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Is there a substitute for atenolol?
  1. #1
    Michael Guest

    Default Is there a substitute for atenolol?

    I first diagnosed myself with type 2 when I saw my FBG levels at about
    130. I immediately dropped my intake of carbs to below 10/day. This
    helped. I then dropped my dose of atenolol from 100 to 50 per day and
    began taking lisiniprol. This combination got my FBG down to 100.

    After a month of this my heart was still giving me trouble. I realize it
    takes longer than a month to really come off atenolol. However, my
    physician told me that beta blockers are a real boon to those of us with
    exertional angina. I have had exertional angina for 25 years. When I
    take 100 mg of atenolol I can trot up two flights of stairs in my home.
    I cannot do this on 50.

    I am scheduled to see a cardiologist in about a month. I will discuss my
    quandary with him and see if there is anything to be done.

    My physician took me off the lisiniprol and recommended that I go back
    to 100 mg of atenolol which I already had done. My FBG shot right back
    up to 130 within two days of restarting 100 mg of the beta blocker. My
    diet remained the same.

    I feel like I am in an unhappy position of deciding which is worse, a
    FBG of 130 or exertional angina on the stairway. My physician clearly
    believes that the FBG of 130 is the better choice. He said in my exam
    room "It would be a shame for you to be able to have great FBG levels
    but then die of heart failure".

    If there is no good substitute for atenolol, would I be better off
    taking metformin to get my FBG down to normal?

    Michael

  2. #2
    Bob Guest

    Default Re: Is there a substitute for atenolol?

    On Mon, 27 Apr 2009 12:30:29 -0500, Michael <[email protected]>
    wrote:

    >I first diagnosed myself with type 2 when I saw my FBG levels at about
    >130. I immediately dropped my intake of carbs to below 10/day. This
    >helped. I then dropped my dose of atenolol from 100 to 50 per day and
    >began taking lisiniprol. This combination got my FBG down to 100.
    >
    >After a month of this my heart was still giving me trouble. I realize it
    >takes longer than a month to really come off atenolol. However, my
    >physician told me that beta blockers are a real boon to those of us with
    >exertional angina. I have had exertional angina for 25 years. When I
    >take 100 mg of atenolol I can trot up two flights of stairs in my home.
    >I cannot do this on 50.
    >
    >I am scheduled to see a cardiologist in about a month. I will discuss my
    >quandary with him and see if there is anything to be done.
    >
    >My physician took me off the lisiniprol and recommended that I go back
    >to 100 mg of atenolol which I already had done. My FBG shot right back
    >up to 130 within two days of restarting 100 mg of the beta blocker. My
    >diet remained the same.
    >
    >I feel like I am in an unhappy position of deciding which is worse, a
    >FBG of 130 or exertional angina on the stairway. My physician clearly
    >believes that the FBG of 130 is the better choice. He said in my exam
    >room "It would be a shame for you to be able to have great FBG levels
    >but then die of heart failure".
    >
    >If there is no good substitute for atenolol, would I be better off
    >taking metformin to get my FBG down to normal?


    TOP ROL-XL
    Comment by person suggesting this instead of atenolol was it was
    broken down by liver instead of kidneys.

  3. #3
    Peppermint Patootie Guest

    Default Re: Is there a substitute for atenolol?

    In article <_YlJl.216454$[email protected]>,
    Michael <[email protected]> wrote:

    > I first diagnosed myself with type 2 when I saw my FBG levels at about
    > 130. I immediately dropped my intake of carbs to below 10/day. This
    > helped. I then dropped my dose of atenolol from 100 to 50 per day and
    > began taking lisiniprol. This combination got my FBG down to 100.
    >
    > After a month of this my heart was still giving me trouble. I realize it
    > takes longer than a month to really come off atenolol. However, my
    > physician told me that beta blockers are a real boon to those of us with
    > exertional angina. I have had exertional angina for 25 years. When I
    > take 100 mg of atenolol I can trot up two flights of stairs in my home.
    > I cannot do this on 50.
    >
    > I am scheduled to see a cardiologist in about a month. I will discuss my
    > quandary with him and see if there is anything to be done.
    >
    > My physician took me off the lisiniprol and recommended that I go back
    > to 100 mg of atenolol which I already had done. My FBG shot right back
    > up to 130 within two days of restarting 100 mg of the beta blocker. My
    > diet remained the same.
    >
    > I feel like I am in an unhappy position of deciding which is worse, a
    > FBG of 130 or exertional angina on the stairway. My physician clearly
    > believes that the FBG of 130 is the better choice. He said in my exam
    > room "It would be a shame for you to be able to have great FBG levels
    > but then die of heart failure".
    >
    > If there is no good substitute for atenolol, would I be better off
    > taking metformin to get my FBG down to normal?
    >
    > Michael


    Metformin is a standard first line drug for type 2 diabetics. It is not
    a substitute for atenalol.

    You need to remember that this is a marathon, not a sprint. You're
    seeing your cardiologist in a month. Why are you wanting to make
    changes now?

    I keep seeing you doing this, Michael -- reacting impulsively and not
    paying attention to what you're told. Dropping carbs to below 10/day
    and then cutting your atenalol dosage in half are wild and dramatic
    actions for you. You need to think this out WITH YOUR DOCTORS (which
    means you present your ideas too) and come up with a plan of action -- a
    studied, reasonable, long-term, PLAN of action. No more of this going
    off half-cocked and doing something wild based on something you're told
    by a bunch of strangers who know a lot about diabetes but aren't
    cardiologists -- and to whom you don't actually pay that much detailed
    attention. 130 isn't bad. It's not ideal, but it's not bad. For
    pete's sake just walk through the next month and see what your
    cardiologist says! And stop doing things without thinking them through!

    PP, T2

  4. #4
    Peppermint Patootie Guest

    Default Re: Is there a substitute for atenolol?

    In article <[email protected]>,
    Peppermint Patootie <[email protected]> wrote:

    > In article <_YlJl.216454$[email protected]>,
    > Michael <[email protected]> wrote:
    >
    > > I first diagnosed myself with type 2 when I saw my FBG levels at about
    > > 130. I immediately dropped my intake of carbs to below 10/day. This
    > > helped. I then dropped my dose of atenolol from 100 to 50 per day and
    > > began taking lisiniprol. This combination got my FBG down to 100.
    > >
    > > After a month of this my heart was still giving me trouble. I realize it
    > > takes longer than a month to really come off atenolol. However, my
    > > physician told me that beta blockers are a real boon to those of us with
    > > exertional angina. I have had exertional angina for 25 years. When I
    > > take 100 mg of atenolol I can trot up two flights of stairs in my home.
    > > I cannot do this on 50.
    > >
    > > I am scheduled to see a cardiologist in about a month. I will discuss my
    > > quandary with him and see if there is anything to be done.
    > >
    > > My physician took me off the lisiniprol and recommended that I go back
    > > to 100 mg of atenolol which I already had done. My FBG shot right back
    > > up to 130 within two days of restarting 100 mg of the beta blocker. My
    > > diet remained the same.
    > >
    > > I feel like I am in an unhappy position of deciding which is worse, a
    > > FBG of 130 or exertional angina on the stairway. My physician clearly
    > > believes that the FBG of 130 is the better choice. He said in my exam
    > > room "It would be a shame for you to be able to have great FBG levels
    > > but then die of heart failure".
    > >
    > > If there is no good substitute for atenolol, would I be better off
    > > taking metformin to get my FBG down to normal?
    > >
    > > Michael

    >
    > Metformin is a standard first line drug for type 2 diabetics. It is not
    > a substitute for atenalol.
    >
    > You need to remember that this is a marathon, not a sprint. You're
    > seeing your cardiologist in a month. Why are you wanting to make
    > changes now?
    >
    > I keep seeing you doing this, Michael -- reacting impulsively and not
    > paying attention to what you're told. Dropping carbs to below 10/day
    > and then cutting your atenalol dosage in half are wild and dramatic
    > actions for you. You need to think this out WITH YOUR DOCTORS (which
    > means you present your ideas too) and come up with a plan of action -- a
    > studied, reasonable, long-term, PLAN of action. No more of this going
    > off half-cocked and doing something wild based on something you're told
    > by a bunch of strangers who know a lot about diabetes but aren't
    > cardiologists -- and to whom you don't actually pay that much detailed
    > attention. 130 isn't bad. It's not ideal, but it's not bad. For
    > pete's sake just walk through the next month and see what your
    > cardiologist says! And stop doing things without thinking them through!
    >
    > PP, T2


    I realize my underlying point didn't come through clearly. Your heart
    problems are more liable to cause you dramatic damage in the short term,
    yes? Your MD's comment of dying of heart failure makes me think that.
    Type 2 diabetes is a long term health risk. You are not likely going to
    suddenly drop dead of type 2 diabetes. It usually does its damage in
    long term slowly-developing complications. A fasting BG of 130 while
    you're eating low carb (and thus not spiking), would probably not kill
    you for decades, if that. Messing with your cardiac treatment in order
    to achieve some kind of perfection in your BG numbers is insane because
    stopping treating your heart problem could kill you NOW or very soon.
    You need to prioritize here. A dramatic tragic end soon or a long
    lifetime of managing illness, during which you have many adventures,
    meet lovely people, and have a positive impact on the world? Your
    choice.

    PP

  5. #5
    [email protected] Guest

    Default Re: Is there a substitute for atenolol?

    On Apr 27, 11:28�am, Peppermint Patootie
    <Peppermint_Patoo...@yahoo.com> wrote:
    > In article <_YlJl.216454$Yx2.183...@en-nntp-06.dc1.easynews.com>,
    >
    >
    >
    >
    >
    > �Michael <mico...@sbcglobal.net> wrote:
    > > I first diagnosed myself with type 2 when I saw my FBG levels at about
    > > 130. I immediately dropped my intake of carbs to below 10/day. This
    > > helped. I then dropped my dose of atenolol from 100 to 50 per day and
    > > began taking lisiniprol. This combination got my FBG down to 100.

    >
    > > After a month of this my heart was still giving me trouble. I realize it
    > > takes longer than a month to really come off atenolol. However, my
    > > physician told me that beta blockers are a real boon to those of us with
    > > exertional angina. I have had exertional angina for 25 years. When I
    > > take 100 mg of atenolol I can trot up two flights of stairs in my home.
    > > I cannot do this on 50.

    >
    > > I am scheduled to see a cardiologist in about a month. I will discuss my
    > > quandary with him and see if there is anything to be done.

    >
    > > My physician took me off the lisiniprol and recommended that I go back
    > > to 100 mg of atenolol which I already had done. My FBG shot right back
    > > up to 130 within two days of restarting 100 mg of the beta blocker. My
    > > diet remained the same.

    >
    > > I feel like I am in an unhappy position of deciding which is worse, a
    > > FBG of 130 or exertional angina on the stairway. My physician clearly
    > > believes that the FBG of 130 is the better choice. He said in my exam
    > > room "It would be a shame for you to be able to have great FBG levels
    > > but then die of heart failure".

    >
    > > If there is no good substitute for atenolol, would I be better off
    > > taking metformin to get my FBG down to normal?

    >
    > > Michael

    >
    > Metformin is a standard first line drug for type 2 diabetics. �Itis not
    > a substitute for atenalol.
    >
    > You need to remember that this is a marathon, not a sprint. �You're
    > seeing your cardiologist in a month. �Why are you wanting to make
    > changes now?
    >
    > I keep seeing you doing this, Michael -- reacting impulsively and not
    > paying attention to what you're told. �Dropping carbs to below 10/day
    > and then cutting your atenalol dosage in half are wild and dramatic
    > actions for you. �You need to think this out WITH YOUR DOCTORS (which
    > means you present your ideas too) and come up with a plan of action -- a
    > studied, reasonable, long-term, PLAN of action. �No more of this going
    > off half-cocked and doing something wild based on something you're told
    > by a bunch of strangers who know a lot about diabetes but aren't
    > cardiologists -- and to whom you don't actually pay that much detailed
    > attention. �130 isn't bad. �It's not ideal, but it's not bad. �For
    > pete's sake just walk through the next month and see what your
    > cardiologist says! �And stop doing things without thinking them through!
    >
    > PP, T2


    Well said, Priscilla.

    Kurt

  6. #6
    Michael Guest

    Default Re: Is there a substitute for atenolol?

    Peppermint Patootie wrote:
    > In article <[email protected]>,
    > Peppermint Patootie <[email protected]> wrote:
    >
    >> In article <_YlJl.216454$[email protected]>,
    >> Michael <[email protected]> wrote:
    >>
    >>> I first diagnosed myself with type 2 when I saw my FBG levels at about
    >>> 130. I immediately dropped my intake of carbs to below 10/day. This
    >>> helped. I then dropped my dose of atenolol from 100 to 50 per day and
    >>> began taking lisiniprol. This combination got my FBG down to 100.
    >>>
    >>> After a month of this my heart was still giving me trouble. I realize it
    >>> takes longer than a month to really come off atenolol. However, my
    >>> physician told me that beta blockers are a real boon to those of us with
    >>> exertional angina. I have had exertional angina for 25 years. When I
    >>> take 100 mg of atenolol I can trot up two flights of stairs in my home.
    >>> I cannot do this on 50.
    >>>
    >>> I am scheduled to see a cardiologist in about a month. I will discuss my
    >>> quandary with him and see if there is anything to be done.
    >>>
    >>> My physician took me off the lisiniprol and recommended that I go back
    >>> to 100 mg of atenolol which I already had done. My FBG shot right back
    >>> up to 130 within two days of restarting 100 mg of the beta blocker. My
    >>> diet remained the same.
    >>>
    >>> I feel like I am in an unhappy position of deciding which is worse, a
    >>> FBG of 130 or exertional angina on the stairway. My physician clearly
    >>> believes that the FBG of 130 is the better choice. He said in my exam
    >>> room "It would be a shame for you to be able to have great FBG levels
    >>> but then die of heart failure".
    >>>
    >>> If there is no good substitute for atenolol, would I be better off
    >>> taking metformin to get my FBG down to normal?
    >>>
    >>> Michael

    >> Metformin is a standard first line drug for type 2 diabetics. It is not
    >> a substitute for atenalol.
    >>
    >> You need to remember that this is a marathon, not a sprint. You're
    >> seeing your cardiologist in a month. Why are you wanting to make
    >> changes now?
    >>
    >> I keep seeing you doing this, Michael -- reacting impulsively and not
    >> paying attention to what you're told. Dropping carbs to below 10/day
    >> and then cutting your atenalol dosage in half are wild and dramatic
    >> actions for you. You need to think this out WITH YOUR DOCTORS (which
    >> means you present your ideas too) and come up with a plan of action -- a
    >> studied, reasonable, long-term, PLAN of action. No more of this going
    >> off half-cocked and doing something wild based on something you're told
    >> by a bunch of strangers who know a lot about diabetes but aren't
    >> cardiologists -- and to whom you don't actually pay that much detailed
    >> attention. 130 isn't bad. It's not ideal, but it's not bad. For
    >> pete's sake just walk through the next month and see what your
    >> cardiologist says! And stop doing things without thinking them through!
    >>
    >> PP, T2

    >
    > I realize my underlying point didn't come through clearly. Your heart
    > problems are more liable to cause you dramatic damage in the short term,
    > yes? Your MD's comment of dying of heart failure makes me think that.
    > Type 2 diabetes is a long term health risk. You are not likely going to
    > suddenly drop dead of type 2 diabetes. It usually does its damage in
    > long term slowly-developing complications. A fasting BG of 130 while
    > you're eating low carb (and thus not spiking), would probably not kill
    > you for decades, if that. Messing with your cardiac treatment in order
    > to achieve some kind of perfection in your BG numbers is insane because
    > stopping treating your heart problem could kill you NOW or very soon.
    > You need to prioritize here. A dramatic tragic end soon or a long
    > lifetime of managing illness, during which you have many adventures,
    > meet lovely people, and have a positive impact on the world? Your
    > choice.
    >
    > PP


    Hi PP,

    I know you are right. I have had a lifetime of making impulsive
    decisions. I think it is in my dna. I mean that literally. I also
    realize that at my age, I cannot make dramatic changes in my treatment
    and expect to live through bad consequences every time.

    I have been seeing that 130 reading as really bad. I had gotten the
    reading down to a consistent 100. I felt a little angry and wanted to do
    something right now. I will coast along with that reading for now. I had
    just decided to reduce my carb count to zero. However, I realize after
    your message that going with 130 until I see my cardiologist is not
    going to kill me.

    I want to choose life. And I want the time to contribute something back
    to the society which has been so kind to me. It is not clear to me right
    now what I want to do. I had been working for several years as a
    volunteer in an AIDS house in Portland before I retired. I cannot do
    that here in this small town. There is a hospital here that might take
    me as a volunteer. I spent 20 years working at a medical school and have
    some skills and energy that they might be able to use.

    My wife is a moderating influence on me. She stops me from making rash
    decisions when she is aware of it. However, I can modify my treatment
    without her knowing about it. She occasionally sits me down and looks me
    in the eye and asks if I have been withholding any information about my
    health. It is impossible for me to get around that one.

    Michael

  7. #7
    Julie Bove Guest

    Default Re: Is there a substitute for atenolol?


    "Michael" <[email protected]> wrote in message
    news:_YlJl.216454$[email protected]..
    >I first diagnosed myself with type 2 when I saw my FBG levels at about 130.
    >I immediately dropped my intake of carbs to below 10/day. This helped. I
    >then dropped my dose of atenolol from 100 to 50 per day and began taking
    >lisiniprol. This combination got my FBG down to 100.


    Huh? BP meds won't lower your BG.
    >
    > After a month of this my heart was still giving me trouble. I realize it
    > takes longer than a month to really come off atenolol. However, my
    > physician told me that beta blockers are a real boon to those of us with
    > exertional angina. I have had exertional angina for 25 years. When I take
    > 100 mg of atenolol I can trot up two flights of stairs in my home. I
    > cannot do this on 50.


    I see that you are taking a Beta Blocker and it can cause diabetes. I think
    this is what happened to me. But in my case, my BG was all over the place
    with highs and lows.
    >
    > I am scheduled to see a cardiologist in about a month. I will discuss my
    > quandary with him and see if there is anything to be done.


    Okay.
    >
    > My physician took me off the lisiniprol and recommended that I go back to
    > 100 mg of atenolol which I already had done. My FBG shot right back up to
    > 130 within two days of restarting 100 mg of the beta blocker. My diet
    > remained the same.


    Hmmm... Perhaps you need to be on a diabetes med?
    >
    > I feel like I am in an unhappy position of deciding which is worse, a FBG
    > of 130 or exertional angina on the stairway. My physician clearly believes
    > that the FBG of 130 is the better choice. He said in my exam room "It
    > would be a shame for you to be able to have great FBG levels but then die
    > of heart failure".


    That would be a shame. But did he offer a diabetes med in the meantime?
    >
    > If there is no good substitute for atenolol, would I be better off taking
    > metformin to get my FBG down to normal?


    I would do that until you see the heart Dr.



  8. #8
    Peppermint Patootie Guest

    Default Re: Is there a substitute for atenolol?

    In article <gt54v0$kfm$[email protected]>,
    "Julie Bove" <[email protected]> wrote:

    > "Michael" <[email protected]> wrote in message
    > news:_YlJl.216454$[email protected]..
    > >I first diagnosed myself with type 2 when I saw my FBG levels at about 130.
    > >I immediately dropped my intake of carbs to below 10/day. This helped. I
    > >then dropped my dose of atenolol from 100 to 50 per day and began taking
    > >lisiniprol. This combination got my FBG down to 100.

    >
    > Huh? BP meds won't lower your BG.


    Atenalol tends to raise BG. That's a fact, and it's why I'm going to
    get off it. But not by cutting my dose in half on an impulse!

    PP, T2

  9. #9
    Bill Guest

    Default Re: Is there a substitute for atenolol?

    In article <gt54v0$kfm$[email protected]>,
    "Julie Bove" <[email protected]> wrote:

    > "Michael" <[email protected]> wrote in message
    > news:_YlJl.216454$[email protected]..
    > >I first diagnosed myself with type 2 when I saw my FBG levels at about 130.
    > >I immediately dropped my intake of carbs to below 10/day. This helped. I
    > >then dropped my dose of atenolol from 100 to 50 per day and began taking
    > >lisiniprol. This combination got my FBG down to 100.

    >
    > Huh? BP meds won't lower your BG.
    > >
    > > After a month of this my heart was still giving me trouble. I realize it
    > > takes longer than a month to really come off atenolol. However, my
    > > physician told me that beta blockers are a real boon to those of us with
    > > exertional angina. I have had exertional angina for 25 years. When I take
    > > 100 mg of atenolol I can trot up two flights of stairs in my home. I
    > > cannot do this on 50.

    >
    > I see that you are taking a Beta Blocker and it can cause diabetes. I think
    > this is what happened to me. But in my case, my BG was all over the place
    > with highs and lows.
    > >
    > > I am scheduled to see a cardiologist in about a month. I will discuss my
    > > quandary with him and see if there is anything to be done.

    >
    > Okay.
    > >
    > > My physician took me off the lisiniprol and recommended that I go back to
    > > 100 mg of atenolol which I already had done. My FBG shot right back up to
    > > 130 within two days of restarting 100 mg of the beta blocker. My diet
    > > remained the same.

    >
    > Hmmm... Perhaps you need to be on a diabetes med?
    > >
    > > I feel like I am in an unhappy position of deciding which is worse, a FBG
    > > of 130 or exertional angina on the stairway. My physician clearly believes
    > > that the FBG of 130 is the better choice. He said in my exam room "It
    > > would be a shame for you to be able to have great FBG levels but then die
    > > of heart failure".

    >
    > That would be a shame. But did he offer a diabetes med in the meantime?
    > >
    > > If there is no good substitute for atenolol, would I be better off taking
    > > metformin to get my FBG down to normal?

    >
    > I would do that until you see the heart Dr.


    ............................

    Read this a few times.

    "What we show is that in hypertension, when you slow down the heart rate
    with a beta blocker, it actually shortens your life."

    Medical art not a science

    Bill

    >>>>>>>>>>>>>


    HYPERTENSION
    Reducing heart rate in hypertension is harmfulor is it just atenolol?
    OCTOBER 22, 2008 | Lisa Nainggolan
    New York, NY - Slowing the heart rate with beta blockers in people with
    hypertension is associated with an increased risk of cardiovascular
    events and death, a new systematic review shows [1]. Furthermore, the
    slower the heart rate, the greater the risk, report Dr Sripal Bangalore
    (St Luke's Roosevelt Hospital, New York) and colleagues in the October
    28, 2008 issue of the Journal of the American College of Cardiology.

    What we show is that in hypertension, when you slow down the heart rate
    with a beta blocker, it actually shortens your life.
    Senior author Dr Franz Messerli (St Luke's Roosevelt Hospital) told
    heartwire: "Slowing heart rate is known to prolong life expectancy, and
    with beta blockers post-MI and in heart failure, the slower you can make
    the heart rate, the better. But this new paper goes against the grain.
    What we show is that in hypertension, when you slow down the heart rate
    with a beta blocker, it actually shortens your life expectancy, it
    causes more heart attacks, more heart failure, and more strokes."
    Messerli says he and his team believe the likely explanation for this is
    "that slowing the heart rate with beta blockers increases the central
    pressure, and obviously the latter is one of the determinants of stroke
    and heart attack."
    Another hypertension expert sees things slightly differently, however.
    Dr John Cockcroft (Wales Heart Institute, Cardiff, UK) argues that in
    this review, the studies included almost exclusively used
    atenololsomething the authors do point outand that it is this drug per
    se that is likely the culprit here.
    What is vitally important to determine in this setting, he adds, "is
    whether it's atenolol that's bad or whether it's reduction of heart rate
    that's bad." This is crucial because there are other drugs that aren't
    beta blockers that lower heart rate, he explained, such as the new agent
    ivabradine (Procoralan, Servier). "This issue needs resolving because if
    it's heart-rate reduction [that is the cause], then that's bad news, and
    we need to know about it."

    Bradycardia not synonymous with cardioprotection in hypertension

    In the new review, Bangalore et al included nine randomized controlled
    trials evaluating beta blockers for hypertension that also reported
    heart-rate data, including 34*096 patients taking beta blockers, 30*139
    taking other antihypertensives, and 3987 receiving placebo. Of the
    patients in the beta-blocker arms, 78% received atenolol, 9% took
    oxprenolol, 1% propranolol, and 12% received
    atenolol/metoprolol/pindolol or hydrochlorothiazide.
    Paradoxically, a lower heart rate (as attained in the beta-blocker group
    at study end) was associated with a greater risk for the end points of
    all-cause mortality (r=-0.51; p<0.0001), cardiovascular mortality
    (r=-0.61; p<0.0001), MI (r=-0.85; p<0.0001), stroke (r=-0.20; p=0.06),
    or heart failure (r=-0.64; p<0.0001).
    "In contrast to patients with MI and heart failure,
    beta-blocker-associated reduction in heart rate increased the risk of
    cardiovascular events and death for hypertensive patients," the
    researchers conclude.
    Messerli told heartwire: "In the past, the term cardioprotection was
    synonymous with bradycardia. The more you had bradycardia, the better
    the heart was protected. This is not the case in hypertension. This may
    be okay post-MI and in heart failure, but it's not okay in hypertension."
    In an editorial accompanying the review, Dr Norman M Kaplan (University
    of Texas Southwestern Medical Center, Dallas) agrees [2]: "With this
    addition to the evidence, beta blockers will surely remain as indicated
    for heart failure, for after MI, and for tachyarrhythmias, but no longer
    for hypertension in the absence of these compelling indications."

    Difficult to extrapolate findings beyond atenolol

    Messerli and his colleagues do state in their discussion, however:
    "Further studies are needed to establish causation. It should also be
    noted that the beta blocker used in the studies was mainly atenolol, and
    hence, any meaningful extrapolation of these results to other beta
    blockers, including the newer vasodilating beta blockers, should be done
    with caution."

    Any meaningful extrapolation of these results to other beta blockers,
    including the newer vasodilating beta blockers, should be done with
    caution.
    Cockcroft contends that because this new review contains studies almost
    exclusively using atenolol, "this doesn't move the argument forward very
    much." Atenolol, he says, "has been tried and found guilty, and yet
    around 40% of prescriptions for beta blockers in the UK and in the US
    are still for atenolol. Atenolol should not be given to anybody. Nobody
    disagrees that atenolol is guilty, and yet we are still using it."
    He says that people think lowering heart rate is good, "because it
    reduces the amount of cyclical stress on the aorta, but if at the same
    time you are putting the central aortic pressure up, these things may
    cancel each other out." Atenolol has been compared in this respect with
    one of the newer vasodilating beta blockers, nebivolol (Bystolic,
    Forest/Mylan), and it was found that atenolol increases the central
    aortic pressure but nebivolol does not [3], he notes.
    "The newer vasodilating beta blockers may well not have any of these
    detrimental effects. Because they are vasodilatory, they may well offset
    the slowing of heart rate by decreasing wave reflection from the
    periphery and, in the case of nebivolol, by releasing nitric oxide, an
    endogenous vasodilator with antiatherogenic activity," he adds.

    To beta block or not, that is the question

    Regarding the role now of beta blockers in hypertension, Messerli
    commented to heartwire: "Beta blockers in hypertension are not very
    useful, and you probably should use any other single drug first before
    you add a beta blocker, and if you want to add a beta blocker, please
    use a vasodilating one such as carvedilol or nebivolol."

    Atenolol should not be given to anybody. Nobody disagrees that atenolol
    is guilty, and yet we are still using it.
    Cockcroft agrees with much of this, but maintains that beta blockade is
    still very important. "Beta blockade is vital. A large number of
    patients with hypertension have angina as well, so they've got to have a
    beta blocker. Furthermore, there is now evidence that younger subjects
    with hypertension (<50 years of age) may well be better treated with a
    beta blocker than older hypertensives, as they have a different
    hemodynamic form of hypertension. It's what beta blocker you give them
    that counts, and it shouldn't be atenolol."
    He believes the continued obsession with atenolol is "partly due to
    cheapness and habit, but also due to the failure of the people with good
    beta blockers to disseminate information on the deleterious effects of
    atenolol."

    Most important issue still not resolved; central pressure should be the
    focus

    Cockcroft says the more vital issue "that still needs resolving is
    whether it's atenolol that is bad or heart-rate reduction that is bad
    news. If it's the latter, we need to know about it, because there are
    other drugs that lower heart rate, such as ivabradine, and if you look
    at the BEAUTIFUL trial with this new drug, it was very negative."
    He believes a trial directly comparing ivabradine with atenolol in terms
    of central aortic pressure is needed, "and then you look at the effects
    on hemodynamics in terms of central pressure."
    Another way of examining this issue could be to give atenolol to people
    who have pacemakers in to slow their heart rate down and then switch the
    pacemaker back on and bring the heart rate back up to the baseline
    levelstill with them having atenolol on boardand "if the detrimental
    hemodynamics go away, then it's all heart rate, and if it doesn't, then
    atenolol has some effect beyond heart-rate reduction that is bad.
    "These are very, very important mechanistic experiments that need to be
    done now that we have other drugs that lower heart rate that aren't beta
    blockers, and we clearly need to be doing these studies," Cockcroft
    stresses.
    "I personally think that it's the atenolol that is bad and that it has
    some effects beyond heart-rate reduction that are bad, but we don't know
    from this Messerli review. If half [the trials they included] had used
    another beta blocker, then you would know for sure."
    "It's central pressure that the pharmaceutical industry should be
    focusing on," he adds, "because different drugs, especially beta
    blockers, have differential effects on central pressure, and we know
    from the Strong Heart Study that central aortic pressure is a better
    predictor of outcome than pressure in the arm."
    Messerli is a member of the speakers' bureau for Abbott,
    GlaxoSmithKline, Novartis, Pfizer, AstraZeneca, Bayer, Boehringer
    Ingelheim, Bristol-Myers Squibb, Forest, Sankyo, and Sanofi and has
    received research funding/grants from GlaxoSmithKline, Pfizer, Novartis
    and CardioVascular Therapeutics. Cockcroft is on the advisory board of
    Forest, which markets nebivolol, and has received research funding from
    the company.

    Sources
    1. Bangalore S, Sawhney S, and Messerli FH. Relation of beta-blocker
    induced heart rate lowering and cardioprotection in hypertension. J Am
    Coll Cardiol 2008; 52: 1482-1489.
    2. Kaplan NM. Beta-blockers in hypertension. Adding insult to injury.
    J Am Coll Cardiol 2008; 52: 1490-1491.
    3. Dhakam Z, Yasmin, McEniery CM, et al. A comparison of atenolol and
    nebivolol in isolated systolic hypertension. J Hypertens 2008; 26:
    351-356.

    Related links
    BEAUTIFUL for some: No overall advantage of ivabradine, but
    high-heart-rate patients may benefit
    [Clinical cardiology > Clinical cardiology; Aug 31, 2008]
    New review "beats the drum" for not using beta blockers in
    uncomplicated hypertension
    [Lipid/Metabolic > Lipid/Metabolic; Aug 08, 2007]
    Central aortic pressure readings seen as more prognostic than
    standard brachial pressure
    [Prevention > Prevention; Jun 18, 2007]
    Cochrane review: Beta blockers should not be first line for
    hypertension
    [HeartWire > News; Feb 02, 2007]
    New UK hypertension guidelines omit beta blockers for routine use
    [HeartWire > News; Jul 06, 2006]
    CAFE published: Amlodipine/perindopril combo reduces central aortic BP
    [Hypertension > Hypertension; Feb 21, 2006]


    .......................

    : J Am Coll Cardiol. 2008 Sep 23;52(13):1062-72.
    Links

    Beta-blockers for primary prevention of heart failure in patients with
    hypertension insights from a meta-analysis.
    Bangalore S, Wild D, Parkar S, Kukin M, Messerli FH.
    Department of Medicine, Division of Cardiology, St Luke's Roosevelt
    Hospital and Columbia University College of Physicians and Surgeons, New
    York, New York 10019, USA.
    OBJECTIVES: This study sought to evaluate the efficacy of beta-blockers
    (BBs) for primary prevention of heart failure (HF) in patients with
    hypertension. BACKGROUND: The American College of Cardiology/American
    Heart Association staging for HF classifies patients with hypertension
    as stage A HF, for which BBs are a treatment option. However, the
    evidence to support this is unknown. METHODS: We conducted a
    MEDLINE/EMBASE/CENTRAL search of randomized controlled trials that
    evaluated BB as first-line therapy for hypertension with follow-up for
    at least 1 year and with data on new-onset HF. The primary outcome was
    new-onset HF. Secondary outcomes were all-cause mortality,
    cardiovascular mortality, myocardial infarction, and stroke. RESULTS:
    Among the 12 randomized controlled trials, which evaluated 112,177
    patients with hypertension, BBs reduced blood pressure by 12.6/6.1 mm Hg
    when compared with placebo, resulting in a 23% (trend) reduction in HF
    risk (p = 0.055). When compared with other agents, the antihypertensive
    efficacy of BBs was comparable, which resulted in similar but no
    incremental benefit for HF risk reduction in the overall cohort (risk
    ratio: 1.00; 95% confidence interval: 0.92 to 1.08), in the elderly (>
    or =60 years) or in the young (<60 years). Analyses of secondary
    outcomes showed that BBs confirmed similar but no incremental benefit
    for the outcomes of all-cause mortality, cardiovascular mortality, and
    myocardial infarction but increased stroke risk by 19% in the elderly.
    CONCLUSIONS: In hypertensive patients, primary prevention of HF is
    strongly dependent on blood pressure reduction. When compared with other
    antihypertensive agents, there was similar but no incremental benefit of
    BBs for the prevention of HF. However, given the increased risk of
    stroke in the elderly, BBs should not be considered as first-line agents
    for prevention of HF.
    PMID: 18848139 [PubMed - in process

    --
    Garden in shade zone 5 S Jersey USA

    Not all who wander are lost.
    - J.R.R. Tolkien (1892-1973)









  10. #10
    Peppermint Patootie Guest

    Default Re: Is there a substitute for atenolol?

    In article <U%nJl.56428$[email protected]>,
    Michael <[email protected]> wrote:
    > Peppermint Patootie wrote:
    > > I realize my underlying point didn't come through clearly. Your heart
    > > problems are more liable to cause you dramatic damage in the short term,
    > > yes? Your MD's comment of dying of heart failure makes me think that.
    > > Type 2 diabetes is a long term health risk. You are not likely going to
    > > suddenly drop dead of type 2 diabetes. It usually does its damage in
    > > long term slowly-developing complications. A fasting BG of 130 while
    > > you're eating low carb (and thus not spiking), would probably not kill
    > > you for decades, if that. Messing with your cardiac treatment in order
    > > to achieve some kind of perfection in your BG numbers is insane because
    > > stopping treating your heart problem could kill you NOW or very soon.
    > > You need to prioritize here. A dramatic tragic end soon or a long
    > > lifetime of managing illness, during which you have many adventures,
    > > meet lovely people, and have a positive impact on the world? Your
    > > choice.


    > Hi PP,
    >
    > I know you are right. I have had a lifetime of making impulsive
    > decisions. I think it is in my dna. I mean that literally.


    Any chance you have an Attention Deficit Disorder? Don't laugh! I was
    diagnosed at age 53, and I've discovered a salutary decrease in my
    impulsivity since I've been treating it. Codgers like us can certainly
    have it, because they weren't diagnosing it when we were kids, and some
    of us rather smart types have been able to compensate in some ways so we
    haven't stuck out. My ability to compensate started to wear through
    about 5-10 years ago, hence my recent (2 years) diagnosis. There are
    *many* types, not just the hyperactive type. If you think this is
    possible, check out _Driven to Distraction_ by Edward Hallowell from
    your local library.

    > I also
    > realize that at my age, I cannot make dramatic changes in my treatment
    > and expect to live through bad consequences every time.


    There you go. Write that on a slip of paper and tape it to the mirror
    in your bathroom. Maybe with an affirmation like, "I am improving my
    health by making careful decisions." Hmmm?

    > I have been seeing that 130 reading as really bad. I had gotten the
    > reading down to a consistent 100. I felt a little angry and wanted to do
    > something right now. I will coast along with that reading for now. I had
    > just decided to reduce my carb count to zero. However, I realize after
    > your message that going with 130 until I see my cardiologist is not
    > going to kill me.


    Michael, you may find people here bemoaning a 130, but that's usually
    people who have years of experience tightly controlling their BG and who
    may not have other significant medical issues. That is not you! You're
    not going to be able to be perfect because you have too many variables
    at work. Do I suspect correctly that you might have a problem with
    trying to do things perfectly? T'ain't gonna happen, dude. You get to
    muddle along with the rest us humans. With so many apples in the air,
    you need to accept that "good enough" is darned good enough for you
    right now.

    > I want to choose life.


    Excellent choice.

    > And I want the time to contribute something back
    > to the society which has been so kind to me. It is not clear to me right
    > now what I want to do. I had been working for several years as a
    > volunteer in an AIDS house in Portland before I retired.


    Oregon or Maine? I'm in Boston.

    > I cannot do
    > that here in this small town. There is a hospital here that might take
    > me as a volunteer. I spent 20 years working at a medical school and have
    > some skills and energy that they might be able to use.


    Sounds possible. Are there any school kids who could use mentoring?
    Maybe some guy who's rubbed shoulders with academics and doctor types
    might be able to help some kid realize they're interested in pursuing an
    education in science? Even reading to little kids can have a lifelong
    effect on their interest in books and thus in expanding their minds and
    their horizons.

    > My wife is a moderating influence on me. She stops me from making rash
    > decisions when she is aware of it. However, I can modify my treatment
    > without her knowing about it. She occasionally sits me down and looks me
    > in the eye and asks if I have been withholding any information about my
    > health. It is impossible for me to get around that one.


    Do her a favor, and yourself, and keep her in the loop. She may serve
    as a sensible brake for when you start to accelerate off a cliff.
    Marriage is a partnership, right? Let your partner in on your thinking.

    > Michael


    Just suggestions. Overall -- chill, remember it's a marathon not a
    sprint, and make sure you're eating lots of non-starchy veggies and
    getting out for some nice long walks if that's on your "OK" list from
    your MD. OK?

    Hang in, Michael! Remember the tortoise and the hare.

    Priscilla

  11. #11
    Michael Guest

    Default Re: Is there a substitute for atenolol?


    > Related links
    > BEAUTIFUL for some: No overall advantage of ivabradine, but
    > high-heart-rate patients may benefit
    > [Clinical cardiology > Clinical cardiology; Aug 31, 2008]
    > New review "beats the drum" for not using beta blockers in
    > uncomplicated hypertension
    > [Lipid/Metabolic > Lipid/Metabolic; Aug 08, 2007]
    > Central aortic pressure readings seen as more prognostic than
    > standard brachial pressure
    > [Prevention > Prevention; Jun 18, 2007]
    > Cochrane review: Beta blockers should not be first line for
    > hypertension
    > [HeartWire > News; Feb 02, 2007]
    > New UK hypertension guidelines omit beta blockers for routine use
    > [HeartWire > News; Jul 06, 2006]
    > CAFE published: Amlodipine/perindopril combo reduces central aortic BP
    > [Hypertension > Hypertension; Feb 21, 2006]
    >
    >
    > ......................
    >
    > : J Am Coll Cardiol. 2008 Sep 23;52(13):1062-72.
    > Links
    >
    > Beta-blockers for primary prevention of heart failure in patients with
    > hypertension insights from a meta-analysis.
    > Bangalore S, Wild D, Parkar S, Kukin M, Messerli FH.
    > Department of Medicine, Division of Cardiology, St Luke's Roosevelt
    > Hospital and Columbia University College of Physicians and Surgeons, New
    > York, New York 10019, USA.
    > OBJECTIVES: This study sought to evaluate the efficacy of beta-blockers
    > (BBs) for primary prevention of heart failure (HF) in patients with
    > hypertension. BACKGROUND: The American College of Cardiology/American
    > Heart Association staging for HF classifies patients with hypertension
    > as stage A HF, for which BBs are a treatment option. However, the
    > evidence to support this is unknown. METHODS: We conducted a
    > MEDLINE/EMBASE/CENTRAL search of randomized controlled trials that
    > evaluated BB as first-line therapy for hypertension with follow-up for
    > at least 1 year and with data on new-onset HF. The primary outcome was
    > new-onset HF. Secondary outcomes were all-cause mortality,
    > cardiovascular mortality, myocardial infarction, and stroke. RESULTS:
    > Among the 12 randomized controlled trials, which evaluated 112,177
    > patients with hypertension, BBs reduced blood pressure by 12.6/6.1 mm Hg
    > when compared with placebo, resulting in a 23% (trend) reduction in HF
    > risk (p = 0.055). When compared with other agents, the antihypertensive
    > efficacy of BBs was comparable, which resulted in similar but no
    > incremental benefit for HF risk reduction in the overall cohort (risk
    > ratio: 1.00; 95% confidence interval: 0.92 to 1.08), in the elderly (>
    > or =60 years) or in the young (<60 years). Analyses of secondary
    > outcomes showed that BBs confirmed similar but no incremental benefit
    > for the outcomes of all-cause mortality, cardiovascular mortality, and
    > myocardial infarction but increased stroke risk by 19% in the elderly.
    > CONCLUSIONS: In hypertensive patients, primary prevention of HF is
    > strongly dependent on blood pressure reduction. When compared with other
    > antihypertensive agents, there was similar but no incremental benefit of
    > BBs for the prevention of HF. However, given the increased risk of
    > stroke in the elderly, BBs should not be considered as first-line agents
    > for prevention of HF.
    > PMID: 18848139 [PubMed - in process
    >

    Oh s*** Bill,

    Not only does atenolol raise BG levels but it looks like it kills you
    with heart attacks or stroke. I have been on it for 25 years now. I hope
    my new cardiologist is up on this. So now the question is still
    unanswered. We don't know if it is the atenolol or just the fact that it
    slows the heart.

    What is interesting about atenolol is that it has an absolutely direct
    effect on BG levels. At least for me. If I cut my atenolol dose in half
    my FBG goes down 30 points. Start taking it again and it goes back up 30
    points. YIKES

    Michael

  12. #12
    W. Baker Guest

    Default Re: Is there a substitute for atenolol?

    Michael <[email protected]> wrote:
    : I first diagnosed myself with type 2 when I saw my FBG levels at about
    : 130. I immediately dropped my intake of carbs to below 10/day. This
    : helped. I then dropped my dose of atenolol from 100 to 50 per day and
    : began taking lisiniprol. This combination got my FBG down to 100.

    : After a month of this my heart was still giving me trouble. I realize it
    : takes longer than a month to really come off atenolol. However, my
    : physician told me that beta blockers are a real boon to those of us with
    : exertional angina. I have had exertional angina for 25 years. When I
    : take 100 mg of atenolol I can trot up two flights of stairs in my home.
    : I cannot do this on 50.

    : I am scheduled to see a cardiologist in about a month. I will discuss my
    : quandary with him and see if there is anything to be done.

    : My physician took me off the lisiniprol and recommended that I go back
    : to 100 mg of atenolol which I already had done. My FBG shot right back
    : up to 130 within two days of restarting 100 mg of the beta blocker. My
    : diet remained the same.

    : I feel like I am in an unhappy position of deciding which is worse, a
    : FBG of 130 or exertional angina on the stairway. My physician clearly
    : believes that the FBG of 130 is the better choice. He said in my exam
    : room "It would be a shame for you to be able to have great FBG levels
    : but then die of heart failure".

    : If there is no good substitute for atenolol, would I be better off
    : taking metformin to get my FBG down to normal?

    : Michael

    That 130 may well be the better chice that having the heart problems. It
    may mean that at some time you will need some kind of diabetic med so you
    can control BOTH your heart and your bg's .

    I had a discussion with my endo about a year or so ago about going on an
    Atkins type very low carb diet to try to lose some weight. As I
    somethimes hav some funny numbers involving cratenine/bun, which he
    believes is related to dehydrations, but is enough to cause a small worry
    about kidney problems down the road, he advised against a high protein
    diet because he said onec the kidneys go it is not good or reparable adn
    IF NECESSARY, aditional diabetic meds could be added without damage.

    I am using this an an snalygous situation, not that you, necesssarily,
    would need meds, but that is the kind of thinkig that goes into th
    equations of beign a diabetic and havign other issues.

    Wendy

  13. #13
    Peppermint Patootie Guest

    Default Re: Is there a substitute for atenolol?

    In article <87qJl.217373$[email protected]>,
    Michael <[email protected]> wrote:

    > Oh s*** Bill,
    >
    > Not only does atenolol raise BG levels but it looks like it kills you
    > with heart attacks or stroke. I have been on it for 25 years now. I hope
    > my new cardiologist is up on this. So now the question is still
    > unanswered. We don't know if it is the atenolol or just the fact that it
    > slows the heart.
    >
    > What is interesting about atenolol is that it has an absolutely direct
    > effect on BG levels. At least for me. If I cut my atenolol dose in half
    > my FBG goes down 30 points. Start taking it again and it goes back up 30
    > points. YIKES
    >
    > Michael


    Michael, I don't know who this Bill is or how good his information is.
    Please don't just take anyone one's word for anything.

    INVESTIGATE before you swallow anything as true.

    PP

  14. #14
    Bill Guest

    Default Re: Is there a substitute for atenolol?

    In article <[email protected]>,
    Peppermint Patootie <[email protected]> wrote:

    > In article <87qJl.217373$[email protected]>,
    > Michael <[email protected]> wrote:
    >
    > > Oh s*** Bill,
    > >
    > > Not only does atenolol raise BG levels but it looks like it kills you
    > > with heart attacks or stroke. I have been on it for 25 years now. I hope
    > > my new cardiologist is up on this. So now the question is still
    > > unanswered. We don't know if it is the atenolol or just the fact that it
    > > slows the heart.
    > >
    > > What is interesting about atenolol is that it has an absolutely direct
    > > effect on BG levels. At least for me. If I cut my atenolol dose in half
    > > my FBG goes down 30 points. Start taking it again and it goes back up 30
    > > points. YIKES
    > >
    > > Michael

    >
    > Michael, I don't know who this Bill is or how good his information is.
    > Please don't just take anyone one's word for anything.
    >
    > INVESTIGATE before you swallow anything as true.
    >
    > PP


    Susan may know That I am an idiot.

    Bill

    --
    Garden in shade zone 5 S Jersey USA

    Not all who wander are lost.
    - J.R.R. Tolkien (1892-1973)









  15. #15
    Tiger Lily Guest

    Default Re: Is there a substitute for atenolol?

    Michael wrote:
    > I first diagnosed myself with type 2 when I saw my FBG levels at about
    > 130. I immediately dropped my intake of carbs to below 10/day. This
    > helped. I then dropped my dose of atenolol from 100 to 50 per day and
    > began taking lisiniprol. This combination got my FBG down to 100.
    >
    > After a month of this my heart was still giving me trouble. I realize it
    > takes longer than a month to really come off atenolol. However, my
    > physician told me that beta blockers are a real boon to those of us with
    > exertional angina. I have had exertional angina for 25 years. When I
    > take 100 mg of atenolol I can trot up two flights of stairs in my home.
    > I cannot do this on 50.
    >
    > I am scheduled to see a cardiologist in about a month. I will discuss my
    > quandary with him and see if there is anything to be done.
    >
    > My physician took me off the lisiniprol and recommended that I go back
    > to 100 mg of atenolol which I already had done. My FBG shot right back
    > up to 130 within two days of restarting 100 mg of the beta blocker. My
    > diet remained the same.
    >
    > I feel like I am in an unhappy position of deciding which is worse, a
    > FBG of 130 or exertional angina on the stairway. My physician clearly
    > believes that the FBG of 130 is the better choice. He said in my exam
    > room "It would be a shame for you to be able to have great FBG levels
    > but then die of heart failure".
    >
    > If there is no good substitute for atenolol, would I be better off
    > taking metformin to get my FBG down to normal?
    >
    > Michael


    yup, your Dr has a good point

    and so do you...... perhaps metformin will fix the high fasting bg levels

    i know a type 2 who takes 500 mg of metformin before bed, and that's
    sorted the am fasting bg level out for him

    good luck

    kate (diovan and propanolol)

  16. #16
    Howard S Shubs Guest

    Default Re: Is there a substitute for atenolol?

    In article <_YlJl.216454$[email protected]>,
    Michael <[email protected]> wrote:

    > I first diagnosed myself with type 2 when I saw my FBG levels at about
    > 130. I immediately dropped my intake of carbs to below 10/day. This
    > helped. I then dropped my dose of atenolol from 100 to 50 per day and
    > began taking lisiniprol. This combination got my FBG down to 100.
    >
    > After a month of this my heart was still giving me trouble. I realize it
    > takes longer than a month to really come off atenolol. However, my
    > physician told me that beta blockers are a real boon to those of us with
    > exertional angina. I have had exertional angina for 25 years. When I
    > take 100 mg of atenolol I can trot up two flights of stairs in my home.
    > I cannot do this on 50.


    My doctor switched me to an ACE inhibitor. It has a kidney-protecting
    effect as well.

    --
    Don't bother with piddly crap like "gun control".
    Life is 100% fatal. Ban it.

  17. #17
    Susan Guest

    Default Re: Is there a substitute for atenolol?

    x-no-archive: Yes

    W. Baker wrote:

    > I had a discussion with my endo about a year or so ago about going on an
    > Atkins type very low carb diet to try to lose some weight. As I
    > somethimes hav some funny numbers involving cratenine/bun, which he
    > believes is related to dehydrations, but is enough to cause a small worry
    > about kidney problems down the road, he advised against a high protein
    > diet because he said onec the kidneys go it is not good or reparable adn
    > IF NECESSARY, aditional diabetic meds could be added without damage.



    Wendy, he's wrong. Low carb is NOT high protein, it's high fat and fiber.

    And high protein does not damage normal kidneys, glucose does.

    Susan

  18. #18
    bgl Guest

    Default Re: Is there a substitute for atenolol?

    "Susan" <[email protected]> wrote in message
    news:[email protected]..
    >
    > W. Baker wrote:
    >
    >> I had a discussion with my endo about a year or so ago about going on an
    >> Atkins type very low carb diet to try to lose some weight. As I
    >> somethimes hav some funny numbers involving cratenine/bun, which he
    >> believes is related to dehydrations, but is enough to cause a small worry
    >> about kidney problems down the road, he advised against a high protein
    >> diet because he said onec the kidneys go it is not good or reparable adn
    >> IF NECESSARY, aditional diabetic meds could be added without damage.

    >
    >
    > Wendy, he's wrong. Low carb is NOT high protein, it's high fat and fiber.
    >
    > And high protein does not damage normal kidneys, glucose does.
    >


    If you're already having "funny numbers" on kidney tests, & you don't
    *know for a fact* that it's not due to "damage" (or a very early hint),
    you can't assume (at least I wouldn't want to risk it) that your
    kidneys are "normal".
    JMO
    bj





  19. #19
    Michael Guest

    Default Re: Is there a substitute for atenolol?

    Well,

    I decided to coast along the way I am eating and exercising for now. My
    FBG this morning was 120. This is not a good number but it is not a
    damage causing number. I decided to just be calm about this until I
    speak with my cardiologist. I will put my quandary to him.

    Hopefully, he will have an answer that makes sense.

    Thanks, for all your comments. I think I need to raise my freak out
    threshold a bit.

    Michael

  20. #20
    krom Guest

    Default Re: Is there a substitute for atenolol?

    right every study showign protien damages kidneys was done on already VERY
    SICK ELDERLY patients and were giving extreamly high protien amounts that
    the failed kidney couldnt take.

    i am sure those failed kidneys couldnt take sugar or fiber or much anything
    tossed at them in high levels.

    Testing a on dialosis needing... 60 year old ..with massive amounts of
    anythings is not only bad science but cruel and inhumane.

    so the studies like that prove nothing.

    the studies done on healthy adults show no such damage to kidneys and
    improvment in other areas such as lipids and brain function.

    KROM


    "Susan" <[email protected]> wrote in message
    news:[email protected]..
    > x-no-archive: Yes
    >
    > W. Baker wrote:
    >
    >> I had a discussion with my endo about a year or so ago about going on an
    >> Atkins type very low carb diet to try to lose some weight. As I
    >> somethimes hav some funny numbers involving cratenine/bun, which he
    >> believes is related to dehydrations, but is enough to cause a small worry
    >> about kidney problems down the road, he advised against a high protein
    >> diet because he said onec the kidneys go it is not good or reparable adn
    >> IF NECESSARY, aditional diabetic meds could be added without damage.

    >
    >
    > Wendy, he's wrong. Low carb is NOT high protein, it's high fat and fiber.
    >
    > And high protein does not damage normal kidneys, glucose does.
    >
    > Susan




  21. #21
    Peppermint Patootie Guest

    Default Re: Is there a substitute for atenolol?

    In article <9mGJl.186381$[email protected]>,
    Michael <[email protected]> wrote:

    > Well,
    >
    > I decided to coast along the way I am eating and exercising for now. My
    > FBG this morning was 120. This is not a good number but it is not a
    > damage causing number. I decided to just be calm about this until I
    > speak with my cardiologist. I will put my quandary to him.


    Good.

    > Hopefully, he will have an answer that makes sense.


    I hope so. He'll certainly have a perspective to add to the collection
    that ends up producing your treatment decisions.

    > Thanks, for all your comments. I think I need to raise my freak out
    > threshold a bit.


    Oh, just a tad! ;-) Maybe some breathing exercises? More long walks?

    Hang in there, Michael!

    Priscilla

  22. #22
    Alan S Guest

    Default Re: Is there a substitute for atenolol?

    On Tue, 28 Apr 2009 10:06:33 -0400, Susan
    <[email protected]> wrote:

    >x-no-archive: Yes
    >
    >W. Baker wrote:
    >
    >> I had a discussion with my endo about a year or so ago about going on an
    >> Atkins type very low carb diet to try to lose some weight. As I
    >> somethimes hav some funny numbers involving cratenine/bun, which he
    >> believes is related to dehydrations, but is enough to cause a small worry
    >> about kidney problems down the road, he advised against a high protein
    >> diet because he said onec the kidneys go it is not good or reparable adn
    >> IF NECESSARY, aditional diabetic meds could be added without damage.

    >
    >
    >Wendy, he's wrong. Low carb is NOT high protein, it's high fat and fiber.
    >
    >And high protein does not damage normal kidneys, glucose does.
    >
    >Susan


    Just an aside Susan.

    You may recall a comment I made about archiving recently.
    Last night I was searching for something else and found my
    own name appearing on a site called medkb; we see people
    posting via that source occasionally.

    Although some think usenet is dead there is a thriving
    industry feeding off our posts. Medkb happens to be one such
    site, too lazy to set up their own forum so their
    subscribers think this is their forum. Others include, but
    are not limited to, http://www.foodbanter.com/ ,
    http://forum.lowcarber.org/ and
    http://www.cyclingforums.com/

    Oddly, I would have to register on one of those to post here
    through them; not all mention that this is usenet.

    Whether or not you use x-no archive, every post made here
    that passes their moderation filters is recorded for
    posterity in places like that.

    Compare these two threads:
    Google:
    http://tinyurl.com/cngfm3 or
    http://groups.google.com/group/alt.s...d8ed2c7c8fab20

    Medkb:
    http://www.medkb.com/Uwe/Forum.aspx/...saturated-fats

    You will also find several other sites feeding off us in the
    same way without respecting x-no archive or similar
    commands.

  23. #23
    Susan Guest

    Default Re: Is there a substitute for atenolol?

    x-no-archive: yes



    Alan S wrote:

    > Just an aside Susan.
    >
    > You may recall a comment I made about archiving recently.
    > Last night I was searching for something else and found my
    > own name appearing on a site called medkb; we see people
    > posting via that source occasionally.
    >
    > Although some think usenet is dead there is a thriving
    > industry feeding off our posts. Medkb happens to be one such
    > site, too lazy to set up their own forum so their
    > subscribers think this is their forum. Others include, but
    > are not limited to, http://www.foodbanter.com/ ,
    > http://forum.lowcarber.org/ and
    > http://www.cyclingforums.com/
    >
    > Oddly, I would have to register on one of those to post here
    > through them; not all mention that this is usenet.
    >
    > Whether or not you use x-no archive, every post made here
    > that passes their moderation filters is recorded for
    > posterity in places like that.
    >
    > Compare these two threads:
    > Google:
    > http://tinyurl.com/cngfm3 or
    > http://groups.google.com/group/alt.s...d8ed2c7c8fab20
    >
    > Medkb:
    > http://www.medkb.com/Uwe/Forum.aspx/...saturated-fats
    >
    > You will also find several other sites feeding off us in the
    > same way without respecting x-no archive or similar
    > commands.


    I've been aware of such sites for years, Alan. It's one reason, though
    not the main reason, that I stopped using a real name online many years
    ago.

    Susan

  24. #24
    Chris Malcolm Guest

    Default Re: Is there a substitute for atenolol?

    Peppermint Patootie <[email protected]> wrote:
    > In article <U%nJl.56428$[email protected]>,
    > Michael <[email protected]> wrote:


    >> Hi PP,
    >>
    >> I know you are right. I have had a lifetime of making impulsive
    >> decisions. I think it is in my dna. I mean that literally.


    > Any chance you have an Attention Deficit Disorder? Don't laugh! I was
    > diagnosed at age 53, and I've discovered a salutary decrease in my
    > impulsivity since I've been treating it.


    How are you treating it? The usual stimulants are ruled out for me,
    another ADDult, having had a heart attack and having high blood
    pressure. Except for the old natural herbal stimulant remedies of tea,
    coffee, and chocolate :-)

    --
    Chris Malcolm

  25. #25
    Peppermint Patootie Guest

    Default Re: Is there a substitute for atenolol?

    In article <[email protected]>,
    Chris Malcolm <[email protected]> wrote:

    > Peppermint Patootie <[email protected]> wrote:
    > > In article <U%nJl.56428$[email protected]>,
    > > Michael <[email protected]> wrote:

    >
    > >> Hi PP,
    > >>
    > >> I know you are right. I have had a lifetime of making impulsive
    > >> decisions. I think it is in my dna. I mean that literally.

    >
    > > Any chance you have an Attention Deficit Disorder? Don't laugh! I was
    > > diagnosed at age 53, and I've discovered a salutary decrease in my
    > > impulsivity since I've been treating it.

    >
    > How are you treating it? The usual stimulants are ruled out for me,
    > another ADDult, having had a heart attack and having high blood
    > pressure. Except for the old natural herbal stimulant remedies of tea,
    > coffee, and chocolate :-)


    I do take Adderall, but I've also found some some non-medicinal tools to
    treat some of the symptoms -- finding ways which provide novelty to
    approach tasks which have trouble holding my attention otherwise,
    keeping lists, opting towards structure, enlisting others to help me.
    But that Adderall really does help. The first day I took it, it was
    like someone hit me over the head with a velvet hammer, and for the
    first time in my life the law of gravity applied to me. Amphetamines,
    in very low doses, *slow* down my thinking and allow it to be controlled.

    Would your MD possibly allow a trial of a very low dose? I take 10 mg
    of extended-release Adderall (mixed amphetamine salts) twice a day.

    I have a friend who treats her ADD with large doses of caffeine, but
    that wouldn't be good for someone with heart issues either, would it?

    Priscilla

  26. #26
    Chris Malcolm Guest

    Default Re: Is there a substitute for atenolol?

    Peppermint Patootie <[email protected]> wrote:
    > In article <[email protected]>,
    > Chris Malcolm <[email protected]> wrote:


    >> Peppermint Patootie <[email protected]> wrote:
    >> > In article <U%nJl.56428$[email protected]>,
    >> > Michael <[email protected]> wrote:

    >>
    >> >> Hi PP,
    >> >>
    >> >> I know you are right. I have had a lifetime of making impulsive
    >> >> decisions. I think it is in my dna. I mean that literally.

    >>
    >> > Any chance you have an Attention Deficit Disorder? Don't laugh! I was
    >> > diagnosed at age 53, and I've discovered a salutary decrease in my
    >> > impulsivity since I've been treating it.

    >>
    >> How are you treating it? The usual stimulants are ruled out for me,
    >> another ADDult, having had a heart attack and having high blood
    >> pressure. Except for the old natural herbal stimulant remedies of tea,
    >> coffee, and chocolate :-)


    > I do take Adderall, but I've also found some some non-medicinal tools to
    > treat some of the symptoms -- finding ways which provide novelty to
    > approach tasks which have trouble holding my attention otherwise,
    > keeping lists, opting towards structure, enlisting others to help me.


    I got better at doing that kind of thing too, but I'm afraid the
    self-indulgences that retirement has permitted hasn't helped my self
    discipline. On the other hand it has very likely improved my mental
    and physical health :-)

    > But that Adderall really does help. The first day I took it, it was
    > like someone hit me over the head with a velvet hammer, and for the
    > first time in my life the law of gravity applied to me. Amphetamines,
    > in very low doses, *slow* down my thinking and allow it to be controlled.


    I found that too, long ago, buying them illegally in the street.

    > Would your MD possibly allow a trial of a very low dose? I take 10 mg
    > of extended-release Adderall (mixed amphetamine salts) twice a day.


    He wouldn't do that without a diagnosis. Last time I tried pushing
    that one through I ended up in the office of a "specialist" in ADHD
    who didn't know that girls and adults sometimes suffered from ADHD as
    well as boys, and got pretty freaked out when I tried to educate her.

    > I have a friend who treats her ADD with large doses of caffeine, but
    > that wouldn't be good for someone with heart issues either, would it?


    I also do the powerful coffee thing, which does worry my doctor. If
    coffee was a prescription drug he would probably refuse to prescribe
    it. But I did my own research and discovered that some of the evils
    attributed to caffeine are in fact due to the oxidation byproducts of
    the usual standard stale coffee, which researchers hardly ever control
    for. I'm a seriously high quality coffee drinker, and discovered long
    ago that weak stale coffee messed up my heart a lot more than strong
    really fresh coffee.

    Now that my heart attack, angina, and diabetes diagnosis are all years
    behind me, and I've changed to a much healthier lifestyle (lower carb
    and higher exercise), my heart feels a lot better. It used to feel
    rather fragile, and often had episodes of irregular beats, choking
    feelings, etc.. It now feels pretty robust, hardly ever feels a bit
    fragile or beats irregularly, and when it does the episodes are much
    milder and much shorter in duration.

    When it was at its most fragile, I had to go up stairs slowly and had
    to be careful not to go up more than three flights of stairs without
    taking a rest. I can now run up three flights of stairs, and several
    weeks ago went up the 300 steps to the top of an ancient monument
    while carrying about 20 pounds weight.

    The measurements my doc uses to assess my heart health don't seem to
    have changed much, so he still worries. But the feelings I use to
    assess my heart health have improved hugely, so I'm much less worried.

    --
    Chris Malcolm

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