I am a 75 year old male having lived in Mexico in retirement for the past 15 years. I have been a heavy, drinker of hard, straight alcohol for years but recently stopped alcohol usage completely on my own without the need for detox rehabilitation and any noticeable effects of previous significant alcohol consumption are no longer manifest. During the past two years I developed CKD and am fighting that disease with some success at preventing a downward trend for the past year but am uncertain as to where I am headed from here. I am not diabetic but have high blood pressure as I have had for at least 45 years controlled most recently over the past couple of years with daily doses of Micardis/Temisartan 40-80 MG. and hydrochlorizide 25 MG. or Furosemide 40 MG. The Furosemide when my high blood pressure becomes periodically problematic. I understand as a lay person that Micardis/Telmisartan is an ARB as opposed to an ACE Inhibitor. The Micardis remedy was prescribed to me by a doctor before my kidney problems arose. Should I continue with Micardis or Telmisartan or do you recommend I discuss an alternative with my nephrologist here in Guadalajara. Any recommendations as to what alternatives are worthy of exploration or do you recommend that I continue with Telmisartan?

I cannot prescribe medical treatment without performing a complete history and physical examination.  In this case, I suggest that you discuss your treatment with your nephrologist.  It is best to have someone who can examine you and provide on-going follow up of your blood pressure control and your kidney function.  The most important aspect of your treatment is to make sure that your blood pressure stays well controlled and average less than 130/80.

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