A hypertension medicine that’s perfect for (forgetful) seniors

[Terpe]

A new drug by a Japanese company offers 24-hour blood pressure control, so patients don’t have to remember what to drink at what time of day


Know your blood pressure like you know your body weight. In fact, if you want to live your optimal best during your senior years, know your numbers by heart—your weight, your blood pressure, your cholesterol and your sugar.

The recent media briefing by research-based global pharmaceutical company Takeda on “Bridging the Gap in the Management of Hypertension” revealed that rising numbers of Filipinos were suffering from hypertension.

The study, conducted by the National Nutrition and Health Survey II, states that 20.6 percent of Filipinos suffered from hypertension in 2008 compared to 16.4 in 2003. That’s an increase of 4 percent in just five years.

Even more alarming is the low awareness among Filipinos of the disease. Only 16 percent of the patients know the consequences of having high blood pressure.

“If I ask you what your body weight is, you can tell me. If it changes by 2 kg, you get worried. The same should go for your blood pressure. If it goes up, you should take the tablet. Medication is not something you can postpone,” said Dr. Hermann Haller, professor of medicine at the University of Hannover and director of the Department of Nephrology and Hypertension at Hannover Medical School, Germany.

No. 1 killer

Hermann’s call for urgent treatment is for a very good reason. Hypertension is the no. 1 killer worldwide, he said. While hypertension does not kill you immediately, it is the condition that leads to myocardial infarction (heart attack) and stroke.

Uncontrolled hypertension, when target blood pressure is not achieved despite medication, increased dosage or a combination of medicines, increases the risk of heart problems and stroke. As a general rule, blood pressure should be below 140/90.

“At any age, it is necessary to have a low blood pressure to decrease your risk for certain diseases. Control is an issue. You lose control over your organs when you are not able to control your blood pressure,” he said.

And just because 140/90 is the acceptable blood pressure doesn’t mean you’re still good if your reading is, say, 145/95. If blood pressure goes up by a mere 10 or 20 millimeters of mercury (mmHg), your risk doubles.

Some high-risk patients, such as those with who’ve had a stroke, heart attack or diabetes, should also maintain a lower blood pressure than the norm. “Doubling of risks is not acceptable even if it’s still within normal levels,” said Inquirer health columnist and heart specialist Dr. Rafael Castillo.

“People have to understand why they are being treated. Preventing major events like stroke or heart attack are hugely important in terms of quality of life,” said Dr. Alan Gradman, professor of medicine at Temple University School of Medicine in Pennsylvania.

Your highest blood pressure is always in the morning, between 8 and 10 a.m., said Dr. Dante Morales, president of the Philippine Society of Hypertension. That’s the reason high blood pressure medications are taken at the start of the day, and the reason heart attacks and sudden death almost always occur in the morning.

During the day, blood pressure is reduced and stabilizes, but at nighttime it should, ideally, dip a little bit. He said nondippers, those whose blood pressure is not reduced, and risers, those whose blood pressure go up at night, should be wary.

“There is a correlation between nondippers and cardiovascular event,” Morales said.

For the 96 percent of hypertensive patients, the cause of the disease is unknown. Patients are broadly grouped into the genetically predisposed and those influenced by environmental (lifestyle) factors.

Contributing factors

Morales said the top contributing factors that lead to hypertension include weight gain (an increase of about 5 mmHg in blood pressure is observed per 10 lbs of weight gained), high calorie intake, high salt consumption (the World Health Organization set a limit of 1 tbsp of salt a day or about 6 g of all salt and sodium consumed, including those used in cooking and at the table), lack of exercise, and too much alcohol consumption.

Lifestyle changes, along with proper medication, will help reduce and control blood pressure. Morales also added that patient compliance with medication drops by almost 60 percent when they take medications at three or more different times of the day. Many patients take a combination of two or three pills on top of other medications. It is therefore important, added Hermann, to have one pill that can control blood pressure at different times of the day.

Fixed dosage

Japan-based pharmaceutical company Takeda introduced to the country Azilsartan medoxomil, a once-a-day treatment for mild to moderate essential hypertension in adults. Azilsartan, a class Angiotensin II Receptor Blockers (ARB) drug, gives 24-hour blood pressure control.

Hermann said studies measured Azilsartan against other similar ARB drugs available in the local market today. The study showed that a dosage of 80 mg Azilsartan lowered blood pressure by 14.3 mmHg, compared to 11.7 mmHg with Olmesartan 40mg and 10 mmHg with Valsartan 320 mg.

Also from Takeda is a once-a-day combination drug for the elderly with hypertension. Blood pressure goes up as people age. By creating a fixed dosage of an ARB and calcium channel blocker in the form of Candesartan-Amlodipine, the two-in-one pill makes it easier for the elderly to not miss medication.

“If you treat a thousand patients with hypertension who are elderly, you will prevent more strokes and heart attacks than you will if you treat a thousand younger patients. In Asia, stroke is the predominant complication of hypertension. In the US, it is both myocardial infarction and stroke. The instance goes up dramatically with age,” Gradman said.

The pressing issue for the elderly is preventing strokes. Oftentimes senior citizens are the most neglected, said Gradman. People figure, for instance, that if you live to be 80 you must be doing something right. Why fix something when it isn’t broken? But that’s not true in this case.

Heart failure is the most common reason for admission to the hospital for people over the age of 65, Gradman said. The elderly treated with Candesartan-Amlodipine reduced fatal strokes by 45 percent, all strokes by 28 percent, total mortality by 28 percent and heart failure by 72 percent

Source:-
http://lifestyle.inquirer.net/99039/a-hypertension-medicine-thats-perfect-for-forgetful-seniors

[Doc Alan]

The topic of hypertension ( high blood pressure ) was updated last September (
http://filipinaroses.com/showthread.php/41040-High-blood-pressure-and-rising-!
).

• It is indeed increasing in frequency in the Philippines and other “ developing “ countries ( about ¾ of hypertensives live in such countries ). It would be more meaningful to say about 1/5 filipinos ( probably an under-estimate ) rather than the “ 20.6% “ quoted !

• Rates of awareness, treatment and control are low. The problems with hypertension – wherever it occurs – are that it usually doesn’t have symptoms but is a major risk factor for heart disease, stroke, kidney disease, and eye problems. About a billion people are thought to be affected worldwide.

• Cause is usually unknown - but there are risk factors ( those which can’t be changed, such as age, genetic/family/ethnic factors ; and those which can, such as unhealthy diet/obesity, excess alcohol, excess salt and low potassium intake, lack of exercise, urban living/stress, and smoking ).


• There are a range of established, relatively inexpensive and effective drugs for treating hypertension where needed. Usually blood pressure should be below 140/90. Generic drugs ( not protected by patents ) are the cheapest and best - IF they are of proven quality. Counterfeit/fake drugs bought “ over-the-counter “ or online in the Philippines and elsewhere do include antihypertensives.

• There is no such thing as a perfect medicine ! They all have “ side effects “ affecting a proportion of people taking them.

• One class of antihypertensive drugs is “ angiotensin-II receptor antagonists “ / blockers. Angiotensin-II causes blood vessels to narrow and kidneys to retain water/salt. The drug made by Takeda ( azilsartan medoxomil ) - known as “ Edarbi “ - was launched in the UK a year ago. It does only need to be taken once a day - but it’s expensive; already has known side-effects ( dizziness, tiredness, potassium too low ); and should be used with caution in certain kidney, liver and heart diseases.

• Wherever you live, the only way of knowing your blood pressure is to have it measured ! Hypertension is not called the “ silent killer “ for nothing. The decision to treat, and how, depends on the level ( around 130/80 is usually “ normal “ ). Drugs may not be needed at all, if “ lifestyle “ risk factors for hypertension can be reduced.

[joebloggs]

A hypertension medicine that’s perfect for (forgetful) seniors

:yikes: what do you mean senior, your making me feel so :olddude::cwm24:

[Doc Alan]

A hypertension medicine that’s perfect for (forgetful) seniors

:yikes: what do you mean senior, your making me feel so :olddude::cwm24:

It's neither perfect, nor a first choice of antihypertensive drug for ANY age ! The drug is relatively new, so we don't yet know all possible side effects. Most of the conditions where it should be used with caution are commoner with increasing age - like hypertension itself.

[grahamw48]

Mine is 120/90...and I'm quite old. :olddude:

30 years ago it was 130/80, but I suppose it can vary, depending upon what time of day it was tested ?

[Doc Alan]

Blood pressure does vary, with a “ skewed normal distribution “ across any population – risks progressively increase as it rises. It also varies in individuals with time of day ( lowest sleeping, highest morning ) ; left and right arms ; exercise ; stressful situations ( UKBA, Thatcher ) ; and who is measuring it ( “ white coat hypertension “ - whether measured by doctor or nurse - in clinic ).


If pressure appears raised initially, two repeated measurements are suggested to confirm ; followed by regular checking ( at home and/or probably every 3-5 years at the clinic ) .


Ideally a healthy lifestyle should keep blood pressure at a level without significant risk. Drug treatment may not be offered if hypertension is mild ( between 140/90 and 160/100 ) – but this depends on other factors ( such as diabetes, previous heart attack, kidney disease ).


Drug companies ( such as Takeda ) make their profits from branded drugs with patents. Other drug companies have been accused of “ evergreening “ ( slightly altering existing drugs ) to apply for new patents and maintain profits.


For our cash-strapped NHS, and especially in the Philippines, even if hypertension IS diagnosed and needs treatment - safe, reliable, proven GENERIC drugs should be the first choice. They may be the ONLY choice if the patient has to pay directly !

[grahamw48]

:xxgrinning--00xx3:

[Terpe]

As I understand it from my GP, blood pressurre can be too high and may also be a little low.
Mine was a tad too high and is now under control of medication I take every day
My wife's is considered a bit low, but she has no medication, just an annual 'MOT'
Not sure if anything can be read into that. :Erm:

[Doc Alan]

We all have blood pressure – systolic ( when your heart beats and pumps blood into arteries ) and diastolic ( heart “ resting “ between beats ). This gives us a normal reading of, say 130/80 mmHg ( millimetres of mercury ).

By far the commonest type of hypertension is “ essential “ ( cause not understood, but risk factors known ). The definition is arbitrary because of how blood pressure is distributed in any community – you don’t suddenly become hypertensive above a certain level.

Similarly - within limits - the lower your blood pressure, the healthier you are ; and with no symptoms it doesn’t need treating. If it is consistently below around 90/60, this is hypotension; may cause dizziness or falls; and could be due to drugs, injury or illness.

It’s perhaps surprising that we usually don’t know the cause of such an important and common condition as hypertension. This is not for lack of research effort over many years. That research has allowed better understanding, however, and a range of antihypertensive drugs.

Each type affects a different component of blood pressure control ( diuretics ; calcium-channel blockers ; beta blockers ; those affecting the “ renin-angiotensin system “ ; and others ). Unfortunately cost is a problem – especially if reliable “ generic “ drugs are unavailable.

Hypertension is not a disease – it’s a risk factor FOR diseases, which progressively increases. Between a fifth and a half of the world’s population have pressure raised sufficiently to increase the risk – such that it’s a leading cause of illness and death. This is because it’s not diagnosed, and/or inadequately treated – in a majority of cases.

We know the avoidable lifestyle factors, and antihypertensive drugs are effective. But there’s a huge gap between what we know and ( can ) do in prevention and management - especially in countries like the Philippines.

[les_taxi]

Sure mines gone up with the Maggie debate:yikes:

[joebloggs]

Sure mines gone up with the Maggie debate:yikes:

thats what women do to us :bigcry:

[mickcant]

thats what women do to us :bigcry:

Hasn't it been found married men live longer than single ones? :Cuckoo:
Mick.

[joebloggs]

Hasn't it been found married men live longer than single ones? :Cuckoo:
Mick.


i find that hard to believe :blahblah::76:.. :NoNo::cwm3::cwm24:

Married men live longer than a single men, but married men are lot more willing to die!

[Terpe]

Beetroot 'can lower blood pressure'

Drinking 250ml (8oz) cut high blood pressure readings by 10mm of mercury (mmHg) in a study of 15 patients, bringing some into the normal range, the journal Hypertension reports.

Most marked after three to six hours, the effect was detectable a day later.

Scientists say the nitrate in beetroot widens blood vessels to aid flow. And many people with angina use a nitrate drug to ease their symptoms.

The researchers, from Barts and The London School of Medicine and Dentistry, who have been studying beetroot's blood pressure lowering effects for years, say more work is still needed.

And they warn there could be one unexpected consequence of drinking beetroot juice - it can turn your urine pink.

Nitrate is found naturally in soil, where it is taken in by vegetables through the roots to help them grow.

Researcher Dr Amrita Ahluwalia said: "We were surprised by how little nitrate was needed to see such a large effect.

"Our hope is that increasing one's intake of vegetables with a high dietary nitrate content, such as green leafy vegetables or beetroot, might be a lifestyle approach that one could easily employ to improve cardiovascular health."

Prof Peter Weissberg, medical director at the British Heart Foundation, which funded the research, said: "It supports current advice that we should all be eating plenty of green veg.

"But we need larger studies in patients to determine if nitrate-rich vegetables are effective at lowering blood pressure over the long term."

Source:-
http://www.bbc.co.uk/news/health-22152901

[Terpe]

I like Beetroot :xxgrinning--00xx3:
Never tried Beetroot juice though, maybe I'll give it go and see if it's nice. Seems there's a lot of good aspects to Beetroot.:xxgrinning--00xx3:

[grahamw48]

Seems good, especially if it helps restore circulation to other regions.

I suppose being a 'root' crop. Hmm. :Erm:

[les_taxi]

See no-one reads my posts:cwm23:
I posted over a year ago the benifits of beetroot juice something I must get back in stock-Holland and Barrett sell it,tastes good as it has a bit of grape juice in it,but be warned it does turn poo pink :icon_lol:

[grahamw48]

Too much information ! :cwm24:

[les_taxi]

Better to know before you drink it so you don't rush down to casualty:icon_lol:

[Doc Alan]

This is what I said last September :-

• Beetroot – the “ Mail Online “ didn’t have space to mention that the studies quoted were on 18 volunteers ( beetroot ) and 14 volunteers ( bread with added beetroot ) – all males with normal blood pressure to start with. The “ Mail “ also didn’t say that the research workers themselves remind us of the benefits to health of eating adequate amounts of fruit and vegetables, one of which is preventing hypertension developing in the first place.



The recent study reported in “ Hypertension “ journal involved only 15 paid volunteers with systolic blood pressure between 140-159 mmHg ; no " other medical complications " ; and not taking blood pressure medication. They drank 250 ml ( about 8 oz ) of beetroot juice or water containing a “ low amount “ of nitrate and their blood pressure was monitored for 24 hours - both systolic and diastolic fell by about 10 mmHg.

My blood pressure ? 120/70 without beetroot ( don't like the taste ) or medication !


Eating more fruit, and vegetables rich in nitrate and other nutrients, is just ONE of several lifestyle choices which could help prevent hypertension and its consequences – even if “ five portions of fruit and veg a day “ advice in the UK has proved unrealistic for many people !