5 Steps to prevent Heart Disease

Thursday, November 12, 2015

Aggressive treatment of hypertension

 Aggressive treatment of hypertension

NEJM article on getting systolic pressure less than 120

Contrary view 5 min video 
Medical Nihilism

HOPE trial: Ramapril : Jan 2000
"Ramipril significantly reduces the rates of death, myocardial infarction, and stroke in a broad range of high-risk patients who are not known to have a low ejection fraction or heart failure."

My personal story.
I was diagnosed with diabetes type 2 in Jan. 1999 at 242 pounds.  
I hoped to lose weight and exercise to get my glucose down.
A few months later I developed peripheral neuropathy and my denial was shattered. 
Lifestyle changes are always the first step in the guidelines but not productive. 

 As a diabetic, a patient often needs to go on several drugs:
ACE inhibitor

After my personal experience and studying for the Obesity Boards I would have concentrated on weight loss with Atkins diet or Low Carbohydrate High Fat diet.  I now would offer Invokana and Victoza to help control the glucose and help with weight loss. 

On Invokana with Ramipril my systolic blood pressure in the physicians office varies from 90 to 120. 

On 60% fat diet my LDLp has ranged from less than 300 to 907 since 12-6-11 My data link

On Victoza I lost 6 lbs without changing diet or exercise. 1-12
On Invokana I lost 20 lbs without changing diet or exercise. 3-14
On Qsymia I lost 13 lbs without changing diet of exercise. 6-15

 My experience with weight loss medicine  

I realized I am on 5 diet medications 

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