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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffer Hypertension. Taking Olmasartan. Suffer Severe Pain In Tendons Of Knee. Feel Chest Pain And Mild Nausea After Work Out. Cure?

Hi, I'm 62 years male, from India, have hypertension and have been taking Olmasartan 20mg/day. Rare smoker, stopped 3 years ago, indulge in chewing tobacco once/twice a day, fitness fanatic, average an hour of workout every day. Used to go for 15 to 20km walks once or twice a week, but reduced to 5km, because of severe pain in the tendons of the right knee, which had a surgery in a car accident 20 years ago. Since a months increased weights and stretching - for an hour 3 to 4 times a week. Suffered from MI 3 days, attributable to severe exercises I would say and the doctor seemed to agree. Felt chest pain and mild nausea 5 minutes after an hour on the treadmill 6/6.6km and 2 to 10 ramp. The day before did 80 stretches within 30 to 40 minutes with 5Kg weight on each foot and feet touching floor over and behind the head. Went to the hospital immediately and was admitted. Blood chemistry showed perfect but CK/CPK and CKMB and Troponin markers were all high in next day morning's results. Was under observation for a day and the next morning angiography was done, which showed D2 branch of LAD had a block, and was opened with Blue Medical 1.5mmx10mm and Resore Deb drug eluting 2x20mm, Fluor time 7.7 minutes. Medication prescribed ASA, Plavix, Lipitor, Coversyl, and Concor. Question 1: I guess I must not take Olmasartan as long as I'm taking the last two, i.e., Coversyl and Concor, which also reduce the blood pressure as I understood. Please confirm. Question 2: How is this procedure and the medication going to affect my sexual life? I guess beta blockers do affect potency. Before Olmasartan, which I've been taking for almost five years, I changed the drug for HT three times, as they seemed to affect my sexual performance. Groin feels pretty cold for now, though I miss my wife. She is away for a week. Married for 28 years and have always enjoyed excellent sex life.
Last two years from time to time I took Tadalafil 20mg (one or two once in a month or two). In general food habits are good to the extreme, avoiding all processed foods and drinks including canned juices, no whites and only browns (rice, bread, and sugar), low salt, low fat, low meats except fish, sometimes milk with chocolate and brown sugar or honey, sodas never ever.good intake of fresh veg's and fruits. Good breakfast before starting the day. Sorry if I made it too long. Thank you very much for your kind attention and advice.
Tue, 24 Sep 2013
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Internal Medicine Specialist 's  Response
Hi there,

Thanks for seeking advice on HCM. I am sorry to learn that you had had an acute MI and had to undergo angioplasty with stents.

I appreciate your high degree of motivation to strictly adhere to the prescribed diet.

As far as the Blood Pressure (post-heart attack) is concerned, the target should be to keep it to less than 130/85.

You should continue taking Olmesartan along with Coversyl + Concor. Coversyl and Olmesartan exert their action somewhat differently, but have a synergistic effect in reducing the workload on the heart. However, if your BP is below 120/80 without Olmesartan, you should stop it.

Like Coversyl/Olmesartan, Concor too has a beneficial effect on the heart (post-heart attack) and is the drug of choice. Concor- in low dosages- does not significantly affect erections/libido. But, given their beneficial effects on the heart, they need to be continued throughout life.

As far as your sexual life is concerned, it depends on the degree of restoration of blood flow in the arteries supplying the heart muscles. Your doctor must have briefed you about it. If this has not been discussed by your doctor, it would be advisable to undergo a fresh TMT. If is negative for inducible ischaemia, sexual intercourse will be more or less safe.

However, a word of caution : avoid Tadanifil/Viagra at all costs.

If you have any further clarifications, please feel free to revert back.

Wish you a speedy recovery and return to normal life
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Suffer Hypertension. Taking Olmasartan. Suffer Severe Pain In Tendons Of Knee. Feel Chest Pain And Mild Nausea After Work Out. Cure?

Hi there, Thanks for seeking advice on HCM. I am sorry to learn that you had had an acute MI and had to undergo angioplasty with stents. I appreciate your high degree of motivation to strictly adhere to the prescribed diet. As far as the Blood Pressure (post-heart attack) is concerned, the target should be to keep it to less than 130/85. You should continue taking Olmesartan along with Coversyl + Concor. Coversyl and Olmesartan exert their action somewhat differently, but have a synergistic effect in reducing the workload on the heart. However, if your BP is below 120/80 without Olmesartan, you should stop it. Like Coversyl/Olmesartan, Concor too has a beneficial effect on the heart (post-heart attack) and is the drug of choice. Concor- in low dosages- does not significantly affect erections/libido. But, given their beneficial effects on the heart, they need to be continued throughout life. As far as your sexual life is concerned, it depends on the degree of restoration of blood flow in the arteries supplying the heart muscles. Your doctor must have briefed you about it. If this has not been discussed by your doctor, it would be advisable to undergo a fresh TMT. If is negative for inducible ischaemia, sexual intercourse will be more or less safe. However, a word of caution : avoid Tadanifil/Viagra at all costs. If you have any further clarifications, please feel free to revert back. Wish you a speedy recovery and return to normal life