Posted on 10/17/2005 11:34:22 PM PDT by FairOpinion
A "FIRST-line" anti-high blood pressure drug is leaving patients at far greater risk of suffering strokes than if they take other medication for the condition, according to a major study.
People taking the commonly prescribed beta-blockers had a 16 per cent higher chance of stroke than if they took other drugs to treat high blood pressure, according to the findings by Swedish researchers. One particular beta-blocker, atenolol, was found to be associated with a 26 per cent higher stroke risk.
Medical experts warned yesterday that patients should not stop taking beta-blockers, which are beneficial for a range of other conditions. But an editorial in the medical journal the Lancet said the current endorsement of the drugs should be changed.
A team of researchers led by Professor Lars Hjalmar Lindholm, from Umea University Hospital, Sweden, pooled together data from 13 trials involving more than 105,000 patients.
In a further investigation involving 27,500 patients from seven studies, the scientists found that those taking beta-blockers were only 19 per cent less likely to have a stroke than those having no treatment at all. This was about half the benefit expected from previous trials.
The Lancet said: "It will be interesting to see how the many guideline committees respond to the latest information."
Alison Shaw, a medical spokeswoman at the British Heart Foundation, said: "People taking beta-blockers should not consider stopping or changing their medications on the basis of this study.
"However, they could discuss the other options for successful blood pressure lowering with their doctor."
for later reading
Tomorrow she sees another doctor for chronic diarrhea. I know it means more drugs. Why not? A few more won't hurt. It's probably the drugs that are causing the current problems.
I have no confidence in any of them.
While grandma $_its her pants, Dr. Whore wins a trip to France.
I said or implied no such thing. Every post I have made on this thread has at least hinted at being an active partner in your health care. If you don't trust your current doctor, find another. If you want to manage your own healthcare without a doctor, have at it.
So, in essence, what you're saying, doc, is either we are subservient to the all-knowing, monopolistic doctor, or we'll die? LOL!
No, what I am saying is that in the early 1900's, the life expectancy was what, about 40? Now it's what? Late 70's? Walk through an old cematary in any big city. How many infants are there from the late 1800's? The increase in life expectancy with a phenomenal decrease in infant mortality was not the result of a fatalistic, humanistic philosophic system.
Send some of them my way. I have yet to recieve such an offer.
Is that wrong? Philosophically yes it is. But remember, when the only tool you have is a hammer, all the world looks like a nail.
Have ya'll have a long talk with your mother's primary care provider? (either a Family Practice Physician, Internist, Family Nurse Practitioner, or Physician Assistant)
The thing I would do is focus on any symptoms she is having and do a good scrub of the $700.00 a month of drugs she is on. What can happen (notice I said can happen) is a drug will cause a symptom that a specialist will treat with another drug. It does take some patience and time on the part of the patient, family, and "doc" to sort through this, but it might help.
Another thought is to see a gerontologist. Their specialty is to take care of old folks and they are quite skilled at getting to the bottom of such issues. (There are also Gerontological Nurse Practitioners who are great at doing this)
In order to counteract the side effects of the serax, she's been put on tons of other drugs.
She had a mastectomy a couple of years ago and was without her serax a few hours. I saw what a drug addict goes through on the withdrawal of the drugs.
There was some good news about the doctor she visited today. He sounds reasonable and he volunteered to put her on an antibiotic for the chronic diarrhea but my sister said she preferrs to make sure she really needs an antibiotic before she takes one.
Over the years she's had two doctors I respect. One told her she did not need chemo or radiation and the other one was today. Mom is 90 and in a nursing home.
The article that I linked in comment# 5 of this thread was the last that Lindholm had printed in Lancet according to an author search on PubMed.
It failed to find the latest Lancet article found by searching directly at Lancet. Here is its abstract:
The Lancet Early Online Publication, 18 October 2005
DOI:10.1016/S0140-6736(05)67573-3
Should β blockers remain first choice in the treatment of primary hypertension? A meta-analysis
Lars Hjalmar Lindholm a , Bo Carlberg a and Ola Samuelsson b
Summary
Background
Beta-blockers have been used widely in the treatment of hypertension and are recommended as first-line drugs in hypertension guidelines. However, a preliminary analysis has shown that atenolol is not very effective in hypertension. We aim to substantially enlarge the data on atenolol and analyse the effect of different β blockers.
Methods
The Cochrane Library and PubMed were searched for β blocker treatment in patients with primary hypertension. Data were then entered into the Cochrane Collaboration Review Manager package and were summarised in meta-analyses. 13 randomised controlled trials (n=105,951) were included in a meta-analysis comparing treatment with β blockers with other antihypertensive drugs. Seven studies (n=27,433) were included in a comparison of β blockers and placebo or no treatment.
Findings
The relative risk of stroke was 16% higher for β blockers (95% CI 4 - 30%) than for other drugs. There was no difference for myocardial infarction. When the effect of β blockers was compared with that of placebo or no treatment, the relative risk of stroke was reduced by 19% for all β blockers (CI 7 – 29%), about half that expected from previous hypertension trials. There was no difference for myocardial infarction or mortality.
Interpretation
In comparison with other antihypertensive drugs, the effect of β blockers is less than optimum, with a raised risk of stroke. Hence, we believe that β blockers should not remain first choice in the treatment of primary hypertension and should not be used as reference drugs in future randomised controlled trials of hypertension.
Affiliations
a Department of Public Health and Clinical Medicine, Umea University Hospital, Umea, Sweden b Department of Nephrology, Sahlgrenska University Hospital, Goteborg, Sweden
Correspondence to: Prof Lars H Lindholm, Department of Public Health and Clinical Medicine, Umea University Hospital, SE 901 85 Umea, Sweden
Here's the URL:
http://www.thelancet.com/journals/lancet/article/PIIS0140673605675733/abstract?iseop=true
You'll have to register, not subscribe, before you can access the abstract.
Check with your doc before you make any changes. The article doesn't differentiate between the two main types of stroke.
Thanks - I've been on atenolol for 13 years.......yikes!
Let me tell you how that conversation often goes....
Dr: Well Mrs Jones, I'm going to give you drug x for your high blood pressure and drug y for your diabetes...here's your prescriptions.
Mrs. Jones: Do I have to take all these medications? I really don't understand...they are expensive and bothersome...isn't there anything else I could do?
Dr: Well, I suppose that you could lose, say, 100 or more pounds lbs to get down to ideal body weight, watch your diet to lower our cholesterol and start an exercise program...Quitting smoking would be advisable too. I have literature and a plan for you if you want it. Losing weight and exercising will help with your diabetes AND high blood pressure...
Mrs. Jones: Ummmm.....Now, where were those prescriptions again?
I did an internal medicine internship, and quickly realized that MOST people would rather take medicine than adjust their lifestyle. It's easier to take a pill than to diet etc. The number of patients that want 'other' choices is limited IMO.
Dr: Well, I suppose that you could lose, say, 100 or more pounds lbs to get down to ideal body weight, watch your diet to lower our cholesterol and start an exercise program...Quitting smoking would be advisable too. I have literature and a plan for you if you want it. Losing weight and exercising will help with your diabetes AND high blood pressure...
Mrs. Jones: Ummmm.....Now, where were those prescriptions again?
I did an internal medicine internship, and quickly realized that MOST people would rather take medicine than adjust their lifestyle. It's easier to take a pill than to diet etc. The number of patients that want 'other' choices is limited IMO.
Interesting, I never thought of it as an either/or, nice to know it is a choice. When I see a doctor and they ask for a list of my medicines, they're always surprised the list is: several aspirin a month. But I guess if I want to keep it that way, I should up the exercise, lose some weight etc.
Thanks for the information (and the ping).
She was in her early 50s. The RA was not better and her liver was being harmed.
In my opinion, drugs do not effectively treat chronic disease. They only treat symptoms and if the drugs are piled on and at early enough age, you will run into real trouble.
What the docs have done to my mom is a total disaster. They've turned her into a $700 a month drug addict who has not found happiness with the drugs.
Big Pharma got rid of that option eons ago.
Back then the natural options were outpulling the chemicals.
During the last major flu pandemic of the early 1900's the doctors using natural options so far out pulled the others that Pharma had to do something.
Amen!
Very deceiving headline. It implies that the risk of stroke is increased by taking a beta blocker. Read the last paragraph- beta blockers DECREASE the risk of stroke, they just don't decrease the risk of stroke as much as previously thought; other antihypertensives are better at reducing stroke risk. Beta-blockers have well-proven advantages for heart attack prevention.
I am very sorry about your Mother. Prayers go out to you and her.
A lot of it is due to better plumbing. But much of it, and an increase in general quality of life for many, is due to inoculations and antibiotics.
My doctor told me, as part of his sales pitch (he knew I wasn't about to take or change anything without being convinced) for a change in medication that of all the cholesterol lowering drugs, only the statins have been demonstrated to actually increase life span. I changed, and my numbers are much lower. I was amazed and pleased, and so was he. Can't remember all the numbers but LDL went from 130 to 60, triglycerides down about 1/3 (and they weren't that bad to begin with). Actually the LDL went from 160 to 60, but that 160 was up from 130 due to a misfiling of a previous prescription by the pharmacy. I was taking zyrtec instead of zestril! (pills looked about the same, and I thought the difference was due to a change in generic brand when I changed pharmacies, not to the pharmacy having mis read the prescription) Had trouble sleeping for a week or so after stopping it. I had wondered why I was so drowsy in the afternoon, after taking it at lunch time. :) I was also taking Allegra at the same time. Well no long term harm done I guess, I hope.
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