Monday, June 14, 2010

Bad news about a good blood pressure drug....

Today's Post: Monday, 6-14-2010

Virtually every online news source for health news had this story today.

The ARB blood pressure reducing drugs have been one of the few decent drugs to treat high blood pressure.

Drugs to lower high blood pressure have mostly been a bit of a train wreck and lost cause. ARB’s have been one of the very few exceptions.

Now it looks like taking ARB’s may cause some people who take them to get cancer they otherwise would not have.

It’s not a large effect and has not yet been completely established as real. But it does NOT look good.

We’ll cover a bit from the stories; then say why it’s such bad news; and then say what can be done about it.

Here’s the story:

In the AP story I found some key points. These include these points.

The effect was small, except for lung cancer which was worse, the researchers calculated that one extra cancer would occur for every 105 people taking ARB’s for about four years.

The analysis of people taking ARB’s that found extra cases of cancer found many kinds including breast and prostate cancer. The effect also seemed to be about double for lung cancer.

About 85 % of the people they analyzed who were taking ARB’s were taking telmisartan, sold as Micardis, made by Boehringer Ingelheim.

To be fair, the other 15% taking other ARB’s seemed to also show this effect from what I read today.

Here’s why it’s such bad news:

Many people with high blood pressure feel fine or only feel bad for other reasons. Then they or their doctors find out they have high blood pressure. As a result the doctor prescribes a drug to lower the high blood pressure. The person then all too often feels like hell and risks other health harm even if their blood pressure goes down.

This situation is NOT conducive to a good quality of life. Often, it’s NOT that protective. And, it can do more harm than good besides.

One large study found that high blood pressure drugs only cut the death rate when prescribed for people with blood pressures of 160 over 100.

As a result, many people refuse to go on high blood pressure drugs -- or even worse, try them and then stop taking them suddenly which can be dangerous.

ARB drugs for lowering high blood pressure have until now been one of the few success stories. Some people get side effects or do so on high doses. But most people on medium or low doses of ARB’s get lower blood pressure and few side effects.

The news today on ARB’s is NOT as good. It could be far worse; but it isn’t good either.

Here’s what to do about it:

I. The best solution that produces the best quality of life and the least amount of harm is to prevent or treat high blood pressure with a health supporting diet that’s also quite low in salt; regular exercise; significant and permanent fat loss for those who need it; no exposure to tobacco smoke; & some key supplements.

1. The DASH II diet that is high in vegetables and extremely low in junk food and fatty meats and has people average 1500 mg a day or less of salt, both prevents and has been proven to lower high blood pressure. It even works on people who didn’t have high blood pressure before they began eating in this way.

Similarly, a Mediterranean diet that has extra vegetables and less pasta and bread and goes easy on the red wine AND also has a limit of 1500 mg a day or less of salt, very likely will have similar effects and has other health benefits.

2. Regular exercise lowers blood pressure both right after you do it and all the time. People who exercise only on some days a week, have lower blood pressure on the days they exercise. And, people who exercise every week both have lower blood pressure than they would have if they didn’t exercise AND also get direct protection from the things lower high blood pressure is supposed to protect against.

3. Not smoking and staying away from second hand smoke are doubly critical. Tobacco and its smoke cause the build up of arterial plaque that CAUSES high blood pressure and heart disease; it triggers heart attacks and fatal ones in people who might otherwise have escaped them, and it increases blood pressure every single time a person is exposed to it. Yikes !!
This means if you avoid tobacco smoke, your blood pressure will be lower and the heart attacks, strokes, and mental decline blood pressure drugs are aimed at preventing will be prevented!

4. Dr Mark Houston who is both a certified expert on treating high blood pressure and self educated on how supplements that actually lower it work, states that the herb hawthorn acts like an ACE inhibitor; taking 600 to 800 mg a day of magnesium – 200 mg three or four times a day -- acts like a Calcium Blocker; and that taking CoQ10 lowers blood pressure in many people who take it about as well as one or two blood pressure drugs!

In fact, he reports many of his patients who take CoQ10 have been able to stop their blood pressure drugs or lower their doses.

The news since he published this is even better. Taking 50 to 200 mg of the ubiquinol form of CoQ10 delivers 4 to 8 times as high a blood level of the C0Q10. By taking ubiquinol, more people will be able to avoid blood pressure drugs or take lower doses of them.

Other than people who take far more magnesium than this, none of these three supplements has side effects!

It’s also significant that hawthorn, CoQ10, and ubiquinol have positive effects on people with heart failure. Since, ARB’s have also been prescribed to treat heart failure, that too is helpful.

5. Anyone who has more than 10 pounds of excess fat who loses it and keeps it off will have lower blood pressure.

That’s true for three reasons.

a) With less fat, your heart only has to pump hard enough to serve the important parts of your body instead of the added load of getting blood to your fat; and your blood vessels stop being squeezed by the space and weight of the fat.

And, the fatter you are the more effective this is. Many fat people with high blood pressure who lose all their fat, find they also lost all their high blood pressure too!

b) In order to lose fat, you have to eat a DASH diet or a Mediterranean diet with extra vegetables and less pasta and bread. Soft drinks, lots of fatty meats, soft drinks, lots of sugar, and junk food all get dumped.

We already know doing that lowers high blood pressure even before the fat is lost.

c) In order to lose fat and keep it off you need to get regular exercise and do best by doing strength training, interval cardio, and some third kind of more moderate exercise each week.

Here again, we already know doing that kind of regular exercise lowers high blood pressure even before the fat is lost.

II. Strongly consider mostly only having people with blood pressure less than 160 over 100 use only the 5 methods above. They are effective at lowering high blood pressure and are dramatically MORE effective at protecting health than blood pressure drugs.

III. Always start people on the lowest possible dose of an ARB; and for those where this is not enough, add a second drug such as a calcium blocker at a low dose before considering a larger dose of the ARB.

III. Refuse to treat anyone who smokes with an ARB. Treat their exposure to tobacco smoke ONLY until it’s gone.

It’s very significant that the bad effect of ARB’s reported today doubles for lung cancer.

Might it even be that this effect ONLY happens in smokers? Given the horrible track record of exposure to tobacco smoke in causing both cancer AND high blood pressure, this strikes me as not only possible but quite likely.

IV. If your blood pressure is over 160 over 100 without drugs and you are taking an ARB now that’s working to lower your blood pressure to readings less than 16 over 100 and not causing you side effects, you might be wise to consider doing the following four things instead of stopping the drug now.

All too many of the alternatives will not be pleasant due to side effects.

(That said, a low dose of an ACE inhibitor that does NOT give you a dry, hacking cough might work. Some will and some will not. And, a low dose of a calcium blocker you do on OK on might work; and that class of drugs cuts morning and other surges in blood pressure and are therefore extra protective.)

1. Do all five of the ways to treat high blood pressure without drugs listed above.

Be sure to eat plenty of raw cruciferous vegetables including broccoli florets or cauliflower as part of your intake of vegetables each week. That is MORE protective from cancers than this effect even if it’s proven to exist.

2. Do literally everything in your power to avoid tobacco smoke. Doing that both lowers your blood pressure and protects you against all cancers and lung cancers and very possibly this bad side effect too!

3. Take 5,000 iu a day of vitamin D3, take a daily curcumin supplement, and eat curried foods with the spice turmeric a few times each week. That combination also protects you against virtually all cancers we now know.

4. Once you get under 140 over 90 consistently by using these other methods in addition, THEN, try a smaller dose of the ARB or try doing without it.

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Blogger David said...

In double checking information on Hawthorn supplements I found that they not only can lower high blood pressure, they might cause drugs that lower high blood pressure to work too well.

This could be a bit dangerous, particularly if you are taking a larger dose and it is working to lower your high blood pressure to desirable levels.

But, it also might be a way to get a drug that has failed to lower your blood pressure below the 150 over 80 now thought to be a conservative but desirable level to do so.

Or, it might enable you to take a smaller dose, get good blood pressure lowering, and have fewer side effects.

The key thing to work out with your doctor is how to test it safely.

If you have blood pressure under 160 over 100 with no drugs, one way to do this is find out from your doctor or pharmacist how to stop taking the drug safely. Do that. And, then try the hawthorn to see how well it works.

4:54 PM  

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