Common antibiotics and blood pressure medication may result in hospitalization

ScienceDaily (Jan. 18, 2011) — Mixing commonly used antibiotics with common blood pressure medications may cause hypotension (abnormally low blood pressure) and induce shock in older patients, requiring hospitalization, according to a study published in CMAJ (Canadian Medical Association Journal).

"Macrolide antibiotics (erythromycin, clarithromycin and azithromycin) are among the most widely prescribed antibiotics, with millions of prescriptions dispensed in Canada each year." writes Dr. David Juurlink, Scientist at the Sunnybrook Research Institute and the Institute for Clinical Evaluative Sciences with coauthors. "The drugs are generally well-tolerated, but they can cause several important drug interactions."

This study was conducted among Ontarians 66 years and older who were treated with a calcium-channel blocker (drugs often used to treat high blood pressure) between 1994 and 2009. The researchers then identified those who were hospitalized for low blood pressure and, in that group, whether or not a macrolide antibiotic had been prescribed shortly beforehand.

The researchers identified 7100 patients hospitalized for low blood pressure or shock while taking a calcium channel blocker. Treatment with erythromycin was found to increase the risk of low blood pressure almost 6-fold, while clarithromycin increased the risk almost 4-fold. In contrast, azithromycin did not increase the risk of hypotension.

"In older patients receiving calcium channel blockers, the two macrolide antibiotics erythromycin and clarithromycin are associated with a major increase in the risk of hospitalization for hypotension," conclude the authors. "However, the related drug azithromycin appears safe. When clinically appropriate, it should be used preferentially in patients receiving a calcium channel blocker."

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Canadian Medical Association Journal, via EurekAlert!, a service of AAAS.

Journal Reference:

Alissa J. Wright, Tara Gomes, Muhammad M. Mamdani, John R. Horn and David N. Juurlink. The risk of hypotension following co-prescription of macrolide antibiotics and calcium-channel blockers. CMAJ, 2011; DOI: 10.1503/cmaj.100702

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Medication adherence improves blood pressure control in chronic kidney disease

ScienceDaily (Nov. 3, 2010) — Researchers at the University of Cincinnati (UC) and the Cincinnati Veterans Affairs (VA) Medical Center have found that about one-third of chronic kidney disease patients who are prescribed therapies for high blood pressure do not often adhere to treatments.

This report was published in the Nov. 2 online edition of the American Journal of Nephrology.

The study, led by researchers at UC and the Cincinnati VA, showed that treatment of hypertension in patients with chronic kidney disease continues to be a challenge in their care and that by simply improving medication adherence, outcomes would improve greatly.

Chronic kidney disease is the slow loss of kidney function over time. The main function of the kidneys is to remove wastes and excess water from the body. Ongoing hypertension is often associated with kidney disease.

"Hypertension, or high blood pressure, is probably the most important modifiable risk factor in chronic kidney disease -- a precursor to end-stage renal disease that is associated with increased risk of morbidity and mortality," says Charuhas Thakar, MD, associate professor in the division of nephrology and hypertension at UC and chief of the renal section at the Cincinnati VA. "In chronic conditions, such as hypertension, whether or not a patient takes the correct dosage and amount of their hypertension medication is critical in reaching treatment goals.

"Patterns of medication adherence for these agents and their impact on blood pressure in practice settings were not previously well studied. We wanted to find out if medication adherence could make a difference on outcomes in kidney disease patients."

Using two years worth of data from patients seeking ambulatory care at the VA, researchers examined 7,227 chronic kidney disease patients who received at least one blood pressure medication prescription. Outpatient blood pressure measurements were averaged as high (more than 130/80 mm of Hg) versus normal, based on the national guidelines for hypertension management in kidney disease.

Medication adherence was calculated using medication possession ratio, meaning the actual treatment days divided by the total possible treatment days.

"Good versus poor medication adherence groups were compared for differences in demographic, co-morbid and laboratory variables," says Kristen Schmitt, chief of pharmacy at the Cincinnati VA and the lead author of the study. "Results showed that while 67 percent of patients took their medication properly, a total of 33 percent of patients had poor medication adherence. More importantly, those with poor adherence were 23 percent more likely to have sub-optimal blood pressure control during the entire two-year study period."

"With this data, we hope to develop a multidisciplinary approach to help kidney disease patients adhere to their prescribed blood pressure medications. This will not only improve their clinical outcomes but will also help in reducing costs of care," she continues.

"Although the results represent a large sample of patients, they are derived from a single center," adds Thakar. "Further investigations are needed to accurately assess the impact of medication adherence on cardiovascular and renal outcomes in practice."

This study was funded by a Federal Services Research Grant from the American Society of Health System Pharmacists (ASHP) Foundation.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Cincinnati Academic Health Center.

Journal Reference:

Kristen E. Schmitt, Christine F. Edie, Paul Laflam, Loretta A. Simbartl, Charuhas V. Thakar. Adherence to Antihypertensive Agents and Blood Pressure Control in Chronic Kidney Disease. American Journal of Nephrology, 2010; 32 (6): 541 DOI: 10.1159/000321688

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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How Do You Lower Cholesterol Without Medication

How do you lower cholesterol without medication? Is it really possible? Yes it is. Lowering cholesterol naturally is just as effective as using prescription drugs. You can reduce your intake of saturated fats and trans fats, increase your intake of HDL "good cholesterol" foods, and exercise more. Doing these three things alone can make a huge impact in your lifestyle and improve your overall health. Not only will you have a healthier heart; you will have a better life, and have a greater chance of living longer till your golden ages.

To avoid suffering from heart attack, stroke, or other cardiovascular diseases related to high cholesterol, you can also take natural cholesterol busting supplements as well as vitamins and nutrients to boost your immune system. Heart failure due to high cholesterol levels is something you shouldn't brush off your shoulders and laugh about; right now the leading cause of death in the States is heart attack and you shouldn't want to be included in this statistics.

So first you should get yourself checked to confirm if you have high cholesterol. Your doctor would most probably prescribe statins to lower your cholesterol, but talk to him about natural options. You can then take steps to lower your cholesterol at home. You can observe how your body is managing your fat elimination by checking your feces. If it floats, then it means it has a high amount of fat in it eliminated from your body; but if it sinks, it means it has very little fat, which could indicate that your body has absorbed most of the fats you have eaten. If this is the case, then it's a sign that you should eat more soluble fibers to soak up the fats and cholesterol in your body in order to be flushed out from your system the next time you go potty.

It is recommended to eat 57-147g of oatmeal per day or 10-30g of psyllium husks or 2-3 apples (or pears). An alternative is also to eat at least 100-150g of legumes. You can supplement this by taking artichoke leaf extract, de-ionized garlic, or red yeast rice to reduce more of the cholesterol in your body. Many people also swear by the benefits of fish oil in lowering their cholesterol.

Dieting, exercising, and taking natural supplements for lower cholesterol have various cardiovascular and general health benefits, and have a lasting effect on your health. For a healthier heart and a better lifestyle, all of these should be part of your daily regimen. You really don't have to take expensive prescription drugs that have numerous side effects. You can rather treat and manage your cholesterol level through natural means. It's easy as the three simple steps mentioned above. Even doctors advice these healthy ways to feel better, avoid illnesses, especially heart diseases, and hence prolong and improve the quality of your life.

Now you know that treating cholesterol naturally is indeed effective, you can start applying these suggested answers to the question, "how do you lower cholesterol without medication," to improve your health.

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Blood Pressure Medication

If you are suffering from high blood pressure, otherwise called hypertension, and you failed to control it by making lifestyle changes, then you will probably be taking blood pressure medication. This medication is important to hold the 'Silent Killer' at bay. Therefore, it is equally vital to take the tablets regularly, because otherwise the blood pressure will begin to rise quite rapidly even within twenty-four hours of missing taking the blood pressure medication.

So, how do you make sure that you bear in mind to take the tablets as prescribed by your doctor? It can be a problem for those individuals who have a bad memory, a busy lifestyle or many tablets to take. Some people purchase pill boxes with the numbers one to thirty-one on different compartments, so that they can see whether they have missed a day. This is a good concept which works for most individuals.

Others store their medication on the rack in the bathroom next to their toothbrush, so that they cannot help seeing their blood pressure medication. It is also a good concept to get into the habit of taking your tablets at the same time each day.

However, some tablets should be taken with or just after eating food to reduce the likelihood of upsetting your stomach. So, if you brush you teeth after breakfast, all well and good. Otherwise, you could leave your pills where you usually eat your breakfast or evening meal, so that you can take them with or after eating.

Regularity or routine is the best way of remembering to take your tablets. After even a short time, you will reach for them automatically like Pavlov's dogs if you take the action that triggers taking the tablets. I work from home and any tablets that I have to take, I leave by my computer so that I take them with coffee as soon as I start work.

This works if you work from home, but it is not a useful idea to have one set of tablets on the go in your employer's office and another one at home. You should never double up on this sort of tablets - it is normally better to miss a day than risk taking them twice if you are really not certain. Taking them late however is better than not taking them.

I do not have a pill box, so I just write the date the pill has to be taken on the back of the foil with a felt tip pen so that I can see effortlessly where I am.

Strive to associate taking your tablets with an action or make it a part of another action. For example, if you maintain a diary, make a point of putting a mark each day to indicate that you have taken your tablets and keep the tablets by the diary. If the strips of tablets are small, you can keep them with your money - literally in with your money, so that you see them a number of times a day.

If you use a computer every day, you can easily (very easily, honest) set up a daily reminder in Outlook or some other electronic organizer to tell you each day by pop-up to take your blood pressure medication.

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