Date: Thu, 1 Jul 1999 20:07:03 -0400
From: "Eddie Bollenbach"
Subject: Post-Polio and high blood pressure
> Re: blood pressure/pps...I am 49, my polio is 49. Onset at 4 months...bulbar paralytic polio.
> At 47, my BP was 174/102...my doctor put me on Prinivil 5 mg. She said there were only
> a handful of meds. that work well with polio's.
This isn't true! There are a few different categories of antihypertensive drugs and they all act by doing different things. Your medication Prinivil acts by stopping a reaction which converts a substance called angiotensin I into angiotensin II. This second substance has the affect of constricting blood vessels, making the amount of space the blood is in smaller, and consequently raising blood pressure. One of the advantages of this type of medication is that it is not centrally active and doesn't cause depression. It also has a different side effect profile and interacts differently with different drugs.
Another class, the beta blockers, should work for people who have had polio also. These work by blocking stimulation of the nervous system's impulses to the heart and major blood vessels. They work very well and are often used as a first choice for hypertension. The problem with them is that some people cannot tolerate them and they can cause depression as a side effect, as well as some other side effects different from the ACE inhibitors like Prinivil.
Then there are Calcium channel blockers like Calan. these substances inhibit the movement of calcium across membranes in cardiac muscle. The result is to slow the heart and increase the amount of blood pumped with each beat. They also relax the muscles surrounding the arteries. They also have a different side effect profile. Recently, the shorter acting ones, like nephedipine, have been shown to result in an increase in heart attack or sudden death. It has not been shown, to my knowledge, that the longer acting ones, like Calan, result in this problem. They also do not generally affect the Central nervous system as do the beta blockers and generally do not cause depression and again have a different side effect profile.
Alpha blockers< are another class of older antihypertensives and have more side effects, generally. They get into the CNS and can cause problems there.
Diuretics are substances that have an antihypertensive effect by increasing the loss of water, therefore blood volume. This often results in a decrease in blood pressure. They should work as well in a person with polio as without.
The choice of an antihypertensive is related to many things: side effects, efficacy, cost, presence of certain comorbities (other diseases) etc. But to my knowledge polio is not one of the considerations.
Contact Professor Edward P. Bollenbach
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