Ace Inhibitor to prevent kidney disease?

I recently went to a cardiologist for screening due to relatives having cardiomyopathy and due to palpitations- everything is fine with my heart. He wants me to take an ace inhibitor to prevent kidney damage and gave me two studies to read that back up that it will prevent this. Is anyone else doing this? I'm not sure what to do. I have no sign of kidney damage at this point. I plan to ask my endo about it in March.

What do you all think?

I had the same recommendation and have taken Lisinopril for a while. Also for borderline hypertension, I was up to 150/100 when I was 275 lbs and was concerned but, since I've lost weight and started running am more like 120/70ish these days but am keeping up the Lisinopril in case it helps my kidneys. I take 2 if I take sudafed when I'm sick, since sudafed seems to crank BP up.

Lisinopril turned me into a slug. I thought I was going to die. My BP was low to start with, I had no kidney damage, and I had autonomic neuropathy, but I was still prescribed Lisinopril. Even at 1/4 of a pill, it would take 3 hours in the morning, and lots of coffee, before I could actually stand up. I don't doubt that it helps some people, it just toasts me that some doctors automatically prescribe it to everyone who has diabetes.

Many years ago my dr I had since I was a teen put me on a drug in the 80s that was to protect my kidneys, what it was I don't remember. There have been those type of drugs for years.

I'd definitely try it. 20% of patients taking lisinopril will develop a chronic cough, which I did. So I was put on a drug in the class of "angiotension receptor blockers" whih are nearly as effective. I have taken it for over 10 years.

I take Benazepril. At first I said no because I take enough meds already and don't want to take things "just in case", but then decided it couldn't hurt. I don't have any side effects from it.

Were the studies related to Type 1 or Type 2? Unfortunately there are not a lot (or any) studies relating to well-controlled Type 1’s.

I tried Lisinopril for a while just to make my endo happy. I was cutting the smallest pill in half and still seeing blood pressures of 70/45. I was getting dizzy every time I leaned over. Then I got the cough followed by plugged sinuses. With my endo’s blessing, I ended that experiment. I’ve had Type 1 for 36 years with no measurable kidney damage. If I get high blood pressure, I’ll happily go on another class of blood pressure meds. Until then I’ll do my best to keep my blood sugars in as good a range as I can manage.

The decision to take “preventative” meds is something that you along with your doctor’s advice need to consider. My decision is not to take them, but many people take them and are happy with their decision.

Let us know what you decide.

Here is a good synopsis of the general literature. The studies come down on both sides of the question and the answer is of course, what are you comfortable with?

http://www.medscape.com/viewarticle/504039_2

ACE Inhibitors are not the only class of drugs shown to either help prevent kidney damage, or prevent further damage once early signs are detected.

I've been on the ARB Losartan for the last couple of years since initially being diagnosed with microalbuminuria. I haven't had any microalbumin detected since. I was initially on Lisinopril, but I had way too many side effects.

Thanks for the link, Rick. If I read the article correctly, it indicates that the ace inhibitor helped after protein leakage had occurred. My memory is that my endo indicated we could re-visit the BP med decision if ever I started having indications of kidney problems. It is good to see a study with Type 1 as most are Type 2.

I remember being freaked out reading the warnings that came with the BP meds because they indicated that kidney damage could be a side effect.

Hi FSH,

I think it was actually Losartan that he wanted me to take but I've lost the prescription now- but that sounds familiar. I just assumed it was an ace inhibitor. He said if I had side effects to stop but I never filled it as I'm not sure what to do really.

Thanks Everyone,

I'm still not sure what to do... I will ask my endo what he thinks. My father didn't think it was a good idea. This cardiologist joked that if I were his wife he would crush the pills and put them in my food secretly. I tend to have bp on the low end and the last thing I need is more symptoms to deal with along with everything else. My bp was higher at that visit though for me so I'm going to buy a machine and monitor it. It's usually in the 110/70 range I think it was 130/80 at the visit- I wasn't feeling well so I'm guessing it was due to that. I have never had high bp except when I was in DKA - it was 170 when I was admitted, not sure what the bottom number was.

Kathy,

Did you have signs of kidney problems when you started on these meds? Did it help? I'm worried about them causing other problems in the long run because we never know how each person will react to them.

I'm not sure, I haven't looked for them yet- I hope I can find the paper I wrote them down on. I will let you know.

My father took 3 different bp meds recommended by his cardiologist and he wound up with dangerously low sodium and some kidney damage after several years. He has switched to another one now which seems to be controlling his bp which has been dangerously high at times. Of course the side effects would have to be what it should be protecting against... that makes sense!

Hi Rick, I can't get to that article, for some reason medscape has forgotten my account. Hopefully I will get a chance to see it later. thanks!

I take Lisinopil, Metoprolol,and a 81mg Bayer.

Unless you have symptoms or have had a cardiac categorization procedure then you and your doctor are clueless. You can have Left anterior descending (LAD) and never know until you have a heart attack...many women die from this with little or no warning just a few light palpitations, light headiness and a little sweating, my wife thought it was just her hormones until she had a cardio cauterization before her thyroid removal and found out she had 40% blockage, her normal blood tests and BP gave no indication. Everyone in her family has heart issues of some kind.

Take the Ace Inhibitor. it will help take some load off your heart, we get over the tired feeling after a week or so

...JMHO

Yes and yes.

I have been taking an Ace Inhibitor and 81 mg aspirin for many years.

I currently take Diovan. I was on Lisinopril, but started having serious swelling issues in my mouth and throat which were attributed to a Lisinopril allergic reaction. When I walked into the emergency and explained my swelling, the first thing they asked was if I was taking Lisinopril. It is a very common side effect.

I don't really think that caused my problem, as I had been on it for years when this all started, but I changed anyway, as that kind of swelling can be life threatening really fast.