Recent Longevity News for the seven days ending 8/8/07.  You should consult your doctor if you are taking any medications.

Vitamin B1 Deficiency Key To Vascular Problems For Diabetic Patients, Study Suggests - Science Daily, 8/7/07 - "thiamine concentration in blood plasma was decreased 76% in type 1 diabetic patients and 75% in type 2 diabetic patients ... the decreased availability of thiamine in vascular cells in diabetes was linked to a marker of microvascular and macrovascular complications"

Doctors Urged to Curb Reliance on Beta Blockers - Intelihealth, 8/7/07 - "The side effects are probably the worst ... While beta-blockers reduce blood pressure, the other drugs do so more effectively and with fewer complications"

Green Tea Holds Promise As New Treatment For Inflammatory Skin Diseases - Science Daily, 8/7/07 - "Green tea could hold promise as a new treatment for skin disorders such as psoriasis and dandruff ... Animal models treated with green tea also showed reduced levels of proliferating cell nuclear antigen, a gene expressed when skin cells multiply. In psoriasis, the gene is over-expressed and speeds production of skin cells"

Caffeine May Help Women's Memory - WebMD, 8/6/07 - "Women who reported drinking at least three cups of coffee or tea per day at the study's start showed less of a drop in their test scores during the study, compared with women who reported consuming at most one daily cup of tea or coffee ... The biggest benefit was seen in the women's verbal memory"

Too Much (Good-for-You) Folate Might Be Really Bad - US News and World Report, 8/5/07 - "Cells use folate to keep their genetic software—their DNA—in good repair and to make copies of DNA when they divide. DNA is less likely to develop the sorts of defects that lead to cancer when it's well maintained, so folate may lower cancer risk in people who are healthy. But once a defect is present, experts theorize, replicating cancer cells hungrily gobble up folate to make new copies of their malevolent DNA"

Acid Blockers Linked to Mental Decline - WebMD, 8/3/07 - "Long-term use of H2 blockers, including Axid, Pepcid, Tagamet, and Zantac, may increase the risk of mental decline in later life ... Patients had two to two-and-a-half times the odds of having a deficit in their cognitive performance ... by blocking stomach acid, H2 blockers interfere with the absorption of vitamin B-12, which is important for mental function"

One Dose of Vitamin D Enhances Immunity to Mycobacteria - Medscape, 8/2/07 - "In healthy people who have been in contact with tuberculosis patients, a single oral dose of vitamin D enhances antimycobacterial immunity"

Coffee Drinking Related To Reduced Risk Of Liver Cancer - Science Daily, 8/1/07 - "hepatocellular carcinoma (HCC) ... The results showed a 41 percent reduction of HCC risk among coffee drinkers compared to those who never drank coffee"

Industry must wake up to tocotrienol opportunities - Nutra USA, 8/1/07 - "While the majority of research on vitamin E has focused on alpha-Toc, studies into tocotrienols account for less than one per cent of all research into vitamin E"

Abstracts from this week's Doctor's Guide Nutrition/Dietetics plus abstracts from my RSS feeds:

Magnesium intake and risk of type 2 diabetes: a meta-analysis - J Intern Med. 2007 Aug;262(2):208-14 - "The overall relative risk for a 100 mg day(-1) increase in magnesium intake was 0.85"

Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community - Circulation. 2007 Jul 31;116(5):480-8 - "Consumption of > or = 1 soft drink per day was associated with increased odds of developing metabolic syndrome (OR, 1.44; 95% CI, 1.20 to 1.74), obesity (OR, 1.31; 95% CI, 1.02 to 1.68), increased waist circumference (OR, 1.30; 95% CI, 1.09 to 1.56), impaired fasting glucose (OR, 1.25; 95% CI, 1.05 to 1.48), higher blood pressure (OR, 1.18; 95% CI, 0.96 to 1.44), hypertriglyceridemia (OR, 1.25; 95% CI, 1.04 to 1.51), and low high-density lipoprotein cholesterol (OR, 1.32"

Pioglitazone Use and Heart Failure in Patients with Type 2 Diabetes and Preexisting Cardiovascular Disease: Data from the PROactive Study (PROactive 08) - Diabetes Care. 2007 Jul 31 - "serious HF (SHF) ... More pioglitazone (5.7%) than placebo patients (4.1%) had a SHF event during the study (P=0.007). However, mortality due to HF was similar (25/2605 [0.96%] for pioglitazone versus 22/2633 [0.84%] for placebo; P=0.639). Among patients with a SHF event, subsequent all-cause mortality was proportionately lower with pioglitazone (40/149 [26.8%]) versus 37/108 [34.3%] with placebo; P=0.1338). Proportionately fewer pioglitazone patients with SHF went on to have an event in the primary (47.7% with pioglitazone versus 57.4% with placebo; P=0.0593) or main secondary endpoint (34.9% with pioglitazone versus 47.2% with placebo; P=0.025)"

Protective Effect of (-)-Epigallocatechin Gallate against Advanced Glycation Endproducts-Induced Injury in Neuronal Cells - Biol Pharm Bull. 2007 Aug;30(8):1369-73 - "Advanced glycation endproducts (AGEs) are believed to be secondary factors in the selective neuronal injury associated with several neurodegenerative disorders. In this study, we investigated the protective effects of (-)-epigallocatechin gallate (EGCG), a major monomer of green tea polyphenols, against AGEs-induced damage in neuron cells. The results showed that EGCG treatment protected against glyceraldehyde-derived AGE-induced neurotoxicity" - See green tea extract at Amazon.com.

Health Focus (first line medications for hypertension).  See my 6/6/07 newsletter for natural methods.  I feel that Micardis (telmisartan) (ARBs) with Altace (ramipril) (an ACE inhibitor, if two drugs are required), are the way to go for the least side effects.  I'm not a doctor, just someone that's done a lot of reading and experimenting with different blood pressure medications.  A doctor prescribed atenolol, a beta blocker for me once.  As soon as I started taking it, the swim that usually took an hour and twenty minutes took an hour and forty minutes plus I thought I was going to pass out after the swim.  I can't believe people will reduce their quality of life that much by taking a cheaper blood pressure medication, not to mention the increased risk of diabetes.  Consult your doctor before taking any supplement or medication.  See:

1. Patient Compliance with Antihypertensive Therapy Appears Longer for Those Taking Angiotensin II Antagonists - Doctor's Guide, 7/18/02 - "One of the most challenging problems in the care of patients with high blood pressure is patient noncompliance with antihypertensive therapy ... Angiotensin II antagonists had the highest rate of persistence followed by ACE inhibitors, calcium channel blockers, beta-blockers, and diuretics"
2. Telmisartan: The ACE of ARBs?  - Sharma 47 (5): 822 -- Hypertension, 3/27/06 - "telmisartan also reduced weight gain, increased total energy expenditure, and increased expression of key mitochondrial enzymes (cyclooxygenase-1 and mitochondrial transcription factor A) in skeletal muscle"
3. Blood Pressure Linked to Erectile Dysfunction - WebMD, 5/16/05 - "Men on older high blood pressure medications (diuretics, beta-blockers) had higher rates and more severe erectile dysfunction than men on newer medications (calcium antagonists, ACE inhibitors, angiotensin II receptor blockers)"
4. Evidence-Based Treatment of Hypertension: What's the Role of Angiotensin II Receptor Blockers? - Medscape, 4/8/05 - "The ARBs themselves are very well tolerated and are not associated with the side-effects known to cause compliance problems with beta blockers, ACE inhibitors and calcium channel blockers such as impotence, dry cough and peripheral oedema"
5. Blood pressure drug reverses sexual dysfunction - Life Extension Magazine, 7/01 - "the active ingredient in Cozaar and Hyaar (losartan) can significantly improve sex lives of men who suffer from sexual dysfunction" - Does this pertain to other ARBs?  The following indicates that it might:
   • Valsartan Appears to Improve Sexual Function in Men and Women with Hypertension - Doctor's Guide, 5/18/03 - "Men and women being treated with the angiotensin II receptor blocker valsartan for mild-to-moderate hypertension appear to show improvements in sexual function and desire"
   • Impotent Patients on Valsartan Find Increased Interest in Sex; Use Sildenafil More Often: Presented at ASH - Doctor's Guide, 6/13/05 - "Hypertensive patients with erectile dysfunction who are taking the angiotensin II receptor blocker valsartan find they have increased sexual desire ... It could be related to the reactive stimulation of angiotensin cascade due to AT1 receptors blockade"
6. Telmisartan-Hydrochlorothiazide Outperforms Valsartan-Hydrochlorothiazide for Blood Pressure Reduction - Doctor's Guide, 5/29/07 - "The change in diastolic blood pressure was -18.2 mmHg for the telmisartan-hydrochlorothiazide group and -17.0 mmHg for the valsartan-hydrochlorothiazide group. The change in systolic blood pressure was -24.6 mmHg and -22.5 for the two groups, respectively"
7. Metabolic effects of telmisartan and irbesartan in type 2 diabetic patients with metabolic syndrome treated with rosiglitazone - J Clin Pharm Ther. 2007 Jun;32(3):261-8 - "Telmisartan seemed to improve glycaemic and lipid control and metabolic parameters of the metabolic syndrome better than irbesartan. These differences could be relevant in the choice of therapy for this condition and diabetes"
8. Telmisartan Superior to Ramipril in Preventing Morning Blood Pressure Rise - Doctor's Guide, 5/19/05 - "Reductions were greater and statistically significant in the highest quartile (34 mmHg), in whom telmisartan reduced systolic surge by 12.4 mmHg and ramipril by 7.1 mmHg"
9. Telmisartan Provides Superior, Powerful Blood Pressure Reduction From Morning to Morning Compared to Other Leading ARBS - Doctor's Guide, 6/15/06 - "telmisartan provides superior, powerful blood pressure reduction from morning to morning compared to other leading angiotensin II receptor blockers"
10. The role of telmisartan in the treatment of metabolic syndrome - Ter Arkh. 2006;78(8):63-6 - "Telmisartan reduced all the study parameters of blood pressure, body mass, fasting and post-prandial hyperglycemia, postprandial hyperinsulinemia. Telmisartan raised peripheral tissue sensitivity to insulin, normalized phases of insulin secretion. Total cholesterol, LDLP cholesterol diminished while HDLP went up"
11. Effects of telmisartan on fat distribution in individuals with the metabolic syndrome - J Hypertens. 2007 Apr;25(4):841-8 - "Systolic and diastolic blood pressure were decreased in both groups to a comparable level. However, insulin and glucose levels during an oral 75 g glucose loading were decreased only in the telmisartan group. The visceral fat area, determined by abdominal computed tomography scan, was reduced in the telmisartan group after 24 weeks' treatment, but the subcutaneous fat area did not change in either group"
12. Bedtime Dosing of Atorvastatin and Valsartan Together Improves Overall Anti-Hypertensive Effects - Doctor's Guide, 5/17/05 - "When valsartan was dosed by itself during the day, patients averaged a 9 mmHg fall in systolic blood pressure; daytime dosing of both valsartan and atorvastatin resulted in a 17 mmHg reduction in the 24-hour mean of systolic and diastolic BP"
13. Valsartan Appears More Effective Than Telmisartan in Patients With Essential Hypertension - Doctor's Guide, 6/25/04 - "At the end of the study, the 24-hour mean BP was statistically lower in the valsartan-treated group compared to telmisartan-treated group" - However:
    • Telmisartan Lowers Early Morning Blood Pressure in Patients With Hypertension More Effectively Than Does Valsartan - Doctor's Guide, 4/12/04 - "telmisartan reduced BP during the last 6 h of the dosing period more effectively than did valsartan (-11/-7.6 +/- 0.8/0.6 mm Hg vs. -8.7/-5.8 +/- 0.8/0.6 mm Hg"
14. Metabolic Effect of Telmisartan [Micardis] and Losartan [Cozaar] in Hypertensive Patients with Metabolic Syndrome - Cardiovasc Diabetol. 2005 May 15;4(1):6 - "Telmisartan, but not losartan, significantly (p < 0.05) reduced free plasma glucose, free plasma insulin, homeostasis model assessment of insulin resistance and HbAic. Following treatment, plasma glucose and insulin were reduced during the oral glucose tolerance test by telmisartan, but not by losartan. Telmisartan also significantly reduced 24-hour mean systolic blood pressure (p < 0.05) and diastolic blood pressure (p < 0.05) compared with losartan"
15. Telmisartan But Not Valsartan Increases Caloric Expenditure and Protects Against Weight Gain and Hepatic Steatosis - Hypertension. 2006 Mar 27 - "Telmisartan, but not valsartan, promoted increases in caloric expenditure and protected against dietary-induced weight gain ... Telmisartan reduced the accumulation of visceral fat and decreased adipocyte size to a much greater extent than valsartan and was also associated with a significant reduction in hepatic triglyceride levels"
16. Evidence-Based Treatment of Hypertension: What's the Role of Angiotensin II Receptor Blockers? - Medscape, 4/8/05 - "The ARBs are highly effective in lowering blood pressure and reducing cardiovascular mortality. They also appear to provide additional renal protection in patients with diabetes, and this effect is independent of their effect on blood pressure. Combinations of ARBs with drugs from other classes such as ACE inhibitors have been found to be highly effective; they may permit lower doses of ACE inhibitors to be used than in monotherapy, which may lower the incidence of dose-related adverse effects. The ARBs themselves are very well tolerated and are not associated with the side-effects known to cause compliance problems with beta blockers, ACE inhibitors and calcium channel blockers such as impotence, dry cough and peripheral oedema"
17. Angiotensin II receptor blockers downsize adipocytes in spontaneously type 2 diabetic rats with visceral fat obesity - Am J Hypertens. 2007 Apr;20(4):431-6 - "adipocyte downsizing was significantly greater with telmisartan compared to valsartan. The likely mechanism for this difference was thought to be the PPAR-gamma-mediated action of telmisartan"
18. The Differential Effects of Angiotensin II Type 1 Receptor Blockers on Microalbuminuria in Relation to Low-Grade Inflammation in Metabolic Hypertensive Patients - Am J Hypertens. 2007 May;20(5):565-72 - "There was a significant increase in high molecular weight adiponectin in the telmisartan group ... The reductions of microalbuminuria and high-sensitivity C-reactive protein (hs-CRP) were significant in the telmisartan group"
19. Telmisartan shows an equivalent effect of vitamin C in further improving endothelial dysfunction after glycemia normalization in type 1 diabetes - Diabetes Care. 2007 Apr 24 - "Combining insulin and vitamin C normalized endothelial dysfunction and decreased oxidative stress to normal level. Telmisartan significantly improved basal endothelial function and decreased nitrotyrosine plasma levels. In patients treated with Telmisartan a near normalization of both flow mediated vasodilation and oxidative stress was achieved when glycemia was normalized, while adding vitamin C infusion did not show further effect on endothelial function or nitrotyrosine plasma levels"
20. Telmisartan Reduces Proteinuria More Than Losartan - Doctor's Guide, 5/28/07 - "Our findings suggest that at similar levels of blood pressure control, telmisartan may confer greater protection against progression to end-stage renal disease"
21. Preliminary Studies Suggest Potential Metabolic Effects of Micardis (Telmisartan) - Doctor's Guide, 9/9/05 - "The Micardis molecule is structurally similar to the PPAR-gamma activator, pioglitazone,3 which has been approved for the treatment of type 2 diabetes.7 Micardis partially activates PPAR-gamma resulting in metabolic effects that differentiate it from other ARBs, according to preclinical data.1-4 These data demonstrate that Micardis has a beneficial effect on insulin resistance and blood lipids, independent of its effect on the renin-angiotensin-aldosterone system"
22. Telmisartan and irbesartan therapy in type 2 diabetic patients treated with rosiglitazone: effects on insulin-resistance, leptin and tumor necrosis factor-alpha - Hypertens Res. 2006 Nov;29(11):849-56 - "The decrease in HbA1c and FPG at 12 months was statistically significant only in the telmisartan group"
23. Novel ARB Provides Greater Reductions in Proteinuria in Diabetics With Overt Nephropathy - Medscape, 5/22/07 - "One year of treatment with the novel angiotensin receptor blocker (ARB) telmisartan provided greater reductions in proteinuria when compared with losartan, a drug approved for the treatment of diabetic nephropathy to prevent renal-disease progression"
24. New treatment strategies for patients with hypertension and insulin resistance - Am J Med. 2006 May;119(5 Suppl 1):S24-30 - "the ability of telmisartan both to activate PPAR-gamma and to block the angiotensin receptor may provide added value not only in the treatment of the metabolic syndrome and prevention of type 2 diabetes but also in prevention and treatment of atherosclerotic cardiovascular disease"
25. Angiotensin II Antagonist Telmisartan Fights Stiffening Arteries In Hypertensive Diabetics - Doctor's Guide, 4/6/01 - "not only effectively lowered blood pressure compared with placebo, but also significantly decreased arterial stiffness"
26. The effects of telmisartan and amlodipine on metabolic parameters and blood pressure in type 2 diabetic, hypertensive patients - J Renin Angiotensin Aldosterone Syst. 2006 Dec;7(4):243-6 - "Group A: rosiglitazone (RSG) 4 mg + Telm 80 mg; Group B: RSG 4 mg + Aml 10 mg ... Lower values of glucose, HbA1C, HOMA index and higher adiponectin levels were observed in Group A compared to Group B ... insulin sensitivity may confer make Telm particularly suitable in the treatment of the metabolic syndrome"
27. The effects of irbesartan and telmisartan on metabolic parameters and blood pressure in obese, insulin resistant, hypertensive patients - J Endocrinol Invest. 2006 Dec;29(11):957-61 - "The greater impact on the improvement of the metabolic profile showed by telmisartan and the inverse correlation between adiponectin levels and blood pressure may be partly due to the action as partial PPARgamma agonist displayed by telmisartan"
28. BP Lowering May Halt Descent Into Dementia - Clinical Psychiatry News, 12/02 - "those in the candesartan arm had a mean 0.5-point decline in MMSE scores during follow-up, compared with a 6-point drop in those on a diuretic. The cognitive benefit was even more pronounced in patients over age 85" - Does this pertain to other ARBs?  I don't know.
29. Dyslipidemia and Concurrent Medications Improve Likelihood of Persistence to ACE Inhibitor Therapy - Doctor's Guide, 10/27/05 - "The adjusted rate ratio of therapy discontinuation was consistently higher for all other ACE inhibitors relative to ramipril"
30. Blood Pressure Drugs May Help People Avoid 'Type 2' Disease, but Healthy Habits Still Best - WebMD, 10/16/01 - "people at high risk for developing diabetes who take the drug Altace [ramipril] were 34% less likely to develop diabetes than those who did not get the drug"
31. Telmisartan May Help Preserve Renal Function in Patients With Hypertension, Diabetes - Medscape, 6/1/07 - "In patients with hypertension and type 2 diabetes, telmisartan and ramipril both may help preserve cardiovascular and renal function by increasing nitric oxide (NO) activity of the renal endothelium"
32. Telmisartan Provides Superior, Powerful Blood Pressure Reduction From Morning to Morning Compared to Other Leading ARBS - Doctor's Guide, 6/15/06 - "telmisartan provides superior, powerful blood pressure reduction from morning to morning compared to other leading angiotensin II receptor blockers"
33. Telmisartan Lowers Early Morning Blood Pressure in Patients With Hypertension More Effectively Than Does Valsartan - Doctor's Guide, 4/12/04 - "telmisartan reduced BP during the last 6 h of the dosing period more effectively than did valsartan (-11/-7.6 +/- 0.8/0.6 mm Hg vs. -8.7/-5.8 +/- 0.8/0.6 mm Hg"
34. Vitamin C 'benefits diabetics' - BBC News, 6/28/07 - "Vitamin C neutralises free radicals, while Telmisarten stimulates the natural removal of the molecules by cells"

Arguments for Ramipril:

1. Keeping Seniors Independent - WebMD, 3/14/02 - "the average three-year decline in walking speed among those women who used ACE inhibitors was 10 times lower than it was in the other groups ... Researchers think several factors may explain these drugs' beneficial effect on delaying disability: ACE inhibitors increase blood flow to the muscles, reduce inflammation, and promote healthy eating habits and better nutrition by inhibiting a substance known to reduce appetite"
2. Not All ACE Inhibitors Have the Same Effect on Mortality - Medscape, 7/28/04 - "enalapril, fosinopril, captopril, quinapril, and lisinopril were associated with higher mortality than was ramipril"
3. Angiotensin-converting Enzyme Inhibitors, Beta Blockers May Postpone Kidney Failure - Doctor's Guide, 10/13/00 - "The ACE inhibitor ramipril (Altace®) or the beta-blocker metoprolol (Toprol®) significantly reduced the risk of kidney failure compared to the CCB amlodipine (Norvasc®) in a group of patients who had at least one gram of protein in a 24-hour sample of urine when they joined the African American Study of Kidney Disease and Hypertension (AASK). Blood pressures were comparable."
4. Ramipril Reduces Advanced Glycation End Products In Non-Diabetic Nephropathy - Doctor's Guide, 4/21/03 - "Ramipril also mildly decreased levels of advanced glycation end products"
5. Some Hypertension Drugs May Help Reduce Dementia Risk - Science Daily, 5507 - "Centrally acting drugs include captropril (Capoten®), fosinopril (Monopril®), lisinopril (Prinivil® or Zestri®), perindopril (Aceon®), ramipril (Altace®) and trandolapril (Mavik®) ... The study found a link between taking centrally active ACE inhibitors and lower rates of mental decline as measured by the Modified Mini-Mental State Exam, a test that evaluates memory, language, abstract reasoning and other cognitive functions"
6. Effect of antihypertensive agents on plasma adiponectin levels in hypertensive patients with metabolic syndrome - Nephrology (Carlton). 2007 Apr;12(2):147-53 - "Ramipril and valsartan increased the plasma adiponectin levels significantly higher than the other regimens"
7. BP Reduction in the Metabolic Syndrome and Type 2 Diabetes - Medscape, 2/13/06 - "Beta blockers are now widely regarded as having worse outcomes than other major classes of antihypertensive agents, though this view is heavily influenced by a single drug, atenolol.[29] Furthermore, the thiazide/beta blocker combination has been associated with an increased risk of the emergence of new-onset diabetes.[30] This has been strongly reinforced by the ASCOT trial, where the likelihood of new diabetes was 30% greater in the thiazide/beta blocker patients as compared to those taking calcium channel blockers with an ACE inhibitor.[31] Conversely, a very recent meta-analysis has shown that overall ACE inhibitors and ARBs reduce the risk of diabetes by about 25%"
8. Blood Pressure Drugs Counter Cancer? - WebMD, 5/23/06 - "After crunching the numbers, the risk reduction in veterans taking ACE inhibitors was 53% for colon cancer, 52% for pancreatic cancer, and 46% for esophageal cancer"
9. Keeping Seniors Independent - WebMD, 3/14/02 - "the average three-year decline in walking speed among those women who used ACE inhibitors was 10 times lower than it was in the other groups ... Researchers think several factors may explain these drugs' beneficial effect on delaying disability: ACE inhibitors increase blood flow to the muscles, reduce inflammation, and promote healthy eating habits and better nutrition by inhibiting a substance known to reduce appetite"

Arguments for combining ARBs and ACE inhibitors:

1. Do we use an ACE, an ARB, or both? What clinical trials tell us - Patient Care, 4/1/05 - "Combining ACEs and ARBs can improve outcomes, particularly for patients with heart failure and those who have hypertension with diabetes"
2. Impact of Telmisartan Versus Ramipril on Renal Endothelial Function in Patients with Hypertension and Type 2 Diabetes - Diabetes Care. 2007 Mar 2 - "In patients with type 2 diabetes telmisartan and ramipril both increased NO activity of the renal endothelium significantly that in turn may support the preservation of cardiovascular and renal function"
3. Addition of an angiotensin receptor blocker to full-dose ACE-inhibition: controversial or common sense? - Eur Heart J. 2005 Nov;26(22):2361-7 - "combination of a full-dose ACE-inhibitor and an ARB can be a rational choice in selected patients" - [full article]
4. Combination ACE inhibitor and angiotensin receptor blocker therapy - future considerations - J Clin Hypertens (Greenwich). 2007 Jan;9(1):78-86. - "The individual gains seen with each of these drug classes have led to speculation that their combination might offer additive if not synergistic outcome benefits. The foundation of this hypothesis, although biologically possible, has thus far not been sufficiently well proven to support the everyday use of these 2 drug classes in combination. Additional outcomes trials, which are currently proceeding to their conclusion, may provide the necessary proof to support an expanded use of these 2 drug classes in combination"
5. See telmisartan and ramipril at OffshoreRx1.comor International Anti-aging Systems.

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