SoylentNews is people
SoylentNews
Arthur T Knackerbracket has found the following story:
Intensive blood pressure control may reduce the risk of atrial fibrillation (AFib), an irregular heartbeat that can lead to serious complications such as stroke, heart failure and heart attacks, according to scientists at Wake Forest School of Medicine.
In a study published in the May 4 edition of the American Heart Association journal Hypertension, the researchers found that lowering a systolic blood pressure to less than 120 resulted in a 26% lower risk of AFib compared to systolic blood pressure of less than 140.
"This is the first evidence from a randomized controlled trial that showed benefit in reducing the risk of atrial fibrillation as a result of aggressive blood pressure control to a target of less than 120 mm Hg," said the study's lead author, Elsayed Z. Soliman, M.D., professor of epidemiology and prevention at Wake Forest School of Medicine, part of Wake Forest Baptist Health.
Journal Reference:
Elsayed Z. Soliman, AKM F. Rahman, Zhu-ming Zhang, et al. Effect of Intensive Blood Pressure Lowering on the Risk of Atrial Fibrillation. Hypertension, 2020; DOI: 10.1161/HYPERTENSIONAHA.120.14766
(Score: 5, Interesting) by stormwyrm on Saturday May 09 2020, @04:27PM (3 children)
Despite what you may think, doctors aren't supposed to prescribe medication without a good reason for it. All medical interventions have risks associated with them, and as such no physician I've ever met has prescribed medication or done any sort of other intervention just for the sake of doing so. They are supposed to weigh the risks and benefits of any intervention, pharmacological or otherwise, and decide what provides the most benefit for the least risk. If I ever run into any doctor who seems too trigger-happy in prescribing medicines and unwilling to explain to my satisfaction why, that physician will very quickly become my former physician and I will find someone else.
When my hypertension was first diagnosed several years ago I was put on a combination of amlodipine and losartan, but after half a year and some tests my cardiologist decided that the amlodipine was unnecessary for maintaining my blood pressure at manageable levels and removed it from my prescriptions. Removing didn't increase my BP too much. Losartan by itself has less side effects and is more safely metabolised, and by itself it is sufficient for generally keeping my blood pressure below 140. As it is I now average at 110 mmHg, so at one point a few years ago my doc attempted to wean me off even losartan too, but doing so made my blood pressure ascend to above 150 after about a week, so sadly losartan still needed to stay. Whenever I see him he keeps nagging me to try to lose weight, eat better, and exercise more so we can lower my blood pressure further without medication, and this is an ongoing process.
This study in the article changes the calculus of risk-benefit though, and may make the side effects of more drugs a lesser risk than the increased possibility of atrial fibrillation. If I can manage to stay at around 140 mmHg without losartan after, say, losing more weight and exercising more, that still might not be enough to remove it from my prescriptions. This is how science-based medicine is supposed to work.
Numquam ponenda est pluralitas sine necessitate.
(Score: 2) by pdfernhout on Sunday May 10 2020, @04:49PM (2 children)
... for problematical diet and lifestyle choices, according to Dr. Joel Furhman:
https://www.drfuhrman.com/get-started/health-concerns/36/blood-pressure [drfuhrman.com]
If a doctor did not give out a permission slip for something like having high blood pressure, then a patient would have to face either changing their diet and other lifestyle choices or accepting the consequences of them...
Ultimately, because medication have side effects and also usually ignore the root cause of an issue which may have other consequences, there often is not much benefit to taking most medications long-term compared to holistic interventions.
One example of a side effect of a permission slip prescription for high BP:
"Death risk increased with two blood pressure drugs"
https://www.medicalnewstoday.com/articles/321194 [medicalnewstoday.com]
YMMV.
The biggest challenge of the 21st century: the irony of technologies of abundance used by scarcity-minded people.
(Score: 2) by stormwyrm on Sunday May 10 2020, @06:41PM (1 child)
Not all cases of high blood pressure can be so easily cured just by lifestyle changes. My father's case of hypertension was evidently of this type. He was a strict vegetarian and a martial arts teacher, seemingly more physically fit than I am. He also scoffed at conventional science-based medicine and instead used acupuncture and other "holistic" therapies as one might expect given his profession. But a few years ago he suffered a massive stroke that paralysed half of his body and left him with barely the mental capacity of a small child. The conventional doctors who treated him afterwards found that his blood pressure was above 180 mmHg, and with very high cholesterol despite his healthy diet and regular exercise. Evidently it seems our hypertension and high cholesterol is partly genetic. My own condition is similar now that I'm past forty, and many of my uncles and aunts are also plagued by similar cardiovascular ailments. I do what I can while I'm still relatively young, but I imagine that in another twenty years it might only be medications like losartan and atorvastatin keeping me from a fate similar to my father's.
Perhaps our hypertension is somewhat analogous to type I diabetes, in that our condition has a genetic component. So are regular insulin injections a "permission slip" for people with type I diabetes too?
Numquam ponenda est pluralitas sine necessitate.
(Score: 2) by pdfernhout on Saturday May 16 2020, @11:49PM
Good point on Type I diabetes -- but even in that case, according to Dr. Fuhrman, insulin use can typically be cut in half and many major complication avoided by going on a Nutritarian (Fuhrman's or similar) diet heavy on whole food especially leafy greens and beans and such.
Sorry to hear about your father's stroke. Genetics may run in families but so too do learned dietary habits. As Dr. Fuhrman says, everyone has weak links from genetics, but whether those weak links get pulled on is usually a matter of diet and lifestyle. Vegetarian or Vegan does not necessarily mean healthy. Dr. Fuhrman treats many vegans and vegetarians in his practice in terrible health for various reasons (lack of iodine, lack of B12, lack of Omega-3s, too many refined starches, not enough micronutrients from leafy greens, not enough nuts and seeds, too much salt for some people, and so on). I have no connection to Dr. Furman other than buying some of his books and products over the last decade or so and paying to have access to his members forum (and I'd agree selling stuff creates a conflict-of-interest for Fuhrman). Fuhrman has his weaknesses, but I'd still suggest you might want to review what he says about high blood pressure. If, say, you are eating too much "vegetarian" sugar and refined carbs and salt and not enough leafy greens, that could explain arterial damage and high blood pressure. There are also two types of strokes -- one from clots and one from burst blood vessels. Diet can effect both -- but it is a complex interplay because the body is always building up and tearing down stuff (like plaque) on arterial walls to respond to inflammation to either strengthen weak walls (to avoid the bursting stroke) or to remove excess stuff (to avoid the clotting stroke). The two different types of cholesterol are involved in doing those two things and we need both in balance. Exercise and vitamin D and other things can help with managing inflammation too so that the body does not think it has to repair arteries. Key Dr. Fuhrman point: make the salad the main dish. If you are not eating one pound raw and one pound cooked vegetables every day, you could do better. I don't usually reach that myself, but I continue to improve in a spiraling back and forth sort of way... See the two movies Fat Sick and Nearly Dead I and II by Joe Cross for some inspiration and more ideas. Or if you want a broader perspective, the book "The Whole Foods Diet" by John Mackey covers a lot of ground with mentions of many practitioners in the field.
Tangentially, Covid-19 serious cases seem to involve blood clotting, which getting enough leafy greens (especially Kale) might help prevent.
Al the best to you and your family on a continuing health journey.
The biggest challenge of the 21st century: the irony of technologies of abundance used by scarcity-minded people.