Fears raised over diuretic drugs

Discussion in 'Food and nutrition' started by Roman Bystrianyk, Jan 11, 2006.

  1. "Fears raised over diuretic drugs", BBC News, January 12, 2006,
    Link: http://news.bbc.co.uk/1/hi/health/4603190.stm

    Doctors are being urged to monitor people to whom they prescribe
    diuretics after a study linked the drugs to low sodium and potassium
    levels.

    A review of 32,000 adults found 20% of those on the drugs for high
    blood pressure and heart conditions had low levels of these key
    minerals.

    But only a third had had these levels tested, a Nottingham-based team
    told the British Journal of Pharmacology.

    Low mineral levels can cause low blood pressure and upset heart
    rhythms.

    The Queen's Medical Centre and Nottingham University team reviewed the
    records of 32,000 adults from six GPs practices.

    They found around 12% of these had been given at least one prescription
    for thiazide diuretics between 1990 and 2002.

    But only 32% of these had had their levels of the key minerals sodium
    and potassium - known as electrolytes - checked.

    Professor Ian Hall, who co-authored the report, said the research
    showed that patients taking higher doses of thiazide diuretics were at
    particular risk of low sodium levels.

    "This points to the need for prescribing low doses of thiazide
    diuretics and monitoring sodium and potassium levels to reduce the risk
    and increase the detection and treatment of these electrolyte
    abnormalities," the expert in molecular medicine said.

    In most people, low electrolyte levels might not matter a great deal,
    he told the BBC News website.

    'Life threatening'

    However, low sodium levels can lead to low blood pressure, dizziness
    and an increased risk of falls for older people, while low potassium
    levels can cause heart rhythm abnormalities.

    "There are a very small number of people in whom very low levels can be
    potentially dangerous. They may end up coming into hospitals with acute
    medical conditions," Professor Hall added.

    It was these people that he hoped monitoring might assist.

    The team's study showed 9% of those with low levels had severe
    electrolyte disturbances and that they had taken the medication for
    between three and 90 months before they underwent tests.

    "The general advice is if you are on these drugs, it is probably
    sensible to have a blood test," Professor Hall added.

    Professor Gareth Beevers, trustee of the Blood Pressure Association,
    agreed that testing was advisable - perhaps once a year.

    He said very low sodium levels could occasionally be life threatening
    and that low potassium levels should be checked.

    The effects of the drugs could be minimised if the lowest possible dose
    of thiazide diuretics is be given, he said.

    However, he added: "The fact remains that thiazide diuretics have been
    immensely successful at preventing strokes, particularly in the elderly
    and therefore they should not be stopped unless under medical
    supervision."

    This was a point reiterated by the research team.

    Ellen Mason, medical spokeswoman for the British Heart Foundation, said
    thiazide diuretics were effective treatments for those with heart
    failure and high blood pressure.

    But she acknowledged reductions in potassium and sodium levels could be
    an important side effect.

    "However," she added, "this study has inherent weaknesses, which its
    authors admit to, that may affect the validity of its conclusions, such
    as not considering other medications patients were on or whether they
    had other illnesses."
     
    Tags:


  2. Mark Probert

    Mark Probert Guest

    Roman Bystrianyk wrote:
    > "Fears raised over diuretic drugs", BBC News, January 12, 2006,
    > Link: http://news.bbc.co.uk/1/hi/health/4603190.stm
    >
    > Doctors are being urged to monitor people to whom they prescribe
    > diuretics after a study linked the drugs to low sodium and potassium
    > levels.
    >
    > A review of 32,000 adults found 20% of those on the drugs for high
    > blood pressure and heart conditions had low levels of these key
    > minerals.
    >
    > But only a third had had these levels tested, a Nottingham-based team
    > told the British Journal of Pharmacology.
    >
    > Low mineral levels can cause low blood pressure and upset heart
    > rhythms.
    >
    > The Queen's Medical Centre and Nottingham University team reviewed the
    > records of 32,000 adults from six GPs practices.
    >
    > They found around 12% of these had been given at least one prescription
    > for thiazide diuretics between 1990 and 2002.
    >
    > But only 32% of these had had their levels of the key minerals sodium
    > and potassium - known as electrolytes - checked.
    >
    > Professor Ian Hall, who co-authored the report, said the research
    > showed that patients taking higher doses of thiazide diuretics were at
    > particular risk of low sodium levels.
    >
    > "This points to the need for prescribing low doses of thiazide
    > diuretics and monitoring sodium and potassium levels to reduce the risk
    > and increase the detection and treatment of these electrolyte
    > abnormalities," the expert in molecular medicine said.
    >
    > In most people, low electrolyte levels might not matter a great deal,
    > he told the BBC News website.
    >
    > 'Life threatening'
    >
    > However, low sodium levels can lead to low blood pressure, dizziness
    > and an increased risk of falls for older people, while low potassium
    > levels can cause heart rhythm abnormalities.
    >
    > "There are a very small number of people in whom very low levels can be
    > potentially dangerous. They may end up coming into hospitals with acute
    > medical conditions," Professor Hall added.
    >
    > It was these people that he hoped monitoring might assist.
    >
    > The team's study showed 9% of those with low levels had severe
    > electrolyte disturbances and that they had taken the medication for
    > between three and 90 months before they underwent tests.
    >
    > "The general advice is if you are on these drugs, it is probably
    > sensible to have a blood test," Professor Hall added.
    >
    > Professor Gareth Beevers, trustee of the Blood Pressure Association,
    > agreed that testing was advisable - perhaps once a year.
    >
    > He said very low sodium levels could occasionally be life threatening
    > and that low potassium levels should be checked.
    >
    > The effects of the drugs could be minimised if the lowest possible dose
    > of thiazide diuretics is be given, he said.
    >
    > However, he added: "The fact remains that thiazide diuretics have been
    > immensely successful at preventing strokes, particularly in the elderly
    > and therefore they should not be stopped unless under medical
    > supervision."
    >
    > This was a point reiterated by the research team.
    >
    > Ellen Mason, medical spokeswoman for the British Heart Foundation, said
    > thiazide diuretics were effective treatments for those with heart
    > failure and high blood pressure.
    >
    > But she acknowledged reductions in potassium and sodium levels could be
    > an important side effect.
    >
    > "However," she added, "this study has inherent weaknesses, which its
    > authors admit to, that may affect the validity of its conclusions, such
    > as not considering other medications patients were on or whether they
    > had other illnesses."
    >


    This just p*sses me off....

    With a post like this, Kent Ross cannot be far behind...
     
  3. Rich

    Rich Guest

    "Roman Bystrianyk" <[email protected]> wrote in message
    news:1137033277.646474.83590[email protected]
    > "Fears raised over diuretic drugs", BBC News, January 12, 2006,
    > Link: http://news.bbc.co.uk/1/hi/health/4603190.stm
    >
    > Doctors are being urged to monitor people to whom they prescribe
    > diuretics after a study linked the drugs to low sodium and potassium
    > levels.
    >
    > A review of 32,000 adults found 20% of those on the drugs for high
    > blood pressure and heart conditions had low levels of these key
    > minerals.
    >
    > But only a third had had these levels tested, a Nottingham-based team
    > told the British Journal of Pharmacology.
    >
    > Low mineral levels can cause low blood pressure and upset heart
    > rhythms.
    >
    > The Queen's Medical Centre and Nottingham University team reviewed the
    > records of 32,000 adults from six GPs practices.
    >
    > They found around 12% of these had been given at least one prescription
    > for thiazide diuretics between 1990 and 2002.
    >
    > But only 32% of these had had their levels of the key minerals sodium
    > and potassium - known as electrolytes - checked.
    >
    > Professor Ian Hall, who co-authored the report, said the research
    > showed that patients taking higher doses of thiazide diuretics were at
    > particular risk of low sodium levels.
    >
    > "This points to the need for prescribing low doses of thiazide
    > diuretics and monitoring sodium and potassium levels to reduce the risk
    > and increase the detection and treatment of these electrolyte
    > abnormalities," the expert in molecular medicine said.
    >
    > In most people, low electrolyte levels might not matter a great deal,
    > he told the BBC News website.
    >
    > 'Life threatening'
    >
    > However, low sodium levels can lead to low blood pressure, dizziness
    > and an increased risk of falls for older people, while low potassium
    > levels can cause heart rhythm abnormalities.
    >
    > "There are a very small number of people in whom very low levels can be
    > potentially dangerous. They may end up coming into hospitals with acute
    > medical conditions," Professor Hall added.
    >
    > It was these people that he hoped monitoring might assist.
    >
    > The team's study showed 9% of those with low levels had severe
    > electrolyte disturbances and that they had taken the medication for
    > between three and 90 months before they underwent tests.
    >
    > "The general advice is if you are on these drugs, it is probably
    > sensible to have a blood test," Professor Hall added.
    >
    > Professor Gareth Beevers, trustee of the Blood Pressure Association,
    > agreed that testing was advisable - perhaps once a year.
    >
    > He said very low sodium levels could occasionally be life threatening
    > and that low potassium levels should be checked.
    >
    > The effects of the drugs could be minimised if the lowest possible dose
    > of thiazide diuretics is be given, he said.
    >
    > However, he added: "The fact remains that thiazide diuretics have been
    > immensely successful at preventing strokes, particularly in the elderly
    > and therefore they should not be stopped unless under medical
    > supervision."
    >
    > This was a point reiterated by the research team.
    >
    > Ellen Mason, medical spokeswoman for the British Heart Foundation, said
    > thiazide diuretics were effective treatments for those with heart
    > failure and high blood pressure.
    >
    > But she acknowledged reductions in potassium and sodium levels could be
    > an important side effect.
    >
    > "However," she added, "this study has inherent weaknesses, which its
    > authors admit to, that may affect the validity of its conclusions, such
    > as not considering other medications patients were on or whether they
    > had other illnesses."
    >


    Potassium is routinely prescribed in conjunction with diuretics.
    Hyponatremia is relatively rare and is seldom associated with diuretic use.
    --


    --Rich

    Recommended websites:

    http://www.ratbags.com/rsoles
    http://www.acahf.org.au
    http://www.quackwatch.org/
    http://www.skeptic.com/
    http://www.csicop.org/
     
  4. vernon

    vernon Guest

  5. Sharon Hope

    Sharon Hope Guest

    Roman,

    Thanks so much for posting this perfect example of manipulation of the
    ad-revenue-dependent press by pharmcos. It would be entertaining, if it
    weren't such a serious topic.

    There are so many 'messages' to be learned from this week's health headlines
    about diuretics.

    On the face of it, there is certainly good information.

    But then, a populace raised on Gatorade ads, along with all the me-too
    sports drinks, knows that excessive fluid loss, be it via urine or sweat,
    would of course cause a net loss of electrolytes.

    So, why would a study that is basically a 'duhhhhh...' make news in so many
    venues? It is certainly not news that doctors should monitor prescription
    drug use for adverse effects (albeit not commn).

    Ahhh, yes, it is counter-spin!

    Remember last year's health headlines finding that simple diuretics are more
    effective than blood pressure medications? (e.g.,
    http://www.nih.gov/news/pr/jun2005/nhlbi-27.htm June '05 "Diuretics
    Effective for People with Diabetes and High Blood Pressure ' In people with
    diabetes, diuretics work as well as ACE-inhibitors and calcium channel
    blockers in protecting against heart attack and improving survival, and
    offer more protection against congestive heart failure. ...' ")

    This produced an urgent need by the marketing arms of the pharmcos who
    produce and sell blood pressure meds to reduce the demand for diuretics.

    Witness the hyperbole and hype in the diuretic articles, with loaded words
    including FEARS, LIFE THREATENING, HEART RHYTHM ABNORMALITIES!

    While people running through the streets screaming in fear of depletion of
    electrolytes in their urine, it is the hopes of these manipulating pharmco
    marketing teams that they won't stop long enough to think about sipping some
    Gatorade/sports drink, and will belly up to the pharmacy counter and demand
    their other blood pressure meds again!

    Let's review those old findings, prior to FEARS RAISED about diuretics
    (gotta sip a sports drink occasionally), from that same June NIH article:

    ===start quote===
    The ALLHAT blood pressure study was a randomized, double-blind trial
    involving 42,418 participants with high blood pressure, ages 55 and older.
    Of those, 31,512 participants were randomly assigned to a diuretic
    (chlorthalidone); a calcium channel blocker (amlodipine); an angiotensin
    converting enzyme (ACE) inhibitor (lisinopril). 13,101 had diabetes, 1,399
    had elevated fasting glucose and 17,012 had normal glucose levels.

    Compared with the ACE inhibitor and the calcium channel blocker, the
    diuretic was:

    a.. More protective against congestive heart failure in patients both with
    and without diabetes (by about 1/6 compared with the ACE-inhibitor, and by
    about 1/3 compared with the calcium channel blocker).


    b.. More effective in lowering systolic blood pressure - the measure of
    blood pressure when the heart beats - among those with and without diabetes.


    c.. At least equally protective against fatal coronary heart disease or
    non-fatal heart attacks in people with diabetes, those with elevated fasting
    glucose, and non-diabetics.


    d.. Equally protective against death from all causes, end-stage kidney
    disease, or cancer in people with diabetes, those with elevated fasting
    glucose, and non-diabetics.


    e.. In Black study participants, more protective against stroke in people
    with and without diabetes (compared with the ACE-inhibitor).


    "This study shows the advantage of diuretics for preventing congestive heart
    failure in most people with high blood pressure - regardless of diabetes
    status. Because some patients may respond differently to medications, they
    should discuss these results and their treatment with their doctors before
    making any changes", advises Dr. Jeffrey Cutler, NHLBI Senior Adviser.

    There were more heart attacks among participants with impaired fasting
    glucose taking the calcium channel blocker compared with those taking the
    diuretic. This finding was unexpected and inconsistent with other results
    and may have occurred just by chance, according to Cutler.

    ===end quote===

    Now, let's review. Where have we seen such marketing counter-spin before
    recently?

    - Vioxx and Celebrex claiming to be better than aspirin because they don't
    upset the stomach, but all the while they cause clotting for 85 hours after
    each pill is ingested, dramatically raising the potential for heart
    attack/stroke.

    - Statins being ineffective in preventing or fighting cancer, as if that
    were a disappointing loss of opportunity, but all the while, we know that
    statins case a depletion and deficiency of CoQ10, and CoQ10 has been shown
    to actually halt growth of cancer cells.
    (http://www.sun-sentinel.com/feature...5,0,920120.story?coll=sfla-features-headlines
    vs http://www.med.miami.edu/news/view.asp?id=403 ) Hmmm, if statin's don't
    treat cancer, and statin's destroy the body's ability to fight cancer, what
    might that mean about statins & development of cancer?????

    OK folks, here is the challenge: How many health headlines can you find
    that are obvious counter-spin hype by pharmco marketing departments?


    "Roman Bystrianyk" <[email protected]> wrote in message
    news:[email protected]
    > "Fears raised over diuretic drugs", BBC News, January 12, 2006,
    > Link: http://news.bbc.co.uk/1/hi/health/4603190.stm
    >
    > Doctors are being urged to monitor people to whom they prescribe
    > diuretics after a study linked the drugs to low sodium and potassium
    > levels.
    >
    > A review of 32,000 adults found 20% of those on the drugs for high
    > blood pressure and heart conditions had low levels of these key
    > minerals.
    >
    > But only a third had had these levels tested, a Nottingham-based team
    > told the British Journal of Pharmacology.
    >
    > Low mineral levels can cause low blood pressure and upset heart
    > rhythms.
    >
    > The Queen's Medical Centre and Nottingham University team reviewed the
    > records of 32,000 adults from six GPs practices.
    >
    > They found around 12% of these had been given at least one prescription
    > for thiazide diuretics between 1990 and 2002.
    >
    > But only 32% of these had had their levels of the key minerals sodium
    > and potassium - known as electrolytes - checked.
    >
    > Professor Ian Hall, who co-authored the report, said the research
    > showed that patients taking higher doses of thiazide diuretics were at
    > particular risk of low sodium levels.
    >
    > "This points to the need for prescribing low doses of thiazide
    > diuretics and monitoring sodium and potassium levels to reduce the risk
    > and increase the detection and treatment of these electrolyte
    > abnormalities," the expert in molecular medicine said.
    >
    > In most people, low electrolyte levels might not matter a great deal,
    > he told the BBC News website.
    >
    > 'Life threatening'
    >
    > However, low sodium levels can lead to low blood pressure, dizziness
    > and an increased risk of falls for older people, while low potassium
    > levels can cause heart rhythm abnormalities.
    >
    > "There are a very small number of people in whom very low levels can be
    > potentially dangerous. They may end up coming into hospitals with acute
    > medical conditions," Professor Hall added.
    >
    > It was these people that he hoped monitoring might assist.
    >
    > The team's study showed 9% of those with low levels had severe
    > electrolyte disturbances and that they had taken the medication for
    > between three and 90 months before they underwent tests.
    >
    > "The general advice is if you are on these drugs, it is probably
    > sensible to have a blood test," Professor Hall added.
    >
    > Professor Gareth Beevers, trustee of the Blood Pressure Association,
    > agreed that testing was advisable - perhaps once a year.
    >
    > He said very low sodium levels could occasionally be life threatening
    > and that low potassium levels should be checked.
    >
    > The effects of the drugs could be minimised if the lowest possible dose
    > of thiazide diuretics is be given, he said.
    >
    > However, he added: "The fact remains that thiazide diuretics have been
    > immensely successful at preventing strokes, particularly in the elderly
    > and therefore they should not be stopped unless under medical
    > supervision."
    >
    > This was a point reiterated by the research team.
    >
    > Ellen Mason, medical spokeswoman for the British Heart Foundation, said
    > thiazide diuretics were effective treatments for those with heart
    > failure and high blood pressure.
    >
    > But she acknowledged reductions in potassium and sodium levels could be
    > an important side effect.
    >
    > "However," she added, "this study has inherent weaknesses, which its
    > authors admit to, that may affect the validity of its conclusions, such
    > as not considering other medications patients were on or whether they
    > had other illnesses."
    >
     
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