Industry manages hypertension society.

[Guest guest]

May 20, 2006 Unease on Industry's Role in Hypertension Debate By STEPHANIE SAUL http://www.nytimes.com/2006/05/20/business/20hyper.html?th & emc=th Three pharmaceutical companies donated

$700,000 to a medical society that used most of the money on a series of dinner lectures last year to brief doctors on the latest news about high blood pressure. The same three companies — Merck, Novartis and Sankyo — also gave the money that the medical society used to formulate the main talking point of those briefings, an expanded concept of high

blood pressure that many doctors say would increase the number of people taking drugs. The seven dinners at Ruth's Chris Steak Houses around the country are just one example of why the small medical society, the American Society of Hypertension, has been in the midst of a dispute over the influence of drug industry money. "This is about the monetarization of medicine," Dr. Michael H. Alderman, a past president of the organization, said in a recent interview. The dinners promoting a new definition of high blood pressure illustrate connections — among the pharmaceutical industry, academic physicians and societies that formulate opinion — that can ultimately affect patient treatment. And the dispute within the society reflects a growing unease that industry money is influencing scientific discourse in medical societies and elsewhere. At a recent speech before another society, the American College of Cardiology, its new

president, Dr. Steven E. Nissen of the Cleveland Clinic, suggested that the medical profession had become addicted to industry money just as the nation was addicted to foreign oil. After months of controversy within the American Society of Hypertension that included accusations of industry influence, the society's president, Dr. Thomas D. Giles, said yesterday that the group's leadership would be required to disclose more details about the money they receive from industry. Controlling blood pressure has long been a mainstay of the pharmaceutical industry. About 65 million Americans have high blood pressure under the current definition and they help fuel a $17 billion annual market in drugs for hypertension. But another 59 million people are on the borderline, and many doctors believe the new definition of hypertension could make drugs a standard treatment for many of them, drastically expanding the potential drug market. Pre-hypertension has been considered a blood pressure reading of 120/80 to 139/89, according to guidelines developed by a National Institutes of Health panel, which first identified the pre-hypertension category in 2003. Currently, pre-hypertension is generally not treated with drugs. The new definition proposes assigning some of the people with pre-hypertension to a new category called Stage 1 hypertension. Hypertension is currently defined as blood pressure readings of 140/90 and above. Dr. Giles estimated that the proposed definition would move half of those whose blood pressure readings are currently considered pre-hypertension to the Stage 1 hypertension category. That determination would be based not just on their blood pressure readings, but also on other risk factors. The proposed definition makes no specific treatment recommendations. But some specialists who have read the proposed definition say it is a short

step from labeling someone with high blood pressure to prescribing pills. And they predict that if the new definition is embraced, it will expand the use of medications. Dr. Curt D. Furberg, a professor of public health science at Wake Forest University, who was among those who withdrew from the writing group, citing concerns that its work was not evidence-based, said, "The industry wants to sell drugs and to as many people as possible." "Our ideal is not the spirituality that withdraws from life but the conquest of life by the power of the spirit." - Aurobindo.

New Messenger with Voice. Call regular phones from your PC and save big.

[Guest guest]

Millions Wasted on Blood Pressure Drugs

 

But Cheaper Diuretics Are Being Used More Often, Expert Says

Salynn Boyles

WebMD Medical News Reviewed By Michael Smith, MD on Monday, Sept. 08, 2003

 

Sept. 8, 2003 -- Americans may be wasting up to a billion dollars a year by choosing newer, more expensive high blood pressure medications over older and cheaper drugs.

That was the finding from an international cost analysis, which calculated the potential annual savings of treating patients with water pills, or diuretics, instead of newer high blood pressure medications such as beta-blockers, ACE inhibitors, and calcium channel blockers.

But an expert who is tracking the use of diuretics for high blood pressure control tells WebMD that the pendulum is swinging back toward the less expensive drugs.

Hats Off to Water Pills

Diuretics were all but ignored in the U.S. as a first-line treatment for high blood pressure until recently, due to a widely held belief that the newer drugs worked better. But a landmark, government-funded study, released late last year, found the opposite to be true. Participants in the ALLHAT trial taking a common diuretic to control their high blood pressure had fewer heart attacks than participants taking three newer high blood pressure medications.

Tulane University epidemiology professor Paul Whelton, MD, who led the ALLHAT study and now leads a committee that is assessing its impact, says doctors are getting the message and are more often choosing diuretics to control their patients' high blood pressure.

He says just about everyone taking high blood pressure medication should be on a diuretic, either alone or in combination with another type of high blood pressure medication.

Cheap But Effective

" Diuretics are extraordinarily inexpensive, and they work very well, " he says. " They are clearly the first-line treatment for uncomplicated high blood pressure.

A year's worth of diuretics cost patients about $25 to $35, compared with about $250 for ACE inhibitors and roughly twice that for calcium channel blockers.

The cost analysis, which was completed prior to the release of the ALLHAT study, found that between $433 million and $1 billion annually could be saved in the U.S. if diuretics were prescribed according to guidelines for high blood pressure control.

Lead researcher Atle Fretheim, MD, tells WebMD, that even though diuretics are the accepted first-line treatment for blood pressure control, many doctors still do not prescribe them. Heavy promotion of the newer, more expensive high blood pressure medications by their manufacturers is one reason, he says.

Too Much Toilet Time

Another is that many doctors still believe patients have more side effects on diuretics, such as frequent urination.

 

" In the old days, patients on diuretics did spend a lot more time in the toilet, but that is not true today, " he says. " The recommended dosages nowadays are so low that there really isn't a diuretic effect. "

When the ALLHAT study came out last December, its researchers also estimated that $1 billion could be saved annually if diuretics were widely prescribed as the first-line high blood pressure medication. Whelton says progress has been made toward lowering that figure, but it is not yet clear how big an impact the study has had.

" That is why we are tracking prescriptions and continuing our efforts to get the word out. And our preliminary data suggest that many more patients are taking diuretics. "

On 5/20/06, Jagannath Chatterjee <jagchat01 wrote:

 

 

 

 

 

 

 

 

 

May 20, 2006

 

Unease on Industry's Role in Hypertension Debate

By

STEPHANIE SAUL

http://www.nytimes.com/2006/05/20/business/20hyper.html?th & emc=th

 

 

Three pharmaceutical companies donated $700,000 to a medical society that used most of the money on a series of dinner lectures last year to brief doctors on the latest news about high

blood pressure.

The same three companies —

Merck,

Novartis and Sankyo — also gave the money that the medical society used to formulate the main talking point of those briefings, an expanded concept of high blood pressure that many doctors say would increase the number of people taking drugs.

The seven dinners at Ruth's Chris Steak Houses around the country are just one example of why the small medical society, the American Society of Hypertension, has been in the midst of a dispute over the influence of drug industry money.

" This is about the monetarization of medicine, " Dr. Michael H. Alderman, a past president of the organization, said in a recent interview.

The dinners promoting a new definition of high blood pressure illustrate connections — among the pharmaceutical industry, academic physicians and societies that formulate opinion — that can ultimately affect patient treatment. And the dispute within the society reflects a growing unease that industry money is influencing scientific discourse in medical societies and elsewhere.

At a recent speech before another society, the American College of Cardiology, its new president, Dr. Steven E. Nissen of the Cleveland Clinic, suggested that the medical profession had become addicted to industry money just as the nation was addicted to foreign oil.

After months of controversy within the American Society of Hypertension that included accusations of industry influence, the society's president, Dr. Thomas D. Giles, said yesterday that the group's leadership would be required to disclose more details about the money they receive from industry.

Controlling blood pressure has long been a mainstay of the pharmaceutical industry. About 65 million Americans have high blood pressure under the current definition and they help fuel a $17 billion annual market in drugs for hypertension. But another 59 million people are on the borderline, and many doctors believe the new definition of hypertension could make drugs a standard treatment for many of them, drastically expanding the potential drug market.

 

Pre-hypertension has been considered a blood pressure reading of 120/80 to 139/89, according to guidelines developed by a National Institutes of Health panel, which first identified the pre-hypertension category in 2003. Currently, pre-hypertension is generally not treated with drugs.

 

The new definition proposes assigning some of the people with pre-hypertension to a new category called Stage 1 hypertension. Hypertension is currently defined as blood pressure readings of 140/90 and above.

Dr. Giles estimated that the proposed definition would move half of those whose blood pressure readings are currently considered pre-hypertension to the Stage 1 hypertension category.

That determination would be based not just on their blood pressure readings, but also on other risk factors.

The proposed definition makes no specific treatment recommendations. But some specialists who have read the proposed definition say it is a short step from labeling someone with high blood pressure to prescribing pills. And they predict that if the new definition is embraced, it will expand the use of medications.

 

Dr. Curt D. Furberg, a professor of public health science at Wake Forest University, who was among those who withdrew from the writing group, citing concerns that its work was not evidence-based, said, " The industry wants to sell drugs and to as many people as possible. "

 

 

" Our ideal is not the spirituality that withdraws from life but the conquest of life by the power of the spirit. " - Aurobindo.

 

 

 

New Messenger with Voice.

Call regular phones from your PC and save big.

 

[Guest guest]

Hypertension is the signal of the body that there is something wrong,

not a full blown disease, as per alternative view. Nutritional

deficiency causes lack of some hormone which keeps vessels elastic,

making blood pumping difficult. The background to what follows is in an

article about the nutritional deficiencies of glycosugars.

 

http://health.ayurveda/messages/6650

 

Author does not give a single tablet or herb for hypertension and

brings it to 110/70 within 3 weeks by hormone balance only. The tablets

used contain the missing kidney hormones and are given to take care of

other problems, while restoring hypertension is a bonus.

 

By adopting Genetically modified foods, or hybrid vegetables/fruits we

have created new problems. By taking seedless fruits we too are

becoming seedless slowly. The seed or sperm contains a micro-photo-copy

of a full blown specy or 6 foot man. When we take seed, we are

virtually carrying forward the entire constitution to next generation.

Most potent herbal remedies use powders or decoction of seeds.

Essential oils in seeds cause the cure. The tree stores all its

medical properties in a tiny seed. Seed perhaps represent seventh

dhatu of tree.

 

It is seen that nutrition in the form of omega-3 fatty acids (1) and

fiber (2) have been effective in helping lower blood pressure. Use of

as Vit. C as antioxidant (e.g. Grapes) brought in Nobel Prize for Dr

Linus Pauling about 20 years ago, but Grape seed appears to have much

stronger anti-oxidant property. Aamalaki is the ayurvedic remedy, but

no acharya got any Nobel prize. Now a new study,(3) presented at the

American Chemical Society Meeting and Exposition has found that

grapeseed extract may provide another way to help lower your blood

pressure.

 

Grapeseed extract's (GPSE) health properties have been found to lie in

its remarkable ability to help minimize oxidative stress(4) The

antioxidant properties of GPSE has even been found to be " significantly

better " than both vitamin C (5) and vitamin E .(6)

 

In the study, researchers divided 20 male and female volunteers

diagnosed with Metabolic Syndrome into three groups and gave them

either 150 mg of GPSE, 300 mg of GPSE, or placebo for one month. Not

only did they see a " significant " drop in systolic blood pressure (the

top number in your blood pressure reading) of 12 mm Hg, the 300 mg GPSE

also reduced oxidized LDL-cholesterol.

 

So, whether you're looking to lower your blood pressure or help protect

yourself against heart disease, grapeseed extract can be an excellent

supplement to your diet. This of course is the marketing hype of

suppliment manufacturers, what author would urge patients is take

grapes with seeds, eat grapefruit, dry seeds in shade and use their

decoction for obvious benifits. After Grape seeds, amalaki seeds

extract may also come as anti-hypertensive, author is sure.

 

Reference:

 

1 Giltay EJ. Blood pressure response to fish oil supplementation:

metaregression analysis of randomized trials. J Hypertens. 2002 Aug;20

(8):1493-9

2 Whelton, SP. Effect of dietary fiber intake on blood pressure: a meta-

analysis of randomized, controlled clinical trials. J Hypertens. 2005

Mar;23(3):475-81

3 American Chemical Society Website

www.chemistry.org/portal/a/c/s/1/acsdisplay.html?

DOC=meetingsatlanta2006home.html

4 Bagchi D. Molecular mechanisms of cardioprotection by a novel grape

seed proanthocyanidin extract. Mutation Research/Fundamental and

Molecular Mechanisms of Mutagenesis 2006; 523: 87-97

5 D. Bagchi, A. Garg, R.L. Krohn, M. Bagchi, M.X. Tran and S.J. Stohs,

Oxygen free radical scavenging abilities of Vitamins C and E, and a

grape seed proanthocyanidin extract in vitro. Res. Commun. Mol. Pathol.

Pharmacol. 95 (1997), pp. 179–190.

6 M. Sato, G. Maulik, P.S. Ray, D. Bagchi and D.K. Das,

Cardioprotective effects of grape seed proanthocyanidin against

ischemia–reperfusion injury. J. Mol. Cell. Cardiol. 31 (1999), pp. 1289–

1297

 

 

 

 

, " kesava pillai "

<kesava.pillai wrote:

>

> *Millions Wasted on Blood Pressure Drugs*

>

> *But Cheaper Diuretics Are Being Used More Often, Expert Says **Salynn

>

>

> On 5/20/06, Jagannath Chatterjee <jagchat01 wrote:

 

> > Unease on Industry's Role in Hypertension Debate By STEPHANIE

SAUL<http://topics.nytimes.com/top/reference/timestopics/people/s/stepha

nie_saul/index.html?inline=nyt-per>

> > http://www.nytimes.com/2006/05/20/business/20hyper.html?th & emc=th

> > Three pharmaceutical companies donated $700,000 to a medical

society that

> > used most of the money on a series of dinner lectures last year to

brief

> > doctors on the latest news about high blood pressure

[Guest guest]

Dear Shirish

 

I would say, talking about holistic approach, " extracts " are not holistic,

but, just a herbal substitute for chemicals, thinking they will cause less

harm.

Take amla seeds, make preparations out of them, they will be more effective

and will have less side effects than having extracts of some seeds (whether

amla or grapes) and discovering after some years that the extracts cause

some side effects.

 

Akalpita

 

 

-

" Shirish Bhate " <shirishbhate

 

Tuesday, May 23, 2006 11:17 AM

Re: Industry " manages " hypertension society.

 

 

> Hypertension is the signal of the body that there is something wrong,

> not a full blown disease, as per alternative view. Nutritional

> deficiency causes lack of some hormone which keeps vessels elastic,

> making blood pumping difficult. The background to what follows is in an

> article about the nutritional deficiencies of glycosugars.

>

> http://health.ayurveda/messages/6650

>

> Author does not give a single tablet or herb for hypertension and

> brings it to 110/70 within 3 weeks by hormone balance only. The tablets

> used contain the missing kidney hormones and are given to take care of

> other problems, while restoring hypertension is a bonus.

>

> By adopting Genetically modified foods, or hybrid vegetables/fruits we

> have created new problems. By taking seedless fruits we too are

> becoming seedless slowly. The seed or sperm contains a micro-photo-copy

> of a full blown specy or 6 foot man. When we take seed, we are

> virtually carrying forward the entire constitution to next generation.

> Most potent herbal remedies use powders or decoction of seeds.

> Essential oils in seeds cause the cure. The tree stores all its

> medical properties in a tiny seed. Seed perhaps represent seventh

> dhatu of tree.

>

> It is seen that nutrition in the form of omega-3 fatty acids (1) and

> fiber (2) have been effective in helping lower blood pressure. Use of

> as Vit. C as antioxidant (e.g. Grapes) brought in Nobel Prize for Dr

> Linus Pauling about 20 years ago, but Grape seed appears to have much

> stronger anti-oxidant property. Aamalaki is the ayurvedic remedy, but

> no acharya got any Nobel prize. Now a new study,(3) presented at the

> American Chemical Society Meeting and Exposition has found that

> grapeseed extract may provide another way to help lower your blood

> pressure.

>

> Grapeseed extract's (GPSE) health properties have been found to lie in

> its remarkable ability to help minimize oxidative stress(4) The

> antioxidant properties of GPSE has even been found to be " significantly

> better " than both vitamin C (5) and vitamin E .(6)

>

> In the study, researchers divided 20 male and female volunteers

> diagnosed with Metabolic Syndrome into three groups and gave them

> either 150 mg of GPSE, 300 mg of GPSE, or placebo for one month. Not

> only did they see a " significant " drop in systolic blood pressure (the

> top number in your blood pressure reading) of 12 mm Hg, the 300 mg GPSE

> also reduced oxidized LDL-cholesterol.

>

> So, whether you're looking to lower your blood pressure or help protect

> yourself against heart disease, grapeseed extract can be an excellent

> supplement to your diet. This of course is the marketing hype of

> suppliment manufacturers, what author would urge patients is take

> grapes with seeds, eat grapefruit, dry seeds in shade and use their

> decoction for obvious benifits. After Grape seeds, amalaki seeds

> extract may also come as anti-hypertensive, author is sure.

>

> Reference:

>

> 1 Giltay EJ. Blood pressure response to fish oil supplementation:

> metaregression analysis of randomized trials. J Hypertens. 2002 Aug;20

> (8):1493-9

> 2 Whelton, SP. Effect of dietary fiber intake on blood pressure: a meta-

> analysis of randomized, controlled clinical trials. J Hypertens. 2005

> Mar;23(3):475-81

> 3 American Chemical Society Website

> www.chemistry.org/portal/a/c/s/1/acsdisplay.html?

> DOC=meetingsatlanta2006home.html

> 4 Bagchi D. Molecular mechanisms of cardioprotection by a novel grape

> seed proanthocyanidin extract. Mutation Research/Fundamental and

> Molecular Mechanisms of Mutagenesis 2006; 523: 87-97

> 5 D. Bagchi, A. Garg, R.L. Krohn, M. Bagchi, M.X. Tran and S.J. Stohs,

> Oxygen free radical scavenging abilities of Vitamins C and E, and a

> grape seed proanthocyanidin extract in vitro. Res. Commun. Mol. Pathol.

> Pharmacol. 95 (1997), pp. 179-190.

> 6 M. Sato, G. Maulik, P.S. Ray, D. Bagchi and D.K. Das,

> Cardioprotective effects of grape seed proanthocyanidin against

> ischemia-reperfusion injury. J. Mol. Cell. Cardiol. 31 (1999), pp. 1289-

> 1297

>

>

>

>

> , " kesava pillai "

> <kesava.pillai wrote:

> >

> > *Millions Wasted on Blood Pressure Drugs*

> >

> > *But Cheaper Diuretics Are Being Used More Often, Expert Says **Salynn

> >

> >

> > On 5/20/06, Jagannath Chatterjee <jagchat01 wrote:

>

> > > Unease on Industry's Role in Hypertension Debate By STEPHANIE

> SAUL<http://topics.nytimes.com/top/reference/timestopics/people/s/stepha

> nie_saul/index.html?inline=nyt-per>

> > > http://www.nytimes.com/2006/05/20/business/20hyper.html?th & emc=th

> > > Three pharmaceutical companies donated $700,000 to a medical

> society that

> > > used most of the money on a series of dinner lectures last year to

> brief

> > > doctors on the latest news about high blood pressure

>

>

>

 

[Guest guest]

, " Dr. Akalpita Paranjpe "

<aspara wrote:

>

> Dear Shirish

>

> I would say, talking about holistic approach, " extracts " are not

holistic,

> but, just a herbal substitute for chemicals, thinking they will

cause less

> harm.

 

There appears to be a confusion here on terminology.

 

Are you aware that ayurveda itself uses a number of extracts while

making tablets? e.g. Aswagandha Ghan Vati, Jyesthimadh Ghan Vati

etc.. Would you call all arka (Kashayas) as extracts? Would you call

Liv-52 tablet as extract?

 

There is a difference between extracts and principla ingredient

separated out of a herb. Extract contains all that herb has to offer,

except some low volatile matter (enzymes) which goes out when herb is

boiled. This matter anyway goes out when herb dries up and

subsequetly used in dry form. Extraction is used to make the herbal

part accepted by our body. Otherwise, body throws out herb just like

wood dust. The herb needs boiling to make it digestible by body. Here

of course author means the procedures of extract formation as

recommended in classical texts.

 

> Take amla seeds, make preparations out of them, they will be more

effective

> and will have less side effects than having extracts of some seeds

(whether

> amla or grapes) and discovering after some years that the extracts

cause

> some side effects.

 

Author believes that you are treating term 'extract' equivalent to

the process of separating active ingredients of a herb used by

conventional pharma. They try to mimic active ingredient made

synthetically. These give side effects since many other harmonious

molecules, which were suprressing toxicity of active ingredient, get

removed.

 

Dr Bhate