Give Blood Pressure Drugs to All - page 5

by Jolie 5,872 Views | 47 Comments

From Medscape CME: May 28, 2009 — Blood-pressure-lowering drugs should be offered to everyone, regardless of their blood pressure level, as a safeguard against coronary heart disease and stroke, researchers who conducted a... Read More


  1. 0
    You may want to look at more of the evidence. There exists a fair amount of evidence that supports the use of ACE inhibitors to help prevent diabetic related complications. However, I cannot find solid evidence that states what specific populations should receive ACE inhibitors. So, I would say a "silver bullet" of evidence is lacking. However, this is the case with most of the evidence out there. You look for the best peer review EMB, see if it is easily duplicated, consider evidence that counters the standard way of thinking, then decide how to proceed.

    Clearly, numerous cautions and contraindications exist, and one must consider the complications associated with ACE inhibitor therapy. However, as I stated earlier, placing diabetics on ACE inhibitors and using the current evidence to back up your decision while considering the patients condition and the possibility of problems is not an unreasonable approach.
  2. 0
    The reason for BP meds for all diabetics is that us diabetics have a higher chance of kidney problems and failure later on because of unknown pressures within the kidneys. The whole idea behind say Lisiniprin, would be to keep pressures of blood flowing lower and therefore hold out more for us diabeitcs and avoid to possibility of being on dialysis.
  3. 0
    Quote from GilaRN
    You may want to look at more of the evidence. There exists a fair amount of evidence that supports the use of ACE inhibitors to help prevent diabetic related complications. However, I cannot find solid evidence that states what specific populations should receive ACE inhibitors. So, I would say a "silver bullet" of evidence is lacking. However, this is the case with most of the evidence out there. You look for the best peer review EMB, see if it is easily duplicated, consider evidence that counters the standard way of thinking, then decide how to proceed.

    Clearly, numerous cautions and contraindications exist, and one must consider the complications associated with ACE inhibitor therapy. However, as I stated earlier, placing diabetics on ACE inhibitors and using the current evidence to back up your decision while considering the patients condition and the possibility of problems is not an unreasonable approach.

    As stated by Dr. Kassirer, high blood pressure does cause kidney failure. Dr. Kassirer has blasted the drug companies every day of the week and twice on Sunday. I am more than willing to think outside of the box. However, when I took at any medical study, I look for terms called absolute risk and Numbers Need To Treat. I also look for financial conflicts of interest. However, sadly, I find that many in the medical profession do not not enjoy research or thinking outside of the box. Every patient is not similar or the same, I am a perfect example of this theory. I am on dialysis, yet, I have to take 2,400 mgs of calcium per day to keep my calcium from falling to unacceptable low levels. In addition, my diet calls for at least one serving of potassium per day, more, if possible. Yes, I have had to take Klor-Con, the potassium pill, horsey pill. How many dialysis patients have these issues, not many. I agree we do need to look at all of the evidence and make reasonable decisions.


    Mark
    Last edit by Silverdragon102 on Jun 8, '09 : Reason: Please do not post email addresses as per terms of service
  4. 0
    while i disagree with blanket statements like the ones in the article, docs and nurses are treating individual patients, and everyone's body is different. i do think there is some evidence that blood pressure meds do have a place being used for milder hypertension, and perhaps earlier rather than waiting for a patient to have consistant readings in the 200's/over high 100's. at least in my case it has done wonders for me.

    i developed high blood pressure in the last six months, it was not excessively high in my doc's opinion 138/92 at my visit complaining of it, but it was running 160/100 after my clinical days. before that it ran 110/60-70, but i'd had tremendous headaches at least once a week for the last 15-20 years. i was put on lisinopril 10 mg qday, i haven't had a headache since. blood pressure is back to my normal of 110/70. when i looked up the lisinopril it was said to be used off label as a prophy for migraines. i much prefer taking it than to wreck my liver with the amounts of ibuprofen or tylenol i was taking each week for my headaches, or the prescribed meds such as lortab or fioricet that i am forbidden by my school's rules to take on a clinical day.

    my only side effect from the lisinopril has been a little increased orothstatic hypotension after my massage twice a month which goes away in a few moments or i can avoid if i get up slower.
  5. 1
    If the medication works for you, that is great. However, according to Professor Kauffman, most individuals stop using blood pressure medication because of side effects. Yet, many in the medical community use stereotypes. I would agree about protecting your liver.
    cursedandblessed likes this.
  6. 0
    Quote from NDXUFan
    If the medication works for you, that is great. However, according to Professor Kauffman, most individuals stop using blood pressure medication because of side effects. Yet, many in the medical community use stereotypes. I would agree about protecting your liver.
    Thinking on it, my mom (I'm adopted so not genetics between us) has had problems with many blood pressure meds. Her last one was a CCB which caused peripheral edema. The only one she's been able to take is the HCTZ with her only side effect was the low K+ which she had to supplement for. Every other one she went off of, even though I told her she needed to tell the doc and try something else(my brother the doc told her as well, and she doesn't listen to him either).

    In regards to the drug companies, I know that most of the drugs she's been put on have been newer drugs only available in name brands and quite expensive, once the samples ran out. I often wonder if her doctor doesn't see that prescribing some newer drugs that cost big $$ to an elderly (75 YO) woman may not be wise. As well from seeing her friends without prescription coverage who are also given samples then expected to purchase a prescription costing around $150 a month or higher is somewhat asking for non-compliance from someone with an income of less than $800 a month.
  7. 0
    Quote from cursedandblessed
    Thinking on it, my mom (I'm adopted so not genetics between us) has had problems with many blood pressure meds. Her last one was a CCB which caused peripheral edema. The only one she's been able to take is the HCTZ with her only side effect was the low K+ which she had to supplement for. Every other one she went off of, even though I told her she needed to tell the doc and try something else(my brother the doc told her as well, and she doesn't listen to him either).

    In regards to the drug companies, I know that most of the drugs she's been put on have been newer drugs only available in name brands and quite expensive, once the samples ran out. I often wonder if her doctor doesn't see that prescribing some newer drugs that cost big $$ to an elderly (75 YO) woman may not be wise. As well from seeing her friends without prescription coverage who are also given samples then expected to purchase a prescription costing around $150 a month or higher is somewhat asking for non-compliance from someone with an income of less than $800 a month.
    Agreed. Professor Kauffman stated that many of the older drugs are just as effective as the newer drugs. I would agree 100 percent with your post.
  8. 0
    Quote from tencat
    Yeah, sounds like some drug company sponsored it....I'd bet money on that.
    I agree!

    My bp runs around 100/60. Think they should offer me some BP meds? My cholesteral is 135, but maybe I'd better take some statins just in case.


Top