Re: blood pressure pill nightmare

On Jan 23, 4:54 pm, Bill <b2forewag...@xxxxxxxx> wrote:
In article
<41f67504-09d2-4047-ace6-7d2300ca7...@xxxxxxxxxxxxxxxxxxxxxxxxxxxx>,



bigvince <Vince.Mirag...@xxxxxxxxx> wrote:
On Jan 23, 11:28 am, Bill <b2forewag...@xxxxxxxx> wrote:
In article <t1bin4p27bhtuhfidhsadem3pps73t3...@xxxxxxx>,

zob <zob...@xxxxxxxxx> wrote:
On Wed, 21 Jan 2009 15:15:11 -0500, Bill <b2forewag...@xxxxxxxx>
wrote:

<snip>

Guess you know about this.

Bill
...................

HYPERTENSION
Reducing heart rate in hypertension is harmful‹or is it just atenolol?
OCTOBER 22, 2008 | Lisa Nainggolan
New York, NY - Slowing the heart rate with beta blockers in people with
hypertension is associated with an increased risk of cardiovascular
events and death, a new systematic review shows [1]. Furthermore, the
slower the heart rate, the greater the risk, report Dr Sripal Bangalore
(St Luke's Roosevelt Hospital, New York) and colleagues in the October
28, 2008 issue of the Journal of the American College of Cardiology.

What we show is that in hypertension, when you slow down the heart rate
with a beta blocker, it actually shortens your life.
Senior author Dr Franz Messerli (St Luke's Roosevelt Hospital) told
heartwire: "Slowing heart rate is known to prolong life expectancy, and
with beta blockers post-MI and in heart failure, the slower you can make
the heart rate, the better. But this new paper goes against the grain.
What we show is that in hypertension, when you slow down the heart rate
with a beta blocker, it actually shortens your life expectancy, it
causes more heart attacks, more heart failure, and more strokes."

That makes no sense whatsoever to me! Beta Blockers do more than slow
heartbeat, they also reduce blood pressure. So for the clown who
wrote that to say that "in hypertension" slowing the heart rate with a
beta blocker shortens your life expectancy is an oxymoron.
It's a bit
like saying that a fat person who diets will have their life
expectancy shortened by anorexia. It's not even logical.

Life is not logical get over it.

Once again I will write that your age say 60 + 100 over 100 was
considered normal before major drug interventions became the vogue .

Age 10 110/100
Age 20 120/100
Age 30 130/100
Age 40 140/100

Do you see the pattern??

The above study says trying for an ideal gets you the low numbers BUT
YOU DIE sooner.

Bon Appetite!

Bill

--
Garden in shade zone 5 S Jersey USA

The really relevant part of this is that at least for
atenolol .....
.But this new paper goes against the grain.
What we show is that in hypertension, when you slow down the heart rate
with a beta blocker, it actually shortens your life expectancy,
it....causes more heart attacks, more heart failure, and more strokes."

And Why?

"Messerli says he and his team believe the likely explanation for this
is
"that slowing the heart rate with beta blockers increases the central
pressure, and obviously the latter is one of the determinants of
stroke
and heart attack." "

It should be noted that both the American Heart association , and the
America Society of Hypertension have removed Beta blockers as drugs
recommended in hypertension why ?

It should also be noted that the Doctors quoted are the leaders in
the field .

Another hypertension expert sees things slightly differently, however.
Dr John Cockcroft (Wales Heart Institute, Cardiff, UK) argues that in
this review, the studies included almost exclusively used
atenolol‹something the authors do point out‹and that it is this drug
per
se that is likely the culprit here.
What is vitally important to determine in this setting, he adds, "is
whether it's atenolol that's bad or whether it's reduction of heart
rate
that's bad." This is crucial because there are other drugs that aren't
beta blockers that lower heart rate, he explained, such as the new
agent
ivabradine (Procoralan, Servier). "This issue needs resolving because
if
it's heart-rate reduction [that is the cause], then that's bad news,
and
we need to know about it."

Atenolol is the most widely used beta blocker . No study anywhere
has shown it to reduce either death rates ; heart attack or strokes.
It does however have side effects As noted ...

" " Atenolol, he says, "has been tried and found guilty, and yet
around 40% of prescriptions for beta blockers in the UK and in the US
are still for atenolol. Atenolol should not be given to anybody.
Nobody
disagrees that atenolol is guilty, and yet we are still using it.".

Any comment on the POISE study

No comments but as I wish I knew nothing about this stuff. Second site
seems more human friendly.

Bill

180/110 seems to be not good see # 2 below.

<http://www.ncbi.nlm.nih.gov/pubmed/18614596?ordinalpos=1&itool=EntrezSys
tem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Disc
overy_RA&linkpos=1&log$=relatedarticles&logdbfrom=pubmed>

<http://www.ncbi.nlm.nih.gov/pubmed/18959836?ordinalpos=2&itool=EntrezSys
tem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_
RVDocSum>

--
Garden in shade zone 5 S Jersey USA


http://heartdisease.about.com/b/2008/05/16/poise-the-muddle-of-beta-blockers-in-noncardiac-surgery.htm
By Richard N. Fogoros, M.D., About.com Guide to Heart Disease since
2000



POISE: The Muddle of Beta Blockers in Noncardiac Surgery
Friday May 16, 2008
The publication of the Perioperative Ischemic Evaluation trial (the
POISE study) this week in The Lancet has the cardiology world in a
semi-tizzy, since it suggests that certain guidelines published by the
American Heart Association (AHA) and the American College of
Cardiology (ACC) are causing more harm than good.

At issue is the question of whether patients having noncardiac surgery
who are at increased risk for coronary artery disease ought to be
given beta blockers in the perioperative period (i.e. during the time
immediately before, during, and after surgery). Previous studies have
shown that perioperative beta blockers in such patients can reduce the
risk of heart attacks during and after surgery. .......

Unfortunately, the POISE study (which enrolled over 8000 patients from
23 countries who were over 45 years of age, had increased cardiac
risk, and were having noncardiac surgery) showed that, while the risk
of heart attack was indeed reduced in patients randomized to beta
blockers, they also had a significantly increased risk of stroke and
death. Overall, the use of beta blockers in these patients led to net
harm.........


This was the gold standard of care . One estimate I read said I
million needless deaths and 800 thousand strokes.
.