May 23, 2024
9 min read
Is it time to deprescribe lifetime beta-blockers for chronic coronary disease?
How Long Should We Continue Beta-Blockers After MI?
Jan 23, 2017 | Katy Bockstall, MD, FACC; Sripal Bangalore, MBBS, FACCExpert Analysis
https://www.sciencedirect.com/science/article/abs/pii/S0167527312009072
https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/drug-cabinet/beta-blockers
Withdrawal is possible.
Withdrawal of antihypertensive medication: a systematic review
J Hypertens. 2017 Sep; 35(9): 1742–1749. Published online 2017 May 9. doi: 10.1097/HJH.0000000000001405
PMCID: PMC5548513PMID: 28486271
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548513/
Stopping blood pressure medications in older people
Aim
This review aimed to find out if it is possible to stop blood pressure medications in older people. We also wanted to find out the effects of stopping these medications.
Antihypertensives can cause dangerous side effects, such as dizziness and fatigue which might lead to falls. Older people are at greater risk of medication side effects compared to younger people. It is unclear whether the benefits of antihypertensive medications outweigh the harms in older people.
Study characteristics
Our search to April 2019 found six studies, including 1,073 older adults in total. People in the studies had an average age of 58 to 82 years. In three of the studies, the dose of the antihypertensive was slowly lowered before stopping.
Key results
We found that stopping antihypertensive medications is possible in older adults. Most of the older people in the discontinuation groups did not need to restart their medication.
We found low certainty of evidence that stopping antihypertensive medication increased blood pressure by a small amount.
https://www.cochrane.org/CD012572/HTN_stopping-blood-pressure-medications-older-people
Can weight loss reduce the need for blood pressure medicine?
Answer From Francisco Lopez-Jimenez, M.D.
If you're overweight, losing even just 5 pounds (2.3 kilograms) can lower your blood pressure. The more weight lost, the more blood pressure can drop. As you lose weight, it may be possible to reduce your dose of blood pressure medicine. Or you might be able to stop taking blood pressure medicine completely.
J Clin Hypertens (Greenwich). 2003 May-Jun; 5(3): 234. Published online 2007 May 21. doi: 10.1111/j.1524-6175.2003.02403.x
PMCID: PMC8099264PMID: 12826792
Can I Stop Taking This Blood Pressure Medicine?
Raymond R. Townsend, MD 1
In many patients hypertension is weight‐related. If someone has lost 15 pounds (or more), and had modest elevations in blood pressure before therapy, that patient may be a candidate for drug reduction. The same is true regarding salt intake, though my experience has been that weight loss is a more potent blood pressure reduction measure. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) 2 also supports antihypertensive drug reduction particularly in conjunction with successful lifestyle modification.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099264/
Ud. 22.9.2024
pub. 26.9.2022
Chapter 11Myalgia and Fatigue
Translation from Mouse Sensory Neurons to Fibromyalgia and Chronic Fatigue Syndromes
Alan R. Light, Charles J. Vierck, and Kathleen C. Light.
https://www.ncbi.nlm.nih.gov/books/NBK57253/
It is not be neglected. It can be the early symptom of cardiovascular problems. There is need to consult doctor and do the treatment as prescribed.
Experts now believe that erectile dysfunction preceding heart problems is more often due to the dysfunction of the inner lining of the blood vessels (endothelium) and smooth muscle. Endothelial dysfunction causes inadequate and impaired blood flow to the penis leading to ED. It also results in inadequate blood supply to the heart and it aids in the development of atherosclerosis, which is buildup of plaque.
Free Access
Endothelial Dysfunction in Erectile Dysfunction: Role of the Endothelium in Erectile Physiology and Disease
Trinity J. Bivalacqua, Mustafa F. Usta, Hunter C. Champion, Philip J. Kadowitz, Wayne J. G. Hellstrom
First published: 02 January 2013 https://doi.org/10.1002/j.1939-4640.2003.tb02743.x
https://onlinelibrary.wiley.com/doi/10.1002/j.1939-4640.2003.tb02743.x
The corpus cavernosum of the penis is composed of a meshwork of interconnected smooth muscle cells lined by vascular endothelium. Of note, endothelial cells and underlying smooth muscle also line the small resistance helicine arteries that supply blood to the corpus cavernosum during penile tumescence. Pathological alteration in the anatomy of the penile vasculature or impairment of any combination of neurovascular processes can result in ED.
https://my.clevelandclinic.org/health/body/23471-endothelium
Blood Vessels and Endothelial Cells
https://www.ncbi.nlm.nih.gov/books/NBK26848/
Tadalafil in the treatment of erectile dysfunction
PDE5 Inhibitors
Armaan Dhaliwal; Mohit Gupta.
Last Update: April 10, 2023.
https://www.ncbi.nlm.nih.gov/books/NBK549843/
Tadalafil in the treatment of erectile dysfunction
Robert M Coward and Culley C Carson
Ther Clin Risk Manag. 2008 Dec; 4(6): 1315–1330.
Published online 2008 Dec. doi: 10.2147/tcrm.s3336
PMCID: PMC2643112
PMID: 19337438
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643112/
Originally Published 28 August 2006
Free Access
Effect of Regular Phosphodiesterase Type 5 Inhibition in Hypertension
James J. Oliver, Vanessa P. Melville, and David J. Webb
https://www.ahajournals.org/doi/full/10.1161/01.HYP.0000239816.13007.c9
Adverse Effects
25 persons were in the study
Two subjects were withdrawn while taking sildenafil, 1 because of severe headache (after 3 days) and the other because of back pain and feeling generally unwell (after 6 days), and 1 subject was withdrawn while taking placebo, because of joint pains, nausea, and headache (after 11 days). For a full summary of the symptoms experienced see the online supplement. Dyspepsia occurred in 10 subjects with sildenafil and lasted ≤5 days. Headaches occurred in 8 subjects and were generally mild and transient. Low back/buttock/leg muscle ache occurred in 7 subjects, was usually responsive to simple analgesia, and tended to settle within a few days. Plasma creatine kinase concentrations were measured in 4 of the subjects who experienced these symptoms, and all were within the normal laboratory reference range. Six of the 18 men in the study reported increased penile erection, which occurred only with sildenafil.
Ud. 12.6.2024
Pub. 30.4.2023
Parietal Gray Matter
Temporal Gray Matter
Frontal Gray Matter
Grey Matter
Grey matter is an essential type of tissue in your brain and spinal cord. It plays a significant role in mental functions, memory, emotions and movement.
https://www.technologynetworks.com/neuroscience/articles/gray-matter-vs-white-matter-322973
https://draxe.com/health/increase-size-your-brain/
https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2021.645258/full
Vitamin C and Brain
Front. Integr. Neurosci., 21 August 2020
Volume 14 - 2020 | https://doi.org/10.3389/fnint.2020.00047
The Contribution of Plasma and Brain Vitamin C on Age and Gender-Related Cognitive Differences: A Mini-Review of the Literature
Nikolaj Travica et al.
https://www.frontiersin.org/journals/integrative-neuroscience/articles/10.3389/fnint.2020.00047/full
Gray matter volume -Papers
Preventive Medicine
Volume 161
, August 2022, 107149
Preventive Medicine
Basic lifestyle habits and volume change in total gray matter among community dwelling middle-aged and older Japanese adults
Author links open overlay panel
Rei Otsuka a
,
Yukiko Nishita a
,
Akinori Nakamura b c
,
Takashi Kato b
,
https://www.sciencedirect.com/science/article/pii/S0091743522001980
The mean gray matter volume that was normalized by the total intracranial volume was 568.67 cm3 and 583.35 cm3 in men and women, respectively.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004040/
Brain size and grey matter volume in the healthy
human brain
Eileen LĖders, Helmuth Steinmetz1 and Lutz Jncke2,C
COGNITIVE NEUROSCIENCE AND NEUROPSYCHOLOGY
Vol 13 No 17 3 December 2002
Table 1 Means (7 s.d.) and ranges of absolute volumes and proportional volumes (absolute compartmental volume related to total brain volume in %)
Men Women T p
Mean Mean
Brain volume (dm3 ) 1.51 1.32
Grey matter (dm3) 0.82 0.74
White matter (dm3) 0.42 0.36
CSF (dm3) 0.27 0.23
Grey matter (%) 54.41 55.71
White matter (%) 27.73 27.14
CSF (%) 17.85 17.15
One-year Age Changes in MRI Brain Volumes in Older Adults
Susan M. Resnick, Alberto F. Goldszal, Christos Davatzikos, Stephanie Golski, Michael A. Kraut, E. Jeffrey Metter, R. Nick Bryan, Alan B. Zonderman
Cerebral Cortex, Volume 10, Issue 5, May 2000, Pages 464–472, https://doi.org/10.1093/cercor/10.5.464
Published: 01 May 2000
https://academic.oup.com/cercor/article/10/5/464/279148
Table 2 Open in new tabYear 1 MRI volumes (in cm3) by age group and sex
Age Sex
59–69 70–85 Men Women
n 63 53 68 48
Age (years)64.6 ± 3.2 77.3 ± 4.7 70.7 ± 7.5 70.1 ± 7.5
VBR 0.025 ± 0.010 0.043 ± 0.023 0.039 ± 0.021 0.026 ± 0.014
Right 0.012 ± 0.005 0.021 ± 0.011 0.019 ± 0.010 0.013 ± 0.007
Left 0.013 ± 0.006 0.022 ± 0.012 0.020 ± 0.011 0.013 ± 0.007
Ventricular volume 25.2 ± 10.8 41.1 ± 23.0 39.0 ± 20.5 23.2 ± 12.0
Right 12.3 ± 5.3 20.4 ± 11.2 19.1 ± 9.9 11.5 ± 6.4
Left 12.9 ± 5.9 20.7 ± 12.0 19.9 ± 11.0 11.7 ± 5.8
Brain 999.7 ± 99.1 946.8 ± 81.8 1017.6 ± 80.3 915.9 ± 81.7
Right 502.2 ± 50.2 475.2 ± 40.8 511.2 ± 40.9 459.7 ± 40.5
Left 497.5 ± 49.2 471.7 ± 41.3 506.4 ± 39.8 456.3 ± 41.5
Gray 538.6 ± 51.0 516.0 ± 47.8 550.4 ± 40.9 497.0 ± 46.6
Right 272.0 ± 26.4 259.9 ± 24.1 277.7 ± 21.5 250.5 ± 23.3
Left 266.6 ± 25.1 256.1 ± 24.0 272.7 ± 20.0 246.4 ± 23.6
White 461.0 ± 53.2 430.8 ± 45.4 467.2 ± 48.0 419.0 ± 43.5
Right 230.2 ± 27.0 215.3 ± 22.7 233.4 ± 24.3 209.1 ± 21.7
Left 230.9 ± 26.6 215.5 ± 23.6 233.8 ± 24.5 209.8 ± 22.1
Frontal 370.1 ± 37.2 353.0 ± 33.0 377.4 ± 31.0 340.8 ± 32.2
Right 187.4 ± 19.1 178.6 ± 17.4 191.3 ± 16.1 172.3 ± 16.6
Left 182.6 ± 18.6 174.3 ± 16.3 186.1 ± 15.7 168.5 ± 16.1
Parietal 211.8 ± 20.8 196.4 ± 17.1 212.3 ± 18.5 194.2 ± 18.9
Right 105.9 ± 11.0 98.3 ± 8.5 106.3 ± 9.7 97.0 ± 9.4
Left 106.0 ± 10.0 98.1 ± 9.0 106.0 ± 9.1 97.2 ± 9.8
Temporal 201.4 ± 21.8 189.6 ± 17.7 205.1 ± 18.2 183.1 ± 17.2
Right 99.8 ± 10.8 93.1 ± 8.6 101.2 ± 9.3 90.4 ± 8.3
Left 101.7 ± 11.2 96.4 ± 9.4 103.9 ± 9.2 92.7 ± 9.1
Occipital 115.4 ± 12.4 109.1 ± 10.3 117.1 ± 11.2 106.1 ± 9.8
Right 58.3 ± 6.9 55.2 ± 5.2 59.2 ± 6.1 53.7 ± 5.4
Left 57.1 ± 6.0 53.9 ± 5.6 57.9 ± 5.8 52.4 ± 4.9
Physiological brain volume reduction during aging is less than 0.2% per year. Therefore a volume reduction of about 6% during the 2 months of extreme running appears to be substantial. The reconstitution in global volume measures after 8 months shows the process to be reversible.
Daily home-based meditation can increase the amount of grey matter in brains of patients with mild Alzheimers disease: Study
A recent study by Indian researchers has shown that a six-month daily home-based meditation can increase the amount of grey matter in brains of patients with mild cognitive impairment (MCI) or those with mild Alzheimer’s disease. Meditation, therefore, appears to have a protective effect on the brain in these patients.
Persons with MCI are forgetful but can lead independent lives. However, they have a higher risk of developing Alzheimer’s disease. Alzheimer’s disease is progressive and irreversible and a major global health problem with huge socioeconomic implications. Yet, except for one prohibitively costly drug that is still being evaluated for clinical benefit, no medicine can alter the disease progression nor prevent or delay its conversion from the stage of MCI.
A research supported under the SATYAM program by Department of Science & Technology, Govt. of India was led by Dr. Amitabha Ghosh Director and Head Department of Neurology, Apollo Multispecialty Hospital Kolkata (erstwhile Apollo Gleneagles Hospital) together with Dr. S Bapi Raju {Cognitive Science lab at IIIT Hyderabad}, in collaboration with other researchers shows that a simple, cheap, easy to follow, meditation routine, when practiced daily for several months, can reverse grey matter loss in MCI and even in mild Alzheimer’s disease. This work has been published in the journal ‘Frontiers in Human Neuroscience’.
For more details, Amitabha Ghosh (amitabhaghosh269[at]gmail[dot]com) can be contacted.
https://dst.gov.in/daily-home-based-meditation-can-increase-amount-grey-matter-brains-patients-mild-alzheimers-disease
Can Walking Reverse Brain Aging?
A recent study finds that exercise can strengthen the brain and improve memory.
Posted August 11, 2021
Ud. 8.9.2024
Pub. 20.8.2024
