On Sun, 10 Jun 2012 07:02:13 -0700 (PDT), "
wrote:

On Jun 8, 1:43*pm, Dogman wrote:
Just how effective are blood pressure medications?

http://www.drbriffa.com/2012/06/08/j...re-blood-press...

"Even if we extend these NNTs over time, they still are not
impressive. Taking the best numbers here (stroke prevention in men),
an NNT of 160 over one year equates to an NNT of 32 over 5 years. So,
of 32 men treated, one will avoid a stroke, but the other 31 will not.
Which means 97 per cent of men taking two medications over 5 years
will not benefit in terms of stroke prevention.

"Now, of course, these slim benefits need to be weighed against the
potential adverse effects of antihypertensives (of which there are
many, unfortunately)."


That this doctor would call avoiding one stroke in 32 men in 5 years
a slim benefit pretty much tells you he's an idiot.

Yes, of course he's an "idiot," he isn't pushing drugs for every
ailment known to man!

Gosh, but I'd love to see your credentials matched up against his:

http://www.drbriffa.com/about-2/

One in 32 dead
or crippled for life doesn't seem slim to me.

It also doesn't mean that any of another cohort of identically matched
32 men will have a stroke, either.

Statistics just aren't your thing, are they?

As for the side effects of medication, there is a wide array of
blood pressure medication available today.

Yes, of course there is, because it's a lucrative business, but they
all come with pretty much the same package of side effects, one of
which is DEATH.

Just listing all
the possible side effects from any medication is nothing but
scare tactics.

Actually, what it is, is being open and honest about taking drugs for
hypertension - they all come with a cost.

And what Dr. Briffa is saying, and what I am saying, is that you
should consider nutritional, diet, and lifestyle changes before
rushing out and taking a drug with known serious side-effects, because
there is beaucoup evidence out there that they can have a positive and
profound effect on one's hypertension.

And if that makes us "idiots," I'm happy to be one!

Someone who's blood pressure is 140 is probably
going to find it very easy to find a medication that lowers it
with no side effects. Conversely, the person most likely to
have side effects because of the higher dosages required,
eg, someone at 200+, is also the person who is going to benefit the
most in terms of reducing the risk of heart attack, stroke, premature
death, etc.

Not necessarily, because until one learns WHY he or she has BP that
high, simply taking a drug for it may not help solve the underlying
REASON(S) for it.

It would be like having the engine warning light in your car come on
and then just turning it off (which is something I can easily see you
doing, or just popping another pill!). Voila! No more engine problem,
right? Well, whatever it was that caused that light to come on in the
first place hasn't actually been dealt with, has it? And what may
happen next? Total engine failure, that's what.

Moron.

So for those non-morons out there, listen to the advice of Dr. Briffa,
and before you resort to drugs, give diet (especially low-carb),
nutrition, and lifestyle change a chance to rid yourself of
hypertension. Then if you still want to take drugs, take them. It's
your life.

PS: I also observed this in the Comments section of Dr. Briffa's
article:

Underlying this discussion is what is the cause the major of
hypertension cases in the first place – and why are we seeing so much
of it today? The 800-pound gorilla in the in the living room is our
modern high carb diet. As I explain in my newest (soon-to-be-published
book, Healing Your Hypertension):

While everyone has been focused on accusing obesity, stress, dietary
fat, and excess salt as the culprits responsible for today’s epidemic
of hypertension and other cardiovascular problems, the real
troublemaker has gone unnoticed by Big Medicine. This is truly
mind-boggling because researchers as far back as the 1860s had
identified this obvious risk factor and written it into the medical
literature. How and why it doesn’t appear on modern medicine’s radar
screen today is one of the most disturbing mysteries of the modern
era. But the evidence is very strong indeed pointing to this single
cause as being responsible for the 90 percent of hypertension which
doctors maintain “has no known cause.”

Much recognition and gratitude is due author Gary Taubes for tracking
it down and bringing it to the public’s attention in his book, Good
Calories, Bad Calories. His account reads like a spellbinding
detective novel, and as such, it follows the evidence and takes care
to question every unsubstantiated assumption. His research is thorough
and convincing, making it all but impossible for any open-minded
reader or investigator to doubt his ultimate conclusion: That
something in modern diet other than fat or sodium is responsible for
today’s high rates of hypertension and cardiovascular disease. And
that something is the refined carbohydrate.

In his book, Taubes points to early scientific evidence that
carbohydrate-rich diets raise blood pressure by causing the body to
retain water, just as salt consumption is supposed to do. This was
first noted by the German chemist Carl von Voit in 1860. It was
corroborated in 1919 by Francis Benedict, director of the Nutrition
Laboratory of the Carnegie Institute of Washington, who described the
phenomenon this way: “With diets predominantly carbohydrate, there is
a strong tendency for the body to retain water, while with diets
predominantly fat there is a distinct tendency for the body to lose
water.”

Benedict was referring to the weight loss which occurs in the first
few weeks of any diet that restricts either calories or carbohydrates
(especially the latter). This initial weight is mostly water, not body
fat, as many veteran dieters know. What is less well-known is that a
corresponding effect of this water loss is a lowering of blood
pressure.

Consuming a carbohydrate-rich diet causes the kidneys to hold on to
salt that is already in the body, rather than to excrete it. In
reaction to this, the body retains water to maintain the sodium
concentration of the blood. This is the same result (water retention)
that occurs when we consume more sodium. “Removing carbohydrates from
the diet works, in effect, just like the antihypertensive drugs known
as diuretics, which cause the kidneys to excrete sodium, and water
along with it,” early researchers noted. In fact, this drop in blood
pressure is so considerable that it led critics of low-carbohydrate
diets to worry publicly about the “low blood pressure resulting from …
losses of … fluid, sodium, and other minerals.”

By the early 1970s, researchers concluded that this water-retaining
effect of carbohydrates was due to the insulin that they stimulated
the pancreas to secrete. This in turn forced the kidneys to re-absorb
sodium rather than excrete it. (This made sense because insulin levels
are generally higher in people with hypertension than in normal
individuals.) So widely accepted was this notion that by the
mid-1900s, diabetes textbooks were discussing the likelihood that
chronically-elevated levels of insulin were causing hypertension in
Type 2 patients. Unfortunately, no one considered this might also be
true for non-diabetics.

Today, it is a well-demonstrated phenomenon that a low-carbohydrate
diet causes the excretion of water (causing a reduction in blood
pressure), and conversely, that carbohydrate consumption leads to
retention of both salt and water (which elevates blood pressure).
Therefore, it is ironic that doctors advise overweight hypertensives
to lose weight in order to reduce their blood pressure by adopting the
standard low-fat, high-carb diet. This is self-defeating, not only
because low-fat diets have been shown to be effective ways to lose
weight, but also because consuming more carbohydrates will cause water
retention and an elevation of blood pressure.

Carbohydrate-rich diets also stimulate chronically high insulin levels
(because insulin is needed to clear the bloodstream of the glucose
that carbohydrates break down to in the digestion process; so the more
carbohydrates that are consumed, the more insulin is required) — and
insulin has a very direct influence on raising blood pressure. Harvard
researchers found that it stimulates the nervous system with the same
“flight-or-fight” response triggered by adrenaline, thus increasing
the heart rate and constricting blood vessels, resulting in an
increase in blood pressure. “The higher the insulin level, the greater
the stimulation of the nervous system,” the researchers discovered.
“And if insulin levels remain high, the result would be constantly
elevated blood pressure.”

This is one reason hypertension appears so frequently with diabetes.
But it should be remembered that high-carb diets (which featured
consumption of sugar and refined carbohydrate foods, such as bread,
baked goods, snack foods, and sodas) also stimulate elevated levels of
insulin even in people without diabetes. Furthermore, these early
researchers found that elevated insulin levels cause hypertension,
independent of any of the risk factors.

How effectively your body uses insulin is directly related to your
risk of developing high blood pressure, reported researchers from Wake
Forest University Baptist Medical Center. “We found you can predict
who’s at higher risk for developing high blood pressure based on their
insulin resistance,” said David Goff Jr., Ph.D., M.D., the lead
researcher for the Insulin Resistance Atherosclerosis Study (IRAS)
conducted in 2000. Numerous other studies, before and since IRAS, have
confirmed this connection.
When Dr. Goff’s study began, all 809 middle-age adults had normal
blood pressure and varying levels of resistance to insulin. Five years
later, researchers found that participants who were most resistant to
insulin had a higher incidence of high blood pressure. “The one-third
of participants with the highest levels of insulin resistance had
rates of hypertension that were 35 percent higher than the one-third
with the least resistance,” said Dr. Goff. “These findings point out
that reducing the body’s resistance to insulin may help prevent
hypertension and cardiovascular disease.”

Sugar and hypertension. Excess sugar consumption in hypertension go
hand-in-hand, and the number one culprit is sodas and sweetened
beverages. Researchers tracked the diets of nearly 2,700 people and
found that those who drank sugar-sweetened beverages had higher blood
pressures—both systolic and diastolic numbers. The highest blood
pressure levels occurred in those who consumed the most fructose and
glucose, which are both found in HFCS.

Another study examined the nutritional data of 4,500 people, none of
whom had hypertension. But after consuming 74 grams of HFCS a day (the
equivalent of two and a half cans of soda), they had a 77 percent
greater risk of having blood pressure level of 160/100 or higher. And
the negative affect that sweets have on blood pressure happens rather
quickly. One study found that men eating a high-fructose diet began to
see their blood pressure numbers rise after just two weeks.

Since the average annual soda consumption in the US is about two cans
per person per day, according to the National Soft Drink Association,
this means that vast majority of hypertension in a country could be
eliminated if people simply swore off soda (and beer).

HFCS and hypertension. Studies conducted by Dr. Richard Johnson,
professor of medicine at the University of Colorado, where he runs the
kidney division and is charge of blood pressure research reveals that
HFCS (and all sugars, in general) breaks down into uric acid, a
harmful waste product, immediately after ingestion. Elevated levels of
uric acid are usually associated with gout, but it also is recorded in
people with hypertension and kidney disease. Uric acid drives up blood
pressure by inhibiting nitric oxide in your blood vessels. Nitric
oxide helps blood vessels maintain their elasticity and facilitates
their expansion (dilation). Thus, suppression of nitric oxide by HFCS
consumption leads to increases in blood pressure. This is confirmed by
17 studies which demonstrate that elevated uric acid levels lead to
hypertension. Too much uric acid is also is a factor in kidney
disease, insulin resistance and diabetes, obesity, fatty liver
disease, elevated triglycerides and LDL, and cardiovascular disease.

--
Dogman

"I have approximate answers and possible beliefs in different degrees of certainty
about different things, but I'm not absolutely sure of anything" - Richard Feynman