Some Blood-Pressure Drugs Tied to Cancer Risk

wsj ^ | 6/14/10 | PETER LOFTUS

[neverdem]

Lisinopril is an ACE (angiotensin converting enzyme) inhibitor.

That's correct.

The angiotensin receptor blockers are the next step down the metabolic pathway.

That's not so. The angiotensin receptor blockers are the next step down in the pharmacologic interference of the renin-angiotensin-aldosterone pathway. ACE inhibitors block the conversion of angiotensin I into angiotensin II, which is part of normal metabolism. Blocking the angiotensin II receptor isn't. That's just pharmacology.

[paterfamilias]

You are exactly right. I should have written “Next step down the physiologic pathway...”

Obviously, I was attempting to simplify the concept in an attempt to make it more easily understandable by the layman.

I have found over the years that, except for a few very sophisticated patients, the subtlties of pharmacology and physiology (that we spend years to learn and understand) tend to obfuscate rather than clarify in usual clinical situations. Those sophisticated patients usually make their knowledge base known, and more accurate discussions ensue.

So, it is rarely necessary for me to enter into a discussion of concentration-dependent vs. concentration-independent antimicrobial agents, inhibitory quotients, and mutation rate of HIV when preparing a patient to begin a lifetime of antiretroviral medications. It is usually sufficient to explain that “you can’t ever miss a dose, or your drug levels will fall and the virus will become resistant.”

However, that discussion has indeed occurred when the patient has had a career in medical research or clinical medicine.

Thanks for keeping me honest.

[Pining_4_TX]

A lot of times the ending of the name of the drug gives you a clue as to what class of drugs it is. I would imagine that any drug that ends with “sartan” or “artan” is an ARB.

It’s a guess, but I’ve usually found it to be true.

The problem is that we are all taking way too many drugs in a futile quest to achieve what the doctors have decreed to be the perfect number. Sometimes it takes years for the serious side effects of a drug to surface. Personally, I would not take any drug that has not been on the market for less than 10 years.