For the reasons @adssx mentioned, I’d think about pushing the dose of telmisartan gradually to 160 mg with monitoring if needed to get into a good BP range. If that ends up being inadequate, you’ll have great PPAR effects, and a tiny dose of a third agent could be considered, or a different CCB that doesn’t risk edema, in a higher dose could be considered.
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Not really. But my mom was on 40 mg Telmisartan while switched from other ARB equivalent (50mg Losartan) but at the end she had to double it to 80mg by her doctors because its “weak action”. Here is the equivalency chart:
Why do you think indapamide didn’t help you? Any sides?
I wouldn’t take high doses of telmisartan just to extend longevity or to possibly ward off dementia in the vague and distant future. But that’s just me.
I did order some hawthorn though. I think it’s worth an experiment.
Her doctors are stupid. Make sure to change doctors.
These equivalency charts are just a help. They say nothing about the potency of a drug. What matters is the effect on biomarkers (here SBP, DBP, PP, MAP, BPV, HOMA-IR, etc.).
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I felt quite bad taking it (only 2 weeks). But I had issues with my glucose variability before and thiazides can mess up glucose regulation in some people. So I’m just unlucky to be one of those.
Anyway I’m on telmisartan 80 mg + amlodipine 5 mg + dapagliflozin 10 mg + taurine 3 mg and still have elevated BP 
I’ll discuss Hawthorn and COQ10 with my doctor…
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You can do a deep dive on Carvedilol ( beta blocker seems to be superior to nebivelol ) or Nifedipine a calcium channel blockers with positive effects on elastin and utilize one of them or both.
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I start the day with hibiscus tea. This is also thought to help lower BP.
I buy the dried flowers by the kilogram from healthysupplies.co.uk
Tim, why not add an SGLTi like dapa or empagliflozin? You’d get all the potential health benefits along with at least some additional drop of BP.
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Thanks for the recommendation. Yes, these meds sound attractive but the potential sides give me pause:
“The main adverse events of SGLT2i include urinary tract and genital infections, as well as euglycemic diabetic ketoacidosis. Concerns have also been raised about the association of SGLT2i with lower limb amputations, Fournier gangrene, risk of bone fractures, female breast cancer, male bladder cancer, orthostatic hypotension, and acute kidney injury.”
Now this may be a lawyer talking, doing a nice job of CYA. Plus, I don’t have diabetes, so most of the warnings probably don’t apply to me. I’ll talk to one of my docs about it. It could be just the thing.
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That’s the position I’m taking for myself – that the scary sounding side effects are not only extremely rare, but even more extremely rare in a non-diabetic. If you haven’t read through the thread titled “Canagliflozin – another top anti-aging drug”, the published studies on the safety of these meds are very reassuring to me, and the potential health benefits appear to be enormous.
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Last time I checked nifedipine it was inferior to amlodipine. And its 2h half-life is way too short to ensure good BP control over 24h. Carvedilol is interesting but I think it lowers heart rate and mine is already in the lower range of normal.
Hibiscus tea: interesting but not convenient when traveling.
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