#224

Thanks. No sources provided by Gemini so hard to comment. Telmisartan is indeed a great drug, probably the best antihypertensive. I’m taking 80 mg.

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#225

That’s interesting. I am currently on 80mg/day of telmisartan and interested in 160mg. I was going to pair it with pioglitazone 7.5mg/day, but all my plans went out the window because of unexpected surgery coming up (ACDF) involving fusion of a couple vertebra in my neck with titanium plate and screws. The bone fusion is critical and can take up to 18 months. Since pioglitazone is a negative for bone health (suppresses osteoblasts, can enhance osteoclasts), I don’t want to risk poor bone fusion in my cervical spine. This means at least an 18 month delay of the pioglitazone for me.

Can you speak to your experiences/results of the 160mg telmisartan dose? Thx.

#226

I too had a cervical fusion, except no Ti plates but bone graft from iliac crest. I had broken C5 and C6 at the age of 18! Anyways many moons ago!

I am afraid other than my potassium levels I cannot speak to anything. My BP did not change between 80 and 160 other than day to day fluctuations, nothing ascribable. Tell me what I should be looking for and I will respond. My Hba1c is around 7.2, had been as high as 12, but this decrease is due to Semaglutide and Tirzapetide. I am continuing with 160 because I did not experience anything negative and I can tolerate the added cost.

#227

Among other good things, combining Telmisartan and an SGLT2 inhibitor creates a “bookend” geroprotective for aging kidneys. Telmisartan acts primarily at the efferent arteriole (glomerular exit), while SGLT2 inhibitors act at the proximal tubule and afferent arteriole (glomerular entrance). The two create synergistic hemodynamic and metabolic protection. It is a combination worth considering by older adults, including those whose BP is at least toward the middle of the normal range. My long term mean systolic BP was 118 before initiating telmisartan but the standard deviation was high. Adding 80 mg. Telmisartan lowered the mean to ~108 and significantly lowered the SD below the equivalence of the lower mean (another discussion but adding 250 mg. aged black garlic dropped my mean systolic further to ~104 – I’m leaving it there). Currently, I’m taking 5 mg. Canagliflozin but may increase that to 10 mg. at some point after re-assessing kidney function metrics.

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