Copyright Larry FatNews.com, All Rights Reserved. Thursday, June 18, 2009

Similar documents
High Blood Pressure and Your Kidneys

Getting the most from blood pressure medicines

Prescription Pattern of Anti Hypertensive Drugs used in Hypertensive Patients with Associated Type2 Diabetes Mellitus in A Tertiary Care Hospital

High Blood Pressure (Essential Hypertension)

High Blood pressure and chronic kidney disease

About High Blood Pressure

HIGH BLOOD PRESSURE AND YOUR KIDNEYS

High Blood Pressure and Chronic Kidney Disease. For People With CKD Stages 1 4

Easy or complex? University Pharmacy. Pharm.D. candidates, 2011

Case Study 6: Management of Hypertension

GFR (Glomerular Filtration Rate) A Key to Understanding How Well Your Kidneys Are Working

Secondary Stroke Prevention Luke Bradbury, MD 10/4/14 Fall WAPA Conferfence

Hypertension and Diabetes

High blood pressure (hypertension)

ADVANCE: a factorial randomised trial of blood pressure lowering and intensive glucose control in 11,140 patients with type 2 diabetes

Aggressive Lowering of Blood Pressure in type 2 Diabetes Mellitus: The Diastolic Cost

Systolic Blood Pressure Intervention Trial (SPRINT) Principal Results

Medical management of CHF: A New Class of Medication. Al Timothy, M.D. Cardiovascular Institute of the South

High Blood Pressure and Chronic Kidney Disease

HYPERTENSION ASSOCIATED WITH RENAL DISEASES

Treatment of Hypertension: JNC 8 and More

ADULT HYPERTENSION PROTOCOL STANFORD COORDINATED CARE

CME Test for AMDA Clinical Practice Guideline. Diabetes Mellitus

Hypertension Guideline V4

High Blood Pressure. A Guide to Understanding Blood Pressure...

Duration of Dual Antiplatelet Therapy After Coronary Stenting

High Blood Pressure and Your Kidneys

嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯

Guidance for Industry Hypertension Indication: Drug Labeling for Cardiovascular Outcome Claims

Cardiovascular Risk in Diabetes

High blood pressure and stroke

Cardiovascular Disease Risk Factors

U.S. Food and Drug Administration

RATE VERSUS RHYTHM CONTROL OF ATRIAL FIBRILLATION: SPECIAL CONSIDERATION IN ELDERLY. Charles Jazra

MY TYPE 2 DIABETES NUMBERS

High Blood Pressure and Kidney Disease

S1. Which of the following age categories do you fall into? Please select one answer only years of age years of age years of age

Dual Antiplatelet Therapy. Stephen Monroe, MD FACC Chattanooga Heart Institute

High Blood Pressure. What Is Blood Pressure?

Kardiovaskuläre Erkrankungen ein Update für die Praxis, 22. Mai 2014 PD Dr. Matthias Wilhelm

Journal Club: Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy by the AIM-HIGH Investigators

Milwaukee School of Engineering Case Study: Factors that Affect Blood Pressure Instructor Version

Strokes and High Blood Pressure

Management of High Blood Pressure in Adults Based on the Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC8)

Blood Pressure Assessment Program Screening Guidelines

Identifying and treating long-term kidney problems (chronic kidney disease)

4/4/2013. Mike Rizo, Pharm D, MBA, ABAAHP THE PHARMACIST OF THE FUTURE? METABOLIC SYNDROME AN INTEGRATIVE APPROACH

INVESTIGATING HEART RATE AND BLOOD PRESSURE

Antihypertensive Drug Management to Achieve Systolic Blood Pressure <120 mmhg in SPRINT

CASE B1. Newly Diagnosed T2DM in Patient with Prior MI

Novel Trial Designs in T2D to Satisfy Regulatory Requirements for CV Safety

Communicating uncertainty about benefits and

PRESSURE POINTS SERIES: Introducing high blood pressure

Neal Rouzier responds to the JAMA article on Men and Testosterone

Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria.

Can Common Blood Pressure Medications Cause Diabetes?

COMPARING TWO KINDS OF BLOOD PRESSURE PILLS:

Rx Updates New Guidelines, New Medications What You Need to Know

2013 ACO Quality Measures

Therapeutic Approach in Patients with Diabetes and Coronary Artery Disease

Clinical Quality Measure Crosswalk: HEDIS, Meaningful Use, PQRS, PCMH, Beacon, 10 SOW

ECG may be indicated for patients with cardiovascular risk factors

Perspectives on the Selection and Duration of Dual Antiplatelet Therapy

Main Effect of Screening for Coronary Artery Disease Using CT

2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY

Papers. Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials. Abstract. Introduction.

Heart Failure: Diagnosis and Treatment

Special Communication

From Concept to Rapid Visualization a Data Analytics Case Study

Cardiovascular disease physiology. Linda Lowe-Krentz Bioscience in the 21 st Century October 14, 2011

Aging Well - Part V. Hormone Modulation -- Growth Hormone and Testosterone

PROCEEDINGS DIABETIC NEPHROPATHY: DETECTION AND TREATMENT OF RENAL DISEASE IN PATIENTS WITH DIABETES* Jiten Vora, MA, MD, FRCP ABSTRACT

ACLS PHARMACOLOGY 2011 Guidelines

Chronic Kidney Disease and Diabetes

Calcium , The Patient Education Institute, Inc. nuf40101 Last reviewed: 02/19/2013 1

Oral Zinc Supplementation as an Adjunct Therapy in the Management of Hepatic Encephalopathy: A Randomized Controlled Trial

Using multiple biomarkers to predict renal and cardiovascular drug efficacy: Implications for drug development and registration

Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis

Scottish Medicines Consortium

The Link Between Obesity and Diabetes The Rapid Evolution and Positive Results of Bariatric Surgery

Cardiac Rehabilitation

Cohort Studies. Sukon Kanchanaraksa, PhD Johns Hopkins University

DISCLOSURES RISK ASSESSMENT. Stroke and Heart Disease -Is there a Link Beyond Risk Factors? Daniel Lackland, MD

Drug Treatment in Type 2 Diabetes with Hypertension

Kidney Disease WHAT IS KIDNEY DISEASE? TESTS TO DETECT OR DIAGNOSE KIDNEY DISEASE TREATMENT STRATEGIES FOR KIDNEY DISEASE

Diabetes and Stroke. Understanding the connection between diabetes and the increased risk of stroke

Report on comparing quality among Medicare Advantage plans and between Medicare Advantage and fee-for-service Medicare

Prevent a Heart Attack. Public Information Pamphlets

High Blood Pressure. Dr. Rath s Cellular Health Recommendations for Prevention and Adjunct Therapy

Isabella Sudano & Franco Muggli

GENERAL HEART DISEASE KNOW THE FACTS

Systolic blood pressure and mortality

Trends in Part C & D Star Rating Measure Cut Points

Drug/Drug Combination: Bevacizumab in combination with chemotherapy

EXPLORING THE INTERACTION BETWEEN EXERCISE AND MEDICATION FOR CHRONIC DISEASE: CONSIDERATIONS FOR FITNESS PROFESSIONALS

ANNE ARUNDEL MEDICAL CENTER CRITICAL CARE MEDICATION MANUAL DEPARTMENT OF NURSING AND PHARMACY. Guidelines for Use of Intravenous Isoproterenol

Congestive Heart Failure

Improving Quality of Care for Medicare Patients: Accountable Care Organizations

Assess adherence with medication and lifestyle changes at every opportunity and intervene if necessary

Guidelines for the management of hypertension in patients with diabetes mellitus

Transcription:

... beta blocker therapy has been shown to cause... weight gain... and to significantly increase the risk of developing diabetes. Franz Messerli, MD, European Heart Journal, 2003

Beta blockers include drug like atenolol (Tenormin) and propranolol (Inderal).

Hi, this is Larry Hobbs @ FatNews.com

European Heart Journal, March 2003, 24(6): 487-9 2009, Larry Hobbs, FatNews.com European Heart Journal (2003) 24, 487 489 Hotline Editorial The LIFE study: the straw that should break the camel's back Franz H. Messerli * Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA In the LIFE study, the most recent landmark trial in hypertension, 1 3 more than 9000 hypertensive patients were randomized to either a losartanreliable and more powerful surrogate endpoint for cardiovascular fatal and non-fatal events than blood pressure per se. 9,10 What has not clearly been

European Heart Journal, March 2003, 24(6): 487-9 2009, Larry Hobbs, FatNews.com 488 Hotline Editorial allow us to explain the discrepancy between cerebral and cardiac events in the losartan arm. 12 2. We should not forget that there were small, albeit distinct, differences between the two treatment arms. Although blood pressure seemed to have been reduced to a very similar level, close scrutiny of the blood pressure curves in the diabetic population 2 shows that systolic pressure was consistently higher and diastolic pressure consistently lower in patients on atenolol compared with those on losartan. This is not surprising since betablockers have a negative chronotropic effect and increase stroke volume to some extent, which in turn usually leads to an increase (or to a lesser fall) in pulse pressure than is seen with vasodilatory agents such as losartan which do not affect stroke volume. In the betablocker compared with the losartin group, more patients withdrew from double-blind medication (27.1 vs. 22.6%; P<0.001), whereas fewer proceeded to combination therapy lic hypertension. 3 However, the statement in this manuscript, Previous intervention studies in ISH with diuretics or beta-blockers or calcium antagonists or angiotension converting enzyme inhibitors have shown 36%, 42% and 38% reductions in stroke or placebo. A further 40% reduction in stroke with losartan-based therapy is an important finding, is disturbing. The authors seemingly want us to believe that had losartan been compared to placebo, a reduction in stroke in the order of magnitude of 80% would have been achieved. The references that they give for their statements are Syst-Eur, Syst-China, and SHEP. None of these studies documented a stroke reduction with betablockers (or ACE inhibitors). Given that in patients with isolated systolic hypertension there was a robust 40% difference in stroke reduction between losartan and atenolol, there seems to be little need to inflate these findings by a deceptive statement.

benefits that were similar to captopril, there was no significant reduction in coronary artery disease, sudden death or MI. On the contrary, beta-blocker therapy has been shown to cause systematic weight gain 19 and to significantly increase the risk of developing diabetes. 20 Given the known spotty record of beta-blockers in the diabetic population, the superiority of an angiotensin receptor inhibitor in the LIFE study in these patients is hardly a surprise. European Heart Journal, March 2003, 24(6): 487-9... On the contrary, beta blocker therapy has been shown to cause... weight gain... Franz Messerli, MD 2009, Larry Hobbs, FatNews.com Thus, to put it somewhat pointedly, a losartanbased regimen did not reduce MI more than placebo (i.e. atenolol), but showed efficacy in reducing

benefits that were similar to captopril, there was no significant reduction in coronary artery disease, sudden death or MI. On the contrary, beta-blocker therapy has been shown to cause systematic weight gain 19 and to significantly increase the risk of developing diabetes. 20 Given the known spotty record of beta-blockers in the diabetic population, the superiority of an angiotensin receptor inhibitor in the LIFE study in these patients is hardly a surprise. European Heart Journal, March 2003, 24(6): 487-9... and to significantly increase the risk of developing diabetes. Franz Messerli, MD 2009, Larry Hobbs, FatNews.com Thus, to put it somewhat pointedly, a losartanbased regimen did not reduce MI more than placebo (i.e. atenolol), but showed efficacy in reducing

only in about 10% of all patients with monotherapy, European Heart Journal, March 2003, 24(6): 487-9 the lesser of the two evils. Underscoring the 2009, Larry Hobbs, FatNews.com superiority of losartan over atenolol, Brunner and Gavras 21 wrote an accompanying editorial with the title, Angiotensin blockade in hypertension: a promise fulfilled. Mutatis mutandis one could change the title of this editorial to Beta-blockers in hypertension a promise broken. This semantic issue notwithstanding, the LIFE study should be... one could change the title of this editorial to Beta-blockers in hypertension a promise broken. Franz Messerli, MD considered as the final straw that will break the camel's back and hopefully motivate physicians to no longer expose their elderly hypertensive patients to the cost, inconvenience, adverse

promise fulfilled. Mutatis mutandis one could European Heart Journal, March 2003, 24(6): 487-9 change the title of this editorial to Beta-blockers 2009, Larry Hobbs, FatNews.com in hypertension a promise broken. This semantic issue notwithstanding, the LIFE study should be considered as the final straw that will break the camel's back and hopefully motivate physicians to no longer expose their elderly hypertensive patients to the cost, inconvenience, adverse effects, and most importantly, to the inefficacy of beta-blockers.

change the title of this editorial to Beta-blockers in hypertension a promise broken. This semantic issue notwithstanding, the LIFE study should be considered as the final straw that will break the camel's back and hopefully motivate physicians to no longer expose their elderly hypertensive patients to the cost, inconvenience, adverse effects, and most importantly, to the inefficacy of beta-blockers. European Heart Journal, March 2003, 24(6): 487-9 2009, Larry Hobbs, FatNews.com... [this study will] hopefully motivate physicians to no longer expose their elderly hypertensive patients... to the inefficacy of beta blockers. Franz Messerli, MD

European Heart Journal, March 2003, 24(6): 487-9 2009, Larry Hobbs, FatNews.com European Heart Journal (2003) 24, 487 489 Franz H. Messerli, MD Ochsner Clinic, Section on Hypertension Hotline Editorial 1514 Jefferson Hwy The LIFE study: the straw that should break the camel's back Franz H. Messerli * Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA New Orleans, LA 70121 (504) 842-4077 phone (504) 842-3144 phone (504) 842-4220 fax Fmesserli@aol.com In the LIFE study, the most recent landmark trial in hypertension, 1 3 more than 9000 hypertensive patients were randomized to either a losartanreliable and more powerful surrogate endpoint for cardiovascular fatal and non-fatal events than blood pressure per se. 9,10 What has not clearly been

Do not be fooled into thinking that just because a drug lowers blood pressure,...

... or blood sugar...

... or cholesterol...

... that it must be good for you.

This is NOT necessarily so.

The only thing that matter is how the drug affects your Total Risk of Death.

I believe that potassium bicarbonate is vastly superior to beta blockers...

and the other blood pressure medicines...

... for improving health.

I ve been taking 1000 mg of potassium twice a day (2000 mg per day) in the form of potassium bicarbonate since 2000.

My blood pressure dropped from roughly 140/80 mm Hg to 124/73 mm Hg.

WARNING: Only take potassium under a doctor s supervision. Too much potassium can kill you.

Eur J Nutr 40 : 200 213 (2001) Steinkopff Verlag 2001 ORIGINAL CONTRIBUTION L. Frassetto R. C. Morris, Jr. D. E. Sellmeyer K. Todd A. Sebastian Diet, evolution and aging The pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet They have found that potassium bicarbonate: Reduce muscle loss Reduces bone loss Summary Theoretically, we humans should be better adapted physiologically to the diet our ancestors were exposed to during millions of years of hominid evolution than to the diet we have been eating since the agricultural revolution a Increases growth hormone fects on the body, including growth retardation in children, decreased muscle and bone mass in adults, and kidney stone formation, and that correction of acidosis can ameliorate those conditions. Is it possible that a lifetime of eating disalt of potassium (potassium citrate) with NaCl prevented NaCl from increasing urinary calcium excretion and bone resorption, as occurred with NaCl administration alone. Earlier studies estimated dietary

Potassium chloride reduced blood pressure in older people from 160/89 to 145/81 mm Hg.

Potassium chloride reduced blood pressure in older people from 160/89 to 145/81 mm Hg. 1750-2300 mg of potassium per day lowered systolic pressure by 15 point and diastolic pressure by 8 points.

Why not try potassium (bicarbonate) first?

Daniel Amen, MD, a psychiatrist and author of A Magnificent Mind at Any Age, said on Public Television...

He uses natural treatments whenever possible. Daniel Amen, MD, psychiatrist

I use medication in my practice, but it s NOT the first thing that I use. Daniel Amen, MD, psychiatrist

I always think about the least toxic, most effective treatment. Daniel Amen, MD, psychiatrist

And often, with [psyciatric conditions] [I treat them] with... Daniel Amen, MD, psychiatrist

... natural supplements [first]... Daniel Amen, MD, psychiatrist

So in my mind, I think, why not at least try that first? Daniel Amen, MD, psychiatrist

I have to ask the same question about blood pressure...

Why not try potassium (bicarbonate) first?