The Black Liszt

Blood Pressure Pills can make you Blind

As a direct result of ridiculous, anti-scientific standards, pills to lower blood pressure are the mostly widely prescribed pills in the US, with over 100 million people supposedly cursed by the “disease” of hypertension. Did you know that there’s a never-refuted medical study published by the American Academy of Ophthalmology and sponsored by the National Eye Institute (part of NIH) showing that taking those pills greatly increases the risk of going blind? I didn’t think so.

AMD: Age-related Macular Degeneration

More than 11 million people in the US have this disease. It mostly affects people 60 and older. The most common variety of it – dry AMD – is progressive and has no cure. Eventually it leads to complete loss of vision. Here is the NEI description of the disease, its causes, prevention and non-cures. You will notice that there is NO mention of blood pressure medication.

I have described the largely suppressed side effects of blood pressure medication, and my path to freedom, with the result that I'm not taking the pills and I'm healthier. Two years ago I was diagnosed with early stage AMD. After resolving the issue with harmful blood pressure pills, I decided to see if the pills also impacted AMD. While it wasn't too hard to find out about the side effects of blood pressure medications, including the ones related to heart health I experienced, I hadn't seen anything about vision in general, much less AMD. I decided to look harder.

I mostly found things like this from the Cedars-Sinai website:

In other words, they don't really know. And they clearly state that "uncontrolled high blood pressure" -- in other words, failure to take blood pressure medicine when you "should" -- is a cause.

OK, let's go to the professionals. the American Academy of Ophthalmology. What do they say about blood pressure drugs and AMD?

This blows me away. The very first risk factor they list is the garbage about saturated fat. Totally wrong. This is the cornerstone of the explosion of obesity that harms so many and has nothing to do with AMD. I'm suspicious. Scanning down the list, I see one of the causes they list is "have hypertension (high blood pressure)." Not "treating" it or "taking blood pressure medications," but simply "have" it. In the linked article about high blood pressure, they simply declare that it can lead to big trouble, and "can cause permanent vision loss." OMG! I'd better start taking pills to get my blood pressure under control!

I guess it's clear. Whatever the cause of my AMD, it can't be the blood pressure pills I took for eight years.

The Beaver Dam Eye Study

Stubborn guy that I am, I kept looking. I found a little eye group in the DC area that promotes its services. I found them because my search engine surfaced two closely related blog entries on the site, one of them titled "The Link between Blood Pressure Drugs and AMD," a close match to my search string. Score! The second sentence of the post is: "If you take medication to lower your blood pressure, it’s important to know that you could be increasing your risk of developing AMD, or age-related macular degeneration." The bold was in the original!

Both blog posts give a reference to the 2014 study and extract some details, all of which I have verified. Here is the attention-grabbing sentence from the blog post: "For residents who were not taking blood pressure drugs, only 8.2 percent of them developed early AMD. For residents who took medication for high blood pressure, nearly 20 percent of them developed AMD."

The chances of getting AMD were more than doubled by taking the drugs.

Here are the highlights of the study.

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In short, thousands of people in a Wisconsin town were followed over 20 years, tracking their use of blood pressure medication and the incidence of AMD. Here is the conclusion at the top of the paper:

Conclusions: Use of vasodilators is associated with a 72% increase in the hazard of incidence of early AMD, and use of oral b-blockers is associated with a 71% increase in the hazard of incident exudative AMD. If these findings are replicated, it may have implications for care of older adults because vasodilators and oral b-blockers are drugs that are used commonly by older persons. Ophthalmology 2014;121:1604-1611 ª 2014 by the American Academy of Ophthalmology.

Whatever the chances of you getting leads-to-blindness AMD are, you increase them by about three quarters by taking widely-prescribed blood pressure pills. Still think lowering your blood pressure is worth it, particularly considering the proven facts I describe here?

So where are the headlines? Where are the cautions about the vision-killing side effects of blood pressure drugs? Where are the follow-up studies? Where are they on the websites of major public and private healthcare organizations? Nowhere, that's where they are. Nowhere!!

It's clear that this isn't just ignorance. It's suppression. Just above I showed how there's no hint of a problem with blood pressure pills on the official AAO website. When I did a full search on Google for "AMD blood pressure," instead it showed me results for "And blood pressure." I corrected it and mostly found propaganda, but did find a reference to the Beaver Dam study. When I used my favorite non-Google search engine, which I like because they don't have thousands of engineers hard at work adding bias to the results, the very first result was a direct link into ... the AAO website! ... to a news item about the Beaver Dam study! The Expert-fueled AAO organization put a brief post on their site about the study, but failed to mention it anywhere else! Not only that, when you use their embedded (Google) search facility on the site, their own post fails to appear in the results!

Why do you suppose that is? Pharma money? What about the ethics of the healing profession, not to mention their self-respect? Given the near-total suppression of the information, I suppose simple ignorance could explain the actions of most providers, along with "standards of care" that demand regular taking of blood pressure and prescribing medications according to standards. Which are wrong, not to mention destructive.

I paid to get a copy of the full study. It had important information not included in the brief summaries. Look at this extract from Table 4 near the end of the paper:

The first line is the one often quoted. Let me show the math. Of the 2714 people in the study, 295 of them (more than 10%) got AMD because they were taking the BP pills.

I took two pills for eight years. One was Amlodipine, a calcium channel blocker, which in the study nearly doubled the chance of getting AMD. I also took Losartan, an ARB, which had zero percent AMD -- not because it was innocent, but because as shown in an earlier table, almost none of the participants took it. It could be awful, but the study was too small to know.

An earlier table also showed the incredible extent of BP medication use. About a third of the participants in the youngest age group (under 64 years) took medications, while over two thirds of those over 85 were taking them. Most of whom shouldn't have been taking them at all! I  wonder, just wonder, if this could have something to do with the increasing incidence of AMD with age -- you think that's a possibility that should be studied?

Conclusion

I used to think that the pharma and the industrial food industries make mistakes, like any industry, and you have to take the good with the bad. There is certainly some good. But the more I learn, the more I discover the all-too-widespread shameless self-dealing of the industries, strongly supported by government agencies and professional authorities. They force through regulation putting misinformation on our food and our diets in hospitals, and are making billions of dollars selling pills that are standard procedure for preventative care that, instead of keeping us healthy, actively make us sick -- even to the point of making us blind -- along with numerous other problems I have briefly touched on in prior posts.

 

The Dimension of Software Automation Breadth Examples

One of the major ways software evolves is by increasing along the dimension of automation breadth. A domain can be dominated by products at a given breadth of automation, and suddenly a existing or new competitor starts winning by increasing its breadth of automation, offering its customers more value for less effort and money. It's a classic move and a good way for new entrants to disrupt a market.

One of the most frequently given pieces of advice, including by me, is to “focus,” i.e. basically solve fewer problems, try to satisfy a narrower range of customers, etc. While this advice is applicable more often than not, the natural and recurring progression of products through the spectrum of “automation breadth” makes it clear that, sometimes, when the conditions are right, the winning strategy is to be among the first to increase the breadth of automation that you incorporate into your product.

Example: Athena Health

A clear example of this is shown by the story of AthenaHealth. At the time the founders started the company, a wide variety of products were already available to run physician offices, from small single-office practices to extended medical groups. These products generally ran on inexpensive machines that the practice would keep in some back room, and would support multiple users via a LAN or terminals. Most of the products were sold by license, so that the office had to pay only a modest price for the license, and then annual maintenance.

Along comes little Athenahealth, with a better way of doing things. Athena had a cool new practice management system (PMS). Unlike all PMS’s at the time, it was built using internet technologies, so that it could be operated as a service, with people at the office accessing the system using machines with browsers and internet connections. Athena took care of the computers, relieving the medical office of a burden it basically didn’t want.     

But they ran into a little problem: the people in charge of medical practices are doctors, and doctors really don’t care about PMS’s – they care about patients and medicine. A PMS is a necessary evil, something you should buy for as little as you can get away with and ignore until things get so bad you are forced to buy a new one. Money spent on the PMS is just money out of the doctors’ pockets, as far as they’re concerned. Oh, you have a “better” one, do you, whatever that means? Stop wasting my time.

The folks at Athena noticed that one little thing the PMS does is produce bills and claims, the purpose of which is to get patients and insurance companies to send them money. No claim, no money. Unfortunately, merely producing the claims rarely proves to be sufficient to get the money flowing. People are required to do special things to the claims, provide additional information, harass the payers, etc. This is so specialized and time-consuming that it either consumes the time of a number of people at the office, or is outsourced to a “billing service.”

The Athena folks went on to notice additional important things: (1) the chances of getting paid are a direct reflection of the quality and appropriateness of the information on the claim; (2) the PMS and how it is used is the main source of this information; (3) by actually performing the billing service, you can learn how to produce a better PMS that produces better claims, increasing the effectiveness of the billing service while reducing the cost of running it at the same time. Finally, they found out that there is something the doctors who run medical practices care about other than medicine – surprise, surprise, that something is money.

So Athena introduced an outsourced billing service, but required practices that use it to also use their practice management system – at no additional cost! And they got so good at collecting the money that doctors could essentially get more money and a really cool, state-of-the-art PMS (like they cared…) for free!

This is a nice story for Athena, but the point of telling it here is that it illustrates the principle of product automation breadth evolution. While products are evolving within a “level” of automation breadth (i.e., how many of an organization’s functions it automates), it is normally a good idea to maintain discipline, avoid distractions, and concentrate on automating that function. But at a certain point in the evolution of each product category, pretty much everyone in a space has automated everything within that function, and everyone is reduced to concentrating on sales strategies and niggling little details. At that point, and PMS’s were at that point when Athena came along, it makes sense to do what you’re normally supposed to avoid – look for another function inside the organization to automate, particularly if there are synergies in implementing the two functions within a single framework, as there certainly were in this case.

Example: Bank and Retail Credit Cards

In 1983 a small company called CCS (Credit Card Software, later called Paysys) released a body of COBOL code that would enable a bank to process credit cards. A number of small and regional banks bought copies of the code and ran it successfully. The code was enhanced over the years.

A major retailer, Michael's Jewelers, approached CCS and asked if they could make a version of the bank software that could handle purchases from their stores, including a variety of payment plans and financing options offered by the store that were not supported by bank card software.

The company's programmers quickly gave up on the idea of modifying the bank code to handle the problem. Many aspects of bank card processing, such as the difference between issuing and acquiring, were irrelevant to retail. In addition, the many financing options supported by retailers went far beyond anything banks did. So they borrowed from the bank code to the extent that it helped and ended up creating a separate body of software called Vision 21. Once it was available, it proved to be a big success in the market, and was quickly enhanced by customer demand to include all the options desired by retailers Before long it supported the needs of retailers in other countries as diverse as Japan and South Aftrica.

Finally, there was very large processor, Household International, that was running multiple copies of both products, separate because they had been customized for a variety of reasons, for example to support methods of credit that were unique to a market (for example “hire-purchase” in South Africa). While CCS, now called Paysys, had failed to create a generic bank/retail product when confronted with an example of the generic problem, unifying multiple bodies of related code into a single, highly parameterized code base proved to be a far more tractable problem, particularly with a single important customer who insisted that these variations were the only ones to worry about.

The industry quickly rallied to this new product, called Vision PLUS, that could be directed at so many different problems with such relative ease. For example, it enabled retailers to issue co-branded cards that worked like regular bank cards, except when used in the issuer's retail store, when it acted like a classic store card with features like "90 days same as cash" options that bank cards don't support. While “parameterized product” may sound like an abstract concept, it translates directly into business advantage compared to more primitive product types, by enabling the product to be customized, installed, upgraded and maintained with less labor, less time and lower risk of error.

The company that built Vision PLUS was bought by First Data, a major card processor. The reason is interesting: in spite of having thousands of programmers (Paysys had only dozens), First Data was unable to modify their US-centric code base to handle processing in Japan. At the time of the sale, Vision PLUS was processing about 150 million cards world-wide. The code lives on and currently runs over 600 million cards.

Conclusion

These are two examples of companies growing by broadening their focus -- in a strategic way, driven by just a couple of representative customers. In neither case did they address a whole new market at the beginning, though that was the eventual goal. They took their existing software along with a cooperative customer and met that customer's needs. Athena started with just one specialty in one state with a single payer. Paysys started with a single existing customer. In each case they grew the broadening of their focus a step at a time, making each customer happy as they went. As they grew, word got around in the industry, and they shifted to saying "no" to the vast majority of inquiries in order to maintain the step-wise customer success they were building.

This is a classic pattern of focus broadening that can bring transformative success to companies when handled well.

 

The Destructive Treatment of Hypertension

I’ve talked about how all the medical authorities are united in the importance of fighting the “silent killer” of blood pressure that’s too high, i.e., hypertension. I’ve described in detail that what doctors call ‘essential hypertension” is NOT a disease. Fighting the non-disease of hypertension is an ongoing bonanza for doctors and the drug companies while leading to serious problems for patients.

In this post I’ll describe my personal experiences that led me to these observations. What happened to me was not unusual, and others have had it worse than I have.

Getting Cancer and Hypertension

Eight years ago I developed a rare form of cancer, desmoid tumor, of which there are about a thousand cases a year. I was treated with drug infusions. The drugs sometimes have bad effects on the heart, so I received tests and a consultation with a NYC cardiologist. She told me I had high blood pressure that must be treated immediately. I was surprised since my reading had always been low, but complied, ending up taking daily doses of Amlodipine and Losartan.

This was unusual for me, because I normally dive in and check for myself everything that’s important to me. I didn’t in this case. I was consumed with my study of my rare cancer and the ineffective early advice I got. I found the one doctor in the country who knew how to treat it. The blood pressure seemed like a bump in the road at the time. My bad.

I kept up with the daily drugs after that, with new prescriptions issued by my primary care doctor with minor adjustments. Not once did any doctor mention anything about side effects. I felt OK and did no research.

About a year ago I started monitoring my blood pressure myself because I began experiencing symptoms it was hard to put a finger on. I knew the drugs I was taking were generics and had discovered the widespread corruption of generic drug makers and the ineffectiveness of the quality monitoring conducted by the FDA. I asked my primary care doctor for prescriptions for the branded versions of the drugs, which I hoped were more carefully monitored. I discussed in detail with my local CVS pharmacist, who ultimately was unable to get the drugs.

Symptoms of Heart Trouble

The symptoms increased. In March 2022 I had a tough time driving with symptoms that included being light-headed and a heart pulse rate that was high for me, as though I were exercising. I went to my primary doctor who gave me some tests including an EKG. With inconclusive results, she referred me to a cardiologist. The cardio guy gave me lots of tests, including an electro-cardiogram, a nuclear stress test, a week-long Holter monitor. This all took a few weeks.

Meanwhile, I did what I should have done eight years ago – dove in and studied heart function and blood pressure. It didn’t take long for me to discover – surprise! – that the symptoms I experienced were the same as side effects of the drugs I was taking, and were widely reported by patients online. I tried to get FDA data on them and discovered the great lengths the FDA goes into order to keep drug adverse reactions as secret as possible – kind of like the way medical offices say you have full access to your medical records, except that they prevent it, as I have described in detail.

I brought up the subject on my next visit with the cardiologist. He immediately dismissed the possibility. He refused to discuss it or take seriously the possibility that my symptoms were due to the drugs that he and all the other members of his profession profusely prescribe.

After that I took matters into my own hands. I stopped taking the drugs after the last test was conducted, in order to avoid confusing the results. I continued daily blood pressure readings, sometimes more often.

I finally got the results of all the tests. Nothing was wrong with me – except of course when you monitor for seven days straight, sometimes your heart beats fast. It’s scary! It’s called supraventricular tachycardia (SVT). Once or twice a day, for a dozen beats at a time and on the low end of the "fast" scale. Call 911! My valves are fine, no blockages, no Afib, etc. etc. His recommendation? Consult one of his friends to get either a pacemaker or a six hour operation to zap random bits of my heart in hopes that the scary SVT would go from 0.001% to zero. Maybe. NFW, thanks anyway, esteemed board-certified cardiologist.

My first step after stopping the drugs was to start taking a well-reviewed natural heart-health additive based on L-Arginine. After 3 weeks I was better, but not satisfied. So I just stopped messing with my body and its extremely complex mechanisms. After my body cleared out, I was much better.

The blood pressure numbers are interesting:

Average        Systolic         Diastolic

with drugs     137              64

L-Arg only     157              74

nothing          144              65

Taking no blood pressure or other drugs resulted in Diastolic numbers that were unchanged and Systolic numbers that were 7 points higher, well within a healthy range, though not according to current cardiologist drug-pushing fashion.

Side effects of blood pressure control drugs

There are lots of non-government places to learn about the side effects of the awful blood pressure drugs -- thanks, internet! No thanks at all, cardiologists! -- and even published studies that show 10% of participants in studies dropping out due to the intolerable side effects.

Here are a few samples of problems with Amlodipine from a data-rich site.

fast, irregular, pounding, or racing heartbeat or pulse

Common (1% to 10%): Palpitations, ankle edema

Amlodipine has an average rating of 3.7 out of 10 from a total of 571 ratings for the treatment of High Blood Pressure. 20% of reviewers reported a positive experience, while 61% reported a negative experience.

41% gave it 1 star out of 10

Common in reviews below: “feeling lightheaded, heart palpitations and arrhythmia”

After 35 years of taking it, “I took myself off of 2 years ago, but could not get through the withdrawals. It caused my heart to feel like it was beating out of my chest”

After starting “suddenly I felt dizziness I went to ER they admitted me to the heart hospital. I was told I needed a pacemaker. I declined.”

After strong heart beat “I attended a pre-operative assessment where I was given a routine ECG and this confirmed that I had become tachycardic while taking amlodipine. My pulse was racing at over 100 BPM”

After stopping “Five weeks later I still have the tinnitus”

After 6 years, “worse side effects have been; heart pounding/palpitations, fatigue, and increased anxiety…. I stopped taking the Amlodipine Besylate 10 mg. over 3 weeks ago and and have noticed that my energy level has increased, anxiety lessened and heart pounding decreased.”

After 18 months “… anxious. Couldn't sleep, couldn't concentrate. I noticed muscle tics all the time, heart palpitations, more joint pains, memory loss and more. …I had myself convinced I had contracted some fatal condition (ALS, MS, etc...). After every specialist I could find, we decided it was anxiety. Then one day I read someone's account of anxiety and amlodipine. …try a switch. Today I am back to my old self.”

Conclusion

I have re-learned one of life’s most important lessons: if you want to be healthy, take charge of your own health. It’s your health, no one else’s. You own it, you have to live with it. There are experts and authorities all over the place who are lined up to tell you what to do. They want you to pay them, take drugs and undergo invasive procedures. Most of these people are highly trained and well-meaning. They sometimes know things that are worth knowing. They can be of great help. It’s worth listening. But it is not worth mindlessly following their orders, because their profession’s best, standard advice is all too often wrong. WRONG. And not just wrong – actively harmful.

Once I took my health into my own hands eight years ago, I found a truly expert doctor who brought my nasty rare cancer into remission, a place where I hope it’s happy. On the path, I stupidly and without examination followed doctor’s orders about blood pressure, following advice given to nearly half the population of the US. How could it possibly be bad? Easy. The same way the nutrition advice given to ALL the US population was and remains highly destructive, leading to the ongoing obesity epidemic and widespread avoidable suffering. The same way bad science about blood cholesterol has led to the most profitable drug in pharma history, treatment which shortens lives and makes patients less healthy.

The good news is that you’re not alone. There are dedicated people devoted to discovering and putting out the facts so that diligent, self-reliant people can find out what’s best for their health, most importantly for those cases where the medical profession stubbornly clings to destructive error, as it has so often in the past. It’s your health. Own it!