The Minimal Impact of a Big Hypertension Study

NY Times ^ | November 28, 2008 | ANDREW POLLACK

[neverdem]

Major Outcomes in Moderately Hypercholesterolemic, Hypertensive Patients Randomized to Pravastatin vs Usual Care

The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)

[neverdem]

Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic

It helps reading the abstract first.

FReepmail me if you want on or off the diabetes ping list.

[steve86]

Thanks, I read the NY article in some detail. Interesting to see the relative prescribing rates of the various classes of anti-hypertensives; I did not realize beta blockers were so far down on the list. Also don’t understand why they keep prescribing BBs for my wife when they can worsen diabetes symptoms.

[DB]

Neverdem, are you a doctor?

And if so what is your take on Pravastatin?

[caveat emptor]

Got any references to studies similar in size and design with two treatment groups as follows:

1. Either of the drugs used in this study.
2. Diet and lifestyle changes as recommended by, say, Heart and Stroke Foundation.

Thanks

[neverdem]

Thanks, I read the NY article in some detail. Interesting to see the relative prescribing rates of the various classes of anti-hypertensives; I did not realize beta blockers were so far down on the list.

I think you got the wrong message. Beta blockers are so high on the list for CHD that ALLHAT didn't question them, just the relaive benefits of chlorthalidone the diuretic, amlodipine the calcium channel blocker and lisinopril the ACE inhibitor for hypertension.

[neverdem]

Neverdem, are you a doctor?

Yes, I'm guilty.

And if so what is your take on Pravastatin?

I'm not impressed from ALLHAT's abstract.

[DB]

My doctor recently put me on it and I’m not sure what to think about it. Whether the risk is higher with it or without it...

[neverdem]

There's nothing that's convenient.

All drug classes are problematic.

[Star Traveler]

The article said — “Six years later, though, the use of the inexpensive pills, called diuretics, is far smaller than some of the trial’s organizers had hope.”

It seems that the diuretics are the first place to start treatment for high blood pressure. I was wondering about that as it seems that my blood pressure may be very slightly climbing.

I guess a trip to the doctor to examine the question about how to treat a very minimal rise in blood pressure would be in order. I just wanted to know some things ahead of time and not get prescribed some expensive medicine when something very simple and minimal would do just fine. This study seems to help answer part of that question...

[neverdem]

My doctor recently put me on it and I’m not sure what to think about it. Whether the risk is higher with it or without it...

Get your liver enzymes checked, ALT and AST, periodically. Report any muscle weakness, pain or tenderness as soon as possible.

[DB]

I have. I’m not aware of any muscle issues so far. I’m not super active (work in front of a computer endlessly) so I don’t know if that might hide the symptoms.

[Right Wing Assault]

What are other ways to replace lost potassium (due to diuretics) without eating bananas?

[Hardastarboard]

Sounds like the study is ALLHAT and NO CATTLE.

Sorry - I just couldn't help myself.

[alnick]

Potatoes and lima beans are high in potassium.

[barnrat]

I'm hooked on apple juice. Some brands have 8% of daily requirement in an eight ounce serving. A couple of servings prevent my nocturnal cramps. This provides a much higher dosage than expensive pills. Eat fruits and vegetables. I have to provide my nursing mother cows supplemental minerals during the winter months when the green grass is gone. Otherwise they die. So, eat either dirt or the things that grow from it. I send samples of my dirt to Texas A&M twice a year for test to be sure that the nutrients are there to be taken up by my grass and ingestested by the cows.

Do not trust lab tests that indicate you are in the normal range. These test blood serum levels. I always test normal except on an, hardly heard of, intracellular test that I fail.

[LucyJo]

bookmark

[WaterBoard]

ping

[caveat emptor]

There's nothing that's convenient.

What do you mean by that?

[Glenn]

I’ve been on metoprolol for more than five years. I have benign essential tremor and get a double benefit from it. I would not trade this drug for anything. After nearly 50 years of adrenal agitation, my life is significantly enhanced by the “side effects” of the drug. My only concern is that I am now spilling significant protein and have been for the last 6 months. I’m 55, have had a MIDCAB, DXed DMII at age 36. Been on insulin for 2.5 years. I am not scheduled to see my GP again until April but am thinking about moving that up.

Health is such a roller coaster, but I’m happy to be alive instead of dead, which I would have been not many generations back. Let pharma make their money. They deserve it.