Tuesday, June 23, 2009

FDA Approves Triple-Drug Polypill for the Treatment of Hypertension

Do you have high blood pressure? Tired of taking multiple pills to lower your blood pressure? This just might be your solution. The FDA has approved a triple-drug polypill for the treatment of hypertension (high blood pressure). The polypill, called Exforge HCT contains the calcium channel blocker amlodipine (Norvasc), the diuretic hydrocholorothiazide (HCTZ) and the angiotensin receptor blocker valsartan (Diovan). This is the only single tablet that combines three drugs for treatment of high blood pressure in the United States. This drug may be used as add-on/switch therapy for individuals not adequately controlled on any two components of the triple combination.

There have been several studies demonstrating, the less pills one takes the more compliant they are. Three drugs that treat hypertension being contained in one pill should assist us in becoming more compliant in taking our blood pressure lowering medications. The tablet comes in the following dosages:

Tablets: (amlodipine/valsartan/hydrochlorothiazide mg)






If you are taking these three pills separately; you should consult with your health care provider to see about the possibility of changing over to the polypill. You may find that you miss fewer dosages, becoming more compliant with taking your medications. By doing so will allow for better management of your blood pressure and your health.

Friday, June 19, 2009

High Blood Pressure: Do You Know Your Pressure?

Many patients who come to the office have high blood pressure. What is alarming is they find excuses for the cause of their high blood pressure. Examples include:

  • I was running late
  • I walked in from the parking garage
  • I didn’t sit long before my blood pressure was taken
  • I had a disturbing phone call
  • I ate at a restaurant last evening
  • I had a busy day at work
  • I had a hectic schedule
  • I am under more stress than usual today

Sound familiar?

So many people do not believe they have high blood pressure, even when they come to the office and see their blood pressure is elevated. The other side of the coin is when we treat patients with high blood pressure; patient’s often think it is a disease that can be cured and once their blood pressure is controlled they stop their medications or reduce their current dosage of the medication. Yes, if one is overweight and sedentary they can lower blood pressure by weight loss, decreasing sodium in their diet and exercise—but it is a condition to be managed. For the most part however, once one is on a blood pressure lowering medication you are most likely going to need to stay on the medication.

The facts regarding high blood pressure are: 1 in 3 adult Americans has high blood pressure. Data from the Framingham Heart Study suggest persons 55 y.o. and older have a 90% risk of developing high blood pressure during their lifetime. High blood pressure is associated with:

  • 69% of first heart attacks
  • 74% of heart failure cases
  • 77% of first strokes

In order to prevent these events we must monitor our blood pressures at home and discuss options with our health care provider if our blood pressure is consistently greater than 130/80. As health care consumers, we must know our own blood pressure numbers and seek help if our blood pressure is elevated in order to optimize our health.

So…do you know your numbers?

Monday, June 1, 2009

Top 3 Questions providers ask me about Vitamin D

What lab test do you order to assess Vitamin D levels?

The best lab test to assess Vitamin D levels is the “25 OH Vitamin D Level” test.

What Vitamin D level is considered deficient?

Ideal blood level: 40-70 ng/mL

Sufficient blood level: 30 ng/mL

Insufficient blood level: 21-29 ng/mL

Deficient blood level: 10-20 ng/mL

Severly deficient blood level: 0-10 ng/mL

How do you treat patients with Vitamin D levels considered less than optimal?

21-29 ng/mL: Recommend 50,000 IU of Vitamin D2 (Once per week for four months)

Less than 20 ng/mL: Recomment 50,000 IU of Vitamin D2 (Twice per week for four months)

I would also advise patients to maintain a daily dosage (over the counter) of 2,000 IU to 5,000 IU of Vitmain D3. Three months after beginning treatment, I would check up on my patient’s 25 OH Vitamin D level.