AFIB just started for me... Need advice...

[Guest guest]

Thanks for allowing me access to this group. Let me tell you my

background - Have been on Atenolol (100 mg), Lotrel (10mg/20) and

Aspirin (81 mg) for about 3 years now for BP control. These meds

have given me a few of the classic side effects (Atenolol - the

diving boots problem - sexual issues - etc.), but overall the

experience has been good with the BP nearly normal most of the time.

About 6 months ago, my Dr. decided that the next thing he needed to

address was my LDL level, so he prescribed Zocor (20 mg) to add to

the mix.

About three months ago, I missed my meds for a day due to

forgetfulness and atrial fibrillation hit me for about a day. The

heart lost its normal sinus rhythm and was all over the map for about

24 hours. Once I took the meds again, everything came back to normal

though. I assumed it was due to the lack of Atenolol in my blood

stream and went on about my business. I ran out a of meds a few

weeks later and the problem appeared again, but this time for 5

days! I also noticed after that lack of meds were not necessarily my

triggers - stress, Cialis, numerous things would trigger 1 hour -

multiple day episodes.

I have been sick with a bit of a cold this week and have been in AF

for about a week. I read this morning on the Internet that statins

such as Zocor may have negative interactions with Beta Blockers such

as Atenolol and can cause the AF cancelling the normal rhythmic

control function of the BB's. I am seeing a second doctor in a few

days to get a second opinion since my Dr. thinks that my problem is a

physical one with the heart. I had an echocardiagram a couple of

weeks ago and the heart looked great per the cardiologist.

I am convinced that this is a chemical problem from the drugs not

working together. Does anyone have advice or experiences to share

with me?

Thanks in advance for anything you can share!

Steve

shomer@...

[Guest guest]

I have not been able to find anything about this. Could you please

send us the URL? I am on sotalol now, and might have to re-start a

statin to get my LDL below 70 (It is now just under 100). So, I

would like to know, too. Below are some articles that I found that

seems to endorse taking them both (but they do not say anything about

A-Fib):

http://www.personalmd.com/news.jsp?nid=531099

Statins, Beta Blockers Help Block First Heart Attack

These drugs do more than just reduce cardiovascular disease, study suggests

By Meryl Hyman

HealthDay Reporter

MONDAY, Feb. 20 (HealthDay News) -- Doctors know that

cholesterol-busting statins and beta blocker blood pressure medicines

help prevent cardiovascular disease.

Now, new research suggests they may also ward off the heart attacks

that sometimes appear as the first sign of cardiovascular trouble.

" Probably the most surprising thing was that among all of the

different medications that we examined [including ACE inhibitors,

angiotensin II receptor blockers, calcium channel blockers, diuretics

and alpha-blockers], statins and beta blockers were the only heart

drugs that seemed to protect against having a heart attack as the

first symptom of heart disease, " said study author Dr. Alan Go, a

research scientist with Kaiser Permanente's Division of Research in

Oakland, Calif.

Of nearly 1,400 Kaiser Permanente patients studied in Northern

California, those who had heart attacks were much less likely to have

received statins and/or beta blockers than patients who experienced

chest pain and pressure (angina) with exercise as their warning signs

of heart disease.

The patients who had heart attacks rather than angina were most often

male, smokers, physically inactive and hypertensive, though when

those details were factored out, the statins and beta blockers still

appeared to make the difference.

Patients who had already been diagnosed with coronary disease were

not included in the study.

The study, published in the Feb. 21 issue of ls of Internal

Medicine, also found that women were less likely than men to suffer a

heart attack as their first heart disease symptom.

How might statins and beta blockers fight first heart attack? Go said

it appears that statins work through lowering LDL or " bad "

cholesterol. They may also lower arterial inflammation, keep

cholesterol plaque in blood vessels from rupturing, and improve blood

vessel performance.

For their part, beta blockers lower blood pressure and slow down the

heart rate, which together lower stress on the heart, he noted. These

drugs " may also improve the flexibility of blood vessels, which

allows them to respond better to stress, " Go said.

" We believe that our study provides more evidence that persons who

are at increased risk for heart disease should consider talking with

their doctor about whether they should be taking these medications, "

he said.

Not everyone is convinced it is time to change practice, however.

" There are clear guidelines about who should take statins and beta

blockers, and we should continue to follow those, " said Dr. Harlan M.

Krumholz, a professor of cardiology at Yale University School of

Medicine. " This study doesn't clarify if there are additional groups

who should be treated. "

Krumholz said the real question is, " What strategy would keep people

from having either complication? "

The researchers conceded that they did not have " all possible

confounding factors, including use of aspirin therapy, " and they

stressed that more study is needed.

Also:

http://news.bbc.co.uk/2/hi/health/1256398.stm

Beta-blockers are known to act on the central nervous system, and

previous research on animals has indicated that stress is linked to

atherosclerosis.

In total, 793 volunteers took part in the study, which lasted for three years.

Ultrasound images of the participants' carotid arteries were taken at

enrolment, 18 months, and 36 months.

Metroprolol CR/XL reduced the speed of artery thickening at both 18

and 36 months. People who took the drug also suffered less heart

attacks and strokes.

The researchers also tested the impact of the cholesterol-lowering

drug fluvastatin which is already known to reduce atherosclerosis.

They found fluvastatin reduced the rate of progression of thickening

of the inner lining of carotid arteries by 75%.

The two drugs worked on different sites in the carotid artery, and

there was no indication of any interaction between the two drugs in

patients who were given them both.

Dr Wikstrand, who also took part in the research, told BBC News

Online that patients might benefit from taking a combination of

statins and beta-blockers.

He said: " We can maybe draw a parallel with the combination treatment

with an ACE-inhibitor and a beta-blocker in patients with heart

failure.

" Adding a beta-blocker on top of an ACE-inhibitor will increase

survival by around 35% and reduce the risk of being hospitalized for

worsening heart failure by around 30%.

" We speculate that similar benefits could well be at hand when adding

a beta-blocker to a statin in patients with high cholesterol levels. "

And, from another study on the combined use post myocardial

infarction complicated by congestive heart failure:

http://www.looksmartrelationships.com/p/articles/mi_m3225/is_9_70/ai_n8570401

Review of all-cause mortality demonstrated that treatment with

statins alone was associated with a significant relative risk

reduction of 55.2 percent, while treatment with beta blockers alone

was associated with a significant relative risk reduction of 46.1

percent. The effect of taking both medications on discharge was even

greater, with a relative risk reduction of 72.7 percent compared with

no treatment. Although these decreases in risk were somewhat lower

after adjusting for risk variables that existed before patients were

included in the study, the trend toward decreased risk remained for

all-cause mortality as well as cardiovascular death, hospitalization,

and repeat infarction.

The authors conclude that combined treatment with statins and beta

blockers early after MI complicated by CHF improves outcomes. The

effects of these drugs taken together appear to be additive.

However, I found a potential statin-warfarin interaction:

http://www.ahealthyme.com/topic/heartdrugs

potentially hazardous are the combination of warfarin and... the

cholesterol drug Mevacor

and

Some statins can react in a dangerous way with ... the blood thinner

warfarin (Coumadin),

At 8:33 PM +0000 3/12/06, Steve Homer wrote:

>I read this morning on the Internet that statins

>such as Zocor may have negative interactions with Beta Blockers such

>as Atenolol and can cause the AF cancelling the normal rhythmic

>control function of the BB's.

[Guest guest]

Here is the story that I mentioned finding this morning:

http://www.agape-biblia.org/recom/index6.htm

Re: AFIB just started for me... Need advice...

I have not been able to find anything about this. Could you please send

us the URL? I am on sotalol now, and might have to re-start a statin to

get my LDL below 70 (It is now just under 100). So, I would like to

know, too. Below are some articles that I found that seems to endorse

taking them both (but they do not say anything about A-Fib):

http://www.personalmd.com/news.jsp?nid=531099

Statins, Beta Blockers Help Block First Heart Attack

These drugs do more than just reduce cardiovascular disease, study

suggests

By Meryl Hyman

HealthDay Reporter

MONDAY, Feb. 20 (HealthDay News) -- Doctors know that

cholesterol-busting statins and beta blocker blood pressure medicines

help prevent cardiovascular disease.

Now, new research suggests they may also ward off the heart attacks that

sometimes appear as the first sign of cardiovascular trouble.

" Probably the most surprising thing was that among all of the different

medications that we examined [including ACE inhibitors, angiotensin II

receptor blockers, calcium channel blockers, diuretics and

alpha-blockers], statins and beta blockers were the only heart drugs

that seemed to protect against having a heart attack as the first

symptom of heart disease, " said study author Dr. Alan Go, a research

scientist with Kaiser Permanente's Division of Research in Oakland,

Calif.

Of nearly 1,400 Kaiser Permanente patients studied in Northern

California, those who had heart attacks were much less likely to have

received statins and/or beta blockers than patients who experienced

chest pain and pressure (angina) with exercise as their warning signs of

heart disease.

The patients who had heart attacks rather than angina were most often

male, smokers, physically inactive and hypertensive, though when those

details were factored out, the statins and beta blockers still appeared

to make the difference.

Patients who had already been diagnosed with coronary disease were not

included in the study.

The study, published in the Feb. 21 issue of ls of Internal

Medicine, also found that women were less likely than men to suffer a

heart attack as their first heart disease symptom.

How might statins and beta blockers fight first heart attack? Go said it

appears that statins work through lowering LDL or " bad " cholesterol.

They may also lower arterial inflammation, keep cholesterol plaque in

blood vessels from rupturing, and improve blood vessel performance.

For their part, beta blockers lower blood pressure and slow down the

heart rate, which together lower stress on the heart, he noted. These

drugs " may also improve the flexibility of blood vessels, which allows

them to respond better to stress, " Go said.

" We believe that our study provides more evidence that persons who are

at increased risk for heart disease should consider talking with their

doctor about whether they should be taking these medications, " he said.

Not everyone is convinced it is time to change practice, however.

" There are clear guidelines about who should take statins and beta

blockers, and we should continue to follow those, " said Dr. Harlan M.

Krumholz, a professor of cardiology at Yale University School of

Medicine. " This study doesn't clarify if there are additional groups who

should be treated. "

Krumholz said the real question is, " What strategy would keep people

from having either complication? "

The researchers conceded that they did not have " all possible

confounding factors, including use of aspirin therapy, " and they

stressed that more study is needed.

Also:

http://news.bbc.co.uk/2/hi/health/1256398.stm

Beta-blockers are known to act on the central nervous system, and

previous research on animals has indicated that stress is linked to

atherosclerosis.

In total, 793 volunteers took part in the study, which lasted for three

years.

Ultrasound images of the participants' carotid arteries were taken at

enrolment, 18 months, and 36 months.

Metroprolol CR/XL reduced the speed of artery thickening at both 18 and

36 months. People who took the drug also suffered less heart attacks and

strokes.

The researchers also tested the impact of the cholesterol-lowering drug

fluvastatin which is already known to reduce atherosclerosis.

They found fluvastatin reduced the rate of progression of thickening of

the inner lining of carotid arteries by 75%.

The two drugs worked on different sites in the carotid artery, and there

was no indication of any interaction between the two drugs in patients

who were given them both.

Dr Wikstrand, who also took part in the research, told BBC News

Online that patients might benefit from taking a combination of statins

and beta-blockers.

He said: " We can maybe draw a parallel with the combination treatment

with an ACE-inhibitor and a beta-blocker in patients with heart failure.

" Adding a beta-blocker on top of an ACE-inhibitor will increase survival

by around 35% and reduce the risk of being hospitalized for worsening

heart failure by around 30%.

" We speculate that similar benefits could well be at hand when adding a

beta-blocker to a statin in patients with high cholesterol levels. "

And, from another study on the combined use post myocardial infarction

complicated by congestive heart failure:

http://www.looksmartrelationships.com/p/articles/mi_m3225/is_9_70/ai_n85

70401

Review of all-cause mortality demonstrated that treatment with statins

alone was associated with a significant relative risk reduction of 55.2

percent, while treatment with beta blockers alone was associated with a

significant relative risk reduction of 46.1 percent. The effect of

taking both medications on discharge was even greater, with a relative

risk reduction of 72.7 percent compared with no treatment. Although

these decreases in risk were somewhat lower after adjusting for risk

variables that existed before patients were included in the study, the

trend toward decreased risk remained for all-cause mortality as well as

cardiovascular death, hospitalization, and repeat infarction.

The authors conclude that combined treatment with statins and beta

blockers early after MI complicated by CHF improves outcomes. The

effects of these drugs taken together appear to be additive.

However, I found a potential statin-warfarin interaction:

http://www.ahealthyme.com/topic/heartdrugs

potentially hazardous are the combination of warfarin and... the

cholesterol drug Mevacor

and

Some statins can react in a dangerous way with ... the blood thinner

warfarin (Coumadin),

At 8:33 PM +0000 3/12/06, Steve Homer wrote:

I read this morning on the Internet that statins

such as Zocor may have negative interactions with Beta Blockers such

as Atenolol and can cause the AF cancelling the normal rhythmic

control function of the BB's.

[Guest guest]

Steve - can you describe what you mean by the diving boots problem?

>

> Thanks for allowing me access to this group. Let me tell you my

> background - Have been on Atenolol (100 mg), Lotrel (10mg/20) and

> Aspirin (81 mg) for about 3 years now for BP control. These meds

> have given me a few of the classic side effects (Atenolol - the

> diving boots problem - sexual issues - etc.), but overall the

> experience has been good with the BP nearly normal most of the time.

> About 6 months ago, my Dr. decided that the next thing he needed to

> address was my LDL level, so he prescribed Zocor (20 mg) to add to

> the mix.

>

> About three months ago, I missed my meds for a day due to

> forgetfulness and atrial fibrillation hit me for about a day. The

> heart lost its normal sinus rhythm and was all over the map for about

> 24 hours. Once I took the meds again, everything came back to normal

> though. I assumed it was due to the lack of Atenolol in my blood

> stream and went on about my business. I ran out a of meds a few

> weeks later and the problem appeared again, but this time for 5

> days! I also noticed after that lack of meds were not necessarily my

> triggers - stress, Cialis, numerous things would trigger 1 hour -

> multiple day episodes.

>

> I have been sick with a bit of a cold this week and have been in AF

> for about a week. I read this morning on the Internet that statins

> such as Zocor may have negative interactions with Beta Blockers such

> as Atenolol and can cause the AF cancelling the normal rhythmic

> control function of the BB's. I am seeing a second doctor in a few

> days to get a second opinion since my Dr. thinks that my problem is a

> physical one with the heart. I had an echocardiagram a couple of

> weeks ago and the heart looked great per the cardiologist.

>

> I am convinced that this is a chemical problem from the drugs not

> working together. Does anyone have advice or experiences to share

> with me?

>

> Thanks in advance for anything you can share!

> Steve

> shomer@...

>

[Guest guest]

I have a similar story, I was taken off Atenolol my BP was too low that very

next day had my first bout of AF. Dr. says don't worry everything is fine. Two

weeks later in the hospital with AF. and again almost two months after the

first time had to be cardio inverted. Now o sotalol. Some good days some bad.

Good luck, hope you find better medical help than I have

Rich

Atrial fibrillation Illness

---------------------------------

---------------------------------

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Voice

[Guest guest]

,

Sorry for the delay, but I was waiting for a time when I could lend

my full attention to the reading. I did not find anything really

definitive that cautioned about an interaction between statins and

beta blockers. There was a lot of space devoted to discussing side

effects of statins. And, indeed, you have to watch for side

effects, especially monitoring liver enzymes frequently at the

beginning of administration, just to make sure that you are not one

of the small minority that is being adversely affected by the statins.

I hope that you are learning how to cope with your AFib. It surely

is not fun! I got converted (electrical shock) about a month after

going into AFib, and I have been in normal rhythm since. But, I know

that might not last forever, and also I have to remain on warfarin,

and that is not only dangerous, but a drag to deal with, because I

have to keep going back for finger sticks to measure my coagulation

time and readjusting my doses accordingly. I also just read that

long-term (over one year) warfarin use increases fracture risk in

men. NO FUN AT ALL!

Thanks again for sending this information along,

Steve

At 4:15 PM -0600 3/12/06, Homer wrote:

>Here is the story that I mentioned finding this morning:

>

>http://www.agape-biblia.org/recom/index6.htmhttp://www.agape-biblia.org/recom\

/index6.htm

>