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Running & FitNews, May-June, 2009

I have been running for over 25 years. I am a 64-year-old female currently logging 12 to 15 miles per week over 4 days. I usually run year-round. In addition, I crosstrain by using either an elliptical trainer or stationary bike twice a week. I also weight train with free weights 2 to 3 times per week, attend two 30-minute yoga classes with practice at home 50 minutes 2 to 3 times per week, and stretch after each workout, including using the Wharton Active-Isolated Stretching system. In general I am in good health. Over the years I have decreased both speed and distance in order to keep running. I weigh 120 lbs. and my morning resting pulse is around 48. I take Fosamax and Diovan (80 mg), as well as a multi-vitamin. My question is with regard to blood pressure medication.

My internal medicine doctor of more than 20 years (who is also a runner) placed me on it in the spring of 2004. At that time I was consistently running a BP of 145/90. Today it was 116/71. My insurance company has changed the prescription coverage in the middle of the contract year. Diovan is apparently too expensive and they wish to have me change to one out of a list of 14 that have a generic substitute. One of them is lisinopril which I tried before the Diovan and wound up with a nasty, dry cough that lasted until the med was changed. Can you give me any guidelines as to the class of BP med that would allow me to continue my active lifestyle with the least amount of problems?

Denise Kranston

Shelton, CT

Congratulations on an outstanding running program! It soundsas if your overall health is excellent.

There are four classes of medications that are commonly used to treat hypertension: diuretics, beta blockers, calcium channel blockers, and ACE-inhibitors/ARBs. ACE-inhibitors and ARBs are not identical medications but for practical purposes are very similar and can often be used interchangeably. Lisinopril is an ACE-inhibitor and Diovan is an ARB. About 5-10% of people who use an ACE-inhibitor develop a cough that is caused by the medication. ARBs rarely cause this side effect. Another difference between ACE-inhibitors and ARBs is that ACE-inhibitors have been on the market longer and generic versions of many ACE-inhibitors are now available
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