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Why should i include BP meds with my cycle?
1. Elevated blood pressure associated with AAS use (duh), with high blood pressure you risk heart attack and stroke, especially during high intensity exercise that can temporarily shoot your blood pressure into criticaly high levels.
2. High blood pressure can cause cardiac remodeling. Understanding that high intensity exercise can cause general cardiac remodeling by mimicking hypertension during these exercises, adding actual hypertension to the mix magnifies the problem. In other words the elevated blood pressure itself could effect cardiac remodeling.
3. AAS use can cause a different kind of Cardiac Remodeling by directly binding to heart receptors. AAS can cause unique cardiac remodeling affecting both the left and right ventricle of the heart with fibro fatty inflitration or fibrosis of the heart which can cause dyskinesia of the ventricles. In plain terms AAS, by itself, by binding to the receptors in the heart can cause distortion of and malfunction of both the left and right ventricles.
"Notably, studies in isolated human myocytes have shown that AAS bind to androgen receptors and may directly cause hypertrophy, potentially via tissue up-regulation of the renin-angiotensin system. Indeed, clinical studies suggest a distinct form of LVH(left venticle hypertorphy) in AAS abusers, suggested by textural changes in the myocardium on echocardiography before the onset of overt LVH.59"
of extensive concern to me is this quote "Alarming data have linked AAS with fatal events"
AAS Cardiac Remodeling method of action
The pathway of AAS specific cardiac remodeling appears to be through ACE (Angiotensin-converting enzyme) activity which is prevented (with ACE inhibitors) or blocked (with ARB’s). in this study a group was given both AAS and an ARB and it was found the AAS + ARB group did not develop harmful cardiac remodeling while the AAS groups both training and non training groups did develop cardiac fibrosis, LVH and myocardial collagen issues. Let me repeat this, ARB’s prevented harmful cardiac remodeling in a steroid using grroup where the other steroid groups all developed harmful cardiac remodeling.
ok so all of this suggests we need to prevent hypertension and cardiac remodeling during the use of AAS right?
There are two HBP drug classes that prevent AAS related cardiac remodeling and hypertension. ACEIs and ARBs.
ACE inhibitors
ACE inhibitor (or ACEI) stands for angiotensin-converting enzyme inhibitor. Examples include lisinopril (Zestril), benazepril (Lotensin), and enalapril (Vasotec).
ACE Inhibitors work by preventing the change of angiotensin I to the HBP causing vasoconstrictor Angiotensin II.
Understand there is some concern about serious side effects with Lisinopril and other ACEIs. Reports of sudden death, liver disease, and angioedema have caused some serious concerns about this entire class of drugs. Consider this, 77 million prescriptions of lisinopril are filled each year in the United States alone. The chances of severe side effects are low. Angioedema was found to occur in 0.1 percent of patients with the vast majority of these incidents being extremely minor to the point that many do not even seek medical care. The vast majority of serious side effects from lisinopril occur in patients over 60 years old. https://www.americannursetoday.com/w...se-angioedema/
ARB's
ARB stands for angiotensin-receptor blocker. Major drugs of this class include losartan (Cozaar), valsartan (Diovan), and irbesartan (Avapro) and best of all Telmisartan.
ARBs affect Angiotensin by competing for Angiotensin receptors and preventing Angiotensin II from binding to the blood vessels receptors. This results in blood vessel dilation and a subsequent decrease in blood pressure.
Other side effects.
Both ARBs and ACEIs have protective properties when it comes to kidney disease with one major exception, they both are contraindicated if you have Bilateral Renal Arterial Stenosis. Most if not all renal complications as a side effect of ACE or ARB use relate to this preexisting condition.
Bonus effects
"Drugs known as ARBs (angiotensin II receptor blockers, like Losartan) are not only unlikely to cause erection problems, but they may improve sexual function in men with high blood pressure."
Bonus 2 Telmisartan, a popular ARB has been shown to have PPAR-gamma-inducing property.
Why is this important? PPAR-gamma has been shown to be performance enhancing by creating an energy boost as well as suppressing appetite, promoting body fat loss, and reducing visceral fat. These are things all of us want right?
Plain Language
It might help to look at it this way. Angiotensin II makes your blood pressure go up. Angiotensin II causes your blood pressure to increase by vasoconstriction like putting your thumb over the end of a hose. Less Angiotensin II or blocking it means a decrease in blood pressure. ACE inhibitors are like aromatase inhibitors. it prevents the conversion of Angiotensin I to Angiotensin II. ARB's are like nolvadex, they compete for Angiotensin receptors to prevent vasoconstriction.
AAS use can cause changes to your heart that can negatively effect your health and both ACE inhibitors and ARB's prevent cardiac remodeling.
"Accumulating evidence supports the proposal that angiotensin II type 1 (AT1) receptor blockers (ARBs) have nearly the same beneficial effects as angiotensin converting enzyme (ACE) inhibitors on cardiac hypertrophy, remodeling, and heart failure" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769047/
Side effect concerns
Both ACEIs and ARBs can have serious side effects but this is highly unlikely even if you are over 60 although the risk is higher. Even Motrin is listed as a risk for angioedema. The most common side effect that people get is a cough from ACEIs. Compared to the compounds AAS users routinely use the risk is very low and the benefit is high. Remember millions upon millions of people take these drugs with no problems all over the world.
In Conclusion
Prevention of cardiac remodeling should be a strong concern for all AAS users. While some research has focused on massive dosage regimens of individuals, other research has postulated any supra physiological amount of androgens is a risk for negative effect on cardiac health. This same study also stated low testosterone has a negative correlation with cardiac mortality so another reason for TRT.
ARB's are first choice if money is not an issue or if you are already experiencing erectile dysfunction. Telmisartan is recommended due to its PPAR actions. ACEIs will work if you dont get a cough and are much much cheaper.
all of this is based on a healthy individual using these to prevent AAS induced Cardiac Remodeling.
If you have heart problems already or HBP you should discuss this with your doctor.
you should start at the lowest possible dose and monitor blood pressure and customize dosages to control any blood pressure issues that arise. If your blood pressure does not go up continue with minimum dosage unless you experience low blood pressure. If you experience low blood pressure you would need to reevaluate.
The Future
New research is focusing on combination therapy of ACE inhibitors combined with ARB's to prevent cardiac remodeling, which is showing promising results. A possible future procedure would be a smaller dose of both ACE inhibitors and ARB's. possibly mediating sides from either compound https://www.ncbi.nlm.nih.gov/pubmed/12504813
1. Elevated blood pressure associated with AAS use (duh), with high blood pressure you risk heart attack and stroke, especially during high intensity exercise that can temporarily shoot your blood pressure into criticaly high levels.
2. High blood pressure can cause cardiac remodeling. Understanding that high intensity exercise can cause general cardiac remodeling by mimicking hypertension during these exercises, adding actual hypertension to the mix magnifies the problem. In other words the elevated blood pressure itself could effect cardiac remodeling.
3. AAS use can cause a different kind of Cardiac Remodeling by directly binding to heart receptors. AAS can cause unique cardiac remodeling affecting both the left and right ventricle of the heart with fibro fatty inflitration or fibrosis of the heart which can cause dyskinesia of the ventricles. In plain terms AAS, by itself, by binding to the receptors in the heart can cause distortion of and malfunction of both the left and right ventricles.
"Notably, studies in isolated human myocytes have shown that AAS bind to androgen receptors and may directly cause hypertrophy, potentially via tissue up-regulation of the renin-angiotensin system. Indeed, clinical studies suggest a distinct form of LVH(left venticle hypertorphy) in AAS abusers, suggested by textural changes in the myocardium on echocardiography before the onset of overt LVH.59"
of extensive concern to me is this quote "Alarming data have linked AAS with fatal events"
AAS Cardiac Remodeling method of action
The pathway of AAS specific cardiac remodeling appears to be through ACE (Angiotensin-converting enzyme) activity which is prevented (with ACE inhibitors) or blocked (with ARB’s). in this study a group was given both AAS and an ARB and it was found the AAS + ARB group did not develop harmful cardiac remodeling while the AAS groups both training and non training groups did develop cardiac fibrosis, LVH and myocardial collagen issues. Let me repeat this, ARB’s prevented harmful cardiac remodeling in a steroid using grroup where the other steroid groups all developed harmful cardiac remodeling.
ok so all of this suggests we need to prevent hypertension and cardiac remodeling during the use of AAS right?
There are two HBP drug classes that prevent AAS related cardiac remodeling and hypertension. ACEIs and ARBs.
ACE inhibitors
ACE inhibitor (or ACEI) stands for angiotensin-converting enzyme inhibitor. Examples include lisinopril (Zestril), benazepril (Lotensin), and enalapril (Vasotec).
ACE Inhibitors work by preventing the change of angiotensin I to the HBP causing vasoconstrictor Angiotensin II.
Understand there is some concern about serious side effects with Lisinopril and other ACEIs. Reports of sudden death, liver disease, and angioedema have caused some serious concerns about this entire class of drugs. Consider this, 77 million prescriptions of lisinopril are filled each year in the United States alone. The chances of severe side effects are low. Angioedema was found to occur in 0.1 percent of patients with the vast majority of these incidents being extremely minor to the point that many do not even seek medical care. The vast majority of serious side effects from lisinopril occur in patients over 60 years old. https://www.americannursetoday.com/w...se-angioedema/
ARB's
ARB stands for angiotensin-receptor blocker. Major drugs of this class include losartan (Cozaar), valsartan (Diovan), and irbesartan (Avapro) and best of all Telmisartan.
ARBs affect Angiotensin by competing for Angiotensin receptors and preventing Angiotensin II from binding to the blood vessels receptors. This results in blood vessel dilation and a subsequent decrease in blood pressure.
Other side effects.
Both ARBs and ACEIs have protective properties when it comes to kidney disease with one major exception, they both are contraindicated if you have Bilateral Renal Arterial Stenosis. Most if not all renal complications as a side effect of ACE or ARB use relate to this preexisting condition.
Bonus effects
"Drugs known as ARBs (angiotensin II receptor blockers, like Losartan) are not only unlikely to cause erection problems, but they may improve sexual function in men with high blood pressure."
Bonus 2 Telmisartan, a popular ARB has been shown to have PPAR-gamma-inducing property.
Why is this important? PPAR-gamma has been shown to be performance enhancing by creating an energy boost as well as suppressing appetite, promoting body fat loss, and reducing visceral fat. These are things all of us want right?
Plain Language
It might help to look at it this way. Angiotensin II makes your blood pressure go up. Angiotensin II causes your blood pressure to increase by vasoconstriction like putting your thumb over the end of a hose. Less Angiotensin II or blocking it means a decrease in blood pressure. ACE inhibitors are like aromatase inhibitors. it prevents the conversion of Angiotensin I to Angiotensin II. ARB's are like nolvadex, they compete for Angiotensin receptors to prevent vasoconstriction.
AAS use can cause changes to your heart that can negatively effect your health and both ACE inhibitors and ARB's prevent cardiac remodeling.
"Accumulating evidence supports the proposal that angiotensin II type 1 (AT1) receptor blockers (ARBs) have nearly the same beneficial effects as angiotensin converting enzyme (ACE) inhibitors on cardiac hypertrophy, remodeling, and heart failure" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769047/
Side effect concerns
Both ACEIs and ARBs can have serious side effects but this is highly unlikely even if you are over 60 although the risk is higher. Even Motrin is listed as a risk for angioedema. The most common side effect that people get is a cough from ACEIs. Compared to the compounds AAS users routinely use the risk is very low and the benefit is high. Remember millions upon millions of people take these drugs with no problems all over the world.
In Conclusion
Prevention of cardiac remodeling should be a strong concern for all AAS users. While some research has focused on massive dosage regimens of individuals, other research has postulated any supra physiological amount of androgens is a risk for negative effect on cardiac health. This same study also stated low testosterone has a negative correlation with cardiac mortality so another reason for TRT.
ARB's are first choice if money is not an issue or if you are already experiencing erectile dysfunction. Telmisartan is recommended due to its PPAR actions. ACEIs will work if you dont get a cough and are much much cheaper.
all of this is based on a healthy individual using these to prevent AAS induced Cardiac Remodeling.
If you have heart problems already or HBP you should discuss this with your doctor.
you should start at the lowest possible dose and monitor blood pressure and customize dosages to control any blood pressure issues that arise. If your blood pressure does not go up continue with minimum dosage unless you experience low blood pressure. If you experience low blood pressure you would need to reevaluate.
The Future
New research is focusing on combination therapy of ACE inhibitors combined with ARB's to prevent cardiac remodeling, which is showing promising results. A possible future procedure would be a smaller dose of both ACE inhibitors and ARB's. possibly mediating sides from either compound https://www.ncbi.nlm.nih.gov/pubmed/12504813
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