Sunday Times 2
Beware of fake medical news!
With growing concern, I’ve been reading articles in newspapers and social media, warning people not to take medicines, as they cause more harm than good, specifically, medications used for controlling blood pressure, cholesterol and blood sugar.
Medications are safe as long as they are taken under your doctor's supervision with regular checkups to monitor for side effects
All over the world, heart attacks, strokes and kidney disease, are major causes of death and disability. Although a prudent diet, regular exercise and abstaining from smoking can be helpful, a great majority of the people need to take medications to maintain their blood pressure, cholesterol and blood sugar in the desired range.
Many of these alarmist articles assert, that doctors prescribe pills because they are bribed by pharmaceutical companies with inducements. Nothing could be further from the truth! Most doctors follow guidelines given by professional associations like the European Society of Cardiology, the American Heart Association, and the British, Indian and Australasian Cardiology Societies. They all continue to strongly recommend drug therapy in most patients to prevent and treat cardiovascular diseases. These recommendations are based on randomsed medical trials and are evidence-based. It costs around 2 billion US dollars to bring an effective medication to the market after years of research and development. Good quality effective medicines are not cheap but their effectiveness is beyond dispute.
Guidelines given by professional medical associations are based on committees comprising eminent doctors who base their recommendations on the latest available research. On the other hand, sensational headline grabbing articles in newspapers and social media, are individual opinions based on isolated studies and should be disregarded. Do not be missed! Continue taking medicines prescribed by your doctors. These medicines are safe and the risks of stopping them are far greater than their minimal side effects.
My recommendations, based on over 50 years of experience in taking care of patients, and an extensive study of the medical literature are:
n Obtain a medical checkup, including blood pressure, lipid profile and blood sugar at age 20, if normal, recheck every 5 years. If abnormal especially with a family history of heart attacks, seek medical advice to correct the abnormalities. Since heart disease can be silent for many years before symptoms manifest, your doctor may order tests like an echocardiogram, treadmill exercise test and even a coronary angiogram if you have risk factors for heart disease. These tests will help to detect silent disease which can be treated even if you feel fine with no symptoms. If you have risk factors for heart disease your doctor will prescribe medications to control your blood pressure cholesterol and blood sugar if required, and a baby aspirin to prevent heart attacks and strokes.
n Blood pressure lowering medicines are safe and effective and well tolerated by most patients. They should be taken without interruption, indefinitely, to maintain blood pressure below 130/80. Obtain an electronic blood pressure measuring device and check your blood pressure and heart rate twice a day (home BP monitoring).
n The heart functions as a pump, supplying blood to all the organs of the body. It is important to keep your heart rate below 70 beats per minute. A higher rate can wear out your heart. For example, during a lifespan of 70 years the heart beats 2.5 billion times at 70 beats per minute; however at 60 beats per minute it beats 2.2 billion times — that is 300 million fewer beats, which may cause less wear and tear on your heart. Regular exercise can reduce your heart rate. A class of drugs called Beta Blockers may additionally be prescribed to reduce the heart rate if necessary.
n Cholesterol lowering medicines called Statins are safe and effective and do not cause cancer, permanent liver damage or cognitive dysfunction. Since 2/3 of cholesterol is made in the body according to genetic factors, diet alone is ineffective in getting your cholesterol down to required levels. The bad cholesterol (LDL) should be as low as possible, less than 100 for prevention and less than 70 for those with heart disease. Lower LDL Cholesterol lowers the risk of heart attacks and strokes. For patients intolerant of Statins a new class of drugs called PCSK 9 Inhibitors are available. This monthly injection is very effective but unfortunately very expensive. Statins should be continued indefinitely, as they have been proven to prevent heart attacks and strokes.
n Blood sugar lowering medicines that are heart friendly like Metformin, SGLT-2 inhibitors and GLP agonists should be used to control your blood sugar and included if you have diabetes.
Be assured, medications are safe as long as they are taken under your doctor’s supervision with regular checkups to monitor for side effects. Do not stop them, whatever the prevailing winds of social media might suggest. Sudden unexpected death from heart attacks can have a devastating impact on families and they can be prevented. I urge you to maintain an ideal body weight, exercise regularly, follow a healthy diet, including fruits and vegetables, avoid excess sugar, starch, fat and salt, do not smoke and take your medications without interruption. I tell my patients to do everything in moderation, and most importantly, avoid Fake (medical) News.
- (The writer is a senior cardiologist)