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Medical Forum / General / Cardiology / June 2006

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migraine, blood pressure, maybe cholesterol fixed but theres a small problem

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Napoleon - 22 Jun 2006 20:24 GMT
I am a caucasion male 50 years old.

I had a dr.'s checkup and lab tests one month ago that showed the
following problems:

blood pressure 150/90 - high
ldl cholesterol 240 (hdl was 40) - very high
weight 195 at 5'11" - doughy

and also i have been taking medications for a quite a while for
migraine (maxalt and lately relpax)

So the dr. suggested that we treat the blood pressure and cholesterol
aggressively because the cholesterol was at a frightening level and
these treatements have been known to put the migraines into remission
so now, for the last month, I am taking

Hydrochlorothiazide 25 - 1 per day
Vytorin 10/20 - 1 per day

after one month

blood pressure 90/60 - normal!
ldl cholesterol - not measured yet
weight 188 - slightly better
no migraines! (normally I would have had at least six with two of them
very bad)

I feel very, very good now - almost high all the time - occationally i
feel a tiny pain almost wanting to start on the side of my head only to
dissapear in a few seconds. Also I have very entertaining dreams now
which are more interesting than anything on cable TV. Miracles of
science! But all is not 100% good.

My one dissatisfaction: After a couple days on these pills I became
100% impotent! That is one sad sack penis I have right now ----
pfffffft => nothing ever and it doesn't seem to be getting any better.

I would like to know how to get my erections back but not my blood
pressure or migraines. Are these drugs going to cause a perpetually
limp member? Any ideas? If I can just occasionally get a decent
erection and maintain my other benefits ...what a utopia!
William Wagner - 22 Jun 2006 20:49 GMT
> I am a caucasion male 50 years old.
>
[quoted text clipped - 38 lines]
> limp member? Any ideas? If I can just occasionally get a decent
> erection and maintain my other benefits ...what a utopia!

I'd  suggest  playing with this.   Put in you numbers and lower and
higher numbers.

Risk....?

http://www.mayoclinic.com/health/heart-disease-risk/HB00047

Please note that a hard penis seems to relate to heart health.  
Arteries are arteries  still a heads up  for your total health AKA
life..

I don't give a darn about cholesterol  yet I try to get HDL up.  
Exercise and Niacin for my adventure seem intelligent for me.


As for BP talk to your doc about diuretic  options.

Bill

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This article is posted under fair use rules in accordance with
Title 17 U.S.C. Section 107, and is strictly for the educational
and informative purposes. This material is distributed without profit.

Thorsten Schier - 22 Jun 2006 23:43 GMT
William Wagner schrieb:
[...]
>  I'd  suggest  playing with this.   Put in you numbers and lower and
> higher numbers.
>
> Risk....?
>
>  http://www.mayoclinic.com/health/heart-disease-risk/HB00047

This gives some odd results. I always thought that being male was a risk
factor for heart disease. However, with this risk calculator you get a
considerably higher risk for females then for males if both have the
same other values. Could it be that they made an error and switched male
and female? Or are females only protected against heart disease because
they usually have better risk factors?

Thorsten
Jim Chinnis - 23 Jun 2006 00:04 GMT
Thorsten Schier <Finrod_Felagund@gmx.de> wrote in part:

>William Wagner schrieb:
>[...]
[quoted text clipped - 13 lines]
>
>Thorsten

What age did you enter?
--
Jim Chinnis   Warrenton, Virginia, USA
Thorsten Schier - 23 Jun 2006 00:11 GMT
Jim Chinnis schrieb:
> Thorsten Schier <Finrod_Felagund@gmx.de> wrote in part:
>
[quoted text clipped - 18 lines]
>
> What age did you enter?

Different ages. I always get higher risk values for females than for males.

Thorsten
William Wagner - 23 Jun 2006 00:30 GMT
> Jim Chinnis schrieb:
> > Thorsten Schier <Finrod_Felagund@gmx.de> wrote in part:
[quoted text clipped - 23 lines]
>
> Thorsten

Yea but we only have one age.  But those blood numbers  can vary and my
point was  risk is not impacted by  those numbers  in a linear way based
on this here info.  Interesting  and I wonder if we will ever see
handsome  people speak of this on mass media.

Down with the bad and up with the good.  So simplistic.
There may be copyright with this nonsense.

Bill

Signature

S Jersey USA Zone 5 Shade
This article is posted under fair use rules in accordance with
Title 17 U.S.C. Section 107, and is strictly for the educational
and informative purposes. This material is distributed without profit.

Cindy Wells - 23 Jun 2006 03:34 GMT
Thorsten Schier <Finrod_Felagund@gmx.de> wrote in news:e7f6dp$irv$01$1
@news.t-online.com:

<snip>

> This gives some odd results. I always thought that being male was a risk
> factor for heart disease. However, with this risk calculator you get a
> considerably higher risk for females then for males if both have the
> same other values. Could it be that they made an error and switched male
> and female? Or are females only protected against heart disease because
> they usually have better risk factors?

Pre-menopause most women have lower heart disease risk but after
menopause that benefit disappears rapidly. Also, women tend to
be more pro-active on getting regular checkups and keeping their
weight down. (However, those women who got into yo-yo dieting
will have worse numbers IIRC.)

Cindy Wells
(whose maternal line now has heart disease and stroke on both sides
to go with the migraines (on grandma's side) and TIAs (on grandpa's
side); my paternal line disease risks are harder to a.ses - biological
grandfather died in the military and grandma didn't go to the doctor
for diagnoses in her later years.)

> Thorsten
napoleon_mmvi@yahoo.com - 23 Jun 2006 18:25 GMT
>  I'd  suggest  playing with this.   Put in you numbers and lower and
> higher numbers.
[quoted text clipped - 13 lines]
>
>  Bill

It seems from that calculator that my cholesterol is far more of a
problem than the blood pressure.

It seem the consensus here is that it's the BP medicine that is causing
my problems.
Ignatz's Bricks - 24 Jun 2006 14:44 GMT
>>I don't give a darn about cholesterol  yet I try to get HDL up.
>>Exercise and Niacin for my adventure seem intelligent for me.

If you use Niacin, be sure that your doctor follows up with testing.
Also, use traditional Niacin, which may be hard to find, instead of the
"no flush" and "timed release" versions which don't work as well and
cause stomach problems on many people.

Ignore pen name, I'm 66 year old Caucasian male.

For me:

Control (no prescription medication):
Tri: 155   Total C: 274   HDL: 42  LDL: 201   VLDL: 31

2G total of Niacin daily (no other changes):
Tri: 100   Total C: 220   HDL: 62  LDL: 138   VLDL: 20

>> As for BP talk to your doc about diuretic  options.

> It seem the consensus here is that it's the BP medicine that is causing
> my problems.

I would talk to your doctor about what his intended blood pressure range
is for you.  You may be one of those people who's blood pressure jumps
when they are in the doctor's office and you are being over medicated.
I'd suggest that you get a home blood pressure testing kit and test
yourself at home, and bring that testing kit in with you to the doctor
next time and compare readings in the doctor's office.

Most "water pill" type of blood pressure medicines can cause impotence,
but your body should adjust within a month or two to the new pressure
levels and the impotence may go away.

Ignatz's Bricks
Peabody - 22 Jun 2006 22:11 GMT
Napoleon says...

> My one dissatisfaction: After a couple days on these
> pills I became 100% impotent! That is one sad sack penis
> I have right now ---- pfffffft => nothing ever and it
> doesn't seem to be getting any better.

> I would like to know how to get my erections back but
> not my blood pressure or migraines. Are these drugs
> going to cause a perpetually limp member? Any ideas? If
> I can just occasionally get a decent erection and
> maintain my other benefits ...what a utopia!

I don't know about the Vytorin, but thiazide diuretics are
notorious for causing impotence, as are beta blockers.  I
suggest you tell your doctor about the impotence, and ask
him to switch your blood pressure med to one of the classes
that is less likely to cause a problem - an ace inhibitor,
angiotensin receptor blocker, or calcium channel blocker.

I don't know what effect such a change would imply for your
migranes.

Also, your blood pressure doesn't have to be 90/60.  That's
actually a good bit below normal.

For both of your meds, there are lots of alternatives.  You
just may need to try a number of them to get the results you
want without unacceptable side effects.  But that will
require you to keep the pressure on your doctor.  In my
experience, your doctor won't mind that you're impotent
unless you make an issue of it.  So you will have to put
your foot down on this one.
Muerta - 23 Jun 2006 16:50 GMT
> I don't know about the Vytorin, but thiazide diuretics are
> notorious for causing impotence, as are beta blockers.  I
> suggest you tell your doctor about the impotence, and ask
> him to switch your blood pressure med to one of the classes
> that is less likely to cause a problem - an ace inhibitor,
> angiotensin receptor blocker, or calcium channel blocker.

As I read through the thread, I see Peabody beat me to this. I discussed
this in the long past with my Dr., and as he assisted greatly in my approach
to cure ED, I had said to him..."NO Thiazides or Beta Blockers". He was most
agreeable and sympathetic and we fought my hypertension as a team until back
in the 120/80 normal range.

Used an AT2 blocker and a Calcium Channel blocker.
Napoleon - 24 Jun 2006 00:52 GMT
> As I read through the thread, I see Peabody beat me to this. I discussed
> this in the long past with my Dr., and as he assisted greatly in my approach
[quoted text clipped - 3 lines]
>
> Used an AT2 blocker and a Calcium Channel blocker.

There are several responses now all pointing the finger of accusation
at the hydrochlorothiazide (not the vytorin) which makes me happy
because it seems there are several options for lowering blood pressure.
napoleon_mmvi@yahoo.com - 23 Jun 2006 18:31 GMT
> Napoleon says...
> I don't know about the Vytorin, but thiazide diuretics are
[quoted text clipped - 17 lines]
> unless you make an issue of it.  So you will have to put
> your foot down on this one

Thanks, further confimation that its the BP medication. I think I'm
also going to try the weight loss approach along with asking about less
harsh medication in the mean time. I hope the problem isn't the Vytorin
because I'm pretty worried I won't be able to lower it enough just by
losing weight.
Andrew B. Chung, MD/PhD - 22 Jun 2006 22:18 GMT
> I am a caucasion male 50 years old.
>
[quoted text clipped - 38 lines]
> limp member? Any ideas? If I can just occasionally get a decent
> erection and maintain my other benefits ...what a utopia!

Would suggest two things:

(1) Lose weight.  For many impotence goes away with becoming leaner and
trimmer (and hungrier <-- healthy appetite).  Would suggest you ask
your doctor to supervise your use of the 2PD-OMER Approach:

http://HeartMDPhD.com/wtloss.asp

(2) Inform your doctor about your impotence.  There are medications
that should help until you become healthier, more fit, leaner and
trimmer when you may not need these medications anymore.

Prayerfully in Christ's amazing love,

Andrew
http://HeartMDPhD.com/TheLife
napoleon_mmvi@yahoo.com - 23 Jun 2006 18:37 GMT
> Would suggest two things:
>
[quoted text clipped - 12 lines]
> Andrew
> http://HeartMDPhD.com/TheLife

That gives me hope I can help with some weight loss. You 2 lb of food a
day diet looks interesting and the ultimate in simplicity, but if I'm
going to be very happy on it those 2#  it will have to be something
like Chocolate Fudge Haagan-Daz. (Not seriously of course, but I
calculate the calories would still only come to about 2000 per day
which by past experience I know is easily low enough for me to lose
weight with.)
Andrew B. Chung, MD/PhD - 23 Jun 2006 19:44 GMT
> > Would suggest two things:
> >
[quoted text clipped - 15 lines]
> which by past experience I know is easily low enough for me to lose
> weight with.)

It is unlikely your doctor will like the idea of your being on a Ice
Cream diet dovetailed with the 2PD-OMER Approach.  Instead, less of
everything across the board without changing **what** you are eating
except as your doctor advises you as s/he supervises you.

Prayerfully in Christ's amazing love,

Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://HeartMDPhD.com/TheLife
gPeter - 23 Jun 2006 07:33 GMT
90/60 for BP is a little "better" than normal. But I don't think it has
anything to do with your impotence.
gPeter

"Napoleon" <napoleon_mmvi@yahoo.com> az alábbiakat írta a következo
hírüzenetben: 1151004255.513562.287380@m73g2000cwd.googlegroups.com...
>I am a caucasion male 50 years old.
>
[quoted text clipped - 38 lines]
> limp member? Any ideas? If I can just occasionally get a decent
> erection and maintain my other benefits ...what a utopia!
Napoleon - 24 Jun 2006 00:56 GMT
> 90/60 for BP is a little "better" than normal. But I don't think it has
> anything to do with your impotence.
> gPeter

I wouldn't think so either because I've always believed that impotence
increased with increasing blood pressure not the other way around.
Comax - 23 Jun 2006 09:58 GMT
> I am a caucasion male 50 years old.
>
[quoted text clipped - 38 lines]
> limp member? Any ideas? If I can just occasionally get a decent
> erection and maintain my other benefits ...what a utopia!

Hi Napoleon

Unfortunately for you impotence is quite common. I suggest that you
read the book "The Cure of High Blood Pressure by Respiratory
Exercises" written mid-last century, and now available as an e-book on
www.cureofhighbloodpressure.com, and practice some of the techniques
suggested (with your Doctors knowledge of course!).
Hope this helps,
Good Health!

Comax
judy.n - 23 Jun 2006 20:05 GMT
They actually sell a device called Resperate for around 300$ that
trains you to breath slowly. It's been proven effective. Andrew Weil
(the alternative medicine MD from Tucson is always mentioning it.) I
sent away for literature on it for my husband, and it's a reasonable
device, although somewhat overpriced--but if you compare the price of
meds and the price of experiencing side effects, I suppose it's worth
it. Sometimes it really helps to have an actual device to force you to
practice slow breathing.
http://www.resperate.com/?Ls=J&lk=1

One final comment: the "ideal" blood pressure is currently defined as
120/80. 90/60 is actually quite low, especially for an adult.

Judy
> > I am a caucasion male 50 years old.
> >
[quoted text clipped - 50 lines]
>
> Comax
Juhana Harju - 24 Jun 2006 07:16 GMT
: One final comment: the "ideal" blood pressure is currently defined as
: 120/80. 90/60 is actually quite low, especially for an adult.

Any reference for that?

Signature

Juhana

judy.n - 24 Jun 2006 14:48 GMT
Tne National Heart Lung and Blood Institute publishes guidelines for
treatment of blood pressure: they call them JNC (Joint National
Committee): the most recent is JNC 7. Here's the web site with a free
download of the documents:
http://www.nhlbi.nih.gov/guidelines/hypertension/

In the "old" days, we accepted 140/90 as borderline HTN, now there's a
new ideal of 120/80, yet studies show that to achieve that level, in
Western societies, as we age, most people will require medication.
JNC is a "moving target" as they're always updating their data and
recommendations, but they base in on the levels of blood pressure and
bad outcomes--stroke, heart attacks.
For years we wanted diabetics at 120/80, now it's the ideal for
everyone.
Judy

> : One final comment: the "ideal" blood pressure is currently defined as
> : 120/80. 90/60 is actually quite low, especially for an adult.
>
> Any reference for that?
Juhana Harju - 24 Jun 2006 15:22 GMT
::: One final comment: the "ideal" blood pressure is currently defined
::: as 120/80. 90/60 is actually quite low, especially for an adult.
::
:: Any reference for that?

: Tne National Heart Lung and Blood Institute publishes guidelines for
: treatment of blood pressure: they call them JNC (Joint National
[quoted text clipped - 10 lines]
: For years we wanted diabetics at 120/80, now it's the ideal for
: everyone.

I did not find any reference for your claim that 120/80 would be better than
90/60. The references state that "beginning at 115/75 mm Hg, CVD risk
doubles for each increment of 20/10 mm Hg."

Signature

Juhana

kol_Isha - 24 Jun 2006 15:37 GMT
> : In the "old" days, we accepted 140/90 as borderline HTN, now there's a
> : new ideal of 120/80, yet studies show that to achieve that level, in
[quoted text clipped - 9 lines]
> 90/60. The references state that "beginning at 115/75 mm Hg, CVD risk
> doubles for each increment of 20/10 mm Hg."

I don't think she is saying that 120/80 wouild be better than 90/60.  She is
saying that 120/80 (the "new" standard) is better than 140/90 (the "old"
standard).  Low blood pressure, as far as I know, is not bad (unless it
drops way too low, I guess, and it's not the norm for that individual).
Mine normally runs around 90/60, and my doctor totally pooh-poohs this being
a problem at all, despite the fact that for years, my mother has been
yelling at me to "talk to the doctor about your blood pressure, it's too
low."  (My doctor quietly tells me not to pay any attention to my mother.)
I am also quite certain that low blood pressure does not contribute in any
way to my migraines... although a few times, when I've sought treatment in
the emergency room because my migraine was out of control, it was noted that
my blood pressure at those times is sometimes as low as 80/50.  (I noted on
one emergency room admission sheet that they diagnosed me with "migraine"
and "syncope."  I did NOT faint, but I suppose I probably looked like I
might.  Of course, that could have as easily been the migraine or all the
medications I had taken.)

Regards,

Arlene
Juhana Harju - 24 Jun 2006 15:49 GMT
:: I did not find any reference for your claim that 120/80 would be
:: better than
[quoted text clipped - 4 lines]
: She is saying that 120/80 (the "new" standard) is better than 140/90
: (the "old" standard).

She said that the "ideal" blood pressure is currently defined as 120/80 and
that "90/60 is actually quite low, especially for an adult."

: Low blood pressure, as far as I know, is not
: bad (unless it drops way too low, I guess, and it's not the norm for
: that individual).

I know that low blood pressure is not bad unless it causes dizziness or
fainting. That is the reason I was asking her to post some references to
back her claim.

: Mine normally runs around 90/60, and my doctor
: totally pooh-poohs this being a problem at all, despite the fact that
[quoted text clipped - 13 lines]
:
: Arlene

Signature

Juhana

judy.n - 24 Jun 2006 17:45 GMT
The reference deals with high blood pressure. Low blood pressure is an
issue: it has been implicated in syndromes like chronic fatigue, and if
a patient can not maintain their blood pressure with changes in
position--orthostatic hypotension--they are at risk for dizziness or at
worse, fainting. Tilt table testing is used to formally diagnose
orthostatic hypotension.
 I was at a recent lecture on blood pressure, and the cardiologist
stated that with older people who have "stiffer" blood vessels, rapid
lowering of blood pressure may cause them to not be able to maintain
adequate circulation.
 So, you want me to justify what qualifies as hypotension. Blood
pressure norms vary by age: there are tables for children. After 18 the
normal blood pressures are defined by the article I cited. Symptomatic
hypotension is a completely different subject than guidelines for
treating high blood pressure.
 Again, I've read recent articles that are implicating orthostatic
hypotension in chronic fatigue, and clearly some patients tolerate
lower blood pressures, but older patients frequently do not--they stand
up and faint. If it's not that severe, they might just feel fatigued
and ligthheaded.
 I just peeked at pubmed, and although many articles implicate low
blood pressure in chronic fatigue, a recent article showed that many
people drop their pressure on the tilt table without symtpoms. So, it's
controversial.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra
ct&list_uids=16378795&query_hl=2&itool=pubmed_docsum

The bottom line, for me, is that if you are lowering someone's blood
pressure by medications, you need to be careful, as they have become
used to a higher pressure, and many do have symptoms with too rapid
lowering and too low of a blood pressure.
Here's an article on blood pressure lowering and orthostatic
hypotension
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=1
6685202&itool=pubmed_abstractplus&dopt=abstract&dr=abstract

 Is that enough evidence?
Judy

> :: I did not find any reference for your claim that 120/80 would be
> :: better than
[quoted text clipped - 33 lines]
> :
> : Arlene
judy.n - 25 Jun 2006 15:56 GMT
"I know that low blood pressure is not bad unless it causes dizziness
or
fainting. That is the reason I was asking her to post some references
to
back her claim."
 How do you know this to be true?
 Low blood pressure can be a serioous problem in certain situations.
Judy

> :: I did not find any reference for your claim that 120/80 would be
> :: better than
[quoted text clipped - 33 lines]
> :
> : Arlene
Juhana Harju - 25 Jun 2006 16:21 GMT
:::: I did not find any reference for your claim that 120/80 would be
:::: better than
[quoted text clipped - 16 lines]
:: or fainting. That is the reason I was asking her to post some
:: references to back her claim.

:  How do you know this to be true?

Dr. John P. Cooke, who is the head of Stanford Medical School's vascular
unit, states it clearly in his book /The Cardiovascular Cure/ (Broadway
Books, 2003, p. 6):

"In my opinion, the lower your blood pressure, the better. Obviously, if
your blood pressure is too low, you will faint. But I tell my patients that
their blood pressure should be just high enough to keep them from falling
over. Even if your blood pressure is as low as 90/60 but you can stand
without trouble, this is healthy and, in the long run, better for your heart
and vessels."

http://tinyurl.com/oo7py

Signature

Juhana

Jim Chinnis - 25 Jun 2006 16:56 GMT
"Juhana Harju" <shantigiriorama@gmail.com> wrote in part:

>:::: I did not find any reference for your claim that 120/80 would be
>:::: better than
[quoted text clipped - 31 lines]
>
>http://tinyurl.com/oo7py

Actually, low blood pressure without fainting is a concern:

http://www.theheart.org/viewArticle.do?primaryKey=715681&nl_id=tho20jun06
--
Jim Chinnis   Warrenton, Virginia, USA
Juhana Harju - 25 Jun 2006 17:16 GMT
: "Juhana Harju" <shantigiriorama@gmail.com> wrote in part:
::::
[quoted text clipped - 37 lines]
:
: http://www.theheart.org/viewArticle.do?primaryKey=715681&nl_id=tho20jun06

Thanks for a a good posting! It seems that Dr. Cooke is not well informed in
this respect.

Signature

Juhana

Jim Chinnis - 25 Jun 2006 18:00 GMT
"Juhana Harju" <shantigiriorama@gmail.com> wrote in part:

>: Actually, low blood pressure without fainting is a concern:
>:
>: http://www.theheart.org/viewArticle.do?primaryKey=715681&nl_id=tho20jun06
>
>Thanks for a a good posting! It seems that Dr. Cooke is not well informed in
>this respect.

He was probably well-informed at the time of writing, which could have
anywhere between about 2000 and 2002...
--
Jim Chinnis   Warrenton, Virginia, USA
kol_Isha - 25 Jun 2006 17:21 GMT
"Jim Chinnis" <jchinnis@SPAMalum.mit.edu>

> Actually, low blood pressure without fainting is a concern:
>
> http://www.theheart.org/viewArticle.do?primaryKey=715681&nl_id=tho20jun06
> --
> Jim Chinnis   Warrenton, Virginia, USA

As a person with normally very low blood pressure, I'm naturally very
interested in this topic.  This article does NOT say that low blood pressure
is a concern... it says only that it is a concern in patients with corony
heart disease (CHD)!  And, they are talking about patients with HBP whose
blood pressure is being lowered with medication, and how to maintain the
balance between dyastolic and systolic without lowering one or the other too
much.

I would imagine, as Judy said previously, that it is a problem in some
situations, but not always.  If you faint or pass out or have chronic
fatigue, that is a problem.  If your blood pressure is normally higher, and
then suddenly drops... that is a problem that needs to be looked into.  If
you are on blood pressure medication and your blood pressure takes a
nosedive from very high to too low, that is a problem and your medication
probably needs to be adjusted.  If you have no symptoms and feel fine and
have always had low blood pressure, that is NOT a problem.

Regards,

Arlene
Juhana Harju - 25 Jun 2006 17:29 GMT
: "Jim Chinnis" <jchinnis@SPAMalum.mit.edu>
::
[quoted text clipped - 19 lines]
: have no symptoms and feel fine and have always had low blood
: pressure, that is NOT a problem.

In the abstract below it is explained that the possible hazards associated
with low diastolic blood pressure are probably caused by isolated systolic
blood pressure:

Am J Cardiol. 2004 Aug 1;94(3):380-4.

A likely explanation for the J-curve of blood pressure cardiovascular risk.

Kannel WB, Wilson PW, Nam BH, D'Agostino RB, Li J.

Boston University School of Medicine/Framingham Heart Study, Framingham,
Massachusetts 01702-5827, USA.

We prospectively tested in the combined original and offspring Framingham
cohorts the hypothesis that the increase in cardiovascular disease (CVD)
incidence at low diastolic blood pressure (BP) is largely confined to
subjects with increased systolic BP and hence an increased pulse pressure.
The 10-year risk of 951 nonfatal CVD events and 204 CVD deaths was estimated
at diastolic pressures of <80, 80 to 90, and > or =90 mm Hg, according to
concomitant systolic BP. An increasing tendency for a J-curve relation of
CVD incidence to diastolic BP was observed with successive increments in
accompanying systolic BP. In both genders, a statistically significant
excess of CVD events was observed at a diastolic BP of <80 mm Hg only when
accompanied by a systolic BP of >140 mm Hg that persisted after adjustment
for age and associated CVD risk factors. Patients with this condition of
isolated systolic hypertension have been shown to benefit from
antihypertensive treatment. PMID: 15276113

http://tinyurl.com/g5gwc

Signature

Juhana

Jim Chinnis - 25 Jun 2006 17:57 GMT
"Juhana Harju" <shantigiriorama@gmail.com> wrote in part:

>In the abstract below it is explained that the possible hazards associated
>with low diastolic blood pressure are probably caused by isolated systolic
>blood pressure:

There seem to be at least two hypotheses. One has to do with pulse pressure,
which is often high in *treated* hypertension and in isolated systolic
hypertension. The other concerns the low diastolic pressure, which may
hamper perfusion of heart muscle, particularly where coronary artery disease
is present.
--
Jim Chinnis   Warrenton, Virginia, USA
Juhana Harju - 25 Jun 2006 18:09 GMT
: "Juhana Harju" <shantigiriorama@gmail.com> wrote in part:
:
[quoted text clipped - 7 lines]
: pressure, which may hamper perfusion of heart muscle, particularly
: where coronary artery disease is present.

It is also known that the outcome of drug treated hypertension is not as
good as hypertension treated by diet.

To my knowledge pulse pressure is associated with arterial stiffness which
in turn is mostly caused by impared endothelial function. Do you think that
my reasoning correct if I think that pulse pressure (or isolated blood
pressure) could be treated by enhancing endothelial function by fish oils,
dietary arginine, phytochemicals and glycemic control?

Signature

Juhana

Jim Chinnis - 25 Jun 2006 18:22 GMT
"Juhana Harju" <shantigiriorama@gmail.com> wrote in part:

>: "Juhana Harju" <shantigiriorama@gmail.com> wrote in part:
>:
[quoted text clipped - 16 lines]
>pressure) could be treated by enhancing endothelial function by fish oils,
>dietary arginine, phytochemicals and glycemic control?

I don't think I know enough to really comment.

If the problems of low diastolic pressure or high pulse pressure are due to
poor perfusion of the heart muscle, I don't know if improved endothelial
function would make a sufficient differece to resolve it or not.
--
Jim Chinnis   Warrenton, Virginia, USA
Jim Chinnis - 25 Jun 2006 17:53 GMT
"kol_Isha" <kol_isha@hotmail.com> wrote in part:

>"Jim Chinnis" <jchinnis@SPAMalum.mit.edu>
>>
[quoted text clipped - 24 lines]
>
>Arlene

I don't disagree with you. But I'd say this is an area that is not
well-understood. (Like most.)
--
Jim Chinnis   Warrenton, Virginia, USA
jay1000 - 26 Jun 2006 00:35 GMT
> "Jim Chinnis" <jchinnis@SPAMalum.mit.edu>
>>
[quoted text clipped - 24 lines]
>
> Arlene

There is also a correlation between low diastolic and dementia/Alzheimer's.
Before anyone gets uptight, notice I said correlation and not causation.
From what I understand there is not enough data to say whether low diastolic
causes dementia/Alzheimer's or whether impending dementia/Alzheimer's causes
low diastolic.   The only mechanism suggested is that low diastolic results
in reduced perfusion in the brain and reduced perfusion may result in
dementia/Alzheimer's.

Jay
judy.n - 25 Jun 2006 21:19 GMT
Thanks for the excellent article: very up to date and complete.
If we go back to Napoleon's original concerns: his blood pressure was
fairly dramatically lowered. If we run his Framingham risk, and we
don't have all the details to do so, it would likely suggest an LDL
goal of 100 or 130 depending on the 10 year risk.
 The bottom line is, he has some risk for atherosclerosis, his blood
pressure was lowered fairly dramatically in a short period of time, and
he suffered side effects: likely due to med side effects and possibly
due to the blood pressure lowering. He's likely a person where 90/60 is
too low of a blood pressure.
 We have been arguing if there is a level of blood pressure that is
too low, and obviously there is: it is of most concern if you have
heart and/or kidney disease, or are symptomatic with it.
 This is a migraine forum. Migraine can cause autonomic dysfunction,
some of that may be reflected in some dysregulation of blood
pressure--which is the likely mechanism for the success of calcium
channel blockers, beta blockers, ACE inhibitor and ARB's for the
prophylaxis of migraine.
 As Arlene as written several times, if you are healthy and tolerate
your relatively low blood pressure without symptoms, then it's not a
cause for concern.
 Judy
> "Juhana Harju" <shantigiriorama@gmail.com> wrote in part:
>
[quoted text clipped - 39 lines]
> --
> Jim Chinnis   Warrenton, Virginia, USA
Franz Perlman - 25 Jun 2006 21:38 GMT
> Thanks for the excellent article: very up to date and complete.
> If we go back to Napoleon's original concerns: his blood pressure was
[quoted text clipped - 62 lines]
>>--
>>Jim Chinnis   Warrenton, Virginia, USA
Cindy Wells - 25 Jun 2006 23:01 GMT
<snip>

>   The bottom line is, he has some risk for atherosclerosis, his blood
> pressure was lowered fairly dramatically in a short period of time,
[quoted text clipped - 13 lines]
> cause for concern.
>   Judy

<snip>
My understanding is that healthy blood pressure is also a factor of
height, weight and gender. However, a patient may be uncomfortable with
their bp and should discuss it with their doc - particularly if
undesirable side effects are present (Quality of life matters - and the
doc isn't the one who has to deal with it). Similarly, a doctor might
be unhappy with a patient having too low a bp and want to change the
meds.

Cindy Wells
(who had the latter with Calan (for migraine prophylaxis) starting with
a normal bp. My doc tested my bp standing, sitting and lying down and
questioned why I wasn't coming into the clinic with bruises from
falling when I got up in the morning. Thus we tried the next med in
the list the neuro had made of things to try to break the frequency/
severity routine.)
Juhana Harju - 23 Jun 2006 10:25 GMT
: I am a caucasion male 50 years old.
:
[quoted text clipped - 38 lines]
: limp member? Any ideas? If I can just occasionally get a decent
: erection and maintain my other benefits ...what a utopia!

Pomegranate juice might be a healthier alternative for blood pressure
lowering medications, most likely without any unpleasant adverse effects. In
an Israeli study below drinking pomegranate juice daily reduced systolic
blood pressure by 21 mmHg (not 21% as the abstract mistakenly states). That
would be enough in your case. Besides lowering blood pressure the juice
would also improve your antioxidant status considerably.

http://www.pomwonderful.com/pdf/clinical_nutrition.pdf

Signature

Juhana

Ignatz's Bricks - 24 Jun 2006 15:31 GMT
> Pomegranate juice might be a healthier alternative for blood pressure
> lowering medications, most likely without any unpleasant adverse effects. In
[quoted text clipped - 4 lines]
>
> http://www.pomwonderful.com/pdf/clinical_nutrition.pdf

I don't have high blood pressure, but I take 4 ounces of Pomegranate
juice twice a day for impotence problems, and one side effect that I
noticed was that it lowered my blood pressure by about 10 mmHg Systolic
and by about 05 mmHg Diastolic.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra
ct&list_uids=15947695&query_hl=4


For the record:
These guys really ought to proofread more carefully, too.  The full text
version of the Journal of Urology article has a typo in the formula for
finding the Body Mass Index.

IB
Juhana Harju - 24 Jun 2006 15:54 GMT
:: Pomegranate juice might be a healthier alternative for blood pressure
:: lowering medications, most likely without any unpleasant adverse
[quoted text clipped - 10 lines]
: noticed was that it lowered my blood pressure by about 10 mmHg
: Systolic and by about 05 mmHg Diastolic.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra
ct&list_uids=15947695&query_hl=4


Thanks for your posting! I had not thought about this kind of use of
pomegranate juice. I had not seen the study either.

: For the record:
: These guys really ought to proofread more carefully, too.  The full
: text version of the Journal of Urology article has a typo in the
: formula for finding the Body Mass Index.
:
: IB

Signature

Juhana

wastball - 28 Jun 2006 18:34 GMT
> :: Pomegranate juice might be a healthier alternative for blood pressure
> :: lowering medications, most likely without any unpleasant adverse
[quoted text clipped - 22 lines]
> :
> : IB

Really, the proofreading is outrageout
 
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