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Drugs May Raise Risk of Heart Failure

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Q. You had a letter from a woman worried about her husband’s lack of energy. He was on atenolol, Norvasc and furosemide for high blood pressure. She asked about his low potassium.

As I read her letter, I became concerned that he may have heart failure. I’ve been a cardiology nurse for 14 years. Fatigue is one of the hallmark first complaints of heart failure, which is common in people with hypertension.

Norvasc can worsen undiagnosed heart failure. I hope he will see his doctor for evaluation of his "no energy" complaint. Heart failure is the number one reason for admission into the hospital today and there are safer blood pressure medications.

A. Heart failure is extremely dangerous and is increasing at an alarming rate. Symptoms may include shortness of breath, nighttime cough, fatigue and swollen ankles.

The current controversy over the diabetes drug Avandia involves an increased risk of heart failure. Norvasc also seems to increase this risk (American Heart Journal, Jan. 2007). Atenolol can also contribute to fatigue.

Our Guide to Blood Pressure Treatment discusses the pros and cons of various types of blood pressure medication and lists high-potassium foods for those on diuretics such as furosemide or hydrochlorothiazide.

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Thank you for your newspaper article on Norvasc and Atenolol. You said there are safer drugs. I immedately asked my doctor to prescribe something else. About three weeks after changing to another drug, my swollen legs were back to normal.

Atenolol:
I've been on this drug for ten years to control blood pressure. I stopped taking it 4 weeks ago as an experiment. I started to get tightness in my chest and my heart rate increased dramatically and blood pressure rose dia. 160+ and sys. 90 and up. I went back on the atenolol, first day back my pressure was 129/71 51 pulse.

My point is at age of 73 with all the controversy about these drugs, what is the correct solution to living a full, somewhat normal life?

Amlodipene, Benazapril, Furosemide, Spironolactone, and Atenolol - Do any (or all) of these high blood pressure medications cause coughing? Is there anything my grandmother can do for the cough? She is 85, has trouble sleeping, swollen legs, and fatigue. Should she ask a doctor for other medications?

PEOPLE'S PHARMACY RESPONSE: SHE NEEDS TO TALK WITH HER DOCTOR ABOUT THIS PROBLEM. BENAZEPRIL IS AN ACE INHIBITOR THAT CAN CAUSE COUGH, BUT HER SYMPTOMS MIGHT ALSO SIGNAL HEART FAILURE, WHICH WOULD REQUIRE A DIFFERENT SORT OF TREATMENT REGIMEN.

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