Saturday, December 13, 2008

Beta-Blockers are about to be discarded by doctors.

I’m very concerned with the direction our western (allopathic) medicine is going. In my naturopathic practice I’m very tolerant about drugs. Indeed I tell to my patients: “take the drugs your MD prescribes when you need them, but at the same time let’s work together so that you can get healthier and discontinue those drugs with the permission of your MD”. I used to be very upset and discontented when I was practicing as an MD and I received information that the drugs we were using were, after a close look, either ineffective for the conditions we used them for or had long term side effects that outweighed their positive effects. Such news stories, however, stopped bothering me; I just got to be “immunized” and dulled to them, because they came to me almost monthly.

Just to refresh your memory:

  1. Hormone Replacement Therapy (HRT) for menopausal females: I used to prescribe that left and right: for hypertension onset with menopause, for osteoporosis, to prevent cardio-vascular events, for mood swings, for skin changes…until one day we learned that it sent the rate of female cancer through the roof;

  1. Vioxx for pain. It almost tripled the rate of cardiovascular events;

  1. Antibiotics. I used to prescribe them just to see whether patients could get better. But after we created super-bugs (MRSA and untreatable Tb), I stopped. Antibiotics for H.pilory? Not anymore, now that we have come to believe that that bug actually protects patient from gastro-intestinal cancer;

  1. Fosamax for osteoporosis…;

  1. Blood glucose lowering medications…

The list could go on and on. But I added one more group of medications to this list 2 days ago, the group called beta-blockers. These have been used to treat elevated blood pressure. However, the latest review of the evidence about these drugs, presented in the August 14, 2007, issue of the Journal of the American College of Cardiology, finds that:

“Despite three decades of using beta-blockers for hypertension, the authors of the state-of-the-art paper noted that no study has shown that beta-blocker mono-therapy reduces morbidity or mortality in hypertensive patients, even when compared with placebo. Indeed, in some early trials, such as the British Medical Research Council study in the elderly, beta-blocker mono-therapy was not only ineffective, but whenever a beta-blocker was added to diuretics, the benefits of the antihypertensive therapy distinctly diminished”.

The bottom line: do not take beta-blockers

For me as a doctor several facts remain unclear:

1. If for 30 years morbidity and mortality for patients on beta-blockers was as high as on placebo, then why did we continue to prescribe it?

2. If the blood pressure was lowed in hypertensive patients to normal with beta-blockers (according to previous research data), but patients still had the same morbidity and mortality, then what was the cause of their cardiovascular event if it wasn’t high blood pressure? (We have thought in medicine that there is a direct correlation between high blood pressure and cardiovascular events: the higher your blood pressure, the higher the chance to have a stroke or heart attack).

Examples of beta-blockers: atenolol (brand name: Tenormin), metoprolol (brand names: Lopressor, Toprol XL) and propranolol (brand name: Inderal). Talk to your doctor and consider alternative treatments for hypertension. There are some safe and effective natural treatments; one may be the right one for you.