Any audiophile who is on blood pressure medication

From the January 6, 2000 issue of the New England Journal of Medicine (which is hardly a friend of the pharmaceutical industry): "The overall unadjusted relative risk of death due to coronary artery disease was 1.17 (95% confidence interval, 1.14 to 1.20) per 10 mmHg increase in systolic pressure and 1.13 (95 percent confidence interval, 1.10 to 1.15) per 5 mmHg increase in diastolic pressure." This increase in mortality began with a systolic blood pressure of 125 mmHg and a diastolic blood pressure of 75 mmHg.

The comment by Cdc holds a lot of truth. When I first began practice in the early 70's, most health care was paid for just like your groceries. Consequently, market forces played the primary role in controlling the cost of the services just as it does in the price of groceries or any other competitive product. We took the first step toward a socialized system when third party payers started to appear in the delivery system. This divorced the cost of the service from the consumer. He no longer felt the true cost of the service anymore. With this development, over utilization has ,over the last 30 years, almost swamped our system. If we move to a total socialized system, the over utilization will force rationing which will affect those that need extremely expensive procedures and treatments. This has already started with the advent of HMO's but will accelerate exponentially as government becomes more dominant in the delivery system. This has the potential to create an Orwellian health care system which delivers care based on the perceived value of the recipient, ie, age,social status, etc. Sound crazy, just take a look at Washington right now.

Just come across this thread, I am a family doctor working in the UK National Health Service and with an interest in hypertension. My word, by international standards, you guys are overtreated. Treat people with a systolic over 135? not in the rest of the world. There is no absolute criteria, that varies with age and general health. At my age 60, slim, fit with no concurrent illnesses, I started treatment at 150/95, with a target of 135/85. Clinical trial evidence for treating lower than this is limited and side effects, particularly postural dizziness, start to rise exponentially.
I would agree that non drug treatments are first choice, more exercise, a natural diet with reduced salt in particular and weight loss are vital. In my 30 years experience, 7 to 10lbs weight loss will make a real difference to blood pressure.
Current accepted guidelines for treatment under 60 are diuretics such as HCT and ACE inhibitors like lisinopril, which I am on. Sorry guys, but ARB's, angiotensin reuptake blockers are not better, they avoid the dry cough suffered by 5 to 20% of ACE users, depending on the brand. That is the reason to use them. ACE inhibitors have been around longer and evidence for protecting end organs, particularly the kidneys, in diabetics, is stronger.
Over 60 I tend to use diuretics + calcium channel blockers like amlodipine, both are better at reducing systolic blood pressure which tends to be a problem in the older patient. Almost nowone uses Beta blockers first line, because of side effects and recent evidence that they fail to stop cardiovascular endpoints, a euphemism for strokes and heart attacks.
The National Health service may be Socialist medicine, but it is evidence based, protocol driven and audited. All English family doctors are computerised and anonymous data for how I treat patients is downloaded and I have to be able to justify it.
Sorry for the lecture, which I am sure you audiogon MDs will not agree with.

Hi David12..I am a US pharmacist and I agree with your treatment protocol completely. It is very perplexing to me the pervasive use of ARB's. It seems like we love to make things more complex and expensive than we have to. With the graying population we see over here, I see a lot of overly complex treatment regimens in this group. These people are so over medicated, it is really pathetic. We really do need to get back to basics and practice evidence base medicine as you have suggested. Sometimes less is more. We in this country think medication is the answer to all of our ills.

And who's to say the so called "side-effects" aren't the primary effect while the advertised "primary effect" isn't just a side effect?
Because no one would buy a pill whose main effect is stomach lining destruction with a side effect of reduced inflammation. It's all in the marketing.