Q: My doctor prescribed lisinopril for me because I have diabetes, even though my blood pressure has always been normal. My blood sugar came down to normal on pills. Do I really need another medicine?
A: It depends more on your kidneys and your risk of cardiovascular disease than your blood pressure.
There is a very good reason to take an ACEI that may apply to you. These drugs reduce the risk of kidney damage in people with diabetes who spill small amounts of protein in the urine. Doctors call this microalbuminuria.
Another potential benefit of an ACE inhibitor is the reduced chance of developing heart and other blood vessel problems. People with diabetes have a higher chance of these problems. The risk is even higher if your LDL cholesterol is high or you smoke.
Because of these potential benefits, doctors are increasingly prescribing ACEIs for people with diabetes, at least those with early kidney disease or heart problems.
Similar to all medications, there can be side effects, such as a dry, nagging cough. It's a nuisance but not dangerous.
The two potential worrisome side effects are:
Lightheadedness from blood pressure that's too low
A high blood potassium level
The good news: These side effects are uncommon and almost always correctable.
(Howard LeWine, M.D., is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.
(For additional consumer health information, please visit http://www.health.harvard.edu.)
(c) 2014 PRESIDENT AND FELLOWS OF HARVARD COLLEGE. ALL RIGHTS RESERVED. DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC.
The Medicine Cabinet-Ask the Harvard Experts: Blood pressure pill helps reduce diabetes complications
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