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Is Calcium Channel blocker Amlopidine better for inflammation?

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  • Is Calcium Channel blocker Amlopidine better for inflammation?

    My father has calcium score of 300 and is aged 78. His doctor switched from Losartan to Amlopidine 10mg.
    I was trying to recommend Ramipril.

    Should he stick to Amlopidine or ask his Dr to prescribe Ramipril? What would be the equivalent dosage in Ramipril. His highest BP is around 160/90.


  • #2
    This is another topic which I am not sure if Dr. Brewer can answer without seeming to give medical advice. Since I am not a doctor, I will say what I have heard. Amlopidine has shown benefits relative to cardiovascular disease, and so it probably has some positive effect on inflammation.

    Generally most doctors seem to start with an ARB (or an ACE inhibitor) for hypertension, and then add a calcium channel blocker (like Amlopidine) if necessary. I personally take ramapril now along with amlopidine. Your father's doctor would be more aware of any kidney and/or liver issues which might influence what is prescribed. Some people who get the coughing spells with an ACE inhibitor just quit taking their blood pressure medication, and that can be a significant issue in thinking about any change. I would first ask why the doctor stopped losartan before asking for ramapril. Is your father taking a statin? Is he generally healthy and active, or overweight and doesn't move around a lot?

    The other thing is that doctors have to be careful when implementing the new directive on keeping blood pressure down to 120/80 for elderly patients. Lowering their blood pressure a lot might result in lower blood perfusion (flow) to the brain, which obviously is going to cause problems. No doubt keeping hypertension in check in elderly people is a challenge.
    Last edited by Tom; 08-24-2019, 12:57 AM.


    • fatmax
      fatmax commented
      Editing a comment
      Check out this Topic in the Hypertension forum: Best ACE Inhibitor.
      Perindopril is anti-inflammatory and is often prescribed when patients have non-symptomatic CVD.
      Ramipril and perindopril are the two best ACE inhibitors, with perindopril being superior.
      I take 8mg of it in the morning and 5mg of amlodipine in the PM.
      The combination works for me. I'll wager that your doctor has never heard of perindopril. I recommend you research the benefits on Google.
      The only problem with it is that is isn't cheap. Use GoodRx.
      I'd also suggest that your father take Mg supplements, as a deficiency can induce hypertension. The best is magnesium water, a mixture of unflavored seltzer and milk of magnesia. I also use it. See Dr Davis blog.
      Last edited by fatmax; 08-24-2019, 07:08 AM.

  • #3
    Thanks. Correct about me not being able to answer the specific individual advice. But I can say a couple of things: Amlodipine (check spelling above) is a good bp med. It's a calcium channel blocker. Like other calcium channel blockers, it does not have an impact on CV inflammation. The ACE Inhibitors do. When considering a 78 yo, stable on a bp med, one must consider the risks vs benefits of changing bp meds. Bigger risks are likely to involve IR. I'd consider those first.


    • #4
      Thanks Doctor for your response!
      Also thanks to Tom and Fatmax!

      Healthwise he is ok and functional. He takes Crestor 5mg and Metformin ( 500mg twice a day).

      Funny thing is his BP varies a lot, It could go as high as 160/90 without meds, and when he takes Losartan only on few days it falls upto 90/65.
      He had dry cough and scratchy throat. hence the Doctor switched BP medicine. Otherwise he is non syptomatic.
      So since Amlodipine is a good med, then we would ask the Doctor if he could take 5mg instead.

      Thanks again for your response!