Ever forget your meds?

[reader]

Arrived in Bkk last night and this morning discovered I’d left my blood pressure med at home. Went to the ever reliable Chula pharmacy on Rama 4 (between Silom and Surawong) and was provided what I needed for 80 baht.

it appears that b/p and statins are available without prescription in LOS.

[forky123]

Never forget my meds. Then again they usually take up about 1/3 of my carry on bag so it's kind of obvious to me. Glad to know you can pick up some items though.

[unicorn]

Note: just joking! 😁

[Olddaddy]

I wonder if in reality you need those BP meds?

Have you tried cutting them down to see if your BP rises?

 

[forky123]

42 minutes ago, Olddaddy said:

I wonder if in reality you need those BP meds?

Have you tried cutting them down to see if your BP rises?

 

Sure, I know more than the doctors so I randomly stop taking my meds to "see what happens".

[vinapu]

On 2/7/2024 at 8:24 AM, reader said:

Arrived in Bkk last night and this morning discovered I’d left my blood pressure med at home. Went to the ever reliable Chula pharmacy on Rama 4 (between Silom and Surawong) and was provided what I needed for 80 baht.

it appears that b/p and statins are available without prescription in LOS.

and a lot of other drugs are just over the counter for which my family is eternally grateful to Thailand. Few years ago me nephew , epileptic,  was running out of his drug which happened nowhere to be available or if available , only by prescription from local doctor. ( Later we learned it was due to manufacturing problems ) . Fortunately one of our members was able to find those in Bangkok and buy without any fuss , just ' how much do you need?'  and sent to us literally few days before last pill was taken.

to answer original question , yes I once forgot  BP pills called Olmetec and surely enough they were available just for asking and baht at Chula.

[reader]

6 hours ago, Olddaddy said:

I wonder if in reality you need those BP meds?

Have you tried cutting them down to see if your BP rises?

 

Both my mother and sister died at early age due to massive CVA’s. I watch my b/p like a hawk.

[TMax]

Forgot my full packet of BP meds and arrived with only a few days worth once but got them in the small pharmacy just near Chula (I think AP Medical), no problems at all, just showed them the empty packet with my info on the label and they were happy to sell me some. I do like that one and Chula, if one doesn't have what I need the other most likely will.

[tm_nyc]

Chula is excellent, I agree.  My other resource is Pharmacie de la Gare in Phnom Penh.  It is, as the name suggests, near the defunct (?) PP railway station & prices for some items may be a bit lower than BKK.  I have heard that virtually anything pharmaceutical is available without a prescription in Cambodia.

[Olddaddy]

3 hours ago, reader said:

Both my mother and sister died at early age due to massive CVA’s. I watch my b/p like a hawk.

Is 120/80 the most ideal?

Some of these medications that I was taking had side effects fatigue ,ankle swelling etc 

[reader]

Take all meds plus any supplements you’re taking to your internist and let him evaluate possibility of interactions, or other condition altogether.

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/blood-pressure/art-20050982

[reader]

Duplicate deleted 

[vinapu]

6 hours ago, tm_nyc said:

 near the defunct (?) PP railway station 

station is renovated and working indeed with trains to Sihanoukville and Battambang departing daily

[thaiophilus]

10 hours ago, reader said:

Take all meds plus any supplements you’re taking to your internist and let him evaluate possibility of interactions, or other condition altogether.

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/blood-pressure/art-20050982

Or talk to your pharmacist. They should know, maybe better than the doctor, about possible interactions. And, in the UK at least, are much more accessible ☹️

[unicorn]

On 2/10/2024 at 1:34 AM, Olddaddy said:

Is 120/80 the most ideal?

Some of these medications that I was taking had side effects fatigue ,ankle swelling etc 

Ideal goals vary, depending on patient factors, including especially other health conditions and age. For an average risk patient, there's little benefit in getting the BP much under 139/89. Some patient could benefit more from a BP of 129/79 or lower. Best measurements are home evening measurements in a calm environment, with the BP taken after the person has been sitting for 5 minutes with both feet flat on the floor, back rested, no talking or activity. 

[kokopelli3]

On 2/10/2024 at 1:34 PM, Olddaddy said:

Is 120/80 the most ideal?

Some of these medications that I was taking had side effects fatigue ,ankle swelling etc 

Less than 120/80 per Harvard Health.

http://content.health.harvard.edu/wp-content/uploads/2021/11/bcaf1571-9128-4fc0-8354-52e157cb87d7.jpg

[unicorn]

8 hours ago, kokopelli3 said:

Less than 120/80 per Harvard Health.

http://content.health.harvard.edu/wp-content/uploads/2021/11/bcaf1571-9128-4fc0-8354-52e157cb87d7.jpg

The graph you posted simply posted definitions, not treatment guidelines. Indeed, treatment guidelines do vary, depending on the organization. While there is a small improvement in cardiovascular benefit to getting the BP from the 130s to the 120s, this is counterbalanced by a small increase in harms from the meds for most people. So, for the average patient (not someone with coronary artery disease or congestive heart failure, for example), the risks of tight BP control outweigh the benefits (unless one can bring the BP down from exercise, diet, weight loss, treatment of obstructive sleep apnea, or other non-pharmacological methods). 

https://www.aafp.org/pubs/afp/issues/2022/1200/practice-guidelines-hypertension.html#:~:text=Using a blood pressure target,65 and 80 mm Hg.

Key Points for Practice

• Blood pressure targets of 140 mm Hg systolic and 90 mm Hg diastolic offer similar reduction in cardiovascular and all-cause mortality as lower targets and have fewer adverse effects.

• Lower blood pressure targets lead to a reduction in myocardial infarction, with a number needed to treat of 137 over 3.7 years.

• After achieving initial blood pressure control, shared decision-making can be used to determine whether lower blood pressure targets should be considered.

More recent guidelines take into account more recent studies, which look at overall morbidity and mortality, not simply a reduction in cardiovascular events:

https://www.acc.org/Latest-in-Cardiology/Articles/2024/02/05/11/43/2023-ESH-Hypertension-Guideline-Update

 

Please note that both guidelines stress the importance of individualization of care, not simply "one size fits all." Note the important sentence "Pooled Cohort Equation and SCORE2/SCORE2-OP provide estimates for 10 year risk of fatal/nonfatal cardiovascular events and should be used to guide treatment decisions."

[unicorn]

The Cochrane Review provides some of the most complete and objective literature review:

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010315.pub5/full

This 2022 review of the latest data showed: " At present, evidence is insufficient to justify lower blood pressure targets (135/85 mmHg or less) in people with hypertension and established cardiovascular disease. Several trials are still ongoing, which may provide an important input to this topic in the near future."

[xpaulo]

On 2/9/2024 at 3:05 PM, vinapu said:

a lot of other drugs are just over the counter

 A German pharmacy refused to sell me their equivalent to Imodium without a prescription. I think they've loosened up on that restriction though.

[vinapu]

1 hour ago, xpaulo said:

 A German pharmacy refused to sell me their equivalent to Imodium without a prescription. I think they've loosened up on that restriction though.

each  country has own regulations when comes to drugs but from your adventure one thing is sure - if one has to have diarrhea it is better to have it in Thailand then Germany

[Marc in Calif]

21 hours ago, xpaulo said:

 A German pharmacy refused to sell me their equivalent to Imodium without a prescription. I think they've loosened up on that restriction though.

And that's exactly what Imodium is meant to fix. ☺️

[Olddaddy]

Geez just checked my blood pressure it's 155 😲

I will definitely have to block ""Marc in Calif" 😂it's all his fault 

[Marc in Calif]

2 hours ago, Olddaddy said:

Geez just checked my blood pressure it's 155 😲

I will definitely have to block ""Marc in Calif" 😂it's all his fault 

Blood pressure that high is caused by your wacko communications on this site -- especially your advice to others about BP precautions and medications. 🤣😘🤣

They all come back to bite you! 🎯

[unicorn]

8 hours ago, Olddaddy said:

Geez just checked my blood pressure it's 155 😲

I will definitely have to block ""Marc in Calif" 😂it's all his fault 

It's not a matter of "just checked." It's a matter of what the BP has been running. A valid BP has to be measured in a very specific way. In particular, most people don't follow the very important instruction of sitting quietly (no talking) for 5 minutes before taking the reading: