Blood pressure drug popular with doctors a mediocre choice....

Today's Post: Friday, 1-28-2011

1. Taking drugs to lower high blood pressure is what doctors should only advise as a poor second choice to doing things to lower high blood pressure that help to reverse its causes without drugs.

There are three exceptions. People who are only marginally health oriented and who simply won’t do the protective first choice step at all. People at unusually high risk such as those who have had previous strokes or heart attacks. And, people who have blood pressures well over 160 over 100 or who still do after a month or so using the first choice step.

The real reason to take blood pressure drugs is not just to make your doctor feel like he or she is doing their job; but to prevent strokes, senility, kidney disease, heart attacks and death – in you!

a) Going on the DASH II diet or a very vegetable heavy & minimal grain version of the Mediterranean diet that also limits salt AND discontinuing packaged foods, soft drinks, and most fast food tends to prevent strokes, senility, kidney disease, heart attacks and death. It also is proven to lower high blood pressure.

It’s something that should ALWAYS be tried first before considering blood pressure drugs AND used if drugs are indicated because of truly high blood pressure of over 160 over 100.

b) Regular moderate and carefully done vigorous exercise done several times every week helps prevent strokes, senility, kidney disease, heart attacks and death. It also slows aging and tends to improve your sex life instead of ruining it. It also is proven to lower high blood pressure. People who exercise 4 or 5 days a week even have lower blood pressure those days than on the 2 or 3 days they don’t exercise.

Regular exercise is something that should ALWAYS be tried first before considering blood pressure drugs AND used if drugs are indicated because of truly high blood pressure of over 160 over 100. It is true that people with high blood pressure should be careful to start slowly and build up the amount of exercise and its intensity slowly and include some brief rest breaks.

Such exercise is something that should ALWAYS be tried first before considering blood pressure drugs AND used if drugs are indicated because of truly high blood pressure of over 160 over 100.

(Note that people who have not been doing these first two things who upgrade their lifestyles to always do them will often lose enough fat weight and keep it off to significantly lower their blood pressure.)

c) Smoking or second hand exposure to tobacco smoke even in people without high blood pressure always works to cause strokes, senility, kidney disease, heart attacks and death from those things – in you! Everyone who is exposed to tobacco smoke gets this effect – NOT just some of the people. And, tobacco smoke has also been found to trigger heart attacks in people who would otherwise have escaped having them.

(Tobacco smoke also causes about 30 % of all cancers and about 25 % of all heavy smokers get lung cancer. And smoking speeds up aging. But compared to what it does to CAUSE high blood pressure, strokes, senility, kidney disease, heart attacks and death from those things, the cancer and speeded aging are the LITTLE problem of smoking!)

Everyone who has high blood pressure should be helped to quit smoking and avoid second hand smoke before considering blood pressure drugs AND used if drugs are indicated because of truly high blood pressure of over 160 over 100.

d) Some supplements, notably the ubiquinol form of CoQ10, magnesium, and some others all taken together lower high blood pressure about as much as an effective blood pressure drug. They have other health benefits and both directly and from lowering high blood pressure that tend to prevent strokes, senility, kidney disease, heart attacks and death. Even better they do not have the side effects that make people feel sick or harm them in other ways or ruin their sex lives that many blood pressure drugs DO have.


All of these four things should ALWAYS be tried first before considering blood pressure drugs AND used if drugs are indicated because of truly high blood pressure of over 160 over 100 even after doing them.

When these four steps are taken, most people will get the protection they actually need without any drugs for high blood pressure.

And, if their blood pressure started out well above 160 over 100 or remained there, they will be dramatically better protected by doing these four things AND taking blood pressure drugs. In addition, their blood pressure will be lower from doing these four things AND drugs than just using the drugs would have achieved.

So unless these four steps are addressed, ANY blood pressure drug is a mediocre choice for most people.

2. Given part 1, if blood pressure drugs ARE still needed, which drugs should be tried first?

It seems that the drug most doctors have been using for this a mediocre choice.

Last Monday, 1-24, Reuters Health posted an article titled:

“World's top blood pressure drug gets failing mark.” .

In a review of earlier studies, researchers found this drug, hydrochlorothiazide, a diuretic, lowered blood pressure by only about half as much as common alternatives such as beta blockers and ACE inhibitors.

They found that the low doses of hydrochlorothiazide commonly used reduced systolic blood pressure by 6.5 points. (Systolic is the larger number listed first in blood pressure readings.)

ACE, inhibitors lowered systolic blood pressure by 12.9 points, beta blockers by 11.2, and calcium-channel blockers by 11.

(Many people have bad side effects with beta blockers and I saw a study reported that said they tended to give less real protection despite lowering blood pressure than other kinds of blood pressure drugs.)

While higher doses of hydrochlorothiazide were more effective, one of the researchers noted that were a bad idea due to the increase in blood sugar and insulin problems such higher does of this drug tends to cause. And, since such problems tend to cause heart disease, such higher doses defeat the purpose of real protection and health improvement

In addition, hydrochlorothiazide appears to be particularly weak during the night. "We know that nighttime blood pressure and early-morning blood pressure are very important risk factors for strokes and heart attacks," he said.

(Their source was: http://bit.ly/hL2qWJ JACC/Journal of the American College of Cardiology, online January 24, 2011.)

Diuretics also have other problems. They may be a bad idea for people getting the recommended exercise during hot weather as they can help cause dehydration and even heat stroke. Many people who take diuretics are older men who already have problems having to urinate often enough when going places or sleeping that it’s a problem due to BPH, or enlarged prostate. Adding a diuretic to make this worse is not a great idea. Lastly, though diuretics due remove excess sodium, they also remove potassium, magnesium, calcium, and other water soluble nutrients. This lessens their blood pressure lowering effect and can cause health problems.

Some ACE inhibitors and in some people and in some dosages cause an unstoppable dry cough. But since the right kind of ACE inhibitor for a particular person at the right dose may not do this and ACE inhibitors tested as most effective in this study -- working with your doctor to achieve this outcome may be well worth doing if you do need to take a drug for your high blood pressure.

It’s also worth noting that the supplements, hawthorn and celery seed extract act as ACE inhibitors and have no side effects. So using them instead of the drugs or WITH a lower dose of the ACE inhibitors may produce a good result without the dry cough or other side effects ACE inhibitors have in some people.

Calcium channel blockers and the drug Amlodipine in particular have been tested as preventing all or part of the early morning surge in blood pressure that can trigger heart attacks etc.

Some people have relatively more side effects with these than others. But here again, there are different drugs in this category and, particularly, at lower doses they may work decently without a lot of side effects.

Also, taking 400 to 800 mg a day of magnesium as a supplement in people who are NOT also taking milk of magnesia for constipation tends to act as a calcium channel blocker, prevent constipation, and has other health benefits.

So, taking magnesium instead of a calcium channel blocker or WITH a lower dose of a calcium channel blocker may produce a good result without the side effects calcium channel blockers have in some people.

ARB blood pressure drugs were not included in this study and recently WERE in a study suggesting they might increase cancer a bit. But they do lower blood pressure and tend to have few side effects. So, particularly for people who are nonsmokers and avoid second hand smoke and are eating right as described here and so have a much lower risk of cancer, adding a low dose ARB as a third drug may make sense when needed.