Steven V. Joyal
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 A cautionary note on the antihypertensive drug class known as beta-blockers: researchers who studied more than 143,000 nondiabetic patients who had high blood pressure showed that patients who took beta-blockers were much more likely to develop diabetes than patients who took ACE inhibitors or angiotensin-receptor blockers (ARBs). Calcium channel-blockers were in between: they were not as protective as ACE inhibitors or ARBs but more so than beta-blockers.
Treating High Cholesterol
Diabetics suffer heart attacks and strokes at a greatly increased rate compared with people without diabetes. |
John J. Ratey, MD
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 In quelling the bodily symptoms of anxiety, beta-blockers diffuse panic attacks before they explode. They're also useful for people with social anxiety or stage fright. It's exceedingly common for classical musicians to take beta-blockers before performances because it prevents them from sweating and tensing up, which can really interfere with their ability to play. (It must be hard to play a trombone with stiff lips!)
Sometimes people with panic disorder are treated with both imipramine and beta-blockers — the first to quash the fear and the second to relax the body. |
Herbert Ross, DC with Keri Brenner, L.Ac.
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 Two commonly prescribed types of heart drugs—beta-blockers and calcium-channel blockers—also impair melatonin production. beta-blockers are often used to treat heart problems such as high blood pressure, angina, and arrhythmias (abnormal heart rhythms). They function by interfering with specific cell receptors called beta-adrenergic receptors, which results in relaxed heart rate and lowered blood pressure, but also suspension of normal nighttime melatonin production. The beta-blockers propranolol and atenolol are particularly damaging to melatonin levels. |
Thomson Healthcare, Inc.
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 John's Wort (May induce the metabolism of beta-blockers resulting in reduced drug concentrations and decreased effectiveness of beta-blockers)
BETAXOLOL HYDROCHLORIDE
Kudzu
(P. lobata may interfere with hypotensive agents)
BILBERRY
Anticoagulant drugs, unspecified
(Enhanced anti-aggretory mechanism) Antiplatelet Drugs
(Enhanced anti-aggretory mechanism) Salicylates
(Increases prothrombin time; caution should be observed when used concurrently) Warfarin Sodium
(Increases prothrombin time; caution should be observed when used concurrently)
BISOPROLOL FUMARATE
Kudzu
(P. |
Andreas Moritz
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 One study published in 1995 in the Lancet found that patients who received calcium-channel blockers were 60 percent more likely to suffer a heart attack than those put on either diuretics or beta-blockers. Nifedipine turned out to be the most dangerous of all calcium-channel blockers.
Beta-blockers are hazardous, too. In 1998, the Journal of the American Medical Association reported that apart from being ineffective, the elderly are more likely to suffer a sudden and fatal heart attack while taking these drugs. |
John J. Ratey, MD
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| Exercise serves as a circuit breaker just like beta-blockers, interrupting the negative feedback loop from the body to the brain that heightens anxiety. Back in 1982 a researcher named Herbert de Vries conducted a study showing that people with anxiety have overactive electrical patterns in their muscle spindles and that exercise reduced that tension (just as beta-blockers do). He called it the "tranquilizing effects of exercise. |
| Another class of drug that became popular for treating various forms of anxiety around the same time was beta-blockers, which calm down the sympathetic nervous system. They block epinephrine receptors in the brain and the body and thus prevent epinephrine from elevating blood pressure, heart rate, and breathing during times of stress or anxiety. Often used for heart patients to reduce blood pressure, beta-blockers break the anxiety feedback loop to the brain that otherwise keeps the amygdala on alert. |
| It's exceedingly common for classical musicians to take beta-blockers before performances because it prevents them from sweating and tensing up, which can really interfere with their ability to play. (It must be hard to play a trombone with stiff lips!)
Sometimes people with panic disorder are treated with both imipramine and beta-blockers — the first to quash the fear and the second to relax the body. The real point of understanding how these drugs work is that they provide an explanation for how exercise works. |
Thomson Healthcare, Inc.
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| John's Wort (May induce the metabolism of beta-blockers resulting in reduced drug concentrations and decreased effectiveness of beta-blockers)
BETAXOLOL HYDROCHLORIDE
Kudzu
(P. lobata may interfere with hypotensive agents)
BILBERRY
Anticoagulant drugs, unspecified
(Enhanced anti-aggretory mechanism) Antiplatelet Drugs
(Enhanced anti-aggretory mechanism) Salicylates
(Increases prothrombin time; caution should be observed when used concurrently) Warfarin Sodium
(Increases prothrombin time; caution should be observed when used concurrently)
BISOPROLOL FUMARATE
Kudzu
(P. |
Melody Petersen
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 The class of drugs known as beta-blockers, for example, was initially approved to treat angina and high blood pressure. Years later doctors found that beta-blockers also helped patients suffering from heart failure.
Yet history has shown that drugs prescribed off label have also killed or harmed tens of thousands of patients. The deadly diet pill combination known as fen-phen was an unapproved use of the combination of two drugs. For years doctors have commonly prescribed potent drugs for schizophrenia to patients with Alzheimer's disease, even though the FDA has never approved such use. |
Jack Challem
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 They include
• Antibiotics, which interfere with the B vitamins
• beta-blockers, which interfere with coenzyme Q10
• Metformin, which interferes with vitamins B6, B12, folic acid, and coenzyme Q10
• Oral contraceptives, which interfere with the B vitamins
• Proton-pump inhibitors, which interfere with vitamins B12 and C
• Thiazides, which interfere with magnesium, potassium, and zinc Metformin, one of the most commonly prescribed drugs for prediabetes and diabetes, interferes with the body's absorption and use of folic acid (a B vitamin) and vitamin B12. |
Herbert Ross, DC with Keri Brenner, L.Ac.
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| Drugs that may lead to insomnia include thyroid preparations, oral contraceptives, beta-blockers, and marijuana.8 As mentioned earlier, many over-the-counter medications also contain caffeine and can increase sleep disorders through overstimulation.
While alcohol may initially be relaxing, the end result of drinking is interrupted, less restful sleep. It may help you fall asleep, but when its effects wear off, it disrupts the deeper stages of sleep during the second half of the night.
Alcohol can reduce overall sleep time, including both REM and non-REM sleep. |
Mehmet C. Oz., M.D. and Michael F. Roizen, M.D.
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 And many classes of drugs—especially beta-blockers and the SSRI class of antidepressants—list erectile dysfunction as one of the major side effects. (How's that for a trade-off? Take a drug to improve your mood, but risk cutting off your sexual interest and capabilities at the same time.) If you or your partner experience ED while taking a drug, tell your doc so she can switch you to another class that may not have as powerful an effect. For example, switching from an SSRI to Wellbutrin (bupropion) seems to help alleviate arousal and interest issues that are common in people who take SSRIs. |
Shannon Brownlee
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 We know we can prevent heart attacks with aspirin, and with drugs called beta-blockers. We know that for certain," says Lange. "But it has turned out to be a little more mushy when it comes to the advanced technologies. Angioplasty and stenting have never been shown to improve survival. You can stent until the cows come home and not prevent a heart attack." This finding was supported most recently by a Veterans Affairs study published in the New England Journal of Medicine. |
John J. Ratey, MD
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| Sometimes people with panic disorder are treated with both imipramine and beta-blockers — the first to quash the fear and the second to relax the body. The real point of understanding how these drugs work is that they provide an explanation for how exercise works. As it turns out, exercise impacts the same pathways as these medications — it puts a safety on both triggers.
PUSHING THROUGH THE PAIN
For several decades, common medical wisdom suggested that patients suffering from panic should avoid exercise. It could be dangerous! Or so we thought, based on research from the late 1960s. |
Shannon Brownlee
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| That means quality is more than whether or not your heart attack patients were given prescriptions for beta-blockers on discharge, or any of the other discrete measures in Medicare's P4P plan. It's not just the mortality rate of your heart attack patients, the number of errors committed while treating them, it's also whether the care they received from various specialists and a primary care physician was coordinated over the long haul. |
Andreas Moritz
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| New analysis of 10 trials from a Medline search revealed that beta-blockers, which have been used for over 30 years to treat high blood pressure, are no more effective than a sugar pill.
The American drug reserpin, which is also used to lower elevated blood pressure, has been shown to increase the risk of breast cancer by 300 percent, but it is still given to patients with high blood pressure. Several other classes of drugs—including diuretics and anti-hypertensives (for lowering blood pressure) —are suspected to cause cancer of the kidneys. |
Herbert Ross, DC with Keri Brenner, L.Ac.
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| They function by interfering with specific cell receptors called beta-adrenergic receptors, which results in relaxed heart rate and lowered blood pressure, but also suspension of normal nighttime melatonin production. The beta-blockers propranolol and atenolol are particularly damaging to melatonin levels. Calcium-channel blockers also seriously impair nighttime melatonin levels. As their name suggests, these drugs impede the flow of calcium to cardiovascular cells, thus relaxing the arteries and reducing the amount of oxygen needed by the heart. |
Jonathan V. Wright, M.D. and Alan R. Gaby, M.D.
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 Another class of drugs, known as beta-blockers, also has been shown to be helpful. beta-blockers work by reducing the demand on the heart. Diuretics are often prescribed to remove excess fluid from the body, and digoxin is used to stimidate the heart. However, none of these drugs actually improves the health of the heart muscle; they merely allow the body to cope better with a progressively worsening situation.
DR. WRIGHT'S CASE STUDY m rs. Helen Livingston walked slowly into my office and sat down carefully. "I'd like to sleep lying down for the years I have left," she said. |
Shannon Brownlee
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| He might receive drugs called glycoprotein inhibitors, nicknamed "super-aspirins," to help prevent further clots from forming; beta-blockers to restore an even heartbeat; and maybe angioplasty and a stent to hold open the blocked artery.
All that new technology has helped cut the death rate from heart attacks by nearly two thirds for men in their fifties and sixties—a spectacular medical achievement. |
Thomson Healthcare, Inc.
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| The effect is present after pretreatment with beta-blockers and diminishes after pretreatment with indomethacin or lysine acetylsalicylate (Bettini et al, 1985).
Platelet Aggregation Effects: Bilberry anthocyanosides increased in intracellular concentrations of cyclic AMP or decreased the concentration of thromboxane A2 in platelets, or both (Pulliero et al, 1989, Bottecchia et al, 1987). |
Marshall Editions
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 Medication: Eye drops containing pilocarpine, or a course of oral pilocarpine, beta-blockers, and Diamox® all lower intraocular pressure and they are sometimes prescribed for acute conditions to immediately lower the pressure.
Laser therapy: For chronic or long-term conditions there are new laser procedures that are effective. Iridotomy and trabeculectomy are traditional surgical procedures, which generally totally cure the elevated pressure so that no further treatment or medication is needed. |
| Anyone with cardiovascular or lung diseases and people taking certain types of medication, such as beta-blockers, are also more at risk.
DANGER: If your body temperature rises to over 104°F, a medical emergency exists. Once body temperatures rise above 107°F, cell damage to the brain, liver, kidneys, and skeletal muscle often occurs, as well as bleeding disorders. |
Bottom Line Health
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| The study authors suggest that periodic, repeat ECGs be performed to find out if then; is any evidence of silent heart attacks that had previously gone unnoticed, and patients could then be treated accordingly, with aspirin, beta-blockers, statins and lifestyle changes.
7 Ways to Make Sure You Survive a Heart Attack
Marjory Abrams, publisher, newsletters, Boardroom Inc., 281 Tresser Blvd., Stamford, CT 06901.
Choosing the right hospital can be the key to surviving a heart attack, according to cardiologist Dr. |
Brigitte Mars, A.H.G.
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 Do not use ephedra in conjunction with monoamine oxidase inhibitors, steroids, beta-blockers, or antidepressants. Avoid ephedra at least three days before surgery to prevent blood pressure elevation concerns.
Never exceed the recommended dosage. Avoid using ephedra for extended periods. For safest use, ephedra is best taken under the guidance of a qualified health-care practitioner.
Ephedra brings internal energy to the surface of the body, which can leave one depleted at the core. |
Joan Liebmann-Smith, Ph. D., and Jacqueline Nardi Egan
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 But if your extremities are chron- -Philippine proverb ically cold, it can be a reaction to certain drugs such as beta-blockers, thyroid medications, and drugs used to treat migraines.
Cold fingers and toes that turn blue or white when exposed to the cold are the hallmark of Raynaud's disease (aka Raynaud's phenomenon), a circulatory disorder in which the blood supply to the hands and feet is reduced. Exposure to cold temperatures can precipitate an attack, but in some people stress can do so as well. |
John J. Ratey, MD
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| Back in 1982 a researcher named Herbert de Vries conducted a study showing that people with anxiety have overactive electrical patterns in their muscle spindles and that exercise reduced that tension (just as beta-blockers do). He called it the "tranquilizing effects of exercise." Reducing muscle tension, he found, reduced the feeling of anxiety, which, as I've explained, is important to extinguishing not just the state but the trait of anxiety.
3. It builds brain resources. You know by now that exercise increases serotonin and norepinephrine both in the moment and over the long term. |
Steven V. Joyal
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| Calcium channel-blockers were in between: they were not as protective as ACE inhibitors or ARBs but more so than beta-blockers.
Treating High Cholesterol
Diabetics suffer heart attacks and strokes at a greatly increased rate compared with people without diabetes. People with diabetes almost always have high triglycerides, low good HDL, and high bad LDL levels, with a tendency to form small, dense, atherogenic (artery-clogging) LDL particles. |
J. Douglas Bremner
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 The authors concluded that diuretics (but not beta-blockers, as was the recommendation at the time) should be the first line of treatment for high blood pressure.
Most of the studies of antihypertensive medications have involved men. In the only study focused on women, 30,219 women with hypertension without heart disease were assessed for the relationship between antihypertensive therapy and outcome. Use of calcium channel blockers vs. |
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