Monday, February 22, 2010

Focusing on Blood Pressure -- Waiting for VAP

I'll be taking the VAP lipid panel in early March. That will give me a good sense of how I'm progressing towards my goal of reducing the point score of 835 on my next calcium heart scan in the summer of 2011. The VAP gives essentially the same information as the Berkeley Heart Labs panel.

In particular, I'll be look at any changes in the "Pattern A/B" score. This score is the one that shows how "bouyant" your lipids are. I've been mostly in the "B" area with those small, gritty lipids. But if I can tolerate 5mg of a statin -- remember, I've had problems with statins before -- then I have a chance of moving to the desirable "Pattern A," especially with the new Trilipix and niacin.

So far, I'm tolerating the time-release niacin (Niaspan) at 2 500mg/day. I will hold at this until the next VAP test. At my last test (referenced in the first posting) I improved in every area, but the remaining area is to up my HDL to 60. More niacin is the key here. I scored 45 (which is good for me, but not particularly high) previously taking only 1 500 mg niacin/day. If I can get my HDL up to 50 with 2/day, I have a shot at 60 with more niacin. I think I can tolerate 3/day (1,500mg), but more may be needed to get to 60.

Here I am concerned about the drug interactions. My overall cholesterol was 140 last time and it is sensitive to niacin as well. I don't want to go too low here! Also, the Niaspan, Trilipix, and Crestor (even at 5mg) may elevate my liver enzymes and/or have other consequences, so I'd like to see the lipid profile results before upping my Nisaspan over 2/day. (My specialist thinks I can do 3/day -- I hope so. It may take 4 to up HDL to 60.

So in the meantime, I've been watching my blood pressure with a neat, new iPhone App called HeartWise. You need to have your own monitor (mine is an Omron automatic blood pressure monitor, Model HEM-711), but it is very easy to enter data into the app and it produces very nice information. Here is a graph which it put into my photo library on my iPhone.

What became apparent seeing my data in graphical form was that my systolic scores were often over the 120 mark -- the beginning of the new "pre-hypertensive" range, even though my diastolic scores were fine. This meant that with a modest dose of a good ace-inhibitor (say, generic trandolapril), I might be able to stay under the 120 threshold for the most part. I'll keep you posted on my success (if any) here. I've been taking trandolapril for several days now, and at the beginning, my systolic pressure remained under 120. Too soon to pick up a real trend yet, though.

HeartWise charts your weight and pulse as well. I was surprised at how low my pulse is as a result of exercise over the years, often about 50 in the morning.

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