Re: (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

[Guest guest]

Hi :

Gosh. It is amazing what one can learn at this place! Thank you for

that reminder. Reminders of basic truths are always helpful.

I have never seemed to suffer white coat effect for BP at previous

annual check ups. But the brain, especially the subconscious part of

it, works in mysterious ways, so who knows regarding my experiment.

Also, I first observed the dramatic increase in SBP, to my great

surprise, long before I figured out (thanks only to a suggestion here

from JW - what a place this is!) what I think may be the cause of

it. So it doesn't seem to be a brain-created artifact of a pre-

conceived bias or a determination to prove a point.

The very first time I noticed it was when I walked to the drug store

instead of driving and my SBP was 155!!! I put it down at the time

to the exercise. But now it seems not all of that increase was

exercise-attributable.

What I find REALLY interesting about that study you posted is this

part: " ......... acute administration of 1,25-D caused a fast and

likely nongenomic-mediated decrease in cardiac output in patients

with essential hypertension, which together with a transient BP

increase implies a 1,25-D-induced increase in total peripheral

resistance. "

In plain english, assuming I understand it(!), it means that the

extra D causes the heart to pump LESS(!!!), but despite that, the

pressure in the system rises BECAUSE THE PIPES IN THE PERIPHERY OF

THE SYSTEM SHRINK.

So, if this is what is happening in my case, then the the vitamin D

is reducing heart output, which ought to reduce BP, but it is also

causing restriction in the peripheral parts that way more than makes

up for the reduced heart output. VERY VERY interesting. Thank you

again.

This will need some more thought on my part.

Rodney.

>

> Rodney,

>

> I'm sure you're aware of this, but there is a substantial role of

> anxiety and placebo effect in BP readings. There is, for example,

the

> so-called " white coat effect " , where a patient will get his blood

> pressure taken by a pretty young nurse or an intimidating doctor

type,

> and the BP type is 150/100. Then they go home and it's 120/80.

> There's some controversy about whether higher BP readings in the

> doctor's office that go down like this mean anything.

>

> Anyway, just something to be aware of in your experiments. I would

> take the BP 6 times, throw out the first two values, then throw out

> the remaining highest and lowest values, and average the remaining

two

> readings (I assume it's free, this drugstore machine?).

>

> You may think that you're not suggestible and are " stronger than the

> placebo effect " , but this effect of mind over BP needs to be

> respected. This is why most research, whenever possible, on BP is

> done in a double-blind fashion. Most people will not consider a BP

> study as being reliable if it was not done double-blind.

>

> Now, in your defense, however, I did find a paper showing an acute

> effect of 1,25 vitamin D (calcitriol) on blood pressure in patients

> with essential hypertension, but not in controls. When you take

> cholecalciferol, the liver makes it into 25-D, and then either blood

> vessels, locally, or the kidneys, hydroxylate it a second time to

make

> 1,25-D. Usually, after taking in low doses of cholecalciferol,

> however, (< 1000 IU), the serum level of 1,25-D is unchanged. But...

> who knows?

>

> For what it's worth, here's the paper.

>

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=9657624 & query_hl=3 & itoo

l=pubmed_DocSum

>

>

> Am J Hypertens. 1998 Jun;11(6 Pt 1):659-66.

> comment in: Am J Hypertens. 1999 Mar;12(3):332.

>

> Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in

> essential hypertension.

>

> Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV,

> Kanstrup IL. Department of Medicine, Herlev Hospital, University of

> Copenhagen, Denmark.

>

> A role for vitamin D in the pathophysiology of essential

hypertension

> has frequently been suggested, but acute direct effects on blood

> pressure, cardiac output, renal hemodynamics, or hormones have not

> previously been demonstrated. The rapid effects of

> 1,25-dihydroxycholecalciferol (1,25-D) were assessed over 120 min

> after a bolus injection (0.02 microg/kg body weight) in eight men

with

> essential hypertension and in nine healthy men. A placebo group of

10

> healthy men was also included. Ionized calcium was monitored closely

> during the study, and was kept constant with a clamping technique.

In

> the hypertensive patients, a transient increase in blood pressure

and

> a reciprocal fall in cardiac output measured by a CO2 rebreathing

> technique (-15%, P < .05) were observed after 1,25-D injection. In

the

> control group, both blood pressure and cardiac output remained

> unchanged. The glomerular filtration rate, effective renal plasma

> flow, and urinary sodium and water excretions were unchanged in both

> groups. Plasma levels of atrial natriuretic peptide at baseline were

> higher in the hypertensive patients than in the control subjects (P

<

> .02); plasma levels of renin, aldosterone, norepinephrine,

endothelin,

> and parathyroid hormone(1-84) were similar in the two groups. None

of

> these hormones was affected during the observation time after the

> injection of 1,25-D. In conclusion, acute administration of 1,25-D

> caused a fast and likely nongenomic-mediated decrease in cardiac

> output in patients with essential hypertension, which together with

a

> transient BP increase implies a 1,25-D-induced increase in total

> peripheral resistance. These data suggest an enhanced cardiovascular

> responsiveness to 1,25-D in hypertensive compared to healthy

> normotensive subjects.

>

>

>

[Guest guest]

Hi :

Gosh. It is amazing what one can learn at this place! Thank you for

that reminder. Reminders of basic truths are always helpful.

I have never seemed to suffer white coat effect for BP at previous

annual check ups. But the brain, especially the subconscious part of

it, works in mysterious ways, so who knows regarding my experiment.

Also, I first observed the dramatic increase in SBP, to my great

surprise, long before I figured out (thanks only to a suggestion here

from JW - what a place this is!) what I think may be the cause of

it. So it doesn't seem to be a brain-created artifact of a pre-

conceived bias or a determination to prove a point.

The very first time I noticed it was when I walked to the drug store

instead of driving and my SBP was 155!!! I put it down at the time

to the exercise. But now it seems not all of that increase was

exercise-attributable.

What I find REALLY interesting about that study you posted is this

part: " ......... acute administration of 1,25-D caused a fast and

likely nongenomic-mediated decrease in cardiac output in patients

with essential hypertension, which together with a transient BP

increase implies a 1,25-D-induced increase in total peripheral

resistance. "

In plain english, assuming I understand it(!), it means that the

extra D causes the heart to pump LESS(!!!), but despite that, the

pressure in the system rises BECAUSE THE PIPES IN THE PERIPHERY OF

THE SYSTEM SHRINK.

So, if this is what is happening in my case, then the the vitamin D

is reducing heart output, which ought to reduce BP, but it is also

causing restriction in the peripheral parts that way more than makes

up for the reduced heart output. VERY VERY interesting. Thank you

again.

This will need some more thought on my part.

Rodney.

>

> Rodney,

>

> I'm sure you're aware of this, but there is a substantial role of

> anxiety and placebo effect in BP readings. There is, for example,

the

> so-called " white coat effect " , where a patient will get his blood

> pressure taken by a pretty young nurse or an intimidating doctor

type,

> and the BP type is 150/100. Then they go home and it's 120/80.

> There's some controversy about whether higher BP readings in the

> doctor's office that go down like this mean anything.

>

> Anyway, just something to be aware of in your experiments. I would

> take the BP 6 times, throw out the first two values, then throw out

> the remaining highest and lowest values, and average the remaining

two

> readings (I assume it's free, this drugstore machine?).

>

> You may think that you're not suggestible and are " stronger than the

> placebo effect " , but this effect of mind over BP needs to be

> respected. This is why most research, whenever possible, on BP is

> done in a double-blind fashion. Most people will not consider a BP

> study as being reliable if it was not done double-blind.

>

> Now, in your defense, however, I did find a paper showing an acute

> effect of 1,25 vitamin D (calcitriol) on blood pressure in patients

> with essential hypertension, but not in controls. When you take

> cholecalciferol, the liver makes it into 25-D, and then either blood

> vessels, locally, or the kidneys, hydroxylate it a second time to

make

> 1,25-D. Usually, after taking in low doses of cholecalciferol,

> however, (< 1000 IU), the serum level of 1,25-D is unchanged. But...

> who knows?

>

> For what it's worth, here's the paper.

>

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=9657624 & query_hl=3 & itoo

l=pubmed_DocSum

>

>

> Am J Hypertens. 1998 Jun;11(6 Pt 1):659-66.

> comment in: Am J Hypertens. 1999 Mar;12(3):332.

>

> Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in

> essential hypertension.

>

> Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV,

> Kanstrup IL. Department of Medicine, Herlev Hospital, University of

> Copenhagen, Denmark.

>

> A role for vitamin D in the pathophysiology of essential

hypertension

> has frequently been suggested, but acute direct effects on blood

> pressure, cardiac output, renal hemodynamics, or hormones have not

> previously been demonstrated. The rapid effects of

> 1,25-dihydroxycholecalciferol (1,25-D) were assessed over 120 min

> after a bolus injection (0.02 microg/kg body weight) in eight men

with

> essential hypertension and in nine healthy men. A placebo group of

10

> healthy men was also included. Ionized calcium was monitored closely

> during the study, and was kept constant with a clamping technique.

In

> the hypertensive patients, a transient increase in blood pressure

and

> a reciprocal fall in cardiac output measured by a CO2 rebreathing

> technique (-15%, P < .05) were observed after 1,25-D injection. In

the

> control group, both blood pressure and cardiac output remained

> unchanged. The glomerular filtration rate, effective renal plasma

> flow, and urinary sodium and water excretions were unchanged in both

> groups. Plasma levels of atrial natriuretic peptide at baseline were

> higher in the hypertensive patients than in the control subjects (P

<

> .02); plasma levels of renin, aldosterone, norepinephrine,

endothelin,

> and parathyroid hormone(1-84) were similar in the two groups. None

of

> these hormones was affected during the observation time after the

> injection of 1,25-D. In conclusion, acute administration of 1,25-D

> caused a fast and likely nongenomic-mediated decrease in cardiac

> output in patients with essential hypertension, which together with

a

> transient BP increase implies a 1,25-D-induced increase in total

> peripheral resistance. These data suggest an enhanced cardiovascular

> responsiveness to 1,25-D in hypertensive compared to healthy

> normotensive subjects.

>

>

>

[Guest guest]

Rodney,

This is why I recommended you use the memory feature

of certain home blood pressure monitors and not look

at the numbers until after the memory is full. This

would serve as some measure of blinding for your study.

-

> >

> > Rodney,

> >

> > I'm sure you're aware of this, but there is a substantial role of

> > anxiety and placebo effect in BP readings. There is, for

example,

> the

> > so-called " white coat effect " , where a patient will get his blood

> > pressure taken by a pretty young nurse or an intimidating doctor

> type,

> > and the BP type is 150/100. Then they go home and it's 120/80.

> > There's some controversy about whether higher BP readings in the

> > doctor's office that go down like this mean anything.

> >

> > Anyway, just something to be aware of in your experiments. I

would

> > take the BP 6 times, throw out the first two values, then throw

out

> > the remaining highest and lowest values, and average the

remaining

> two

> > readings (I assume it's free, this drugstore machine?).

> >

> > You may think that you're not suggestible and are " stronger than

the

> > placebo effect " , but this effect of mind over BP needs to be

> > respected. This is why most research, whenever possible, on BP is

> > done in a double-blind fashion. Most people will not consider a

BP

> > study as being reliable if it was not done double-blind.

> >

> > Now, in your defense, however, I did find a paper showing an acute

> > effect of 1,25 vitamin D (calcitriol) on blood pressure in

patients

> > with essential hypertension, but not in controls. When you take

> > cholecalciferol, the liver makes it into 25-D, and then either

blood

> > vessels, locally, or the kidneys, hydroxylate it a second time to

> make

> > 1,25-D. Usually, after taking in low doses of cholecalciferol,

> > however, (< 1000 IU), the serum level of 1,25-D is unchanged.

But...

> > who knows?

> >

> > For what it's worth, here's the paper.

> >

> > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

>

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=9657624 & query_hl=3 & itoo

> l=pubmed_DocSum

> >

> >

> > Am J Hypertens. 1998 Jun;11(6 Pt 1):659-66.

> > comment in: Am J Hypertens. 1999 Mar;12(3):332.

> >

> > Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in

> > essential hypertension.

> >

> > Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV,

> > Kanstrup IL. Department of Medicine, Herlev Hospital, University

of

> > Copenhagen, Denmark.

> >

> > A role for vitamin D in the pathophysiology of essential

> hypertension

> > has frequently been suggested, but acute direct effects on blood

> > pressure, cardiac output, renal hemodynamics, or hormones have not

> > previously been demonstrated. The rapid effects of

> > 1,25-dihydroxycholecalciferol (1,25-D) were assessed over 120 min

> > after a bolus injection (0.02 microg/kg body weight) in eight men

> with

> > essential hypertension and in nine healthy men. A placebo group

of

> 10

> > healthy men was also included. Ionized calcium was monitored

closely

> > during the study, and was kept constant with a clamping

technique.

> In

> > the hypertensive patients, a transient increase in blood pressure

> and

> > a reciprocal fall in cardiac output measured by a CO2 rebreathing

> > technique (-15%, P < .05) were observed after 1,25-D injection.

In

> the

> > control group, both blood pressure and cardiac output remained

> > unchanged. The glomerular filtration rate, effective renal plasma

> > flow, and urinary sodium and water excretions were unchanged in

both

> > groups. Plasma levels of atrial natriuretic peptide at baseline

were

> > higher in the hypertensive patients than in the control subjects

(P

> <

> > .02); plasma levels of renin, aldosterone, norepinephrine,

> endothelin,

> > and parathyroid hormone(1-84) were similar in the two groups.

None

> of

> > these hormones was affected during the observation time after the

> > injection of 1,25-D. In conclusion, acute administration of 1,25-D

> > caused a fast and likely nongenomic-mediated decrease in cardiac

> > output in patients with essential hypertension, which together

with

> a

> > transient BP increase implies a 1,25-D-induced increase in total

> > peripheral resistance. These data suggest an enhanced

cardiovascular

> > responsiveness to 1,25-D in hypertensive compared to healthy

> > normotensive subjects.

> >

> >

> >

>

[Guest guest]

Rodney,

This is why I recommended you use the memory feature

of certain home blood pressure monitors and not look

at the numbers until after the memory is full. This

would serve as some measure of blinding for your study.

-

> >

> > Rodney,

> >

> > I'm sure you're aware of this, but there is a substantial role of

> > anxiety and placebo effect in BP readings. There is, for

example,

> the

> > so-called " white coat effect " , where a patient will get his blood

> > pressure taken by a pretty young nurse or an intimidating doctor

> type,

> > and the BP type is 150/100. Then they go home and it's 120/80.

> > There's some controversy about whether higher BP readings in the

> > doctor's office that go down like this mean anything.

> >

> > Anyway, just something to be aware of in your experiments. I

would

> > take the BP 6 times, throw out the first two values, then throw

out

> > the remaining highest and lowest values, and average the

remaining

> two

> > readings (I assume it's free, this drugstore machine?).

> >

> > You may think that you're not suggestible and are " stronger than

the

> > placebo effect " , but this effect of mind over BP needs to be

> > respected. This is why most research, whenever possible, on BP is

> > done in a double-blind fashion. Most people will not consider a

BP

> > study as being reliable if it was not done double-blind.

> >

> > Now, in your defense, however, I did find a paper showing an acute

> > effect of 1,25 vitamin D (calcitriol) on blood pressure in

patients

> > with essential hypertension, but not in controls. When you take

> > cholecalciferol, the liver makes it into 25-D, and then either

blood

> > vessels, locally, or the kidneys, hydroxylate it a second time to

> make

> > 1,25-D. Usually, after taking in low doses of cholecalciferol,

> > however, (< 1000 IU), the serum level of 1,25-D is unchanged.

But...

> > who knows?

> >

> > For what it's worth, here's the paper.

> >

> > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

>

cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=9657624 & query_hl=3 & itoo

> l=pubmed_DocSum

> >

> >

> > Am J Hypertens. 1998 Jun;11(6 Pt 1):659-66.

> > comment in: Am J Hypertens. 1999 Mar;12(3):332.

> >

> > Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in

> > essential hypertension.

> >

> > Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV,

> > Kanstrup IL. Department of Medicine, Herlev Hospital, University

of

> > Copenhagen, Denmark.

> >

> > A role for vitamin D in the pathophysiology of essential

> hypertension

> > has frequently been suggested, but acute direct effects on blood

> > pressure, cardiac output, renal hemodynamics, or hormones have not

> > previously been demonstrated. The rapid effects of

> > 1,25-dihydroxycholecalciferol (1,25-D) were assessed over 120 min

> > after a bolus injection (0.02 microg/kg body weight) in eight men

> with

> > essential hypertension and in nine healthy men. A placebo group

of

> 10

> > healthy men was also included. Ionized calcium was monitored

closely

> > during the study, and was kept constant with a clamping

technique.

> In

> > the hypertensive patients, a transient increase in blood pressure

> and

> > a reciprocal fall in cardiac output measured by a CO2 rebreathing

> > technique (-15%, P < .05) were observed after 1,25-D injection.

In

> the

> > control group, both blood pressure and cardiac output remained

> > unchanged. The glomerular filtration rate, effective renal plasma

> > flow, and urinary sodium and water excretions were unchanged in

both

> > groups. Plasma levels of atrial natriuretic peptide at baseline

were

> > higher in the hypertensive patients than in the control subjects

(P

> <

> > .02); plasma levels of renin, aldosterone, norepinephrine,

> endothelin,

> > and parathyroid hormone(1-84) were similar in the two groups.

None

> of

> > these hormones was affected during the observation time after the

> > injection of 1,25-D. In conclusion, acute administration of 1,25-D

> > caused a fast and likely nongenomic-mediated decrease in cardiac

> > output in patients with essential hypertension, which together

with

> a

> > transient BP increase implies a 1,25-D-induced increase in total

> > peripheral resistance. These data suggest an enhanced

cardiovascular

> > responsiveness to 1,25-D in hypertensive compared to healthy

> > normotensive subjects.

> >

> >

> >

>

[Guest guest]

,

I don't think that would be sufficient since the placebo effect (if

any) is due, in this case, to taking, or not taking, the vitamin D

supplement. To provide some blinding, I think Rodney would have to be

unaware of when he was taking vitamin D. This would be difficult

unless he has some capsules or tables that looked identical to the

vitamin D capsules which he could mix in somehow.

Tom

On Feb 5, 2006, at 5:20 AM, cronzen wrote:

> Rodney,

>

> This is why I recommended you use the memory feature

> of certain home blood pressure monitors and not look

> at the numbers until after the memory is full. This

> would serve as some measure of blinding for your study.

>

>

> -

[Guest guest]

,

I don't think that would be sufficient since the placebo effect (if

any) is due, in this case, to taking, or not taking, the vitamin D

supplement. To provide some blinding, I think Rodney would have to be

unaware of when he was taking vitamin D. This would be difficult

unless he has some capsules or tables that looked identical to the

vitamin D capsules which he could mix in somehow.

Tom

On Feb 5, 2006, at 5:20 AM, cronzen wrote:

> Rodney,

>

> This is why I recommended you use the memory feature

> of certain home blood pressure monitors and not look

> at the numbers until after the memory is full. This

> would serve as some measure of blinding for your study.

>

>

> -

[Guest guest]

Friday, my ugly nurse measured 140/90. My beautiful (really) doctor measured 124/74. I simply showed her the veins in my arms. Also, I can watch the gauge and feel the pulse.

Maybe it's the black coat effect? I think it was seated with legs dangling versus seated, rested. Just too many errors to account for, so they hafta call it something.

Notice the even numbers given first. If someone quotes me 140/90 I throw it out, period.

I think people who have HTN can be more sensitive to anything they eat.

And like celery, it can be a dual effect. First the patient is allergic to celery,eg, and BP rises, but then the celery has a diuretic effect and BP falls. Same with l-carnitine.

Regards.

[ ] (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

Rodney,I'm sure you're aware of this, but there is a substantial role ofanxiety and placebo effect in BP readings. There is, for example, theso-called "white coat effect", where a patient will get his bloodpressure taken by a pretty young nurse or an intimidating doctor type,and the BP type is 150/100. Then they go home and it's 120/80. There's some controversy about whether higher BP readings in thedoctor's office that go down like this mean anything.Anyway, just something to be aware of in your experiments. I wouldtake the BP 6 times, throw out the first two values, then throw outthe remaining highest and lowest values, and average the remaining tworeadings (I assume it's free, this drugstore machine?).You may think that you're not suggestible and are "stronger than theplacebo effect", but this effect of mind over BP needs to berespected. This is why most research, whenever possible, on BP isdone in a double-blind fashion. Most people will not consider a BPstudy as being reliable if it was not done double-blind.Now, in your defense, however, I did find a paper showing an acuteeffect of 1,25 vitamin D (calcitriol) on blood pressure in patientswith essential hypertension, but not in controls. When you takecholecalciferol, the liver makes it into 25-D, and then either bloodvessels, locally, or the kidneys, hydroxylate it a second time to make1,25-D. Usually, after taking in low doses of cholecalciferol,however, (< 1000 IU), the serum level of 1,25-D is unchanged. But...who knows?For what it's worth, here's the paper.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=9657624 & query_hl=3 & itool=pubmed_DocSumAm J Hypertens. 1998 Jun;11(6 Pt 1):659-66. comment in: Am J Hypertens. 1999 Mar;12(3):332.Acute cardiovascular effect of 1,25-dihydroxycholecalciferol inessential hypertension.Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV,Kanstrup IL. Department of Medicine, Herlev Hospital, University ofCopenhagen, Denmark.A role for vitamin D in the pathophysiology of essential hypertensionhas frequently been suggested, but acute direct effects on bloodpressure, cardiac output, renal hemodynamics, or hormones have notpreviously been demonstrated. The rapid effects of1,25-dihydroxycholecalciferol (1,25-D) were assessed over 120 minafter a bolus injection (0.02 microg/kg body weight) in eight men withessential hypertension and in nine healthy men. A placebo group of 10healthy men was also included. Ionized calcium was monitored closelyduring the study, and was kept constant with a clamping technique. Inthe hypertensive patients, a transient increase in blood pressure anda reciprocal fall in cardiac output measured by a CO2 rebreathingtechnique (-15%, P < .05) were observed after 1,25-D injection. In thecontrol group, both blood pressure and cardiac output remainedunchanged. The glomerular filtration rate, effective renal plasmaflow, and urinary sodium and water excretions were unchanged in bothgroups. Plasma levels of atrial natriuretic peptide at baseline werehigher in the hypertensive patients than in the control subjects (P <.02); plasma levels of renin, aldosterone, norepinephrine, endothelin,and parathyroid hormone(1-84) were similar in the two groups. None ofthese hormones was affected during the observation time after theinjection of 1,25-D. In conclusion, acute administration of 1,25-Dcaused a fast and likely nongenomic-mediated decrease in cardiacoutput in patients with essential hypertension, which together with atransient BP increase implies a 1,25-D-induced increase in totalperipheral resistance. These data suggest an enhanced cardiovascularresponsiveness to 1,25-D in hypertensive compared to healthynormotensive subjects.

[Guest guest]

Friday, my ugly nurse measured 140/90. My beautiful (really) doctor measured 124/74. I simply showed her the veins in my arms. Also, I can watch the gauge and feel the pulse.

Maybe it's the black coat effect? I think it was seated with legs dangling versus seated, rested. Just too many errors to account for, so they hafta call it something.

Notice the even numbers given first. If someone quotes me 140/90 I throw it out, period.

I think people who have HTN can be more sensitive to anything they eat.

And like celery, it can be a dual effect. First the patient is allergic to celery,eg, and BP rises, but then the celery has a diuretic effect and BP falls. Same with l-carnitine.

Regards.

[ ] (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

Rodney,I'm sure you're aware of this, but there is a substantial role ofanxiety and placebo effect in BP readings. There is, for example, theso-called "white coat effect", where a patient will get his bloodpressure taken by a pretty young nurse or an intimidating doctor type,and the BP type is 150/100. Then they go home and it's 120/80. There's some controversy about whether higher BP readings in thedoctor's office that go down like this mean anything.Anyway, just something to be aware of in your experiments. I wouldtake the BP 6 times, throw out the first two values, then throw outthe remaining highest and lowest values, and average the remaining tworeadings (I assume it's free, this drugstore machine?).You may think that you're not suggestible and are "stronger than theplacebo effect", but this effect of mind over BP needs to berespected. This is why most research, whenever possible, on BP isdone in a double-blind fashion. Most people will not consider a BPstudy as being reliable if it was not done double-blind.Now, in your defense, however, I did find a paper showing an acuteeffect of 1,25 vitamin D (calcitriol) on blood pressure in patientswith essential hypertension, but not in controls. When you takecholecalciferol, the liver makes it into 25-D, and then either bloodvessels, locally, or the kidneys, hydroxylate it a second time to make1,25-D. Usually, after taking in low doses of cholecalciferol,however, (< 1000 IU), the serum level of 1,25-D is unchanged. But...who knows?For what it's worth, here's the paper.http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=9657624 & query_hl=3 & itool=pubmed_DocSumAm J Hypertens. 1998 Jun;11(6 Pt 1):659-66. comment in: Am J Hypertens. 1999 Mar;12(3):332.Acute cardiovascular effect of 1,25-dihydroxycholecalciferol inessential hypertension.Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV,Kanstrup IL. Department of Medicine, Herlev Hospital, University ofCopenhagen, Denmark.A role for vitamin D in the pathophysiology of essential hypertensionhas frequently been suggested, but acute direct effects on bloodpressure, cardiac output, renal hemodynamics, or hormones have notpreviously been demonstrated. The rapid effects of1,25-dihydroxycholecalciferol (1,25-D) were assessed over 120 minafter a bolus injection (0.02 microg/kg body weight) in eight men withessential hypertension and in nine healthy men. A placebo group of 10healthy men was also included. Ionized calcium was monitored closelyduring the study, and was kept constant with a clamping technique. Inthe hypertensive patients, a transient increase in blood pressure anda reciprocal fall in cardiac output measured by a CO2 rebreathingtechnique (-15%, P < .05) were observed after 1,25-D injection. In thecontrol group, both blood pressure and cardiac output remainedunchanged. The glomerular filtration rate, effective renal plasmaflow, and urinary sodium and water excretions were unchanged in bothgroups. Plasma levels of atrial natriuretic peptide at baseline werehigher in the hypertensive patients than in the control subjects (P <.02); plasma levels of renin, aldosterone, norepinephrine, endothelin,and parathyroid hormone(1-84) were similar in the two groups. None ofthese hormones was affected during the observation time after theinjection of 1,25-D. In conclusion, acute administration of 1,25-Dcaused a fast and likely nongenomic-mediated decrease in cardiacoutput in patients with essential hypertension, which together with atransient BP increase implies a 1,25-D-induced increase in totalperipheral resistance. These data suggest an enhanced cardiovascularresponsiveness to 1,25-D in hypertensive compared to healthynormotensive subjects.

[Guest guest]

Cardiac output is a function of HR AND force of the pulse. A high HR person can very low BP, and vice versa.

Regards.

[ ] Re: (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

Hi :Gosh. It is amazing what one can learn at this place! Thank you for that reminder. Reminders of basic truths are always helpful.I have never seemed to suffer white coat effect for BP at previous annual check ups. But the brain, especially the subconscious part of it, works in mysterious ways, so who knows regarding my experiment. Also, I first observed the dramatic increase in SBP, to my great surprise, long before I figured out (thanks only to a suggestion here from JW - what a place this is!) what I think may be the cause of it. So it doesn't seem to be a brain-created artifact of a pre-conceived bias or a determination to prove a point.The very first time I noticed it was when I walked to the drug store instead of driving and my SBP was 155!!! I put it down at the time to the exercise. But now it seems not all of that increase was exercise-attributable.What I find REALLY interesting about that study you posted is this part: " ......... acute administration of 1,25-D caused a fast and likely nongenomic-mediated decrease in cardiac output in patients with essential hypertension, which together with a transient BP increase implies a 1,25-D-induced increase in total peripheral resistance."In plain english, assuming I understand it(!), it means that the extra D causes the heart to pump LESS(!!!), but despite that, the pressure in the system rises BECAUSE THE PIPES IN THE PERIPHERY OF THE SYSTEM SHRINK.So, if this is what is happening in my case, then the the vitamin D is reducing heart output, which ought to reduce BP, but it is also causing restriction in the peripheral parts that way more than makes up for the reduced heart output. VERY VERY interesting. Thank you again.This will need some more thought on my part.Rodney.>> Rodney,> > I'm sure you're aware of this, but there is a substantial role of> anxiety and placebo effect in BP readings. There is, for example, the> so-called "white coat effect", where a patient will get his blood> pressure taken by a pretty young nurse or an intimidating doctor type,> and the BP type is 150/100. Then they go home and it's 120/80. > There's some controversy about whether higher BP readings in the> doctor's office that go down like this mean anything.> > Anyway, just something to be aware of in your experiments. I would> take the BP 6 times, throw out the first two values, then throw out> the remaining highest and lowest values, and average the remaining two> readings (I assume it's free, this drugstore machine?).> > You may think that you're not suggestible and are "stronger than the> placebo effect", but this effect of mind over BP needs to be> respected. This is why most research, whenever possible, on BP is> done in a double-blind fashion. Most people will not consider a BP> study as being reliable if it was not done double-blind.> > Now, in your defense, however, I did find a paper showing an acute> effect of 1,25 vitamin D (calcitriol) on blood pressure in patients> with essential hypertension, but not in controls. When you take> cholecalciferol, the liver makes it into 25-D, and then either blood> vessels, locally, or the kidneys, hydroxylate it a second time to make> 1,25-D. Usually, after taking in low doses of cholecalciferol,> however, (< 1000 IU), the serum level of 1,25-D is unchanged. But...> who knows?> > For what it's worth, here's the paper.> > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=9657624 & query_hl=3 & itool=pubmed_DocSum> > > Am J Hypertens. 1998 Jun;11(6 Pt 1):659-66. > comment in: Am J Hypertens. 1999 Mar;12(3):332.> > Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in> essential hypertension.> > Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV,> Kanstrup IL. Department of Medicine, Herlev Hospital, University of> Copenhagen, Denmark.> > A role for vitamin D in the pathophysiology of essential hypertension> has frequently been suggested, but acute direct effects on blood> pressure, cardiac output, renal hemodynamics, or hormones have not> previously been demonstrated. The rapid effects of> 1,25-dihydroxycholecalciferol (1,25-D) were assessed over 120 min> after a bolus injection (0.02 microg/kg body weight) in eight men with> essential hypertension and in nine healthy men. A placebo group of 10> healthy men was also included. Ionized calcium was monitored closely> during the study, and was kept constant with a clamping technique. In> the hypertensive patients, a transient increase in blood pressure and> a reciprocal fall in cardiac output measured by a CO2 rebreathing> technique (-15%, P < .05) were observed after 1,25-D injection. In the> control group, both blood pressure and cardiac output remained> unchanged. The glomerular filtration rate, effective renal plasma> flow, and urinary sodium and water excretions were unchanged in both> groups. Plasma levels of atrial natriuretic peptide at baseline were> higher in the hypertensive patients than in the control subjects (P <> .02); plasma levels of renin, aldosterone, norepinephrine, endothelin,> and parathyroid hormone(1-84) were similar in the two groups. None of> these hormones was affected during the observation time after the> injection of 1,25-D. In conclusion, acute administration of 1,25-D> caused a fast and likely nongenomic-mediated decrease in cardiac> output in patients with essential hypertension, which together with a> transient BP increase implies a 1,25-D-induced increase in total> peripheral resistance. These data suggest an enhanced cardiovascular> responsiveness to 1,25-D in hypertensive compared to healthy> normotensive subjects.> > >

[Guest guest]

Cardiac output is a function of HR AND force of the pulse. A high HR person can very low BP, and vice versa.

Regards.

[ ] Re: (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

Hi :Gosh. It is amazing what one can learn at this place! Thank you for that reminder. Reminders of basic truths are always helpful.I have never seemed to suffer white coat effect for BP at previous annual check ups. But the brain, especially the subconscious part of it, works in mysterious ways, so who knows regarding my experiment. Also, I first observed the dramatic increase in SBP, to my great surprise, long before I figured out (thanks only to a suggestion here from JW - what a place this is!) what I think may be the cause of it. So it doesn't seem to be a brain-created artifact of a pre-conceived bias or a determination to prove a point.The very first time I noticed it was when I walked to the drug store instead of driving and my SBP was 155!!! I put it down at the time to the exercise. But now it seems not all of that increase was exercise-attributable.What I find REALLY interesting about that study you posted is this part: " ......... acute administration of 1,25-D caused a fast and likely nongenomic-mediated decrease in cardiac output in patients with essential hypertension, which together with a transient BP increase implies a 1,25-D-induced increase in total peripheral resistance."In plain english, assuming I understand it(!), it means that the extra D causes the heart to pump LESS(!!!), but despite that, the pressure in the system rises BECAUSE THE PIPES IN THE PERIPHERY OF THE SYSTEM SHRINK.So, if this is what is happening in my case, then the the vitamin D is reducing heart output, which ought to reduce BP, but it is also causing restriction in the peripheral parts that way more than makes up for the reduced heart output. VERY VERY interesting. Thank you again.This will need some more thought on my part.Rodney.>> Rodney,> > I'm sure you're aware of this, but there is a substantial role of> anxiety and placebo effect in BP readings. There is, for example, the> so-called "white coat effect", where a patient will get his blood> pressure taken by a pretty young nurse or an intimidating doctor type,> and the BP type is 150/100. Then they go home and it's 120/80. > There's some controversy about whether higher BP readings in the> doctor's office that go down like this mean anything.> > Anyway, just something to be aware of in your experiments. I would> take the BP 6 times, throw out the first two values, then throw out> the remaining highest and lowest values, and average the remaining two> readings (I assume it's free, this drugstore machine?).> > You may think that you're not suggestible and are "stronger than the> placebo effect", but this effect of mind over BP needs to be> respected. This is why most research, whenever possible, on BP is> done in a double-blind fashion. Most people will not consider a BP> study as being reliable if it was not done double-blind.> > Now, in your defense, however, I did find a paper showing an acute> effect of 1,25 vitamin D (calcitriol) on blood pressure in patients> with essential hypertension, but not in controls. When you take> cholecalciferol, the liver makes it into 25-D, and then either blood> vessels, locally, or the kidneys, hydroxylate it a second time to make> 1,25-D. Usually, after taking in low doses of cholecalciferol,> however, (< 1000 IU), the serum level of 1,25-D is unchanged. But...> who knows?> > For what it's worth, here's the paper.> > http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstract & list_uids=9657624 & query_hl=3 & itool=pubmed_DocSum> > > Am J Hypertens. 1998 Jun;11(6 Pt 1):659-66. > comment in: Am J Hypertens. 1999 Mar;12(3):332.> > Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in> essential hypertension.> > Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV,> Kanstrup IL. Department of Medicine, Herlev Hospital, University of> Copenhagen, Denmark.> > A role for vitamin D in the pathophysiology of essential hypertension> has frequently been suggested, but acute direct effects on blood> pressure, cardiac output, renal hemodynamics, or hormones have not> previously been demonstrated. The rapid effects of> 1,25-dihydroxycholecalciferol (1,25-D) were assessed over 120 min> after a bolus injection (0.02 microg/kg body weight) in eight men with> essential hypertension and in nine healthy men. A placebo group of 10> healthy men was also included. Ionized calcium was monitored closely> during the study, and was kept constant with a clamping technique. In> the hypertensive patients, a transient increase in blood pressure and> a reciprocal fall in cardiac output measured by a CO2 rebreathing> technique (-15%, P < .05) were observed after 1,25-D injection. In the> control group, both blood pressure and cardiac output remained> unchanged. The glomerular filtration rate, effective renal plasma> flow, and urinary sodium and water excretions were unchanged in both> groups. Plasma levels of atrial natriuretic peptide at baseline were> higher in the hypertensive patients than in the control subjects (P <> .02); plasma levels of renin, aldosterone, norepinephrine, endothelin,> and parathyroid hormone(1-84) were similar in the two groups. None of> these hormones was affected during the observation time after the> injection of 1,25-D. In conclusion, acute administration of 1,25-D> caused a fast and likely nongenomic-mediated decrease in cardiac> output in patients with essential hypertension, which together with a> transient BP increase implies a 1,25-D-induced increase in total> peripheral resistance. These data suggest an enhanced cardiovascular> responsiveness to 1,25-D in hypertensive compared to healthy> normotensive subjects.> > >

[Guest guest]

There are too many complexities involved in trying to understand why my BP is effected by pill type vit d.

Fact is, everyone who is going to play in supplements should measure their BP enough that they have enough confidence in their ability to measure it that they can scoff at the "white coat" folks.

Regards.

Re: [ ] Re: (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

,I don't think that would be sufficient since the placebo effect (if any) is due, in this case, to taking, or not taking, the vitamin D supplement. To provide some blinding, I think Rodney would have to be unaware of when he was taking vitamin D. This would be difficult unless he has some capsules or tables that looked identical to the vitamin D capsules which he could mix in somehow.TomOn Feb 5, 2006, at 5:20 AM, cronzen wrote:> Rodney,>> This is why I recommended you use the memory feature> of certain home blood pressure monitors and not look> at the numbers until after the memory is full. This> would serve as some measure of blinding for your study.>>> -

[Guest guest]

There are too many complexities involved in trying to understand why my BP is effected by pill type vit d.

Fact is, everyone who is going to play in supplements should measure their BP enough that they have enough confidence in their ability to measure it that they can scoff at the "white coat" folks.

Regards.

Re: [ ] Re: (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

,I don't think that would be sufficient since the placebo effect (if any) is due, in this case, to taking, or not taking, the vitamin D supplement. To provide some blinding, I think Rodney would have to be unaware of when he was taking vitamin D. This would be difficult unless he has some capsules or tables that looked identical to the vitamin D capsules which he could mix in somehow.TomOn Feb 5, 2006, at 5:20 AM, cronzen wrote:> Rodney,>> This is why I recommended you use the memory feature> of certain home blood pressure monitors and not look> at the numbers until after the memory is full. This> would serve as some measure of blinding for your study.>>> -

[Guest guest]

jt_qod wrote:

> Rodney,

>

> I'm sure you're aware of this, but there is a substantial role of

> anxiety and placebo effect in BP readings. There is, for example, the

> so-called " white coat effect " , where a patient will get his blood

> pressure taken by a pretty young nurse or an intimidating doctor type,

> and the BP type is 150/100. Then they go home and it's 120/80.

> There's some controversy about whether higher BP readings in the

> doctor's office that go down like this mean anything.

>

>

The stuff I've read says that " white coat " hypertension is serious.

Some people get hypertensive when they are under stress. If they get

hypertensive because they feel stress in the Dr's office, they'll get

hypertensive when they get stuck in traffic, when their kid tells them

off, see a pretty/ugly/intimidating person, whatever...

It's just as incorrect to always measure your BP when you are calm

as it is to measure it when you're under stress. (Heck, if I time to

meditate, I can lower my peripheral circulation enough to stop the

blood pressure machine at the mall from getting a reading of all.)

Hypertension causes changes that self-perpetuate, so it's quite

possible that ocasional spikes to 150/100 would raise your " calm " BP

from 115/70 to 120/80.

> You may think that you're not suggestible and are " stronger than the

> placebo effect " , but this effect of mind over BP needs to be

> respected. This is why most research, whenever possible, on BP is

> done in a double-blind fashion. Most people will not consider a BP

> study as being reliable if it was not done double-blind.

>

Hard to do in a study of one.

My doc's eyes popped the last time I showed up in her office and saw

my blood pressure and pulse. A few days later I did some informal

experimentation with substituting plain Zyrtec (antihistamine) for

Zyrtec-D (antihistamine + 120 mg of pseudoephedrine) and found my pulse

dropped from 92 to 68. I did some on cycles and off cycles and was

pretty convinced -- it's a big enough difference that I don't care if

it's a placebo effect.

[Guest guest]

jt_qod wrote:

> Rodney,

>

> I'm sure you're aware of this, but there is a substantial role of

> anxiety and placebo effect in BP readings. There is, for example, the

> so-called " white coat effect " , where a patient will get his blood

> pressure taken by a pretty young nurse or an intimidating doctor type,

> and the BP type is 150/100. Then they go home and it's 120/80.

> There's some controversy about whether higher BP readings in the

> doctor's office that go down like this mean anything.

>

>

The stuff I've read says that " white coat " hypertension is serious.

Some people get hypertensive when they are under stress. If they get

hypertensive because they feel stress in the Dr's office, they'll get

hypertensive when they get stuck in traffic, when their kid tells them

off, see a pretty/ugly/intimidating person, whatever...

It's just as incorrect to always measure your BP when you are calm

as it is to measure it when you're under stress. (Heck, if I time to

meditate, I can lower my peripheral circulation enough to stop the

blood pressure machine at the mall from getting a reading of all.)

Hypertension causes changes that self-perpetuate, so it's quite

possible that ocasional spikes to 150/100 would raise your " calm " BP

from 115/70 to 120/80.

> You may think that you're not suggestible and are " stronger than the

> placebo effect " , but this effect of mind over BP needs to be

> respected. This is why most research, whenever possible, on BP is

> done in a double-blind fashion. Most people will not consider a BP

> study as being reliable if it was not done double-blind.

>

Hard to do in a study of one.

My doc's eyes popped the last time I showed up in her office and saw

my blood pressure and pulse. A few days later I did some informal

experimentation with substituting plain Zyrtec (antihistamine) for

Zyrtec-D (antihistamine + 120 mg of pseudoephedrine) and found my pulse

dropped from 92 to 68. I did some on cycles and off cycles and was

pretty convinced -- it's a big enough difference that I don't care if

it's a placebo effect.

[Guest guest]

The best thing for HTN is to find out yourself how to take the measurement, keep a log book of the BP and what you eat, exercise, and whatever other OTC stuff you take. Lotsa OTC stuff and grapefruit juice also will change your BP or the efficacy of your medication. Some will change the way you pee (Diphenhydramine HCL) and that will change BP.

More than any other thing I can think of you have to take charge because no one else can. Well there's nutrition also.

The serious part of "white coat", IMO, is that anyone bothered to call it by that name. BP can change at any time for many diff reasons. Oddly, mine usually goes opposite to the way they say it will.

But I refrain from watching BS stuff on TV, and I refuse to get excited about world war III etc., things I have no control over anyway. Now if the neighbor's cat attacks my squirrels, I deal with it, but I don't get excited about it.

Basically, I think a lot of the "irritation raises BP", is opposite to my observed "when my BP is high I tend to be more irritable". Mostly, I just say "what the xxxx", and ignore whatever or whomever.

Regards.

Re: [ ] (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

jt_qod wrote:> Rodney,>> I'm sure you're aware of this, but there is a substantial role of> anxiety and placebo effect in BP readings. There is, for example, the> so-called "white coat effect", where a patient will get his blood> pressure taken by a pretty young nurse or an intimidating doctor type,> and the BP type is 150/100. Then they go home and it's 120/80. > There's some controversy about whether higher BP readings in the> doctor's office that go down like this mean anything.>> The stuff I've read says that "white coat" hypertension is serious. Some people get hypertensive when they are under stress. If they get hypertensive because they feel stress in the Dr's office, they'll get hypertensive when they get stuck in traffic, when their kid tells them off, see a pretty/ugly/intimidating person, whatever... It's just as incorrect to always measure your BP when you are calm as it is to measure it when you're under stress. (Heck, if I time to meditate, I can lower my peripheral circulation enough to stop the blood pressure machine at the mall from getting a reading of all.) Hypertension causes changes that self-perpetuate, so it's quite possible that ocasional spikes to 150/100 would raise your "calm" BP from 115/70 to 120/80.> You may think that you're not suggestible and are "stronger than the> placebo effect", but this effect of mind over BP needs to be> respected. This is why most research, whenever possible, on BP is> done in a double-blind fashion. Most people will not consider a BP> study as being reliable if it was not done double-blind.> Hard to do in a study of one. My doc's eyes popped the last time I showed up in her office and saw my blood pressure and pulse. A few days later I did some informal experimentation with substituting plain Zyrtec (antihistamine) for Zyrtec-D (antihistamine + 120 mg of pseudoephedrine) and found my pulse dropped from 92 to 68. I did some on cycles and off cycles and was pretty convinced -- it's a big enough difference that I don't care if it's a placebo effect.

[Guest guest]

The best thing for HTN is to find out yourself how to take the measurement, keep a log book of the BP and what you eat, exercise, and whatever other OTC stuff you take. Lotsa OTC stuff and grapefruit juice also will change your BP or the efficacy of your medication. Some will change the way you pee (Diphenhydramine HCL) and that will change BP.

More than any other thing I can think of you have to take charge because no one else can. Well there's nutrition also.

The serious part of "white coat", IMO, is that anyone bothered to call it by that name. BP can change at any time for many diff reasons. Oddly, mine usually goes opposite to the way they say it will.

But I refrain from watching BS stuff on TV, and I refuse to get excited about world war III etc., things I have no control over anyway. Now if the neighbor's cat attacks my squirrels, I deal with it, but I don't get excited about it.

Basically, I think a lot of the "irritation raises BP", is opposite to my observed "when my BP is high I tend to be more irritable". Mostly, I just say "what the xxxx", and ignore whatever or whomever.

Regards.

Re: [ ] (1) BP and placebo effect; (2)acute effect of 1,25-D on blood pressure

jt_qod wrote:> Rodney,>> I'm sure you're aware of this, but there is a substantial role of> anxiety and placebo effect in BP readings. There is, for example, the> so-called "white coat effect", where a patient will get his blood> pressure taken by a pretty young nurse or an intimidating doctor type,> and the BP type is 150/100. Then they go home and it's 120/80. > There's some controversy about whether higher BP readings in the> doctor's office that go down like this mean anything.>> The stuff I've read says that "white coat" hypertension is serious. Some people get hypertensive when they are under stress. If they get hypertensive because they feel stress in the Dr's office, they'll get hypertensive when they get stuck in traffic, when their kid tells them off, see a pretty/ugly/intimidating person, whatever... It's just as incorrect to always measure your BP when you are calm as it is to measure it when you're under stress. (Heck, if I time to meditate, I can lower my peripheral circulation enough to stop the blood pressure machine at the mall from getting a reading of all.) Hypertension causes changes that self-perpetuate, so it's quite possible that ocasional spikes to 150/100 would raise your "calm" BP from 115/70 to 120/80.> You may think that you're not suggestible and are "stronger than the> placebo effect", but this effect of mind over BP needs to be> respected. This is why most research, whenever possible, on BP is> done in a double-blind fashion. Most people will not consider a BP> study as being reliable if it was not done double-blind.> Hard to do in a study of one. My doc's eyes popped the last time I showed up in her office and saw my blood pressure and pulse. A few days later I did some informal experimentation with substituting plain Zyrtec (antihistamine) for Zyrtec-D (antihistamine + 120 mg of pseudoephedrine) and found my pulse dropped from 92 to 68. I did some on cycles and off cycles and was pretty convinced -- it's a big enough difference that I don't care if it's a placebo effect.