LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Hypertension

OLDER AND CHEAPER MEDICINES MORE EFFECTIVE FOR BLOOD PRESSURE – (01-05-04)

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Misperceptions About Beta-Blockers and Diuretics

This is another one of those times that I have to throw up my hands in utter disbelief and confusion. It is now well accepted and proven that the older, cheaper meds for blood pressure are just as effective and safe as the new fancy-dancy expensive ones. And yet, clinicians are not getting the message. The same is happening with antibiotic overuse. There is such a disconnect between research and clinical practice as to be incredulous. I cannot believe that clinicians (and yes, I am generalizing here…) are so oblivious to what is in the medical literature. The only answer is that they never crack a medical journal and all their “continuing ed” comes from the drug companies. I know this reasoning is the only one that makes sense but I just find it hard to swallow–I believe most clinicians have only the based interests for their patients at heart.

Misperceptions About beta-Blockers and Diuretics. A National Survey of Primary Care Physicians – J Gen Intern Med, Vol 18, Is.. –

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C REACTIVE PROTEIN RISKS IN DEVELOPING HYPERTENSION – (01-05-04)

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C-Reactive Protein and the Risk of Developing Hypertension

Someone needs to write an article entitled “chronic inflammation is a risk factor for and plays a role in every chronic disease known to man,” then we could be done with all these little articles that related markers of inflammation to chronic disease states. It sure would save a bunch of money too… Come to think of it, throwing insulin resistance in the title would double our money saved on future research as well. JAMA — Abstracts: Sesso et al. 290 (22): 2945 –

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EFFECT OF CARDIOVASCULAR OUTCOMES LOWERS VARIOUS RISKS – (12-29-04)

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Association Between Cardiovascular Outcomes and Antihypertensive Drug Treatment in Older Women

I recently reviewed the current version of the Hippocritic Oath. The phrase “abstain from whatever is harmful or mischievous” is used is this oath. It also mentions keeping current with new medical therapies and research. How far we have come.

This study is, unfortunately, another example of a medical approach that, for many years, was considered helpful. When the research is finally done properly, it turns out we’re killing patients instead of helping them. Contrast this with affecting insulin resistance or water only fasting for hypertension. The only adverse affects to these treatments would be lowered risks of diabetes, heart disease, Alzheimers, certain types of cancers… Hardly and undesirable list of “side effects,” huh?

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Arginine Plus: Do L Arginine Benefits Trump Lifestyle?

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Some supplements  for blood pressure use L arginine plus other items to lower blood pressure naturally.  But are L arginine benefits stronger than lifestyle?

Natural medicine is not exempt from taking the wrong approach to fixing today’s chronic health problems.  I have heard the term “green allopathy” to describe “natural” practitioners who use natural compounds in an allopathic (allopath = MD) model.  A perfect example is using red yeast rice to lower cholesterol.  Does it work?  Seems to, but it’s a bad question to ask.  The best question to ask is if this one cause-one cure approach fits with natural approaches.

The bottom line is that is doesn’t.  Today’s chronic diseases are the result of multiple aspects of poor lifestyles that come together to create a disease state like diabetes, high blood pressure or cancer.  If your lifestyle is pristine but you have Wonder bread for breakfast your chances of becoming diabetic are slim (NOT that I am suggesting that Wonder bread in any way, shape or form is ok for human consumption…).

So what about blood pressure? 

A little Biochemistry 501.

First, we need to understand a compound called nitric oxide, or NO.  It all starts with the search for a molecule that was known to relax the blood vessels and lower blood pressure.  Researchers knew it existed, but just couldn’t figure out the actual compound (the initial term was Endothelial-Derived-Relaxing-Factor, or EDRF).  The compound was identified by Louis Ignarro in 1986 as NO.   Basically, NO is a small molecule that has many functions, one of which is dilation of blood vessels to increase blood flow (aka nitroglycerin tablets, Viagra…).

There are two versions of the enzyme that produces NO in our body, called nitric oxide synthase.  One version of these can be “turned on” by giving the amino acid L arginine.  Thus was born the rise of L arginine, the wonder supplement.  Direct marketing companies were formed entirely based on giving more L arginine.  The bodybuilding industry hit it hard as well, produced “explode” type products containing L arginine to get you from a Stan Laurel to Swartzenegger in 2 weeks.

They all got caught up in the “green allopathy” model and forgot something important…

Nitric oxide has an arch enemy.

Asymmetrical dimethyl arginine (ADMA) is a compound that can be considered the arch enemy of nitric oxide.  When ADMA levels are elevated, the enzyme that produces nitric oxide, nitric oxide synthase, is slowed down, resulting in negative effects on blood pressure and our blood vessels. It basically counteracts the L arginine plus nitric oxide combo.

So what causes ADMA levels to go up? 

Back to our ole’ friend prediabetes.  Elevated insulin slows the enzyme that breaks ADMA levels, leading to higher levels of ADMA.  Higher levels of ADMA means that the L arginine benefits are not going to have any long term effects.

Previous studies have looked at whether L arginine benefits on protecting the blood vessels were real and have fallen short.

This particular study goes beyond blood pressure to see if L arginine could have an effect on the cause, diabetes.  But, since L arginine was not fixing anything in the first place, researchers did not find that L arginine had any effect on the risk of developing diabetes.

However, not to completely disparage L arginine, the researchers did find that supplementation over the course of 18 months did seem to improve the function of the beta cells of the pancreas and improve sugar handling in the body.  Not a bad thing, but still follows the “green allopathy” mentality.

 Overall, lifestyle changes designed to lower your risk of diabetes are the best option, and relying on a single supplement to fix the ills of our lifestyles will likely fall short.

BLOOD PRESSURE DAMAGES CELL LYING IN ARTERIES – (09-24-03)

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High Pressure Induces Superoxide Production in Isolated Arteries

Wow! This article suggests that increased blood pressure alone is enough to start a cascade of damage in the cells lining the arteries. Increased super-oxide without ample antioxidants to quench this free radical will result in further damage to the cell. This damage can begin the infiltration of white blood cells that begin plaque formation. This lends more support to the idea of antioxidant supplementation such as Vit C, E and CoQ10 to lower risk of CVD.

Circulation — Abstracts: Ungvari et al. 108 (10): 1253.

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RELATIONSHIP BETWEEN DRIED MILK CONSUMPTION AND ELEVATED BP – (06-09-03)

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Infant nutrition and blood pressure in early adulthood.

There have been numerous stories lately about the impact the beginning of our lives have on our long term health.

This article finds a relationship between dried milk consumption and elevated BP in adults. Personally, being strongly against dairy, this article doesn’t exactly disappoint me. Nursing is still the absolute best way to go. If this isn’t an option, I usually recommend a hydrolyzed formula that has been enzymatically pre-digested so there are no intact proteins for the body to react to.

AJCN — Abstracts: Martin et al. 77 (6): 1489 –

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High Blood Pressure Medication Fails; Die with Better Numbers

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Medicine today is built on a house of cards. We think that if high blood pressure medication lowers our numbers, we’re safe. Not even close to true.

I have covered again and again the fallacy of what is referred to as “surrogate end markers.”

In using surrogate end markers, the idea is that, for Disease X, patients with lower values of Blood marker B live longer or are less likely to get the disease. So, we create a drug that lowers Blood marker B synthetically, thinking that we will have an impact on Disease X. We don’t measure Disease X directly, because that would take too long.

The mistake here is that, what if Blood marker B being low and leading to lowered rates of Disease X is a reflection of the health of the patient, and NOT because Blood marker B itself is low? Time and time again we see that the use of surrogate end markers in research leads to WORSE outcomes when we artificial lower Blood marker B.

The bottom line is that many of us blindly follow our doctor’s advice to take some medication and we think that there is solid research behind this particular use of the drug.

Sadly, this is not often the case.  You may be given this drug because it will make your numbers look better, not because it has been shown to avoid YOUR concern such as a heart attack, stroke, diabetes, osteoporosis or dementia.

Which brings us to this particular study done by the Cochrane group.  Before we get into the results, you need to first understand that the what Cochrane Collaboration is all about.  In their own words:

“The Cochrane Collaboration is an international network of more than 28,000 dedicated people from over 100 countries. We work together to help healthcare providers, policy-makers, patients, their advocates and carers, make well-informed decisions about health care, by preparing, updating, and promoting the accessibility of Cochrane Reviews – over 5,000 so far, published online in the Cochrane Database of Systematic Reviews, part of The Cochrane Library. We also prepare the largest collection of records of randomised controlled trials in the world, called CENTRAL, published as part of The Cochrane Library.”

In other words, this is THE group that can tear apart the medical research on a topic and filter through the bad study designs and bias that can clog up the true results of a study.

So what did they find out about high blood pressure medications used to lower mild hypertension (systolic blood pressure <160 and diastolic blood pressure <100)?

Not really a whole lot.  In the studies reviewed, there was no evidence of a protective benefit from using high blood pressure medication in these patients.  No lowered rate of heart attacks, stroke or death.

Let’s be clear–this doesn’t mean there is NOT a benefit, it just means there is no research to prove it.  Now that we’ve been clear, let’s be honest…

Millions of dollars thrown into research for drugs to lower blood pressure.  BILLIONS of dollars paid annually for people to take these medications.  I’m thinking that, if there was an data to truly prove that they work, the drug companies would’ve been hoisting the research up on a pedestal for everyone to see.

The sad part is that I don’t think that these recommendations are going to be widely adopted.  Dogma rules in medicine and it takes decades to change behaviors.  It has been almost 4 years since the research linking stroke and diabetes with beta blockers for high blood pressure was published, and yet these drugs are still standard treatment for high blood pressure.

I have previously posted on other side effects associated with hypertension drug use and this can be read by clicking here.

The bottom line is that we should lower high blood pressure with lifestyle, not with drugs.  Only then can you be sure that you’re going to lower your risk of diabetes, heart disease, stroke and deaths.

So did you do to lower your high blood pressure?

NEGATIVE EFFECTS ON BLOOD PRESSURE AND BLOOD VESSELS – (01-21-04)

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Cardiovascular Effects of NO Synthase Inhibition with Asymmetrical Dimethylarginine

Biochemistry 501. ADMA is a compound that can be considered to alter ego of nitric oxide. Nitric oxide is a vasodilator and opens up blood vessels and lowers BP. When ADMA levels go up, the enzyme that produces nitric oxide is inhibited, thus resulting in negative effects on blood pressure and blood vessels. So what causes ADMA levels to go up? Back to our ole’ friend hyperinsulinemia. Elevated insulin inhibits the enzyme that breaks ADMA levels. I know I sound like a broken record, but I feel Syndrome X is probably the #1 condition that negatively impacts health in the developed nations, albeit indirectly. Yet it remains the big,huge, gargantuan, super-sized neon purple and construction orange elephant in the clinician’s room. Circulation — Abstracts: Kielstein et al. 109 (2): 172 –

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