Re: Blood pressure - My Doctor is a putz.

From: tcomeau (tunderbar_at_hotmail.com)
Date: 01/18/05 

Date: 17 Jan 2005 19:40:46 -0800

"Sbharris[atsign]ix.netcom.com" <sbharris@ix.netcom.com> wrote in message news:<1105991539.187730.321080@c13g2000cwb.googlegroups.com>...
> COMMENT:
>
> The official US recommendations come from the Coordinating Committee of
> the
> The National High Blood Pressure Education Program (NHBPEP). And for
> the record, the cornerstone of their recommendations, based on the DASH
> study, is a diet centered around fruits, vegetables, non-fat dairy, and
> low in total and saturated fat. The "putz" here is you, how have no
> idea whatever what you're talking about.
>
> SBH

If the National High Blood Pressure Education Program (NHBPEP) is
anything like the National Cholesterol Education Program(NCEP), you've
been had. Putz.

http://www.forbes.com/technology/2004/07/12/cx_mh_0712mrk.html

************
Cholesterol Guidelines A Gift For Merck, Pfizer
Matthew Herper, 07.12.04, 4:30 PM ET

NEW YORK - New guidelines issued by the United States government could
increase the number of people who take cholesterol-lowering medicines;
already the top-selling medication in the world with $26 billion in
annual sales.

The new guidelines were predicted here months ago. (See: "Is Lipitor
The New Aspirin?")

Under previously existing guidelines, 36 million people should be
taking cholesterol-lowering pills such as Lipitor, Zocor, or Pravachol
to prevent heart attacks. In reality, only about 11 million do.
Changes issued today by the National Cholesterol Education Program
(NCEP), to be published in tomorrow's issue of the journal
Circulation, advocate lowering cholesterol in even more patients.
Moreover, patients at the highest risk should receive even more
aggressive treatment--meaning higher, more expensive doses of these
drugs. Now, that figure will increase by millions of people, as the
new guidelines suggest treating diabetics and people who at one time
would have been considered healthy. Those at high risk, or who have
had recent heart attacks, should be treated even more aggressively.

The NCEP did not release an estimate of how many patients should now
take cholesterol-lowering drugs, called statins. Christopher P.
Cannon, a cardiologist at Brigham & Woman's hospital, says 50 million
people should take the drugs. Another cardiologist, Steven E. Nissen
of the Cleveland Clinic, said that number looked reasonable, although
James I. Cleeman, a researcher at the National Heart Blood and Lung
Institute and a co-author of the report said it was "a little high."
The cost of treating that many people with even the lowest dose of
Pfizer's (nyse: PFE - news - people ) Lipitor could approach $40
billion.

But an even more important facet of the guidelines is that many people
would not be on low doses of these drugs. For patients at the highest
risk of heart attack, the new guidelines suggest that "bad
cholesterol," or low-density lipoprotein (LDL), be reduced to 70 mg
per deciliter--although the new guideline is optional. Previous
guidelines suggest that LDL of 100 mg was good enough. Many patients
will not be able to get to those levels at starting doses of most
current drugs. "It may be that reducing cholesterol to levels that are
consistent with what used to be found in rural china is where we need
to head," says Sydney Smith, a cardiologist at the University of North
Carolina, Chapel Hill, and a co-author of the new guidelines.

Even for patients at modest risk of heart attacks--meaning that they
have heart disease, diabetes, or a combination of some risk
factors--the new guidelines suggest lowering cholesterol at least
30-40%. With weaker statins, such as Pravachol from Bristol-Myers
Squibb (nyse: BMY - news - people ) or lovastatin, available as a
cheap generic, that requires the second-highest dose. That could
encourage doctors to use stronger drugs--a big boost for Lipitor.
Crestor, an even more powerful statin from AstraZeneca (nyse: AZN -
news - people ) could also benefit, but may be held back because it
does not have the same track record of safety as Lipitor.

Another big winner could be Vytorin, a new cholesterol pill from Merck
(nyse: MRK - news - people ) and Schering-Plough (nyse: SGP - news -
people ) that is expected to hit the market soon. It combines Merck's
Zocor with another drug, Zetia, to lower cholesterol even more at
lower doses.

Some say the new guidelines do not go far enough. "It's very
disappointing to me that NCEP couldn't get it right given the data,"
says Eric Topol, a cardiologist at the Cleveland Clinic. He points out
that two clinical trials have shown that many patients would benefit
from more cholesterol lowering. Says Topol: "To make an LDL of 70 an
optional strategy is ignoring the trials."
***********

The "scientists"/marketers who are quoted as supporting these new
guidelines are:

Chistopher P. Cannon, Ph.D., Harvard Medical School.Hired consultant
to Bristol-Myers Squibb for the Prove It study. "Drug Marketing 101:
Proving Our Pill is Better than Yours" By Sheryl Gay Stolberg and Jeff
Gerth New York Times 12/23/00. Has received research grant support
from Cor Therapeutics and Merck. (JAMA 2000;283:2941-47)

Steven E. Nissen, M.D., Vice-chairman of Cardiology, and Head of
Clinical Cardiology, Department of Cardiovascular Medicine, Cleveland
Clinic Foundation, Cleveland, OH. Research on lipid-lowering therapy
on progression of coronary atherosclerosis through the use of statins
Pravachol (pravastatin) and Lipitor (atorvastatin) funded by Pfizer.
Research support from AstraZeneca, Merck-Schering Plough, Esperion
Therapeutics, Takeda, Pfizer, and Sankyo. (JAMA. 2004;291:1071-80)

***********

Committee roster members of the National Cholesterol Education
Program:

http://www.nhlbi.nih.gov/about/ncep/ncep_ros.htm

American Diabetes Association, Inc.
Please note: this link will open a new browser window; to return to
this document, either close the new window, or toggle back (ALT-TAB
for Windows users, Apple-TAB for Macintosh users).

Alan J. Garber, M.D., Ph.D.
Professor of Medicine
Biochemistry and Cell Biology
Baylor College of Medicine
Chief of Endocrinology, Diabetes and Metabolism
The Methodist Hospital
Suite 1045
6550 Fannin
Houston, TX 77030

American Dietetic Association
Linda Van Horn, Ph.D., R.D.
Professor
Department of Preventive Medicine
Northwestern University Medical School
Room 1102
680 North Lake Shore Drive
Chicago, IL 60611-4402

American Heart Association
Scott M. Grundy, M.D., Ph.D.
Director, Center for Human Nutrition
Southwestern Medical Center at Dallas
Room Y3.206
5323 Harry Hines Boulevard
Dallas, TX 75235-9052

*********

TC

Relevant Pages

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