High Blood pressure

K9cuddles

Savvy_Sue wrote: »

Alas, when my high BP was causing concern prior to an operation, no-one gave a hoot about the cause, which I couldn't help thinking might just have been stress! You're fortunate to have a GP who will work with you to identify cause and work out non-drug strategies for reducing it rather than throwing drugs at the problem.

Calley, I hope you and your husband have been given some advice about when and how your husband can increase his exercise regime - even if it's 'only' walking which can be excellent exercise.

I have to agree my GP is doing the same kickstarts.. there are some good ones still about!! I'm sticking with her now too! :rotfl:

Ted_Hutchinson

mr_rush wrote: »

please ignore the vitamin D nonsense - there is a reason why the British Hypertension Society do not have anything to do with vitamin D in their anti-hypertension guidelines - because of the lack of evidence.

I had hoped that over the weekend Mr_Rush might have thought a little more about the evidence linking high blood pressure to low Vitamin D status. But as he hasn't seen fit to edit out the word "nonsense" from his previous post perhaps now will he please, interpret the findings of this Plasma 25-Hydroxyvitamin D Levels and Risk of Incident Hypertension. research for us?

The fact Mr_Rush cites the failure of the British Hypertension Society to investigate the issue, as evidence there is no sense at all in the observations that low vitamin d status, (in Winter, at lower altitude, or in darker skinned individuals) is related to higher blood pressure, is simply irrelevant. No sensible organisation bites the hand that feeds them. Look who sponser the BHS( Boehringer Ingelheim BMS/Sanofi Aventis Menarini Merck Sharp & DohmeT Novartis Pfizer Servier Takeda )
Those sponsors are not likely to continue funding an organisation that proves the use expensive and potentially dangerous medications could be reduced by ensuring the UK population acquire optimal (125nmol/L) levels of vitamin D in their blood by regularly going into the sun, using a sun bed (avoiding sunburn), or consuming a safe and effective amount of Cholecalciferol (Vit D3), when sunlight (or it's equivalent) isn't available.

It is about time UK doctors took account of the low Vitamin D status of the population and the impact this has on many conditions.

pink123_2

I have to agree with mr_rush- there is a lack of evidence relating to Vit D!! I happend to work for Merck, Sharp & Dohme who are commited in creating awareness of bloood pressure by continuing to sponsor BHS and make it possible for health care proffesionals to attend important meetings on the BHS guidelines, which unless these 'sensible organisations' paid for our hcp to attend these meeting the NHS would have no way of keeping up to date with current data/guidelines. You may find it hard to believe but it is not always about money with big pharma companies, it is about saving lives (which it does by creating awareness of symptoms such as high blood pressure). There is a reason why pharma companies try to make money by selling drugs.......research to fund/develop new treatments for life saving conditions such as Cancer. If there was any evidence relating to Vit D and hypertension (I am not saying there may not be!), but if there was i am sure the pharma companies would still profit (and why shouldnt they?). India has one of the largest hypertension prevelence in the world and am i wrong in thinking that India is a sunny country??? What about parts of USA, again high HT prevelence ............exposure to alot of sunshine. At the end of the day we are supposed to follow evidence based medicines.........are we not?

pink123_2

Can I add that Vit D has been found to affect Osteoporosis and that is why is prescribed in those patients (even though other pharma companies such as Sanofi Aventis, MSD, GSK) all have 'expensive' products on the market. But because there is evidence that Vit D affects absorption of Calcium in the bones is therefore on the current guidelines. If the same was with HT, there would be no hesitation to add on current NICE/BHS guidelines!

Ted_Hutchinson

pink123 wrote: »

There is a reason why pharma companies try to make money by selling drugs.......research to fund/develop new treatments for life saving conditions such as Cancer.

It looks to me as if the interest in Vitamin D in cancer treatment is anchored around the finding of patentable analogues which will provide profit rather than encouraging the acquisition of free vitamin d, or using cheap unpatentable cholecalciferol for cancer/ms prevention.

India has one of the largest hypertension prevelence in the world and am i wrong in thinking that India is a sunny country??? What about parts of USA, again high HT prevelence ............exposure to alot of sunshine. At the end of the day we are supposed to follow evidence based medicines.........are we not?

And the evidence is that India, USA and the UK populations (see link provided in previous post) have low Vitamin d status but this remains for the most part undetected and untreated because there is no profit in supplying cholecalciferol and the issue is not being brought before the GP's in the same way as the need for new profitable medications is drawn to their attention.
Prevalence of vitamin D insufficiency in postmenopausal south Indian women.
Vitamin d insufficiency & Prostate cancer USA

mr_rush

sorry ted. still nonsense.
who funds NICE? Its the government, not any big pharma company.
Where does it mention vit d in the NICE guidelines on hypertension? Nowhere actually as they are the same as the British Hypertension Soc guidelines.

Tomorrow in clinic when I see patients with hypertension, some of whom have already had strokes, heart attacks etc... I won't be adding vit d to their meds.

ailuro2

Reducing salt intake, a healthy diet, reducing stress and gentle regular exercise have all been tried and found to help by a friend of mine who has tried all the different tablets from his Dr- has had high bp for years.

When he is stressed but doesn't realise it he comes back from check up s with a raised BP- I think that is his most important trigger, just fwiw and imho.

You really need to seek help from your GP or practise nurse, but having less stress, regular exercise and a healthy diet never hurt anoyone.

Ted_Hutchinson

mr_rush wrote: »

sorry ted. still nonsense.
who funds NICE? Its the government, not any big pharma company.
Where does it mention vit d in the NICE guidelines on hypertension? Nowhere actually as they are the same as the British Hypertension Soc guidelines.

Tomorrow in clinic when I see patients with hypertension, some of whom have already had strokes, heart attacks etc... I won't be adding vit d to their meds.

If I were one of your unfortunate patients I would sue you for incompetence and negligence. It really is about time the medical profession woke up to the fact the body uses between 3000 & 5000iu of Vitamin d daily. and this is a risk free level of supplementation when sunlight exposure isn't an option.
The fact that both the NICE & BHS guidelines fail to take note of the obvious link between lower vitamin d status and higher blood pressure is simply evidence of the lack of common sense so common in the medical profession.
How long does it take for the penny to drop?
Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study was published 1990.
Serum 25-hydroxyvitamin D3 concentrations and carotid artery intima-media thickness among type 2 diabetic patients.
You may say that Calcium/vitamin D supplementation and cardiovascular events. shows Calcium/vitamin D supplementation neither increased nor decreased coronary or cerebrovascular risk but who in their right minds would consider using only a tenth of the daily amount the body needs would correct a deficiency status?

If you aren't aware that Low Vitamin D status is a risk marker for Stroke then you should be.

Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men.

It seems that 800 IU (20 microg) vitamin D per day in combination with calcium reduces systolic blood pressure in elderly women.

The concept of vitamin D regulation of blood pressure through the RAS opens a new avenue to our understanding of the physiological functions of the vitamin D endocrine system, and provides a basis for exploring the potential use of vitamin D analogues in prevention and treatment of hypertensio

Its apparent critical role in electrolytes, volume, and blood pressure homeostasis suggests that vitamin D analogues could help prevent or ameliorate hypertension.

since vitamin D(3) varies during the year, mainly following sun exposure, we suggest that vitamin D(3) is one of the factors participating in the seasonal variation of the blood pressure.

Inadequate vitamin D3 and calcium intake could play a contributory role in the pathogenesis and progression of hypertension and cardiovascular disease in elderly women.

You still haven't explained the Plasma 25-Hydroxyvitamin D Levels and Risk of Incident Hypertension. findings for us, I would find your explanation interesting.

calleyw

Savvy_Sue wrote: »

Calley, I hope you and your husband have been given some advice about when and how your husband can increase his exercise regime - even if it's 'only' walking which can be excellent exercise.

Rather a sore point with us about advice and total lack of help since he came out of hospital.

He does go for a walk around the block everyday.

As well as the stroke he has underlying medical condition so is on enough tablets to sink a ship.

We try and have food as natural as possible. And don't add salt to any cooking.

Yours


Calley

mr_rush

Ted on one side, the worlds top scientists, cardiologists, physicians etc one the other. Which one do I believe? Whose advice do I follow?
'If I were one of your unfortunate patients I would sue you for incompetence and negligence. '
only if i started you on vitamin d instead of an ACE inhibitor.
There is a huge difference between abstracts your find on the internet, primary research and what can actually be applied to clinical practice.

there are different grades of evidence as per NICE. grade A evidence is a meta-analysis of several double blind randomised controlled trials. this is the level of evidence we currently have for all the anti-hypertension drugs used in BHS/NICE guidelines.

If you can provide me with meta-analyses of DB-RCT of vit d vs placebo then i will bring it to the attention of one of my consultants who is a member of the BHS.