Procardia

[DaveL]

Hi everyone. I am a 39 year old male with a moderately regurgitant aortic valve (aortic insufficiency). Surgery is not imminent but may very well be sooner than later (echos every six months).

I was recently turned over to a cardiologist by my family doctor on the basis that my echos seemed to be reporting deterioration of the valve. I'm one of those people who doesn't go to the doctor often (*prefers never*) so of course there were some other things to address. My blood pressure, since childhood, has always been on the high side (150/80) and I had always had a murmer which I didn't have diagnosed as the above until three years ago. Currently my blood pressure has gone quite high 175/96 and I finally succumbed to medication. Which brings me to my point of posting (other than of course to just say "hi, what a nice forum you have here" .

The cardiologist prescribed ProcardiaXL at 60mg/day. I have been reading some extremely conflicting opinions on this medication. There are those (and they are highly accredited) who believe this is not the medication of first choice in lowering high blood pressure. Further, they mention studies showing an increase in rates of heart attack on this medication (and yes, they are referring to the long-acting form of nifedilin and not just the short acting form that is almost totally out of use now).

My question is this. Did my doctor prescribe this medication as much to reduce the "afterload" of my heart (which supposedly Procardia does) as to lower my blood pressure also? If not so, would I likely get the same benefits from a standard diueretic or ace inhibitor without the possible complications that Procardia is increasingly being accused of causing?
Any opinions (and yes, I will take them just as that and not doing anything rash without of course talking to the doc) would be greatly appreciated.

Best Wishes,

David

 

[FredH]

Welcome

Welcome

Hi Dave,
Welcome to the site. My Cardiologist told me that if you have a problem with your aortic valve you should not take diuretics. When I had problems with my blood pressure he gave me meds.
I found that by reducing my weight and exercise I was able to bring down my blood pressure. If your doc hasn?t already told you make sure if you exercise you don't lift weights it could be very dangerous. I was like you and never liked to go to the doc but once I found out about my valve problem and conceded that I was getting older I started getting my regular check ups. I also had my echo done on a regular basis and it paid off. In my case I was ok and then within a year went down hill fast and required the surgery. I also found that my regular doc knew nothing about heart problems so you might want to keep in close contact with your cardo doc. Good Luck

 

[Dianne]

Procardia

Hi, DaveL

I have been on Procardia XL 2xs per day for almost a year for severe aortic insufficiency. My cardiologist, as I recall, told me the Procardia was to decrease the "afterload", help reduce my high blood pressure, relieve angina pain, and get away from the side effects I was having from Acupril (oddly enough--excessive coughing which interfered with sleep and talking!). Accupril is an ace inhibitor. He left me on the diuretic Triamterene /HCTZ which was started in 1998, when the valve was damaged by endocarditis. So in my case, a standard diuretic and an ace inhibitor wasn't working. I was unaware of any controversy concerning Procardia at the time I was put on it. So I never questioned the choice of meds. I was just glad to quit coughing so much!

Unlike FredH, my cardiologists never expressed any concern about using a diuretic with aortic problems. I'm not saying his are wrong, by the way!!! It will be interesting to know what your cardiologist has to say. I plan on asking mine when I see him this Thursday for the cardiac cath. Although I have very little experience in all of this, I have found that even cardiologists within the same office have HUGE differences in treatment ideas. My thoughts on this is for you to find a cardiologist you can talk to and trust then stick with that one. You may have to try more than one office.

Like Fred suggested, having a cardiologist rather than a family physician to monitor your valve is important. I had a TEE every year and echos every six months. Initially,my valve, too, was going down hill slowly. In December the doctor was talking no need for replacement for a few years or more;Six months later he said it was time for surgery since the heart is dialating. (date not set yet.) Losing some weight and exercising was of help to decrease the high blood pressure, too. I also started becoming aware of all the hidden salt I either didn't know I was consuming or overlooked.
Good luck to you.
Dianne

 

[DaveL]

Thanks Fred and Dianne for taking the time to share some personal experiences with me. This is still kinda new to me and information like you guys provided is very helpful.

Once again, Thanks

Dave

 

[srwieland]

Procardia

Hi Dave and welcome to our wonderful group of heart buddies.

I was on Procardia (or its generic equivalents) for about four years prior to this last one. My cardiologist prescribed it to reduce the afterload and specifically to prolong the enlargement of my heart that would ultimately require valve replacement surgery. It seemed to work well and I never had any problems with it. It was the only medication I was on for that period and I did not need it for high blood pressure, as my blood pressure is naturally on the low normal side.

However, this last year when my arrhymias and heart pain increased, culminating in a hospitalization with a serious bout of atrial fibrillation evidently triggered by the increasing enlargement of my heart, my cardiologist finally recommended me for valve surgery and switched my meds to a beta blocker and an ACE inhibitor. He said that the Procardia was the best med choice for delaying the enlargement of the heart, but that once it had already become enlarged and my symptoms had worsened, he said that the other meds were better to protect me from heart failure until I could get the valve replaced. I had my aortic valve replaced four weeks ago and am recovering extremely well. The only meds I am on at this time are the beta blocker and ACE inhibitor. I was on a diuretic for the first few weeks after surgery but then it was discontinued.

Hope this helps. I would follow your cardiologists advice and take the Procardia unless you have a reaction to it, and then keep monitored by him with an echo every year at the very least, because once your heart enlarges and the situation starts going south, you don't want to neglect it because you can cause irreversible damage to your heart or even die if you don't attend to it timely. Take care and keep coming back to this forum.