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Cardiovascular issues » Astounder

Posted by kaleidoscope on November 18, 2007, at 16:33:36

In reply to Re: Cardiovascular toxicity of stimulants » kaleidoscope, posted by Astounder on November 15, 2007, at 22:24:40

Hi

I was not trying to extol the benefits of beta blockers in my post :) I was considering the potential cardiac risk of stimulants, which may occur due to vasoconstiction, increased blood pressure, increased heart rate, and possible metabolic effects.

>There's little evidence that beta blockers do any good in healthy persons, indeed they have become disused for treating high blood pressure because of the diabetes risk.

Certainly, beta blockers are not a first-line treatment for hypertension, although they do as you say have a major role in other conditions such as angina, post-MI, heart failure etc.

>Although beta blockers increase exercise tolerance, they abolish the positive effects of chronic exercise on triglyceride & cholesterol levels and insulin sensitivity.

There are differences among the class however...... certain beta blockers such as carvedilol do not share these undesirable metabolic effects.

>while the hypertension is easily reversed by stimulant discontinuation and antihypertensive drugs therapy

I would hope that all patients treated with stimulants are receiving regular monitoring of blood pressure. ACE inhibitors and CCBs may be helpful if hypertension is detected but they can cause side effects of their own. I am not aware of any study which specifically examines the efficacy and safety of drug treatment for stimulant-induced hypertension.

>phenylephrine

As you say, oral phenylephrine has no value as a decongestant. It is disappointing that its inclusion in OTC medications has become so widespread. Decongestant nasal sprays are suitable for 'colds' and can be safely used for a few days. Nasal corticosteroids are very useful in the treatment of allergic rhinitis.

K


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