More intelligently selective criteria for when to give BP drugs….

Today's Post:  Tuesday, 11-12-2013

We now know that many people now taking drugs for high blood pressure are not benefiting enough to justify the costs, risks, and side effects.

If you are taking them now and should be, there are ways to put yourself in the group that does not need them!

Best of all, medical guidelines will soon reflect this because of the release of a recent study showing that many people now taking the drugs can stop carefully with no increase in risks!

Background.

A.  For many years, research found that for anyone who has high blood pressure consistently over or well over 160 over 100, despite their own risks and nasty side effects, taking blood pressure reducing drugs cut the risk of heart attacks, strokes, and death.

B.  Then it was discovered that population wide, there seemed to be some benefit for lowering blood pressures at lower levels – from 140 over 90 to 159 over 99.

So many people today with blood pressures in that moderately high range have been told to take hypertension or blood pressure lowering drugs and many take them.

C.  BUT, there are two ways to get equal or better protection from heart attacks, strokes, and death WITHOUT the drugs for people in this lower level of high blood pressure.

Mercifully that research means that doctors can save some people the dollar costs, obnoxious side effects, and health risks – including a death rate for the blood pressure reducing drugs.

1.  First a study was done by the Cochrane group that found that for people with blood pressures in this range, the drugs seemed to cut the risk of heart attacks, strokes, and death.  But, so did doing regular, vigorous exercise most days of every week.  AND if someone was doing the regular exercises, adding the drugs too produced ZERO extra reduction of the risk of heart attacks, strokes, and death.  

Yes, you did read that right.  This means that once someone has built up safely and slowly in intensity in such exercises and has been doing them a couple of months, they can stop taking the blood pressure drugs without adding to their risks. 

WARNING:  Withdrawing from the drugs needs to be carefully stepped down and monitored by a decent doctor or pharmacist.  That’s even more true of beta blocker drugs.  Otherwise many people get very high blood pressure for a bit as the parts of your system that have been fighting the drug are released and have not yet gotten lower.  That can kill you. 

It’s a reason to be careful getting off the drugs. 

But it’s also a reason not to take them to begin with if you don’t absolutely have to.  Natural disasters and financial ones can suddenly cut off your access to these drugs.

2.  The more recent study just was publicized. I read it on Medical News Today.

That study found that people with high risk factors for heart disease in this lower high blood pressure range, did cut their risks if they took blood pressure lowering drugs.  BUT, it also found that for people with low risks of heart disease, the drugs again offered zero added protection!

That’s HUGELY important because that means we can immediately cut the dollar costs of having people at low risk take these drugs – AND on a nationwide basis.  That’s a lot of money!  But more than that, the reduction, often severe, of quality of life, and the cut to their productivity at work of a very large group of people can be fixed!

2.  However, if they are in bad shape on those measures while the best treatment is to reverse each of those ASAP --

For people just beginning that process of lowering their heart risks or unwilling or unable to do it or simply not very good at it, and who still have those bad measures and practices, THOSE people WILL have fewer heart attacks and strokes if they take the BP drugs.

Here’s the way to see the study from Medical News Today:

Preventing heart attacks and strokes using 'smarter' blood pressure guidelines

http://mnt.to/l/4hNr

 A new way of using blood pressure-lowering medications could prevent more than 

a fourth of heart attacks and strokes - up to 180,000 a year - while using less 

medication overall, according to...

3. But there is yet more to this story.

People can take a surprising amount of control of their heart attack and stroke – and the death risks from those events.

That means that you can start out needing the drugs now and in six months you no longer will.

1.  If someone already has low small particle LDL & HSCRP inflammation AND does vigorous exercise most days of every week, does NOT smoke or get second hand smoke exposure; and knows to avoid excessive and prolonged high efforts without enough breaks, blood pressure drugs are NOT needed and a waste of time and money and the patience of the person in putting up with side effects.

a) If you do regular and vigorous exercise most days of every week that directly lowers the amount of small particle LDL that causes heart disease.  You do have to know to get into the exercises slowly and make progress in small but steady improvements.  AND, we now know that sustained heavy exertion with no breaks even short ones stresses and even damages the heart.

 (If you do 30 seconds of very high speed jump rope; rest at least that long; and repeat a few times, surprisingly if you build up to it slowly and stop a set where it seems to be a bit much in the beginning AND do the other things to protect your heart first and while you do it, it’s both protective and surprisingly safe.

Conversely if you run a half marathon at all out steady pace, you may well give yourself a heart attack and die.  Worse, if you do it that way and survive, it damages your heart!

By varying the pace and taking relative slowdowns as breaks, it’s possible to do such longer exercise safely.  But it’s still a bit risky and the shorter more intense sessions of cardio protect you as well or better, get you as fit, AND can take 5 or 10 minutes instead of hours to do.)

Note that when you do this kind of exercise, your HDL will go up and your triglycerides will go down. 

In fact, research at Harvard found that this combination of high HDL and low triglycerides is a remarkably accurate indicator and an inexpensive one to test to find out how many of the dangerous small particle LDL particles you have.  And high HDL and low triglycerides is good news because it means you don’t have many.  (Conversely, low HDL and very high triglycerides means you are in danger!)

b)  All exposure to tobacco smoke begins to build up plaque in your blood vessels.  It increases your blood pressure while you are exposed.  And, it triggers heart attacks in people who would have escaped them otherwise.  This happens to everyone every single time!  That means there is NO safe level of exposure and everyone exposed it is harmed – NO exceptions.

So if you smoke quit.  If you work where you have to breathe second hand smoke and can get a job in a place you don’t, switch jobs immediately.  (Hint, if you take up exercise even though you must be more careful than someone with lower risk, your ability to quit smoking at least doubles.  And your heart disease risk drops even more by adding a protector and removing a seriously high cause of harm.)

c)  The FDA is finally considering removing trans fats and hydrogenated oils from the foods generally recognized as safe list.

We’ve known these compounds are not only unsafe but cause heart disease for at least 20 years now. 

Research was done that found that ingesting these things directly increases the level of the small particle LDL.  That means that trans fats and hydrogenated oils are quite literally heart attack starter!

But it’s even worse than that!  

People who say to cut down the amount you eat of this stuff are not well informed. 

A small and regular intake of trans fats and hydrogenated oils is extremely harmful even if the amount is small.  That’s because your body only can process some of it each day.  I believe the half life is over two weeks!  That means that after one day of that intake you do have low added risk.  But after that low intake that’s removed so slowly goes on for a month, your system builds up enough for it to be extremely harmful!

So regardless of how much you like a food, if it has ANY trans fats or hydrogenated oils in it on the label, STOP eating or drinking it.

d)  Any high fructose corn syrup and any but the tiniest intake of refined grains, particularly wheat, or an excessive amount of real sugar every single day have each been found to boost triglycerides to very high levels.  There is a good bit of evidence this is also true for artificial sweeteners.  Remember the Harvard study and what it found out about high triglycerides?

Those foods AND both regular and diet soft drinks are ALSO heart attack starter.

So don’t drink ANY soft drinks.  And, read labels to avoid high fructose corn syrup and artificial sweeteners.

The closer to zero your intake of these things is the safer you will be and the lower your triglyceride levels will be!

(There is somewhat better news about sugar in moderation.  If you eat a health OK fat with it and or take or eat cinnamon first it allows your body to process the sugar more slowly and safely.  But do that a few times a week at most.  The average American now eats the equivalent of 7 Tablespoons a day!  You can have sugar safely to some degree.  But do your best to cut your intake to 7 Tablespoons a MONTH.)

e)  Use almost only extra virgin olive oil, discontinue all corn and soy and safflower and canola oil.  And cut your intake of animal fats to near zero where the animals were fed grain.

Why?  Because high chronic inflammation is as much a heart attack starter as high levels of small particle LDL!

Olive oil and the other monosaturated fats are quite low in the pro-inflammatory omega 6 oils.  Corn and soy and safflower and canola oil and animal fats where the animals were fed grain have very high levels of the pro-inflammatory omega 6 oil.

If you eat monosaturated oils and hardly any omega 6 oils, your inflammation will be relatively low.

If you then also eat some organic fruit with antioxidants and eat wild caught fish and take omega 3 oil supplements from purified fish oil or algae, your level of inflammation will drop even more.

Finally if you use cinnamon ginger and turmeric spices almost every day or take them as supplements your inflammation will drop yet again.

There you have 90% of the way to slash your risks of heart disease.

There are some supplements that can remove a majority of the remaining risk.  But I’m out of time today and will leave that to another time.