Pressão arterial ideal que devemos atingir? Sistólica abaixo de 110 ou 100?

[Tim]

Depends on the doctor. Many are conservative by nature, but some are more laissez-faire. Some write prescriptions with a liberal hand, and some act like they pay for every pill. .

[LaraPo]

I also totally understand them. It’s especially risky with somebody like me with kidney transplant. It’s safer to be on a conservative side.

[DeStrider]

The citrulline I use is a powder that I mix into my tea. It ends up making the tea taste like lemonade when I add glycine. I use citrulline malate powder.

[Tim]

You must follow the renal diet, right? Do you ever deviate? What is your weakness?

A friend of mine once maintained a transplanted kidney for 30 years. When it failed they gave him another one, because he had taken such good care of the first.

The one regret I have about entering the health care system is the loss of privacy and independence. I’ve had doctors over the years who prescribed me almost anything. But then they retired and Medicare became a major player. I appreciate the doctors I have, but at the same time I’m straining at the leash.

[LaraPo]

Yes, I follow renal diet and do not deviate. I’ve been on plant based food for decades. I don’t think I have any weaknesses food wise - don’t drink alcohol (and don’t like it so it’s easy) and like what I cook and don’t want to eat anything else.

[RapAdmin]

Researchers created a tool to estimate how much different drugs lower blood pressure. It may transform hypertension care by improving treatment selection and saving lives.

A newly developed Blood Pressure Treatment Efficacy Calculator, the first of its kind, was created using data from nearly 500 randomized clinical trials involving more than 100,000 participants. The tool enables physicians to estimate how much different medications are expected to reduce blood pressure.

Game-Changing New Tool Could Revolutionize How High Blood Pressure Is Treated

https://www.bpmodel.org/

[Ziegelhausen]

This is great Thank you. Nicely illustrates the principle that combining antihypertensives has a greater effect than maxing out on sinlge agents. The popular combo on this site telmisartan 80 + amlodipine 5 yields nice BP lowering effects with this tool.

[RapAdmin]

Source: https://x.com/questmoosa/status/1968397947474751751

But others in that thread comment:

[A_User]

@RapAdmin

But others in that thread comment:

Yeah, it can be converted to oxalate in the body.

High-dose vitamin C linked to kidney stones in men - Harvard Health

I’ve never had a kidney stone. Thank God. According to Quora responses to the question “How painful are kidney stones?” they are about as painful as it gets. They’re the most painful thing a person can experience naturally, leaving aside torture and violent body-dismembering events. Many say they often get to be “10/10 pain”. That’s clearly an ethical catastrophe given that 10% of people experience them at least once during their lifetime.

Someone described the experience of having a kidney stone as “indistinguishable from being stabbed with a white-hot-glowing knife that’s twisted into your insides non-stop for hours”.

I wonder whether from a compassionate (utilitarian/consequentialist) point of view, it would really pay off to have as a priority “adopt a life-style that minimizes the chances of kidney stones”.

It’s likely that the reason why we do not hear about this is because (1) trauma often leads to suppressed memories, (2) people don’t like sharing their most vulnerable moments, and (3) memory is state-dependent (you cannot easily recall the pain of kidney stones for the same reason you can’t recall the qualia of your LSD trip: you’ve lost a tether/handle/trigger for it, as it is an alien state-space on a wholly different scale of intensity than everyday life). If so, maybe that’s to our detriment. Perhaps it’s worth taking these reports very seriously, lest we become victims ourselves.
On Kidney stones, by Andres Gomez Emilsson – Sentience Research

[adssx]

Also posted there: Blood pressure calculator promises more precise medication choices for millions

[DeStrider]

After stopping Telmisartan 20 mg daily for a while, my BP has been creeping back up to 120. So it looks like I still need Telmisartan. I may just use it EOD to see if I can stick the sweet spot.

It seems like it returns to 115-120 after stopping Telmisartan for 2 weeks. But it goes to high 90s if I use it daily. I need something in between.

[CronosTempi]

Well, here’s a paradox for you. I had lower BP on 20mg/day telmi than I have now on 40mg/day. Not huge, but definitely significant, about SBP 8 points and DBP 4 points - these are not fluke readings, I always take them at the same time with the same device, consistently. So who knows, maybe something else has changed, though I can’t think what that would be diet, exercise supplements all kept steady .

[RapAdmin]

@DeStrider

my BP has been creeping back up to 120. So it looks like I still need Telmisartan. I may just use it EOD to see if I can stick the sweet spot.

Another option…

Here’s the breakdown for telmisartan (Micardis and generics) and pill splitting:

1. Tablet formulation

• Telmisartan is supplied as film-coated tablets in fixed strengths (20 mg, 40 mg, 80 mg).
• The coating is not an extended-release or enteric-release technology; it is mainly to improve stability (telmisartan is moisture-sensitive).
• That means splitting does not destroy a time-release system — you still get the same pharmacokinetics.

2. Practicality of splitting

• The tablets are not scored, so breaking them may not give perfectly even halves.
• If you split them, you may see some crumbling, but the drug content should remain stable if consumed soon after.
• Because telmisartan is moisture-sensitive, storing split halves for long periods (weeks/months) is not ideal — the coating helps protect the active drug from degradation.

3. Dosing flexibility

• Clinically, many physicians do split telmisartan tablets (especially the 80 mg ones) to achieve intermediate doses like 40 mg or 20 mg at lower cost.
• Pharmacists often note that variability in split dose (±10–15%) is usually acceptable for blood pressure medications like ARBs, since dosing is titrated to effect and safety margins are wide.

4. Cost considerations

• In some markets, higher-strength tablets (e.g., 80 mg) cost the same as lower-strength ones. Splitting can therefore save money when prescribed by a doctor.
• Insurance and pharmacy policies may differ — sometimes the pharmacy benefit manager disallows splitting.

---

Bottom line:
Yes, telmisartan can generally be split without losing effectiveness, since it is not extended-release. The main issues are dose unevenness and stability after splitting. If you do it:

• Use a proper pill splitter, not a knife.
• Split only what you’ll use in the next few days to weeks (don’t store for months).
• Keep the halves in a dry, airtight container to limit moisture exposure.

Always confirm with your prescribing doctor or pharmacist, because local formulations and coatings can vary slightly.

[CronosTempi]

Note, this may not be applicable to the telmisartan you buy from India. I bought 40mg pills Teleact Ranbaxy/Sun Pharma and they are indeed scored in the middle. Nonetheless it is very true they are moisture sensitive. Also, even though they are scored in the middle, splitting them is tricky, because they tend to crumble very easily, so you are left with two uneven “halves”, and some crumbs and powder. You have to use good splitting technique.

[DeStrider]

Thanks @RapAdmin I currently use the 40 mg tabs and split them to 20 mg. I like to save money on my daily meds.

[Olafurpall]

Nice effect on adiponectin. The increase in adiponectin might be caused by telmisartan being a PPARgamma agonist but activation of PPARgamma can increase subcutaneous fat but reduce visceral fat and the reduction in visceral fat increases adiponectin.

[RapAdmin]

High blood pressure affects more than a billion people worldwide and remains one of the leading drivers of heart, kidney and brain disease. In this episode, I sit down with Dr Raymond Townsend, Professor of Medicine and Director of the Hypertension Programme at the University of Pennsylvania, to uncover what truly causes blood pressure to rise, how it damages the body, and what steps can help reverse or prevent it. With more than four decades of clinical and research experience, Dr Townsend shares insights into the mechanisms of hypertension, the importance of early detection, and why empathy, consistency and accurate measurement matter as much as medication or diet. Together we explore how blood pressure control can protect vital organs, extend healthspan and reduce risk long before symptoms appear.

What Your Doctor Isn’t Telling You About Blood Pressure | Dr. Raymond Townsend | The Proof EP#386

[Jonas]

Interesting comments on Taurine and BP:
Taurine is the most underrated supplement when it comes to blood pressure, abundantly found in heart muscle tissue, modulates calcium handling, reduces sympathetic tone, and enhances nitric oxide.

https://x.com/biohacker/status/1978081005589155926

[Dreamdoc]

Is the cuff charged or have fresh batteries?

[DeStrider]

It’s fully charged. I just used it tonight. The measurements were 123/69. It only goes into the high 90s when I take Telmisartan 20 mg. 123 is a little high, but it’s better than too low and passing out. I guess I’ll have to wait for my arteries to clog up more before taking Telmisartan.