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long time beta-blockers use doesn’t enhance heart health.

long time beta-blockers use doesn’t enhance heart health.

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Following a heart attack, beta-blockers are frequently prescribed to patients to treat high blood pressure and heart conditions.

According to a recent study, taking drugs over the long term after a heart attack doesn’t seem to benefit cardiovascular health.

The observational study, according to experts, offers useful data, but they also point out that beta-blockers continue to be helpful for a large number of people.

Research in the journal Heart found no evidence that long-term beta-blocker use improved cardiovascular health or decreased the risk of further heart attacks.

Researchers looked at the medical records of persons who had a heart attack between 2005 and 2016 and required hospital treatment using the Swedish national registry for coronary heart disease.

Records from 43,618 persons, with an average age of 64, were included in the study. There were about 1 in 4 women. None of them had left ventricular systolic dysfunction or cardiac failure.

One year after being hospitalized for a heart attack, of the participants, 34,253 (78%) were using beta-blockers, whereas 9,365 (22%) were not.

For an average of 4.5 years following their hospitalisation, the researchers followed up with the participants.

Researchers evaluated the two groups in terms of:

  • Death rates from all causes
  • Additional heart attacks
  • Getting re-vascularized, a procedure to bring back blood flow to certain areas of the heart
  • Heart attack

2,028 (22%) and 6,475 (19%) of the beta-blocker users had one of these occurrences during the observation period.

There was no noticeable difference in the rates between the two groups, according to the researchers, who took demographic factors and pertinent co-morbid disorders into account.

According to real-time data, the use of long-term beta-blockers after a heart attack in persons without heart failure or left ventricular systolic dysfunction was not linked to better cardiovascular outcomes.

Physician response to beta-blocker research

The interventional cardiologist at MemorialCare Heart & Vascular Institute at Orange Coast Medical Centre in California, Dr. Hoang Nguyen, recommended beta blockers for patients with left ventricular dysfunction since they had a demonstrable mortality benefit.

According to him, beta blockers are a lifetime in this patient population. “Beta blockers are necessary for patients with a history of coronary artery disease who are not candidates for bypass surgery or stents to lower angina symptoms and hospitalizations for this symptom. I might try to wean them off of beta blockers, especially if they have serious adverse effects if they have undergone revascularization (either with stents or bypass surgery) or have normally left ventricle function.“

This study has prompted some doctors to reconsider their methods, but not all of them are presently prepared to do so.

According to Dr. Devin Kehl, a non-invasive cardiologist at Providence Saint John’s Health Centre in California, “this study suggests that a long-term continuation of beta-blockers following myocardial infarction may not be of significant benefit in patients without any of those factors and with normal cardiac function.” However, because it was an observational study, the results might have been impacted by unrecognized confounders.

To be more clear about whether beta-blockers should be continued or stopped after one year following myocardial infarction, randomized trials are required, according to Kehl, who spoke to us. “Caution is needed in interpreting the results of this type of analysis and applying this clinical practice,” Kehl said.

In conclusion, it is still necessary for a patient’s cardiologist to exercise careful clinical judgement when deciding how long beta-blocker therapy should be administered after myocardial infarction.

Beta-blockers

Beta-blockers are used to treat high blood pressure and heart conditions.

They accomplish this by preventing the negative effects that stress hormones have on the heart and can lower heart rate. They are also beneficial for migraines.

Beta-blockers are typically regarded as secure and efficient. However, there are some adverse effects, such as:

  • Fatigue
  • easily running out of breath
  • Unsteadiness or faintness
  • Depression

Nguyen notes that side effects of the drugs include memory loss and impaired sexual function.

“Perhaps we should try to wean patients off beta blockers if a beta blocker is not needed after one year, especially if the patient’s heart function is normal,” Nguyen suggested.

Some people might not be able to take them or might quit taking them because of the negative effects.

The use of beta-blockers

After the first year of treatment, Miller typically stops prescribing beta-blockers to heart attack survivors with intact cardiac function.

They are only kept on the drug if there is another condition, like hypertension, that calls for it.

Those with heart failure, irregular cardiac rhythm, hypertension, and recurring palpitations that happen without a known trigger (like caffeine), are candidates who can benefit from beta-blockers.

“The patient should always discuss with their physician whether or not a beta-blocker is a suitable treatment and/or should be discontinued,” he said.

Reduce the dosage gradually rather than stopping the drug all at once if a patient decides to stop taking it.

Considering the future

Medication observation studies examine participants’ responses to a drug or treatment without changing their circumstances.

Observational studies are not regarded by medical practitioners as being as reliable as randomised, controlled trials. However, when prescribing medications, they provide important information for doctors and other medical professionals.

“Beta-blockers have long been and will continue to remain a cornerstone medical therapy following a myocardial infarction as they have been clearly demonstrated to reduce the risk of recurrent events and death,” said Kehl. However, clinical trials have not examined the benefit of beta-blockers in patients with normal cardiac function beyond three years after a myocardial infarction, and their benefit is strongest in the early period post-myocardial infarction, according to the study.

Additionally, patients with and without cardiac dysfunction were included in a mixed cohort in clinical trials looking at the benefits of beta-blockers, the author continued. “It is unclear if long-term use of beta-blockers after myocardial infarction benefits people with normal cardiac function. Due to a lack of data from clinical research, the American College of Cardiology guidelines do not directly address the issue. Currently, a long-term continuation of beta-blockers depends on carefully examining the patient’s cardiac history and determining whether there are any other distinct indications for using beta-blockers, such as arrhythmias, angina, cardiac dysfunction, heart failure, or hypertension.”

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Important Note on Hyperthyroidism you need to know.

Important Note on Hyperthyroidism you need to know.

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Your thyroid develops and manufactures hormones that are involved in numerous bodily processes. Thyroid disease is characterised by the overproduction or underproduction of these critical hormones by your thyroid. Thyroid disease comes in a variety of forms, such as hyperthyroidism, hypothyroidism, thyroiditis, and Hashimoto’s thyroiditis.

What is Hyperthyroidism?

When the thyroid gland overproduces hormone, it results in hyperthyroidism, or an overactive thyroid. Diarrhea, respiratory problems, and weariness are just a few of the consequences that may spread throughout the body.

The thyroid is a neck gland with a butterfly form. The body’s growth and metabolism are regulated by the hormones it creates and releases into the bloodstream. In the US, hyperthyroidism affects about 1 in 100 adults over the age of 12. People over 60 are the ones most prone to experience it.

Hypothyroidism, or an underactive thyroid, is distinct from hyperthyroidism. The terms “hyper” and “low” describe the amount of thyroid hormone in the body, respectively. Hyperthyroidism can have serious problems if left untreated. However, by lowering the synthesis of thyroid hormones, medicine can typically regulate it.

What causes hyperthyroidism?

Hyperthyroidism can be brought on by a number of circumstances. The most typical cause of hyperthyroidism is the autoimmune illness Graves’ disease. In Graves’ disease, your thyroid gland is attacked by antibodies produced by your immune system, which causes an excessive amount of hormone to be released.

Women experience Graves’ illness more frequently than males do. According to a 2011 research summary by Trusted Source, environmental circumstances do play a part in determining whether someone would acquire Graves’, but genetics account for the majority of the decision. Graves’ illness isn’t caused by a single gene deficiency, but rather by tiny mutations in a number of genes, according to studies of families and twins.

In order for your doctor to accurately assess your risk factors, you should let them know if any members of your family have been given a hyperthyroidism diagnosis.

Other causes of hyperthyroidism outside Graves’ disease include:

  • Excess iodine. Iodine is a crucial component of T4 and T3, and too much of it might temporarily increase the thyroid hormone’s production. Fish and dairy products are two foods that contain iodine. It can also be found in some drugs, including cough syrups, medical contrast dyes, and amiodarone (for heart arrhythmia).
  • Thyroiditis (inflammation of the thyroid). Conditions known as thyroiditis cause the thyroid gland to enlarge and produce either an excessive amount or an insufficient amount of the hormone.
  • Benign nodules on the thyroid. On the thyroid gland, nodules, which are lumps, frequently form for unclear reasons. Although the majority of thyroid nodules are benign, some do produce excessive thyroid hormones. Nodules are sometimes known as adenomas or benign tumours.
  • Hazardous thyroid nodules (toxic adenoma). There are certain cancerous or malignant thyroid nodules. A nodule’s benignity or malignancy can be evaluated via ultrasound or a procedure known as fine needle aspiration tissue biopsy.
  • Testicular or ovarian cancer.
  • Blood has a lot of T4. Certain dietary supplements or excessive doses of the thyroid hormone drug levothyroxine can cause high levels of T4.

Symptoms of hyperthyroidism

While certain physical signs of hyperthyroidism may be clear, others may be more subtle and first difficult to detect. Sometimes anxiety and hyperthyroidism are confused.

The National Institutes of Health (NIH) lists the following as hallmark signs and symptoms of hyperthyroidism:

It is possible for the thyroid gland to enlarge and develop a symmetrical or unilateral goitre. An enlarged gland is known as a goitre, and it is frequently identifiable as a lump or swelling near the base of the neck. Iodine deficiency is the most typical cause of a goitre.

Complications of hyperthyroidism

Depending on how well the body can adapt to the changes brought on by the extra thyroid hormones and how strictly a person adheres to their treatment plan, hyperthyroidism and accompanying symptoms can vary in severity. Possible complications from the condition are listed below.

Graves’ ophthalmopathy

Light sensitivity, pain or discomfort in the eye, and specific visual issues can all be brought on by Graves’ ophthalmopathy. A person’s eyes could also protrude.

Sunglasses and eye medicines can both aid with symptoms relief. In extreme circumstances, certain medications—such as steroids or immunosuppressive ones—can reduce the puffiness under the eyes.

A thyroid storm

A thyroid storm is a rare reaction that can happen following an illness, injury, or physical trauma like childbirth or surgery. If the person has undetected hyperthyroidism or problems managing the illness, it may also happen during pregnancy.

Emergency medical care is necessary for this potentially fatal reaction. Thyroid storm warning signs and symptoms include:

  • a pounding heart
  • acute fever
  • agitation
  • jaundice
  • vomiting
  • diarrhoea
  • dehydration
  • hallucinations

Treatment of hyperthyroidism

While some drugs focus on addressing thyroid hormone production, others treat the symptoms of hyperthyroidism, such as cardiac issues.

Beta-blockers

While beta-blockers cannot cure hyperthyroidism, they can lessen the symptoms while waiting for other treatments to work. It can take a few weeks or months, though.

Anthyroid medications

Antithyroid medication prevents the thyroid gland from overproducing thyroid hormone. Methimazole is a typical medication that doctors advise.

As methimazole may have adverse effects on the foetus, a doctor may advise propylthiouracil during a patient’s first trimester if the patient is pregnant. Later in the pregnancy, women who are pregnant may switch to methimazole.

The American Thyroid Association estimates that after using antithyroid medication for a period of 12 to 18 months, 20 to 30 percent of Graves’ disease patients have symptom remission. Medication side effects may include:

  • allergy symptoms
  • decreased white blood cells, which raises the risk of infection
  • rarely, liver failure occurs.
  • Iodine-131 radioactive

Active thyroid cells are destroyed when radioactive iodine penetrates them. There is only localised destruction and no adverse impacts that are felt widely. The radioiodine contains a very tiny dosage of radioactivity that is safe to consume.

However, women who are pregnant or nursing should not receive radioiodine treatment. Following therapy, doctors advise against getting pregnant for 6 to 12 months.

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What are the drugs that can cause Erectile dysfunction?

What are the drugs that can cause Erectile dysfunction?

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Summary

Sexual dysfunction is a result of a variety of medical problems and treatments. Antihypertensives, antidepressants, antipsychotics, and antiandrogens are among the medications frequently implicated.

The doctor will be able to customise therapies for the patient and his or her partner by being aware of the potential for drug-induced sexual issues and their detrimental effects on adherence to treatment.

Good clinical treatment necessitates facilitating a conversation with the patient regarding sexual function and offering solutions to the issue.

Introduction

Sexual dysfunction in both men and women is a result of several prescription drug groups. A patient’s likelihood of not adhering increases if they experience drug-induced sexual dysfunction. Antipsychotics and antihypertensives have been found to have this effect. Less information is known on female or couple problems, and the literature has emphasised male sexual disorders.

Alcohol, opioids, stimulants, and hallucinogens are examples of recreational drugs that can alter sexual function. Alcohol consumption has a short-term impact on sexual desire by lowering inhibitions, but it also lowers performance and delays climax and ejaculation. Contrary to what their spouses frequently describe, many substance users claim to have greater sexual function.

The phases of sexual desire, arousal, and orgasm make up sexual function. Any of these periods might be problematic for both men and women. A person’s partner may also be impacted by low desire, lack of swelling and lubrication in women, erectile dysfunction, premature, retrograde, or absent ejaculation, anorgasmia, and painful sex.

Medications resulting in Erectile dysfunction

You might want to start by looking in your medication cabinet if you are having trouble getting or keeping an erection. Many prescription and over-the-counter medications have the potential to cause erectile dysfunction. While these medications may be used to treat an illness or condition, they can also have an impact on a man’s hormones, nervous system, and blood circulation, which might lead to ED or raise the risk of ED.

Below is a list of medications that could result in ED. To rule out any medications as a cause of, or contributor to, ED, talk to your doctor about the medications you are now taking.

Medicine to lower blood pressure

Although all blood pressure drugs have the potential to result in erectile dysfunction, “diuretics” (sometimes known as “water pills”) are the most likely to do so. Following are a few blood pressure drugs that frequently result in ED:

  • Chlorothiazide, chlorthalidone, and hydrochlorothiazide are examples of thiazide diuretics.
  • Furosemide, Torsemide, and Ethacrynic Acid are examples of loop diuretics.
  • Spironolactone
  • Clonidine
  • Guanethidine
  • Methyldopa
  • Lastly, Beta-blockers, another class of heart medication, carry a negligible risk of ED. Popular medications such as metoprolol (Lopressor), atenolol (Tenormin), propranolol (Inderal), and bisoprolol are among them (Zebeta).

There is some good news if you take one of these drugs and experience ED. ED is not frequently brought on by the following blood pressure medications:

  • ACE inhibitors such as lisinopril, benazepril, enalapril, ramipril, quinapril, and ramipril
  • Alpha-blockers such as doxazosin, prazosin, and terazosin

Cholesterol-lowering drugs

Contrary to popular belief, statins (drugs used to decrease cholesterol) such as atorvastatin, simvastatin, and rosuvastatin do not result in ED. Self-reported erectile function for men with ED who take statins for elevated cholesterol really improves by 25%. It’s a win-win situation because the statin also promotes heart and then brain health.

Antidepressants

Low sex drive and erectile dysfunction are frequently brought on by depression. However, a lot of antidepressants might worsen erectile dysfunction and low sex drive.

Examples of antidepressants that cause ED include the following:

  • SSRIs include sertraline, fluoxetine, citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), and paroxetine (Paxil) (Zoloft)
  • SNRIs include duloxetine, venlafaxine, and desvenlafaxine (Effexor, Pristiq) (Cymbalta)
  • MAOIs include tranylcypromine, phenelzine, and isocarboxazid (Marplan) (Parnate)
  • Amitriptyline, nortriptyline, and clomipramine are examples of tricyclic and tetracyclic antidepressants.

The most often prescribed antidepressants and those that are most likely to result in ED are SSRIs (selective serotonin reuptake inhibitors). This is unfortunate because SSRIs are some of the best available antidepressants.

The following antidepressants have a lower risk of causing erectile dysfunction:

  • Bupropion (Zyban) (Zyban)
  • Mirtazapine (Remeron) (Remeron)
  • Patches for selegiline (Emsam)

Finally, discuss this with your doctor if you believe your antidepressant is contributing to erectile dysfunction.

Antihistamines

Erectile dysfunction can also be brought on by antihistamines like Benadryl, Dramamine, and Phenergan. Histamine, a substance in the body that has a role in both allergic reactions and good erections, is blocked by antihistamines.

Acid reflux medications

Similar to antihistamines, some H2 blocker medications used to treat acid reflux can disrupt histamine and result in erectile dysfunction. Cimetidine (Tagamet), a medication in this class, carries the highest risk for ED, but ranitidine (Zantac) and famotidine (Pepcid) carry a lower risk.

Opioid pain medications

Opioids and ED go hand in hand as well. Long-term opiate use can cause low testosterone and erectile dysfunction. Medications that contain opioids include morphine, oxycodone, and hydrocodone.

Do not stop taking the medicine if you have ED and suspect it might be related to your prescription without first talking to your doctor. Your doctor might be able to recommend a different drug if the issue continues.

The following recreational and regularly misused drugs are among those that can induce or lead to ED:

  • Alcohol /Amphetamines
  • Barbiturates
  • Cocaine
  • Marijuana
  • Methadone
  • Nicotine /Opiates

ED is not frequently discussed, aside from the well-known negative effects that using and abusing these medicines can have. However, using these medications can result in ED. These medicines can seriously harm blood vessels and result in persistent ED in addition to affecting and frequently suppressing the central nervous system.

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