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View Full Version : Metropolol vs. Losartan - wonder drugs or bad medacine?



jake
July 3rd, 2010, 05:41 PM
OK, so as I read the page after page about statin use, I must now table the whole beta blocker thing. The more I read about beta blockers, the more I have to wonder if they are right for me.

I was borderline hypertensive when I went into the hospital last year with a blocked RCA, and after discovering I had an aortic aneurism, I was placed on Metropolol. Now I have hard a lot of people out there who were placed on Hyzzar and Cozzar which are both ace inhibitors, not only for blood pressure regulation, but I am now seeing dozens of studies where Losartan (Cozzar) is being used to prevent the growth of aneurisms. There is a ton of compelling evidence out there showing that many folks who have participated in studies of this class of drugs are actually seeing a REDUCTION in size of aortic aneurisms.

Looking at the method in which all beta blockers act, there is furthermore, a lot of evidence that suggests that the use of ACE inhibitors like Metropolol combined with Statin drugs are producing long term heart failure patients. I am getting a good chunk of my research from a lot of sources but was extremely interested in studies by Dr Sinatra who has been looking at the "cocktail" of meds we are given when we leave the hospital after heart procedures, and years later return with high incidents of heart failure.

The acronym that keeps coming up is ATP (adenosine triphospate). THE HEART is an omnivore, able to oxidize a variety of substrates to support ATP production. Ace inhibitors and statin drugs inhibit the production of ATP as well as Coenzyme Q10 which we need to feed our body at the cellular level.

"Traditional treatments for chronic stable angina pectoris are aimed at increasing blood flow to the myocardium via coronary vasodilatation (eg, with nitrates), and at reducing the oxygen requirement of the ischemic tissue by decreasing heart rate, arterial blood pressure, and cardiac contractility (with ß-blockers, calcium channel antagonists, or nitrates). These hemodynamic approaches are effective at reducing anginal symptoms and improving exercise tolerance, but many patients continue to suffer from angina, despite optimal treatment with these drugs "
*William C. Stanley
Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University

I have read the work of a few Dr's like Stephen Sinatra (The Sinatra Solution) who concur with the assertion that ATP is vital to those of us who may be compromised through CAD, or a myriad of other afflictions of the cardio vascular system. Many forward thinking doctors have discovered that many of the traditional drugs we take like Ace Inhibitors and Statins rob our body of the ability to produce ATP and CoQ10. The result is damage to our muscle tissue at the cellular level, and as we all know, the heart is nothing but muscle.

Look, I could go on all night blowing this smoke folks. I certainly don’t have all the answers, and most doctors do not say to simply stop taking your statins or ace inhibitors, HOWEVER, some do! Some say supplementation with compounds like L carnatine, D ribose and CoQ10 are the answer IN ADDITION to the traditional drugs to keep the body producing ATP.

In addition to opening this up for discussion for those of you who are really acutely in touch with the drugs we put into our bodies and the negative effects of them balanced against the good they do, I am really curious if anyone else has reservations about the use of Beta Blockers and Statins in general?

I have some serious concerns about any drugs that screw with heart rate in a person who may have high blood pressure, but no heart rate issues. Sure, they are handing out metropolol like there is no tomorrow, but that’s because it’s cheap! Insurance companies love it vs. other types of drugs that do not mess with heart rate, but cost way more. I have read about people who went on drugs like Metropolol and simply could not stop taking it because it caused tremendous problems with uncontrolled heart rate in people who never had heart rate issues.

Mind you, I am not slamming on Metropolol, raving about Cozzar or pushing Dr. Sinatras book, BUT I am asking those of you who may share some concerns with drugs that alter heart rate where alteration of heart rate is not necessary (other than to reduce BP) where other drugs that could lower BP and leave the heart muscle alone could be used.

What’s your opinion? Has anyone out here read the work of Dr. Sinatra? How are your fairing on Metropolol? I know a lot of you are experiencing the lethargic aftereffects of Ace Inhibitors like I am, but the supplements DO help me. How about any of you?

jake
July 3rd, 2010, 06:50 PM
I wanted to add this link in support of the cozzar thing. Not a full fledged medical study, but just some food for thought:

http://stu.westga.edu/~wmaples/steiner_charles.html

Bill B
July 4th, 2010, 12:26 AM
I've looked at Dr. Sinatra's stuff. It seems to me he is just playing off current fads. His website is just a storefront for his HUGE dietary product line. http://www.drsinatra.com/ He's got something for whatever ails you. I don't see any serious "study" results at all. His resume includes nothing but newsletters and his health books. He's never published anything resembling a scientific study of his claims. Although these compounds are definitely involved in cardiac health, no one has documented a clear benefit from supplemental dietary intake for them. I'm not impressed and I am troubled by most CoQ products. There are no standards for these products and no assurance that what you buy will do anything at all to affect your CoQ levels.

I don't see metoprolol as bad as you do. It has actually proven to be very beneficial in heart failure, contrary to the OLD misconception that beta blockers were contraindicated in heart failure. Metoprolol and others are now approved for and considered quite effective for the treatment of heart failure. In large scale studies they reduced mortality from CHF by 35-65% and lead to substantial improvement in cardiac function. My ejection fraction went from 39% to 55% after starting metoprolol. There never has been inducement of heart failure from longterm beta blockers. Because beta blockers reduce the force of cardiac contraction it was mistakenly believed for many years that they would be detrimental in heart failure. That's what I was taught in pharmacy school in the 1970s, but that was long ago proved incorrect and any doctor that still claims they are harmful in CHF is seriously ignorant. Although rebound tachycardia is possible when you stop metoprolol, it is not likely unless you are on high doses and don't taper the dose over a few weeks, like you did when you started. The documentation for the effect of beta blockers and statins on CoQ synthesis and ATP is scant and not understood well enough to draw any conclusions at all. There is no indication that the CoQ effects of statins impair cardiac function in general. A recent study (reported but not yet published) of statins in heart failure patients found that patients with systolic heart failure benefited from statins while those with diastolic heart failure did not. Large scale studies clearly established the benefits of statins in patients with coronary artery disease. Refuting them with sketchy quasi-biochemistry observations bothers me. If Dr. Sinatra was the only cardiologist in my town, I would move.

Bill

Maryka
July 4th, 2010, 03:53 AM
I did not read your whole LONG post, but I take Losarten, Metropolol and Lovastatin each and every day. I have no ill effects. They are each different classes of drugs as I understand it. Losarten is a BP med and now an anti-connective-tissue-deterioration med. As I understand it, Metropolol is a beta blocker, and Lovastatin is (of course) a statin for cholesterol. They work for me. I "choose life" when it comes to my medications.

Ross
July 4th, 2010, 04:03 AM
Hey Bill, check this out:

http://www.drsinatra.com/sinatra-cv

Just for reference. I'm not taking any sides on this subject.

Bill B
July 4th, 2010, 11:08 AM
Hi Ross: Yes, I saw his cv. Nothing in his publications on the subject other than short opinions and letters to the editor. He may not be bad dcotor, but he is promoting his opinions as if they were fact and profiting from peoples' willingness to buy the latest snake oil cure-alls largely on faith.

Ross
July 4th, 2010, 11:57 AM
Hi Ross: Yes, I saw his cv. Nothing in his publications on the subject other than short opinions and letters to the editor. He may not be bad dcotor, but he is promoting his opinions as if they were fact and profiting from peoples' willingness to buy the latest snake oil cure-alls largely on faith.

Hey at least he's not as bad as Dr.Gourmet. He at least lets people on Coumadin eat greens! :biggrin2:

jake
July 5th, 2010, 06:11 AM
Wow! Some very strong opinions to say the least! I sure didn’t mean to upset anyone. I have read the work of Sinatra, and although I do agree that the prescribed treatment seems “too good to be true” he does site dozens of trials and examples for his combination of supplements.

I guess my curiosity was based on the fact that body builders have been using supplements like carnatine and ribose for many years to feed targeted muscle groups, I guess it made sense that it could, in the correct circumstances, help heart patents. Many years ago, I was in the body building sub-culture and carnatine and ribose were very popular around the gym along with a few others (some bad some good).

My concern for using Metropolol was not so much for folks IN heart failure mode, more those who have suffered a coronary event or aneurism who have been prescribed the drug as a preventative vs. a medication that is touted as not having some of the drastic outcomes that metropolol has when people stop taking it.

As for CoQ10, I have been taking the metabolized version of CoQ10 (ubiquinol) sense I discovered that it significantly reduces muscle pain from statin use a year ago. I have had terrific results taking Ubiquinol as it has provided almost 100% relief from the unpleasant side effects of statin drug use.

One thing I will agree with is that many of these supplements might be a lot more attractive if the FDA regulated them. I think if the FDA made supplements to be as regulated as just over the counter medications like Aleve or Tylenol, 80% of them would just go away!

Marty
July 5th, 2010, 12:08 PM
My 55 yr old daughter recently found out and was quite surprised that she has very high blood pressure. The internist put her on losartan ( Cozaar) 100 mgm daily. No beta blocker . No diuretic. Nothing else. Losartan an ARB- angiotensin receptor blocker. It just went generic so you can take it now without mortgaging your house. My daughter is now running a normal blood pressure most but not all the time. I'm wondering if they shouldn't add one of the other time honored medications.

Maryka
July 5th, 2010, 04:24 PM
Before they knew that Losartan had other properties, a Marfan woman over here in Silver Spring was prescribed Losartan for BP control. At that time Losartan was on the verge of going generic because it was an older, tried-and-true BP med. Both she and her doctor were surprised when her aortic aneurysm got smaller. Of course, soon others discovered the added benefit of Losartan. Losartan did NOT go generic at that time, but, thank goodness, has now gone generic. So, when you say "tried and true" you would be talking about Losartan because it has been around for BP for a very long time.

Nancy
July 5th, 2010, 06:31 PM
I've been on Cozaar for years for high BP. Now, there are times when my blood pressure is too low to even take the medication. So it must have some restorative properties. I have no side effects from it either. I was on a beta blocker prior to that plus a diuretic. Both were bad news. With the beta blocker I couldn't climb stairs w/o stopping midway, and couldn't walk up simple inclines w/o getting terribly out of breath, and the diuretics gave me gout. So I asked to be switched to Cozaar. I am so glad I did.

Bill B
July 5th, 2010, 11:51 PM
Wow! Some very strong opinions to say the least! I sure didn’t mean to upset anyone. I have read the work of Sinatra, and although I do agree that the prescribed treatment seems “too good to be true” he does site dozens of trials and examples for his combination of supplements.

I guess my curiosity was based on the fact that body builders have been using supplements like carnatine and ribose for many years to feed targeted muscle groups, I guess it made sense that it could, in the correct circumstances, help heart patents. Many years ago, I was in the body building sub-culture and carnatine and ribose were very popular around the gym along with a few others (some bad some good).

My concern for using Metropolol was not so much for folks IN heart failure mode, more those who have suffered a coronary event or aneurism who have been prescribed the drug as a preventative vs. a medication that is touted as not having some of the drastic outcomes that metropolol has when people stop taking it.

As for CoQ10, I have been taking the metabolized version of CoQ10 (ubiquinol) sense I discovered that it significantly reduces muscle pain from statin use a year ago. I have had terrific results taking Ubiquinol as it has provided almost 100% relief from the unpleasant side effects of statin drug use.

One thing I will agree with is that many of these supplements might be a lot more attractive if the FDA regulated them. I think if the FDA made supplements to be as regulated as just over the counter medications like Aleve or Tylenol, 80% of them would just go away!Sorry if I seemed to have reacted too strongly. It appeared to me you were getting some incorrect or unfounded information and advice from somewhere. I focused on the value of metoprolol in CHF because you said there is a "lot of evidence" that it and statins are "producing long term heart failure patients". That's pretty provocative. Anyway, if you have evidence that metoprolol will produce CHF, I'd like to see it. Also, I see you repeating a concern about "drastic outcomes" of stopping metoprolol. Where are you getting this? Now you mention "coronary event or aneurysm" as your main area of concern. I'm not sure why. These drugs are quite helpful there. Anyway, I mean to allay these particular fears about metoprolol and statins. They certainly aren't harmless drugs. I hope I'm not coming across as pro-drug, anti-herb. I spent 30 years in pharmacy and the drug industry, most of that time being very skeptical and concerned about the value of drug therapy. Muscle pain syndromes with statins are a concern. I'm glad to hear CoQ10 alleviates muscle pain for you. Anyway, unless you have substantial side effects, the benefits of metoprolol and statins and ACE inhibitors as preventatives or active treatments in patients with coronary artery disease, CHF, hypertension or aneurysms have a pretty strong foundation. It appears someone, maybe Dr. Sinatra, planted some contrary notions and suggested other alternatives. I did see that Dr. Sinatra hasn't totally abandoned statins, but he restricts there use to situations where he is sure they will be of benefit. I have no problem with that idea.

Anyway, it is very good to question the value of drugs. There is too much automatic prescribing of pills for ills. So, you are doing the right thing by looking at alternatives and being concerned about your drug therapy. I've been lucky that my therapy is not causing me any discomfort. I see that yours has been, so I understand your motivation to look into this. And because I question the value of CoQ10 because there is so little solid scientific study doesn't mean that I think it's bad. I just don't know what to think of it yet. But if it might alleviate muscle pain from my statin, if I had that problem, I'd try it too.

jake
July 6th, 2010, 05:37 AM
The thing about Metorpolol and CHF came from some studies that came out of Europe regarding folks who were in a 15 year study group on ACE inhibitors and a high percentage of them returned before the 20 year mark with CHF. One study without details means nothing to me. The reason it jumped out at me was that when I read Sinatra’s book, there was a lot of lip service being given about the depletion of ATP and he felt it was linked back to the use of ACE inhibitors and Statins in young people who have had coronary events and had depleted ATP and CoQ10. Now mind you, the good Doctor does NOT say to stop using ACE inhibitors and Statins, as a matter of fact, quite the contrary. His position was that ATP (as well as CoQ10) must be increased in people with heart issues, not depleted.

Ultimately, in addition to wanting to find the combination that is correct for me, I am more interested in looking at alternatives to the “cookie cutter” method of prescribing these drug combinations after a coronary event. It seems like the trend is to give everyone the same stuff, than make changes as you go based on how one’s body tolerates it. It seemed like a good idea at first, but than I began to discover that the Statins made my muscles hurt, the Metropolol was screwing with my heart rate (jumping around) and than finding out that it’s dangerous to go off of Metropolol because of fears of drastic heart rate problems. No one told me that when I was put on the med in the first place. I sure was not told that there were alternatives. Than when I went for a 2nd and 3rd opinion, I was told that Metropolol would not have been their first choice, as Cozzar would be the safer choice considering my risk factors and my age as well as my aneurism status. When I asked my original Cardio why the Metropolol as opposed to Cozzar, he just said “that’s what we give everyone who has had a heart attack and has hypertension.”

Anyway, I appreciate your input and respect your background in the pharmacy and drug industry. I deem your information valuable and am all ears! I always have an ear up when it concerns my welfare and information is flowing from a good source. I’m only 44 and want to live a long healthy and active life despite some heart troubles. The same drug cocktail a 65 year old person would get may not be good for me. I’m just trying to float out some ideas to find out what others are doing and if anyone else is doing any of this stuff. If nothing else, I don’t want to go into my cardio sounding like a hypochondriac. LOL!!! I value your opinions, just as I value anything that helps me to be better, stronger, and faster. Just like the bionic man!

hook
July 6th, 2010, 06:41 AM
I have been on beta blockers and ace inhibitors for 25 years, and been very athletic the whole time with no deterioration in my left ventricle dilation.

I can honestly say that I blame the introduction of the Stain Lipitor for my condition getting worse. My symptoms showed up 3 to 4 months after starting the drug. I didn't know this discussion was going on so I started a post titled "metabolic Cardiology". I still take the Lipitor, but I do take CoQ10 and Ubiquinol, along with the other supplements suggested by the Sinatra Solution.

Some people judge him harshly, but we have to ask ourselves this question. Does shutting down the pumps that produce our internal cholesterol and CoQ10, cause heart weakening. If these drugs cause muscle weakness and pain, why would heart muscle cells be amused to this. I asked my cardiologist about this when he started me on Lipitor; I think his response was one of utter ignorance and pharma bullcrap. He said heart cells are not affected the way skelital muscles are affected. When I asked him if he could explain the biology why muscle issue comes up at all, he didn't know. You see the irony here.

The gist based on my long term battle with heart disease. Ace Inhibitors and Beta Blocker have helped me; the Lipitor nearly killed me. I still take it, but I supplement with CoQ10.

BTW, I read the Sinatra Solution, and I didn't think he was pushing his line of supliments. In fact I didn't even know he sold them until I looked. I ended up using NOW supliments. In his situation why wouldn't he offer these to sell.