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Preventing Hypertensive Stroke

by George Thomas, MD, PhD


This blog is rather short, because the basic facts and results are quite clear. The biggest risk factor for stroke in the general public is high blood pressure. The first anti-hypertensive to conclusively demonstrate a reduction in stroke risk was thiazide diuretics. They apparently work by lowering the total amount of salt in the body. We also know that thiazide diuretics are synergistic with every other anti-hypertensive medicine, in that diuretics potentiate the effect of every other hypertensive treatment. In fact, if you are on two anti-hypertensive drugs, one of them should be a diuretic, unless you have some very unusual medical condition.

So the message of this blog is that diuretics prevent strokes. I raise this point because recent medical studies have been trumpeted in the newspapers as being more effective or more potent than thiazides in lowering blood pressure. But the question to ask your doctor is if this new and "better" anti-hypertensive treatment has been shown to lower the risk of stroke. If it hasn't, then either ask him to add a diuretic, or see a specialist in hypertension, to see if yours is a special case.

This is a small example of substituting an endpoint for a clinical result. We have seen similar problems in whether or not lowering cholesterol prevents heart attacks, or if lowering CPR is beneficial. To use my favorite analogy, just because you have a better "tool" for returning the arrow over the elevator to the lobby than simply pushing the lobby button, it doesn't mean that your tool will get the elevator down any faster.

George Thomas, M.D., Ph.D. has a Ph.D. in physics as well as M.D. Dr. Thomas has written publications in both physics and medical journals, is a reviewer for both physics and medical journals, a member of science and medical honor societies, a former physics professor and then medical professor at a medical school. He has been on the editorial board for both physics and medical journals, been an encyclopedia author, worked on government-sponsored research and has acted as a contract reviewer for a number of years, as well as has performed volunteer work with a chronic disease group. Dr. Thomas has been in private practice of family medicine for over 25 years. His practice is located in the New York City region.

Dr. George Thomas can be reached at ghthomas3@aol.com.

This blog is also published by George Thomas, M.D., Ph.D. (Physics) at http://www.ghthomas.blogspot.com/.

Dr. Thomas can be reached by e-mail at ghthomas3@aol.com, or by snail mail at P.O. Box 247, Hillsdale, N.Y., 12529

The concepts discussed here are based upon the author's personal professional experiences with patients, or upon his review of the pertinent medical and/or physics literature. Before acting on anything written here, you should discuss it with your personal physician as well as your personal physicist.


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