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This from a recent continuing medical education (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 meta-analysis of 147 randomized trials (comprising 958,000 people) conclude in the May 19 issue of BMJ.
I have heard of this before through Mrs. Bremner, as there was discussion at Emory and the CDC about creating a “polypill” that would be given to the entire population to prevent heart disease. When asked why interventions like diet and exercise couldn’t be tried first the response was “we tried that and it doesn’t work”.
Which just makes me wanna say…
Argggg!!!!!
Not the polypill! Please!
The authors of the BMJ meta analysis have previously advocated that everyone over age 55 should take the polypill, which would include a statin for lowering cholesterol, three anti hypertensive drugs at half dosage, aspirin, and folic acid. Given that questions have arisen about the capacity of statins and anti hypertensive drugs to induce depression, I think they should add Prozac to the polypill.
Anyhoo according to this meta-analysis of anti-hypertension trials, giving three antihypertensive drugs will lower risk of coronary heart disease (CHD) events by 22%. What’s more, it doesn’t matter if your blood pressure is “normal” down to 110/70, you still get the reduction in CHD events.
The CME goes on to quote the study authors:
“Guidelines on the use of blood-pressure-lowering drugs can be simplified so that drugs are offered to people with all levels of blood pressure,” write Drs Malcolm R Law and Nicholas Wald (Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, UK). “Our results indicate the importance of lowering blood pressure in everyone over a certain age, rather than measuring it in everyone and treating it in some.”
“Whatever your blood pressure, you benefit from lowering it further,” Law told heartwire . “Everyone benefits from taking blood-pressure-lowering drugs. There is no one who does not benefit because their blood pressure is so-called normal.”
Ya gotta wonder about the logic of these guys. First of all aspirin has repeatedly been shown to be useless for the primary prevention of heart attacks in terms of its overall risk-benefit ratio. Second of all, statins do not reduce mortality in men without heart disease and are not beneficial at all for women without heart disease not to mention that they have side effects which can be pretty significant.
Hat tip to Rick Lippin MD
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excuse me but this is f*&king insane…my blood pressure ranges from 70/30 to 110/70 like above said blood pressure…IT ALWAYS FEELS TOO LOW even when it is on the normal end…
this idiots would have me die in the name of prevention.
oh man this enrages me. it’s just profoundly sickening…
diet and lifestyle don’t work?? maybe that is because the people they treat haven’t done a damn thing to change either??
man…ick.
A polypill promoted in such a way is insane.
Drugs for HTN: beta blockers can cause impotence, and cardio dysfunction upon disconinuation. Calcium channel blockers can cause pedal edema. ACE inhibitors can cause a chronic cough.
Why take drugs to make you physiologically worse off than if you had not taken such drugs?
ALL drugs have side effects. If a pill does not have side effects, it’s not a drug.
Essentially, drugs are poisonous, and this toxicity is always associated with any benefit a pharmaceutical may have for a patient.
Some drugs are safer than others in the same class. For example, with statins, Pravachol, mevacor and Zocor may be more safer for patients than other statins, as they are natural statins. The other statins are synthetic- and this poses greater toxicity for the consumer of the statin. This premise may be extrapolated to other classes of drugs with many options to choose from by the prescriber.
Clearly, healthcare reform needs to start with physicians who would propose such lunacy. I think med schools need to start screening out idiot savants — the rote learners, those with photographic memories, etc. — and start screening in critical thinkers with common sense.
All this pharmaceutical intervention with nary a mention of magnesium’s role in cardiovascular “events.” It’s shameful ignorance.
And as far as “we tried it and it didn’t work,” well, if the patients have untreated ADHD, of course it didn’t work. When you have a condition that inhibits the ability to implement and maintain routines, avoid impulsive actions (like eating junk foot), and all the rest, of course you’re going to have problems with health lifestyle habits.
But no, the cardio “one pill fits all” crowd is, frankly, too limited in their knowledge to understand real “meta” issues.
I think we should just put the polypill in the water.
If it is good enough for me, it must be good enough for fido, and my children. Hey , my lawn needs watering so a little statin may help the blades grow better.
Doctor SH, I was going to say the same thing, “Just add it to our water supply”. This enrages me. I am 58 and I would refuse this. Diet and exercise has worked for me. Somehow the medical profession things that the when the FDA draws a food pyramid it is “trying diet and exercise”. It’s not.
You maybe talking about putting polypills in the water because there was a leading cardiologist who had the same quote about statins a few years back, ‘this stuff is great, we should put it in the drinking water’. Unfortunately I did not save the quote and havent been able to find it so if anyone knows where it came from let me know.
They’re already in our drinking water, along with other pharmaceuticals — from being flushed, etc.
Perhaps you’re thinking of this guy, Frank Davidoff?
http://www.ama-assn.org/amednews/2005/02/07/hlsb0207.htm
Washington — Helping people lower their artery-clogging cholesterol is an admirable goal, but selling a popular statin drug without a prescription is not the way to go, said two Food and Drug Administration advisory committees during a joint meeting in mid-January.
The panelists voted 20-3 against over-the-counter distribution of 20 mg tablets of Mevacor (lovastatin). The FDA generally follows the advice of its committees.
The lopsided vote does not reflect the difficulty of the decision the panelists wrestled with during the two-day hearing, as officials from Merck & Co. and Johnson & Johnson presented the case for OTC sales of Mevacor for people with certain risk factors for heart disease.
“At times I’ve thought [statins] should be in the drinking water,” said panel member Frank F. Davidoff, MD, editor emeritus of the Annals of Internal Medicine. Dr. Davidoff praised the pharmaceutical companies for bringing the matter forward, but he ultimately voted against their proposal. “While OTC statins may be the right thing to do, I don’t think we’re there yet,” he said.
Don’t forget to add impotence to the list of side-effects.
Is there a safe way to discontinue beta blockers and 10 mg statins ?