Ace -Inhibitors and Potassium & Sodium levels

Quoted message said:

My father who is on medication for hypertension and diabetes is
currently using the following medications . Metformin 500 , Atenalol -
50 mg , Norvasc - 5 mg , Enlapril - 5 mg .

His sodium levels are below normal and potassium levels are slightly
elevated .
Our PCP says it is because of Enlapril which is depleting sodium and
retaining
potassium . He also told us not to cut on sodium intake .

Is it normal with all users of ace-inhibitors ?

s

Enalapril is an Angiotensin-Converting Enzyme (ACE)-inhibitor.
ACE-inhibitors work by suppressing Angiotensin I and II by regulating
the production renin-angiotensin aldosterone (a vasoconstrictor) and
enhancing the life of bradykinin (a vasodilator). One of the effects is
that messages sent to the kidney's cause sodium to be wasted faster and
potassium to be retained without being effectively used. Hyperkalemia
(excess potassium) may result and can be a potentially serious side
effect. This is the reason that regular blood tests are necessary to
monitor potassium levels.

Symptoms of hyperkalemia include temporary loss of feeling in the
extremities, muscle fatigue and in the most serious case arrhythmia.

Be sure to talk to your doctor about any vitamins, supplements, herbal
remedies or other medications as these may exacerbate the elevated
potassium levels.

In the April 2006, JAMA there was an article about how the older,
cheaper diuretics were both safer and more effective than either
ACE-inhibitors or CCB's like Norvasc. You may want to research and
discuss diuretics with your physician.

Treating HBP can be tricky to find just the right combination for the
patient, and treatments may need adjustment over time.

With low sodium and high potassium, it may be advisable to avoid salt
substitutes as many of these contain potassium. Pay attention to dark
yellow urine (and a bad smell) as well as headaches, dizziness or
tingling in the hands and feet.

-elgoog