Heart diseases

[shahriar1119]

What is the drug of choice for predominant diastolic hypertension (8 - 8.5 cmhg sustainedly) in a 53yrs old man , to start?

[gymdandee]

Slash Heart Disease Risk by 81 Percent

For millions or people, statin drugs are the number one doctor-prescribed defense against heart disease. In fact, so many people take them that we spent $12.5 billion on Lipitor in 2006 alone. But brand new research reveals that they may seriously damage your health. That’s because statins significantly increase your risk of diabetes.

That means millions of people taking the drugs now have to decide which is worse… heart disease or diabetes.

An epic study shows that specific dietary changes can reduce your risk of heart disease by 81 percent – without resorting to statin drugs. And leading doctors agree that combatting heart disease through diet isn’t just safer… it’s far more effective too.
                                               Dangers of Statin Drugs
Plenty of reports say statin drugs cause severe pain and can actually make muscles atrophy. Worse, they may actually increase your risk of stroke.
Now, a brand new study, published in The Lancet, confirms that statins do cause diabetes. Researchers reviewed the case files of over 91,000 people from 1994 through 2009. They found a direct link between people taking statins and developing diabetes.



Why use a [drug] with significant risks when other treatments [are] more effective for reducing heart disease? asks Dr. Mark Hyman, a Massachusetts physician who serves on the Board of Advisors at Georgetown University. He says he’s helped hundreds of patients combat heart disease without using statin drugs.

Another study – put out several years earlier by the American Medical Association – also found that statins increase diabetes risk. The paper showed that while statins lowered cholesterol, they raised insulin levels. And that’s a precursor for diabetes.
What’s worse, raised insulin leads to extra body fat… higher blood pressure… and increased inflammation. All of which contribute to heart disease.
“In other words, lowering cholesterol with statins actually increases the risk of heart disease,” says Dr. Hyman.
But statin drugs are huge business. They generate over $12.5 billion in sales each year for Lipitor alone. And many doctors are pushed to prescribe them.
These drugs are the conventional response to high cholesterol. So drug companies have worked to make sure more people take them.
“When I was at medical school, the ‘normal’ cholesterol was 250,” says Dr. Carolyn Dean, MD. “The new ‘normal’ promoted by drug companies is 180. Hammering cholesterol down with statin drugs is the wrong approach.”
                                                  Causes of Heart Disease
The Archives of Internal Medicine has just published the results if its “EPIC” study. Researchers took 23,000 people and studied their risk factors for heart disease. They found that changes in diet reduced heart attack risk by 81 percent.
How could such simple changes deliver such amazing results? By lowering blood pressure and reducing inflammation.
This comes as no surprise to NHD panel member Dr. Dwight Lundell. He was a heart surgeon for 25 years and performed over 5,000 open-heart surgeries. During his career he’s pioneered several innovative advances in coronary medicine.
He says four things cause inflammation and lead to heart disease.
1) Simple carbs and grains are the single biggest threat to heart health. They raise blood sugar which releases insulin into your system. Insulin stores and builds fat – especially around the waist.
“Every time we raise our blood sugar we injure the delicate lining of our blood vessels,” says Dr. Lundell.
And that leads to inflammation and heart disease.
2) Vegetable oils are deadly for our coronary system. They contain an unhealthy amount of omega 6 fatty acids.
Our bodies change these fatty acids into chemicals that cause chronic inflammation.
“We do need omega 6,” says Dr. Lundell. “But we’re getting 20-25 times more in our diets.”
3) Deficiency in omega 3 fatty acids hurts heart health.
“Omega 3 is a powerful natural anti-inflammatory,” he says.
There’s plenty of research which shows omega 3 boosts heart health. Those studies say it’s your best option for cooling inflammation.
4) Oxidative stress damages your heart. Free radical damage causes inflammation and increases stroke risk.
“Oxidative stress is detrimental to health and is definitely [linked] with heart disease,” says Dr. Lundell.
The good news is that all of these heart risks are easy to fix without statin drugs. Small, simple changes in diet can improve heart health.

                                            Boost Heart Health through Diet
You can take a few key steps to improve your diet and heart health. In a nutshell, you need to eat more omega 3s and cut back on omega 6s. Slash your carbs and go for healthy fats and protein. And look to boost your intake of antioxidants.
                                    Here’s a step-by-step guide to what you need to do:
Make omega 3 fatty acids part of your daily diet. So much scientific evidence shows that omega 3s are vital to heart health. And there are plenty of good sources to choose from. There’s no good reason not to enjoy omega 3s.
                                        
                                         Your best sources for these fatty acids include:

Sardines, Tuna, Wild salmon, Grass-fed beef,  Milk, Cage-free eggs,
Be sure when choosing fish that you avoid the farm-raised variety. It’s better to go for cold-water wild fish. That’s because they have a proper ratio of omega 3 to omega 6.
Dr. Lundell says you need to eat at least two to three servings of fresh fish each week.
Another easy option for getting omega 3 into your diet is a simple fish oil supplement.
“Supplement your diet with at least 3 grams of high quality pure fish oil,” says Dr. Lundell.
Cut out omega 6 from your diet. Too much of this fatty acid will do serious harm. So try to keep your omega 3s high and your omega 6s low. It’s pretty easy to do with a little effort and well worth it. Just make sure you avoid the worst foods. These include:

Grain-fed beef, Grain-fed chicken,  Processed foods, Fried foods, Vegetable oils
Try to get more saturated fats into your diet. These can really help to reduce inflammation.
Great sources include:
Olive oil,  Walnuts, pecans, and almonds,  Avocados
Slash sugary and starchy carbs from your diet. These are the worst offenders for raising blood sugar and insulin. That process wreaks havoc on long-term heart health. Worst offenders include:
Bread, Pasta, Rice
Look to enrich your diet with antioxidants.There are so many to choose from. Even foods like dark chocolate and red wine are loaded with them. Some of the best antioxidants include:
Berries,  Broccoli, Grapes,  Spinach
You can easily combine all of these suggestions into simple meal plans. For breakfast, switch out bagels and cheerios for yogurt, hard boiled eggs, and a handful or almonds.
When you’re on the run, try combining your healthy snack foods to enjoy vital omega 3s and antioxidants in one go. A grab-bag of walnuts, blueberries, and grapes packs a powerful punch. A don’t forget to wash it down with some antioxidant-rich green tea.

You can’t beat broccoli and grass-fed beef for dinner… or spinach and wild salmon… for a powerful combination of health benefits. And you can help yourself to a glass of red wine (loaded with youth-preserving resveratrol) and a square or two of dark chocolate.

[lvhguy]

an ACE inhibitor
Which stands for angio-tensin converting enzyme inhibitor.

It causes the arterial system to 'tense' up, taking this relaxes the arterial system and allows the overall hydraulic pressure to be reduced.
Since you are in your fifties, you'll need at some point to add a mild diuretic to gain long term control and that usually is hydrochlorothiazide. BP meds typically are outsmarted by the kidneys over time so long term that is necessary

Very cheap combo is lisinopril/hctz and very effective
They make combination pills of both drugs

If you get a cough as ace inhibitors can sometimes cause, you can switch to angiotensin receptor blocker. Similar effect but these are newer and more expensive and they are also paired usually with HCTZ to prevent the kidneys from holding onto salt in water when they realize the blood pressure is lowered.

[kenkeith]

The three principal cause of high diastolic pressure are obesity, diet, and smoking.  It seems diastole hbp has the same underlying causes as systole bp.  There is medication that relaxes vessels, and effective treatment would reduce the pressure needed to overcome higher than normal resistance of blood vessels.

Thanks for your question.