need $0.02 from altace (rimapril) users

[BillCobit]

I'm doing reasonably well 8 months after mitral valve repair surgery. EKG is normal, no valve leakage. Blood pressure is a little low (100/60 vs 120/80 pre-op) and resting HR is a little high (78 vs 58 pre-op). Ejection fraction is estimated at 45-50%. My triathlon times are lousy (but hey, I'm doing them!).

My cardiologist is inclined to put me on Altace...says it will help my exercise tolerance. I'm dubious. I know Altace has been shown to reverse left ventricular hypertrophy in heart failure patients (EF < 40%), but I'm not so sure I'll get favorable remodeling. Also, I'm concerned about lowering my blood pressure; it's already pretty low....and I'm fearful that tinkering with my cardiovascular system may precipitate some problems I don't currently have ("if it ain't broke, don't fix it").

I'm interested to hear experience/opinions from those of you who have experience w/ Altace, & how it affected your exercise tolerance, side effects, etc.

Thanks
Bill

 

[JimL]

As with all medications, your cardiologist surely knows better than all of us.
That said, I've had two cardiologists tell me to go on altace, so far to no avail. Each time they've prescribed it, I've learned a little more about it, and came to the same conclusion, that it was not for me, at least not yet.
I've read the little Altace brochure, information on the web, and two different Physicians Desk References, the last being the latest edition.
I decided to refuse Altace for a number of reasons:
1. It's for people 55 and over; I'm 47; weak reason.
2. Its main purpose is to lower blood pressure; mine has always been low.
3. It has some side effects, like the cough.
4. Valve replacement patients were specifically excluded from the trials. I've not yet found any reason why, but it seems rather significant to me.
At my last cardiologist visit, the assistant checked my blood pressure and commented that the Altace must be working. I foolishly confessed that I hadn't taken it -- and so the rest of the visit was a campaign to get me on another medication. I hope to think a little faster at my next appointment. "Your EF is at 69%; the Altace must be working." "Yes it is." That's my two cents.