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Old 12-15-2004, 02:13 AM   #1
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Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

Somewhat disturbing new data from the WHI study (Women's Health Initiative) about combo treatment of calcium channel blockers w/ diuretics in women aged 59-70.

Study also included women taking ACE inhibitors with a diuretic, and this combo apparently didn't carry an elevated mortality risk.

Findings will appear in today's (Dec 15) edition of JAMA:

[url]http://jama.ama-assn.org/cgi/content/abstract/292/23/2849[/url]

Even though the overall risk of heart- related death among the 30,000 post-menopausal women in the 6-year study was low, the highest mortality rate was among the 1,223 women taking both a calcium channel blocker and a diuretic together.

Before anyone panics, there's a major drawback to the study which needs to be weighed carefully and taken into consideration.
It was an "observational" study, not controlled ...therefore the drugs were not assigned randomly.

zuzu

Last edited by zuzu8; 12-15-2004 at 02:23 AM.

 
Old 12-15-2004, 02:17 PM   #2
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

Thanks for posting this Zuzu

I ain't no female, but I am surrounded by them and this will help me doctor them, lol. I constantly butt heads with the wife's doc and lose, but this info helps me stay informed. AND what hurts the women usually hurts the men. We're almost human....

Jack

 
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Old 12-15-2004, 03:22 PM   #3
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretic

Hey Jack,

I say lucky are the women who surround you, to have an "almost-human' species in their midst who is interested in things medical, let alone informed!

zuzu xxx

 
Old 12-15-2004, 07:50 PM   #4
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

Well thank you very kindly. Could I say the same back to you? Those that surround you are in good hands. I really enjoy learning and sharing with all of you here. Lots of valuable knowledge and experience flying around, and it's all for free

 
Old 12-16-2004, 04:54 AM   #5
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

I'm glad I quit taking the diuretic I was taking along with my calcium blocker. I had to quit taking it because I got a cough from it and I couldn't get rid of it. It went on for three months but stopped when I stopped taking it. Now I have another good reason for quitting it.

 
Old 12-16-2004, 05:31 AM   #6
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

I think the clear villain here is the calcium channel blocker. They are pushing these things...NORVASC, in particular, to enrich Pfizer's coffers. Calcium Channel blockers should NOT be used for simple hypertension in the absence of heart disease, FDA notwithstanding.

This portion of the excellent reference <thanks ZUZU> says it all:
Quote:
Monotherapy with calcium channel blockers vs diuretics was associated with greater risk of CVD death (hazard ratio, 1.55; 95% confidence interval, 1.02-2.35), controlling for multiple covariates. Women treated with a diuretic plus a calcium channel blocker had an 85% greater risk of CVD death vs those treated with a diuretic plus a -blocker, after adjustment for age, race, smoking, high cholesterol levels requiring medication, body mass index, physical activity, use of hormone therapy, and diabetes. After exclusion of women with diabetes the hazard ratio was 2.16 (95% confidence interval, 1.16-4.03).

Last edited by Lenin; 12-16-2004 at 05:34 AM.

 
Old 12-16-2004, 07:08 AM   #7
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

Lenin

Kinda scary and very much to the point.....YIKES.

We are going to have to start columns for all the various BP drugs, and chart all the positive and negative studies....like 15 for and 12 against, medicine xyz. I think that we here, have them under a microscope, and they can't hide from us! (there I go thinking again)

Y'all have a good one,

Jack

 
Old 12-16-2004, 01:19 PM   #8
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

I am beginning to think that I should stop reading these posts because of the "doom and gloom". Here you are taking medication to stay alive and little by little learn that it could kill you earlier.

 
Old 12-16-2004, 02:53 PM   #9
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

Why do so many of these studies keep investigating non-synergistic combinations? ALLHAT essentially used an ACEI+BB combination to compete against a diuretic+BB combo. And, this study looked at a CCB+diuretic combo against a BB+diuretic and a ACEI+diuretic. And, I guess the results are supposed to be "surprising". This is nothing new. See this nice little abstract from 1998:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_u ids=9707957&dopt=Abstract

Pal

 
Old 12-16-2004, 04:09 PM   #10
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

Quote:
Originally Posted by bharkins
I am beginning to think that I should stop reading these posts because of the "doom and gloom". Here you are taking medication to stay alive and little by little learn that it could kill you earlier.

Bharkins, i agree. I am now very afraid. Now you see why im so wishy washy. I just went to my cardio yesterday and she has put me back on zestril/lisinipril. She took away the thiazide hctz, but lasix 20mgs. She doubled my verapamil to 360 from 240. I told her i was allergic to lisninopril ad she told me i needed to try it again. This is a new dr for me. She is the same dr that told me they could not read my nuclear imaging tests bcuz they didn't come out right. I take a ccb+diuretic. Does this mean i am morely likily to die b4 a woman that do not.

Then i see on the cbs evening news that the fda scientists and drs don't trust they own agency. It is a wonder ppl live to get old.

 
Old 12-16-2004, 09:26 PM   #11
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

Hi JTU, if you haven't checked out my thread on 'over-medicate and die sooner?', you might want to because one of the studies cited in this article included the drug Verapamil (you said doctor just increased your dosage on verapamil). If you are intersted, look at Lenin's post in my thread for the actual medscape website url.

--------------------------------------------------------------------------------

"Just in case anyone else wants to read this article, you have to sign in as a member (free) to access the website. This website looks like a real good reference site for medical issues. FYI, the study Lenin cited involved the drugs Verapamil and Atenolol."

 
Old 12-17-2004, 04:41 AM   #12
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

I too am sick of these multiple drug trials. THis steady flow of studies comparing multiple drugs with multiple drugs just obscures the facts.

My rationale for it is that since the drug companies finance nearly all of these studies, they want their particular drugs to look good (human nature), hence EVERYTHING is tested with as much diuretic as necessary to make them LOOK good.

Otherwise we might have a study showing that a particular ARB lowered systolic from 160 to 153 and this was better than a particular CCB that lowered it to only to 154. What must be hidden, they reason, is the fact that NEITHER drug is an effective hypertensive MONOTHERAPY (and thus a poor hypertensive drug.) This fact MUST NOT get widely circulated, or so they reason.

 
Old 12-17-2004, 04:56 AM   #13
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

From zuzu's JAMA link:
Quote:
Women treated with a diuretic plus a calcium channel blocker had an 85% greater risk of CVD death vs those treated with a diuretic plus a -blocker, after adjustment for age, race, smoking, high cholesterol levels requiring medication, body mass index, physical activity, use of hormone therapy, and diabetes.
I always wonder about these kind of statements. What does that really mean? How can they be smart enough to know how to "adjust" for all these factors, but, not smart enough to know that calcium channel blockers and diuretics don't work well together to begin with?

Pal

 
Old 12-17-2004, 08:13 AM   #14
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

I take a calcium channel blocker called tiazac and it does indeed lower my blood pressure. I have tried all the classes except diuretics and none of them work for me at all except for the ccb. I do not take a diuretic. My only experience with a diuretic was Hyzaar which gave me terrible side effects and did nothing for my blood pressure.

Now the ccb does not completely control my bp, and so I take clonidine in addition. My resting numbers average one teens / 60s. I get sick of people yelling ccbs don't work, when for some people like me, they do indeed work and don't have serious side effects. By the way, I am female and don't have heart disease.

 
Old 12-17-2004, 02:31 PM   #15
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Re: Breaking news: Higher mortality rate with combo calcium channel blockers/diuretics???

mgraylorn, i take a ccb+ace inh+diuretic and non of them are lowering my bp. The only bp meds that lowered my bp would be lisinopril and hctz. I refused the hctz bcuz it caused glucose to rise. I was then put on lasix.

I must said verapamil does not for my bp, but i think im on it bcuz of my other heart problems.
Joann, i read your post and the website you mentioned. I give up. I just can't keep switching drugs. Personally, i would like to stop taking all of them, but that is wishful thinking. I am diabetic, that now has thyroid, heart, cholesterol problems. I think some of these bp drugs caused these other diseases but can't prove it. I just pick and choose what i want to take. The fda is now under fire to approving drugs that may be potentially dangerous to the public.

 
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