Another Drug Deal Gone Bad

Health Alert 48

The drugs in this story are not street drugs. This story is about best selling blood pressure medications. Doctors began using these drugs about 20 years ago. Drug companies said they were better and doctors believed them. Now, in light of a major study proving otherwise, the original evidence supporting their use seems to have disappeared.

One out of four Americans suffer from high blood pressure. Most are told by their conventional doctors to take drugs. Over the past decade, the drugs of choice have changed. Doctors have switched from water pills called diuretics to two newer categories of drugs called calcium channel blockers and ACE inhibitors. These newer drugs include Norvasc, Prinivil, and Zestril.

Manufacturers of the newer drugs relied on heavy advertisement. The marketing was very slick. It included free samples, free stethoscopes, paid for conferences, dinners and tickets to major sporting events. They also paid for studies that seem to suggest the drugs worked better than water pills. It worked. The new drugs overtook diuretics as the preferred treatment. Last year their total sales hit 10 billion dollars.

The problem I have with all this is that the drugs are very expensive and loaded with serious side effects. The older diuretics had a more proven record of accomplishment and cost about 90% less.

* Finally, the Scam Is Up *

The new study appears in the December 2002 issue of JAMA. It reports that diuretics are the best treatment for high blood pressure. It involved 42,000 subjects with high blood pressure. All were over the age of 55. The participants took a diuretic, a calcium channel blocker or an ACE inhibitor. They followed the patients for 5 years.

The study concluded that the risk of heart attacks and death is lower with diuretics than the drugs. All of the treatments lowered blood pressure equally well. But those taking Norvasc had a 38% higher risk of heart failure compared to those taking a diuretic. And those on Zestril and Prinivil had a 19% higher risk of heart disease.

Does this mean that diuretics are the best option to lower blood pressure? No. The study only proves that diuretics are the lesser of two evils. Diuretics may be cheap, but they have their own long list of problems.

Common side effects of diuretics:

• Weakness

• Muscle cramps

• Sensitivity to light

• Diarrhea

• Dehydration

• Joint pain

• Decreased sexual desire

• Vomiting

* How to Lower You BP Safely *

The best way to treat high blood pressure is a combination of stress reduction, exercise, nutrients and herbs. You can learn more about techniques to lower stress in Health Alert 39.

Over 50% of patients coming to my office with high blood pressure already taking blood pressure drugs have been able to stop those drugs by taking the nutrient Co Q10. I’ve talked about CoQ10’s positive effects on blood pressure before. See Health Alert 29 for more information.

Two of my favorite natural therapies for blood pressure are hawthorn and garlic. In clinical trials, both hawthorn and garlic have lowered blood pressure.

Hawthorn is an herb used for centuries as a cardiac tonic. A recent study proved hawthorn’s affect on high blood pressure. Participants either took hawthorn extract, magnesium, or a placebo. The study lasted for 10 weeks. The hawthorn group had a promising reduction in diastolic blood pressure. Hawthorn also reduced anxiety better than the magnesium and placebo.1

I use 1,000 mg of hawthorn extract.

Garlic is an excellent heart-healthy supplement. A German study tested the effects of garlic on high blood pressure. Subjects took either powdered garlic or a placebo. The study lasted for 12 weeks. Those taking the garlic had a drop in diastolic blood pressure, cholesterol, and triglycerides. The placebo group showed no change.2

I prefer to use a clove of raw garlic everyday. Sometimes the patient prefers to take a garlic supplement. If you use a supplement, be sure that it contains at least 3,600 mcg of the active ingredient allicin.

Al Sears MD

1 Walker A., et al., Promising hypotensive effect of hawthorn extract: a randomized double-blind pilot study of mild, essential hypertension. Phytother Res 2002 Feb; 16(1): 48-54

2 Auer W. Et al., Hypertension and hyperlipidaemia: garlic helps in mild cases. Br J Clin Pract Suppl 1990 Aug; 69: 3-6