pain) and high blood pressure. Amlodipine affects the movement of calcium into the cells of the heart and blood vessels. As a result, amlodipine relaxes blood vessels and increases the supply of blood and oxygen to the heart while reducing its workload. High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled. All these medicines can be given individually or in combination with other medicines to treat various symptoms and ailments of Heart related disease. Your doctor must have decided like this considering various aspects and it is in order, as I feel your father is a chronic heart patient. For your information, I may add that I take both Simvastatin and Perindopril. So you need not worry and give the correct dose to the patient as per doctors advice. -

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