Dec
01
2002

What Goes Around Comes Around With Blood Pressure Medications

By | Heart Disease, High Blood Pressure, Prevention, Stroke

A large clinical study with 42,418 men and women 55 years and older has been published in the American Medical Association Journal recently(JAMA 2002:288:2981-2997,3039). The thiazide type water pill chlorthalidone(12.5 mg to 25 mg/day) is the clear winner in this trial, called the ALLHAT trial. It stands for “Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial” and is the largest hypertension trial that was ever performed going over a period of 5 years.

In this trial a calcium channel blocker(amlodipine) and an ACE (=angiotensin converting enzyme)inhibitor(lisinopril) were tested as the initial medication and compared to chlorthalidone.There was a 15% higher risk to develop a stroke with lisinopril and a
38% increased risk with amlodipine to develop congestive heart failure when compared to the chlorthalidone group. The interesting conclusion from this study is that the least expensive therapy for high blood pressure turns out to be the safest. Another ineresting finding was that black patients responded much better to water pills than to ACE inhibitors, which had been noted before by other authors. When more than one medication is required to control high blood pressure, the dosage of the second medication can often be kept lower with a combined therapy thus reducing the likelihood of side-effects and complications.

What Goes Around Comes Around With Blood Pressure Medications

What Goes Around Comes Around With Blood Pressure Medications

Comments: Several decades ago the teaching was that the doctor would start a new high blood pressure patient with a water pill first, and combine this with a second or even third pill of a different medication class, if the water pill would not be effective enough on its own (it was called the “step care therapy”). For decades the side effects of the water pill consisting of low potassium blood levels brought the water pill treatment in disrepute. The original trials,however, were done with chlorthalidone doses of 50 and 100 mg per day, much higher than would now be recommended. It appears that with this study medicine has gone a full circle back to the old stand-by water pill, but at a much safer, lower dosage.

Here is a useful link (regarding hypertension): http://www.nethealthbook.com/articles/cardiovasculardisease_hypertension.php

Last edited December 10, 2012

Nov
01
2002

Heart Attack And Stroke Risk Measured With C-Reactive Protein

By | Heart Disease, Infectious Disease, Prevention, Stroke

An old blood test that has been popular in assessing how aggressive rheumatic illnesses such as rheumatoid arthritis or lupus are, is now considered as the newest test to assess the risk of heart attacks. Up to now subfractions of cholesterol, in particular the LDL cholesterol level, has been used to assess the risk for a heart attack, but this according to a new study in the New England Journal of Medicine (Nov. 14, 2002) by Dr. Paul Ridker should be supplemented by a blood test checking for the C-reactive protein. What is interesting about the C-reactive protein is that it originates from certain lining cells in blood vessels of liver tissue when inflammatory substances circulate in the body. Other research has shown in the past that arteriosclerosis is in part due to an inflammatory process in the lining of the blood vessels that leads to the production of the C-reactive protein. Unfortunately other chronic illnesses and infections also lead to an elevation of the C-reactive protein as does the common cold or the flu. However, when 28,000 women of the Brigham and Women’s Hospital study were followed for 8 years it turned out that the C-reactive protein was a more reliable predictor for who would eventually suffer from a stroke or a heart attack than the traditional LDL cholesterol. The investigators felt that the LDL cholesterol is predictive for who is more likely to develop fatty deposits (atheromatous plaques). On the other hand the C-reactive protein appears to be more predictive for who is at a high risk for rupture of these atheromatous plaques. The bottom line is prevention by eating a diet with less fatty meats, by eating more fruit and vegetables and by engaging in an exercise program.

Heart Attack And Stroke Risk Measured With C-Reactive Protein

Heart Attack And Stroke Risk Measured With C-Reactive Protein

Some patients need their cholesterol reduced with medication such as the statins. You may want to browse through these useful related links to chapters of my free Internet based Nethealthbook: For more details regarding the use of the C-reative protein test in rheumatoid arthritis see this link: http://www.nethealthbook.com/articles/rheumatologicaldisease_rheumatoidarthritis.php Regarding arteriosclerosis, heart attacks and strokes follow this link: http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Last edited December 10, 2012

Nov
01
2002

Nuts Cut Heart Attacks And Strokes In Half

By | Health, Heart Disease, Nutrition, Stroke

According to Dr. Elliot M. Berry of Hebrew University Hadassah Medical School in Jerusalem and Dr. Ram B. Singh of the Medical Hospital and Research Centre, Moradabad/India, the word is out that a Mediterranean diet with walnuts and almonds, fruits and vegetables can safe lives and prevent heart attacks.

In a paper, published in the medical journal Lancet 2002;360:1455-1461, 1000 Asian patients with a high risk for heart disease and strokes were put on two diets: a “control” heart smart diet and the experimental diet,which consisted of the Mediterranean diet.

Surprisingly,not only did the high risk patients benefit from the Mediterranean diet, but also the control group that had already been on a healthy heart smart diet. Over 2 years the heart attack
rates, death rates and heart disease event rates were all roughly cut into half on the Mediterranean diet. Cholesterol levels were significantly reduced,as much as would have been achieved with expensive cholesterol lowering medications. According to Dr.Berry the key to the understanding of this is found in the alpha-linoleic acid found in nuts and almonds. It is a precursor of the omega-3-fatty acids also found in fish oil, which in turn lower cholesterol, prevent blood clotting and are a natural remedy to prevent inflammation in the body.

Nuts Cut Heart Attacks And Strokes In Half

Nuts Cut Heart Attacks And Strokes In Half

Further investigations will be done by the research team to understand the mechanism of action of the healthy Mediterranean diet. In the meantime Dr. Berry stressed that other lifestyle changes must accompany the Mediterranean diet, namely an active exercise program and regular relaxation exercises such as yoga.

You may want to read these useful related links to chapters of
my free Internet based Nethealthbook:

Hardening of the arteries:
http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Fitness: http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Last edited October 25, 2014

Oct
18
2002

Work Stress Is A Killer…More Than 2-Fold Over A Period Of 25 Years

By | Diabetes, Heart Disease, Obesity, Stroke

In mid October 2002 the British Medical Journal(BMJ 2002;325:p.857-860) published a paper by Dr. Mika Kivimäki from the University of Helsinki where 812 healthy factory workers were followed for about 25 years. The issue was whether stress from work would have negative consequences, which could be measured in terms of cardiovascular disease. Various risk groups were defined from low stress to high stress.

Low stress jobs were classified as people who often had more training, more responsibilities, better salaries, physically less strenuous jobs with more job security. High stress jobs involved the opposite(high demand/low job control/low salary/no job security). Depending on which subgroups of high versus low risks were compared, the investigators found a 2.2 to 2.4-fold increase of strokes and heart attacks due to cardiovascular disease.The team measured other cardiovascular risk factors. They found a significant increase of cholesterol in the high stress job group after 5 years. After 10 years there was a marked weight gain in the stressed group with obesity becoming much more frequent. The authors noted that this likely led to a change of metabolism in the sense of hyperinsulinism, which is known to cause high cholesterol levels and leads to hardening of the arteries with heart attacks and strokes.

Work Stress Is A Killer...More Than 2-Fold Over A Period Of 25 Years

Work Stress Is A Killer…More Than 2-Fold Over A Period Of 25 Years

Visit these useful related links to chapters of my free Internet based Nethealthbook:
Hyperinsulinism or syndrome of insulin resistance:
http://www.nethealthbook.com/articles/hormonalproblems_diabetesmellitus.php

Heart disease:
http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Stroke:
http://nethealthbook.com/cardiovascular-disease/stroke-and-brain-aneurysm/hemorrhagic-stroke/

Last edited October 25, 2014

Oct
01
2002

Harp Music After Heart Or Chest Surgery Reduces Pain By Seventy Percent

By | Heart Disease, Pain, Prevention, Stress management, Stroke

Believe it or not: Harp music following serious chest or heart surgery in 17 patients leads to pain relief according to Aragon and colleagues. They reported this mid September 2002 (Altern Ther Health Med 2002;8:p.52-60) and they were measuring blood pressure, pulse, respiratory rate as well as pain and anxiety by psychological assessments to measure the effect on pain perception after listening to 20 minutes of harp music. The pain reduction was about 70% at the end of a 20 minute session and lasted at least 10 minutes (when the 20 minute and 30 minute point from the beginning of the harp music session were compared). This experiment documents the relaxation response, which is known from hypnotherapy as well and can also be brought on by meditation, yoga or prayer. The authors suggest that music therapy following surgeries could be utilized to promote healing and to reduce complications. Other health care settings where such a therapy might be useful would be in the treatment of anxiety disorders, where a reduction in anti-anxiety drugs under psychiatric guidance may be achievable.

Harp Music After Heart Or Chest Surgery Reduces Pain By Seventy Percent

Harp Music After Heart Or Chest Surgery Reduces Pain By Seventy Percent

Self hypnosis tapes can play an integral part of the mental readiness for an exercise program or a weight loss program as this site explains: On self hypnosis (nethealthbook.com)

Last edited October 25, 2014

Oct
01
2002

More Exercise Leads To More Health

By | Fitness, Heart Disease, Prevention, Stroke

Based on an article in the Journal of the American Medical Association (JAMA 2002;288:p.1994-2000) Dr. Mihaela Tanasescu and his group from Loma Linda University in California have followed more than 44,000 health care professionals every 2 years for 12 years.

He asked the question whether a difference could be found between light, moderate or heavy exercise in the prevention of heart attacks.

Here is what they found: 1700 new cases of heart attacks as a result from hardening of arteries were mostly found in those who did NOT exercise or were in the LIGHT aerobic category. The more the persons exercised, the more pronounced the heart protective effect was. For instance, the group of men who engaged in a heavy exercise program had developed 17% less heart disease than the group with the light exercise program. Contrary to the marathon runner studies that had reported a detrimental effect at the high end, this study did not find this effect.

Also, this study is one of the first to show that weight training and other muscle strengthening activities also reduced strokes and heart attacks. Up to now the medical community was of the opinion that body building type muscle training might not prevent strokes or heart attacks.

More Exercise Leads To More Health

More Exercise Leads To More Health

The authors concluded that a combination of aerobic exercises(brisk walking, running, sports etc.) with muscle strengthening exercises(body building, stretching exercises, weight lifting etc.) will give the most beneficial heart protecting health effect. Try these useful related links to chapters of my free Internet based Nethealthbook:

Hardening of the arteries:
http://www.nethealthbook.com/articles/cardiovasculardisease_heartdisease.php

Fitness:
http://nethealthbook.com/health-nutrition-and-fitness/fitness/

Last edited October 25, 2014