Warning on Toprol beat blocker

[yankeeman]

I've just seen a wire service story (from Bloomberg News) that appears to say Toprol (which I'm taking) and its generic knockoffs significantly raise stroke danger among those who take it. Study was reported in the Lancet.

Anybody know anything about this? My cardiologist left it up to me whether to end use (I had valve replacement last July 3) but this sure makes me want to stop it ASAP.

 

[Dina]

I take it also(50mg/qd). Did the report mention what type of stroke;a clot
or blockage one or a hemorrhagic type? Since most of us are also on ACT , I
wonder if this would help or hinder the problem.
Thanks for the heads-up

 

[yankeeman]

Re: type of stroke

Re: type of stroke

The story (and possibly study) appears to focus only on Toprol.

It says that the drug "more than doubles the threat of stroke and increases the likelihood of death by about 33 percent"

Does not go into detail about type of stroke. Story says "While the drug reduced the chance of a heart attack, the increeased possibilities for death and stroke may outweigh its usefulness."

 

[Superbob]

Here is a link to the story tonight on Bloomberg:

http://www.bloomberg.com/apps/news?pid=20601087&sid=aaBkDslvhDWw


Raises more questions than it answers. Maybe more details will be available tomorrow.

 

[KathyM]

I had my surgery 4 weeks ago. I am on 150mg 1xday. This seems high to me compared to a lot of others in the group. What is the ususal dosage. I am now also concerned about being on it. What is everyone else take on this?




Thanks
Just
KathyM

 

[pamela]

I had my surgery 4 weeks ago. I am on 150mg 1xday. This seems high to me compared to a lot of others in the group. What is the ususal dosage. I am now also concerned about being on it. What is everyone else take on this?




Thanks
Just
KathyM

I'm thinking that if you have the diastolic pressures that are causing heart remodelling (particularly LVH) then you're taking the drug for the reasons it's needed and not as a prophylaxis for high risk patients.

 

[Bryan B]

The researchers studied 8,351 patients at risk for cardiac complications who were having an operation that didn't involve the heart. While the drug reduced the chance of a heart attack, the increased possibilities for death and stroke may outweigh its usefulness, they said in The Lancet.

I don't see how this study relates to people who undergo surgery (i.e. having an operation ) that does involve the heart. Most patients that are prescribed Toprol XL (or Lopressor, metoprolol) pre and/or post surgery is to take the stress off of the heart, possibly to reduce BP, but more often than not to reduce the heart rate...especially after heart valve surgery. I stayed on Toprol XL for about 6 months before surgery (after being diagnosed with endocarditis) and for about 1.5 years after my Ross Procedure. It was explained to me that for someone like me who's heart rate was normally in the upper 80's...reducing that number to say the upper 70's would slow down the "wear and tear" on the new valve. My point is that I think a cardiologist and/or cardiovascular surgeon prescribing Toprol XL is quite a different scenario than a non-cardiac surgeon or doctor prescribing it for patients without heart conditions. To me that sounds like it's being used for "off label" situations which probably weren't studied when the drug went through clinical trials. Since the drug was brought to market specifically for controlling HBP and lowering HR in patients with heart disease it doesn't surprise me that it causes side effects in patients without heart disease.

Hey..."Oaktree your in my way". Obviously I agree with your post...it just took me about 15 minutes longer to get my message across.

 

[Superbob]

I've been on metoprolol since my OHS 3-plus years ago, and my wife, who has never had heart surgery, is on it to control BP. It does make a difference. She stopped it for a while, and her BP soared, so she's back on it.

So I'm not really worried about the study. It seems to apply to a particular situation that may not be applicable to us. But we both have GP appointments this month so we will ask about it.

 

[Harmony]

I read this earlier on MSNBC. I thought it was about taking a beta blocker before non cardiac surgery. It said that ToporolXL was used and it could cause a stroke. I have been taking toporol xL 25 about 4 years. In October of 07 I had the hardware removed from my broken leg that had finally healed. I remember my Cardio telling me to be sure and take the Toporol. A year and 1/2before they set the leg and am sure I took a Toporol before that surgery. I take a Toporol XL 25 every morning. After reading this I do not know what to do. Being a Migraine suffer with a PFO I have a bigger risk for having a stroke than most people. I take Toporol because my Cardio thinks it will be a help for my MVP. I do not have high BP

 

[pamela]

Hi Harmony, If you're concerned about the neccessity of taking the Toporol when you don't have BP issues see your doctor. He may be able to give you a different drug for any arrhythmia you may experience without the beta blocker. Are you on anticoagulants as well as the Toporol? That could have a real bearing on stroke susceptibility.

I don't know if I'm on the right track with my thinking or not, but you know the rule:

If in doubt, check it out!​

 

[ALCapshaw2]

Attention: Yankeeman, Ross

Please change the Subject Title of this thread to reflect "Toprol Beta Blocker" (NOT Toprol beat Blocker).

 

[Harmony]

Pamela Thank you for the answer. My Cardio believes that it is importantant to keep my BP on the low side and my cholesterol as well. MJy BP runs 11-to 125 over 60 to 70. My cholesterol with liptor and zelia has gone from 233 to 197 my LDL from 130 to 84 My HDL from 81 to 103. My Cardio believes keeping these low will be helpful for my MVP. I take no other meds except Headache meds as I suffer from Migraines and also have a PFO. I was really upset about the article due to my Migraines and PFO I have a50% greater chance of a stroke and I dont have HBP, Diabetes, Overweight or any other reasons to have a stroke. Now I read this article and find that because some stupid person ( who had killed one person walking probably near me) hit me with a car while I was walking on the sidewalk, and could have caused my death by stroke. Makes me so angry

 

[perrypiratesdad]

and my wife, who has never had heart surgery, is on it to control BP. It does make a difference. She stopped it for a while, and her BP soared, so she's back on it.

Interesting. I was on it too after my surgery and I had a high BP. The docs decided to keep me on it too for my BP, but it really never did anything for that. They eventually put me on some other meds for the BP that control it much better.

Not to long ago though I asked to be taken off the lopressor because it was interfering with exercise (beta blockade) and not letting my heart beat fast enough. When I came off of it (gradually) I had no adverse effects with my BP. My heart rate is faster, but my cardiologist and I believe that the exercise is much better than having a slower heart rate and no exercise.

 

[Blanche]

Perrypiratesdad

Perrypiratesdad

Perhaps the most important concern here for folks with valvereplacements is that the study focused on a different population and it researchers can't generalize to other populations, such as those with valvereplacements.

Oak Tree's post, "The patients in the study were put on it as part of their preparation for noncardiac surgery." is very important. It shows that this study is aimed at a different group of patients.

Can't mix apples and oranges.

Blanche

 

[dennie]

This relates to my conditions. I was on lopressor with frequent migraines in the mornings. Also I had high LDL/Triglyceride and low HDL. I googled and found many studies saying that lopressor (beta-blockers in general) could cause the lipid problem and even lead to diabetes. Also, although beta-blockers are used to treate migraines, for me, it seemd to be rather the cause. Ever since I started to reduce the lopressor dosage, I experienced much fewer migraines.

Now I am in the first week without any beta-blocker. My BP is raised to 125/80 from about 110/70 and hr to 75 from 60. I hope they will get a little better in another two weeks or so when the after effect is totally gone. And I will have my blood tested too. I hope the lipid panel will look good this time.

Pamela Thank you for the answer. My Cardio believes that it is importantant to keep my BP on the low side and my cholesterol as well. MJy BP runs 11-to 125 over 60 to 70. My cholesterol with liptor and zelia has gone from 233 to 197 my LDL from 130 to 84 My HDL from 81 to 103. My Cardio believes keeping these low will be helpful for my MVP. I take no other meds except Headache meds as I suffer from Migraines and also have a PFO. I was really upset about the article due to my Migraines and PFO I have a50% greater chance of a stroke and I dont have HBP, Diabetes, Overweight or any other reasons to have a stroke. Now I read this article and find that because some stupid person ( who had killed one person walking probably near me) hit me with a car while I was walking on the sidewalk, and could have caused my death by stroke. Makes me so angry

 

[Jkm7]

Pamela Thank you for the answer. My Cardio believes that it is importantant to keep my BP on the low side and my cholesterol as well. MJy BP runs 11-to 125 over 60 to 70. My cholesterol with liptor and zelia has gone from 233 to 197 my LDL from 130 to 84 My HDL from 81 to 103. My Cardio believes keeping these low will be helpful for my MVP. I take no other meds except Headache meds as I suffer from Migraines and also have a PFO. I was really upset about the article due to my Migraines and PFO I have a50% greater chance of a stroke and I dont have HBP, Diabetes, Overweight or any other reasons to have a stroke. Now I read this article and find that because some stupid person ( who had killed one person walking probably near me) hit me with a car while I was walking on the sidewalk, and could have caused my death by stroke. Makes me so angry

Are you having the PFO repaired during your surgery, Harmony?

I did. I never knew I had it until the surgery and it was repaired at my second one.

 

[Jkm7]

deleted by poster

(didn't belong in this thread)

 

[Cooker]

Perhaps the most important concern here for folks with valvereplacements is that the study focused on a different population and it researchers can't generalize to other populations, such as those with valvereplacements.

Oak Tree's post, "The patients in the study were put on it as part of their preparation for noncardiac surgery." is very important. It shows that this study is aimed at a different group of patients.

Can't mix apples and oranges.

Blanche

Exactly....I?m just now seeing this thread and called my cardiologist office to get his email address to forward the link. He picked up the phone and we discussed it. He said the benefits for me FAR out way the risk (which he feels are greatly exaggerated). Now I do not have a history of BP problems but I do have a past history of a-fib and that is why he keeps me on 25mg daily. I also had ablation at the time of AVR. Also, he got a ?jab? in on me by saying, ?as high as you keep your INR you don?t need to worry about having a stroke from Toprol??

 

[hensylee]

my dr put me on toprolxl one time but I began to cough and asked him to put me back on atenolol. he said it's the same thing, only toprol is time release. I have been on atenolol since 2000, a med that's been out forever and I've heard nothing bad about it. It must be in this category you are talking about, tho.

 

[Dina]

?as high as you keep your INR you don?t need to worry about having a stroke from Toprol??

Thanks Cooker ...you accidently answered my question at the beginning
of the thread The effect must be blockage/clotting type of stroke as
opposed to the hemorrhagic-Dina