I was browsing through the online Tabloids, and came across this. Opinions from the well informed would be appreciated please! "I was right about beta blocker
Earlier this month I answered a reader’s question about her husband’s heart condition, atrial fibrillation.
He was taking a medicine called bisoprolol and I mentioned that it was not often prescribed for the condition – it’s not what GPs would call first-line treatment. I suggested her husband ask the doctor why he was on it.
I’ve since received emails from other readers saying that they have atrial fibrillation and have been on bisoprolol for years without issue.
Bisoprolol is a beta blocker – it slows the heart beat – but it is only recommended for atrial fibrillation if the patient also has another medical condition, such as diabetes.
I suspect that the readers who say they are on bisoprolol for atrial fibrillation will also be suffering a concurrent problem.
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Just to add that the quote from the online doctor starts with " I was right about the beta blocker' - that is the heading of the article, in case anyone thinks it is my wording ! !!!!!!!
Right first time Bob, but the sad thing is that this rubbish has an enormous circulation , and someone needs to stop this nonsense, I'm not sure who though !
I think what you have omitted is to stress that medications prescribed are relevant to a moment in time. A specific date. A specific year.
I fit your description ...."I suspect that the readers who say they are on bisoprolol for atrial fibrillation will also be suffering a concurrent problem".
So, around 2005 I was warned about my blood pressure. I was 61. AT THAT MOMENT IN TIME ... medical convention was to accept that BP up to 140/80 was acceptable. No action taken. In 2007 my GP prescribed me Simvastatin and Ramipril - Simvastatin for Cholesterol ( prescribed as a precautionary measure not to treat raised Cholesterol !). Ramipril to address BP as it was higher than 140/80. In January 2010 (aged 65) I was diagnosed with paroxysmal AF and the Cardiac Consultant prescribed Bisoprolol and Warfarin whilst agreeing to continue with Ramipril. In those days ... AT THAT MOMENT IN TIME ... Bisoprolol WAS the first line medication in addressing high Heart Rate. It also had some features that made it suitable for BP control. 13 years ago, nevertheless, it was the first line drug of choice. Warfarin, incidentally was also the only anticoagulant that I'm aware of at that time. All these NOAC's that have come onto the market since did not exist in 2010, they were still at the pharmaceutical development stage.
Since 2010 I have moved house and my new GP has also prescribed Felodopine for blood pressure. So you don't need to be a rocket scientist to realise that my underlying, concurrent problem has been and still is blood pressure. BUT, I am at pains to say that for me, I feel Bisoprolol has outlived its usefulness after 13 years, and on Thursday I have an appointment with my Surgery Pharmacist to discuss switching over to another Beta Blocker ... Nebivolol in an attempt to deal with my extreme tiredness. But its still a Beta Blocker, same family different drug. So, yes, I too have been on Bisoprolol for years without issue - until now - BUT again I stress .... here in my part of UK it was regarded as the first line of treatment back in the day, (by a Cardiac Consultant, not a mere GP) and for me it took precedence over cardioversion and ablation. Mind you in 2010, ablations were not the advanced technology that they are today.
So it really does depend on the moment in time the drug (any drug) was first prescribed. Nowadays the medical convention for BP is around 120/80 and my average nowadays ( age 78 and highly medicated), is around 134/70. So I'm quite happy to jog along with a beta blocker.
Hi John - I just copied and pasted the article I read this morning in the D Mail. Not a single word apart than that requesting an opinion from the highly experienced members of the group, is mine, they are the words of the article writer. Go to the Daily Mail on line and read it yourself!
Sorry .... I wouldn't have seen it anyway as I don't do uk newspapers.😱😱. Only get online ones from Sydney ( my home town) as an interest/contact item only.
My husband has recently had a stroke . He jd ablation surgery in 2017 but didn’t realise it was only temporary . He wasn’t out on any meds after as he was sort of out of the system . I wish we had taken the meds route rather than ablation . We now have the effects of the stroke to deal with as well as heart problems . They said at the hospital his heart isn’t functioning at a normal rate . We have an appointment on Monday to see if they can tweak his meds . He s changed over from verapamil to biprolol and also ramprimil and a couple of others cholesterol etc . The consultant said verapamil can sometimes make AF worse so hates to know what to believe sometimes as each doctor says something different .
I was sorry to read that your husband has had a recent stroke. I must say when I was diagnosed with paroxysmal AF in 2010 I was also told that I was asymptomatic too, meaning I could be in AF and not feel any symptoms. I wonder what your husbands medical team meant in saying about your husbands heart, "his heart isn’t functioning at a normal rate". My last Echocardiogram indicated that my heart wasn't in great condition either and so I have extracted a number of comments in the hope it may give you some information.
Echocardiogram in Oct 2020 …..
1 There is a mild degree of concentric Ieft ventricuar hypertrophy with a wall thickness of 1.4crn The left ventricle is not dilated and has normal systolic function with an LVEF of 68%.
2 The aortic valve is trileaflet mildly sclerotic in appearance but exhibits essentially normal Doppler Flow. The proximal ascending aorta is mildly dilated with a maximum diameter of 3.85cm.
3 Appearances would be rnost consistent with mild hypertensive heart disease with preserved LV systolic funcfion and noting that his blood pressure is 152/87mmHg, he may benefit some lowering of his blood pressure with an agent which may also reduce his frequency of PAF.
4 I would also recommend a repeat echocardiograph in 2 years to reassess his aortic dimensions
Echocardiogram in Nov 2022 …..
1 This 78 year old man who is in sinus rhythm has severe concentric left ventricular hypertrophy with a maximal wall thickness of 1.7cm. The left ventricle is not dilated and has normal systolic and diastolic function with an LVEF greater than 60%.
It was actually 65.2%.
2 The aortic valve is trileaflet, mildly sclerotic in appearance but exhibits essentially normal doppler flow. The proximal ascending aorta is mildly dilated with a maximum diameter of 3.57cm.
3 As compared to the echocardiograph performed 2 years ago the degree of left ventricular hypertrophy has increased, although I note his blood pressure today is normal at 142/72mmHg. There has been no increase in the aortic dimensions which I do not think merits further routine echocardiographic surveillance.
An additional finding was ….. An incidental finding is the presence of a small pericardial effusion measuring at most 1.4cm which is not causing any haemodynamic compromise.
I have copied all the above extracts to show my more vital results and to stress the importance of monitoring healthcare stuff over time. Otherwise you (as a patient) have no idea where you are until you feel unwell.
As a matter of interest I discussed the two sets of results with my GP (‘cos most of it was mumbo jumbo) and asked the inevitable question …. well Doc. Just how much of a train wreck is my heart ??? ……. she just said its consistent with age, maybe not too bad.
Hope this is of some use for you. Apologies to you and others for the length of my post.
I would also add that I am now almost two weeks after my stopping Bisoprolol and restarting with Nebivolol and all is well, tiredness is just beginning to recede, HR only up a tad, blood pressure is up but only systolic. Still got a few weeks to go before I have another chat to the Surgery Pharmacist to review the changeover. Meanwhile I stay on my other drugs, Ramipril and Felodopine for BP and Simvastatin for Cholesterol.
I agree completely with Bob! What a load of rubbish. Bisoprolol is the default drug for AF should you present at A&E..I've had 30 years experience of AF.
Me too, I was immediately put on Biso on diagnosis of familial AF because my GP sent me to a Cardio because she was as concerned I had a dissection. That was ruled out and Biso was and is my drug(1.25mg) as prescribed by Cardio and repeated by GP ever since. No attempt to remove it on my annual Cardio visit - I have no underlying conditions.
Factually incorrect. In fact, beta blockers are "first line" for afib with many doctors.
The big question is should they be, especially considering that so many of us get side effects from taking them.
Beta blockers like bisoprolol are primarily rate control drugs, so why are they prescribed so often on a daily basis when someone is not having an afib episode.
For the most part, I was only prescribed rate control drugs like bisoprolol for during an episode to lower my heart rate. The one time I was prescribed it between episodes, it did nothing except make me tired.
Many of us are on medications that may be doing more harm than good. Periodically, your doctor should review all medications. If they are too busy to do that, it's up to us to bring it to their attention.
Bisoprolol is a rate control medication. It also lowers BP although it’s not generally prescribed for that reason. It’s not good for the heart to be beating at way over 100bpm which often happens in AF, hence rate control to keep the HR below 100bpm.
These articles are written by journalists and not very well-informed ones at that. Unfortunately these ill-informed people have a lot of reach. People with AF can manage their condition without beta blockers , or take as a PIP, but that’s entirely dependent on their AF burden.
The journalist, who signs her articles as a doctor, obviously has quite a following. She appears to condemn all beta blockers. It is my understanding (please correct me if I am wrong) that the most important thing with AF is to lower the HR - if the person is on an anti-coagulant the fibrillation is not so serious, as illustrated by people who function very well in permanent AF.
I reluctantly looked up the article. I hadn’t heard of this doctor before. I don’t believe she is factually correct. I was prescribed beta blockers for my rather high ectopic burden but only started taking them after my first AF episode. For me it’s optional. I’m neither for nor against. I don’t consider other peoples’ medication choices to be any of my business. It’s always a choice but making an informed choice isn’t so straightforward when there’s so much misinformation and incorrect information online these days, coupled with the fact that not everyone has sufficient background knowledge to understand everything — and that’s not anybody’s fault, none of us can be expected to know everything. I don’t think there should be any stigma projected on to people who choose or need to take medication.
I'm one of those who consider Western medicine as miraculous. I hold in awe the likes of Jenner, Curie , Salk and their fellow scientists and doctors !
OMG it's absolutely 100% wrong. When I went to see Dr Tim Betts at the Radcliffe (paid appointment) he explained that Bisoprolol was the first line of treatment for AF across the UK. You can even read this I think in the NICE guidelines. As for it only being prescribed if you have other conditions - maybe for hypertension- though it never fixed mine - but diabetes?? Is this person actually a doctor I wonder. I'm.sure you're having a fun time reading our replies and am.glad you checked it out.
Indeed I am - I was flabbergasted when I read the article, and the triumphant note she used when proclaiming she was right about beta blockers. On the other hand, I was sad that thousands if not millions of people, given the global circulation of these online tabloids, could be adversely affected by such a statement.
Hello, here’s a bit of personal experience- my brother confounded heart doctors(specialists) for years as none of the meds you all mention had any lasting or beneficial effects on his condition of AF. He too had diabetes and high blood pressure. We discovered the benefits of B12 as a few of our family were deficient so we tried him with some and with larger and regular doses his blood pressure came down from 190/130 to 135/70-better than anything the doctors had ever managed. Our sister in law has allergies along with other conditions and her BP was even worse with no tolerance for meds. She too took the high doses of B12 and had even better results-maybe worth a try? My theory is that perhaps the AF had a neurological cause in that the nervous impulse is twitching or like a cable-short circuiting? Oh and your cholesterol level could be up as a protective mechanism from wear or response to allergens-both of which will massively benefit from ample Vitamin B12? Worth a try and a very safe way to improve your general health and wellbeing x
Thank you. In my case the issue was subclinical hypothyroidism for several years prior to AF. So both BP and hopefully cholesterol improving now. But that's interesting re B12 isn't it? I take liquid form every day and have had mine checked recently..
I’ve discovered that I was clinically low borderline thyroid at 24 when they found PCOS but was never treated and am very surprised that I haven’t developed AF or diabetes etc at 55 I’m just thankful for small mercies talking to other people and hearing their experiences. I also had a few hormonal imbalances too to add to the mix but was told that the cure was worse than the condition at the time and again was left with no advice other than you will always be childless and fat so learn to live with it-in effect.
The thyroid seems to be quite a 'Badie' in the AF story. I have familial AF, my 4 sisters have it, and we think our late father also suffered from it. However, it was conclusively diagnosed in one of my sisters, when it was discovered she had hyperthyroidism. She had lost a lot of weight! It was treated by inserting some sort of radioactive pellets into the thyroid gland and she recovered (she was in her late 70s when diagnosed). Now at the age of 84 she has been diagnosed with diabetes,which does not thrill her as she is now a normal slim weight. (which she was before the enormous weight loss). Apparently it is not unusual for someone who has thyroid problems to also develop diabetes.
Have you heard about diabetes being potentially caused by iron toxicity? The iron we eat gets stuck and builds up causing a toxicity that affects the organs quite badly leading to diabetes. Apparently without copper you can’t use the iron for anything so it could be we need to look at copper more closely as a supplement etc- anyone else know about that?
Have just been reading some past posts and had some more thoughts on copper to add. Every reaction in your body that needs iron also needs copper but I also discovered that copper is the cross binding between strings of collagen. So when we talk about BP and arteries being stiff etc it’s the collagen keeping them from stretching too far lengthways however the copper cross links between the strands and supplies the healthy elasticity to the vessel walls making it easier for your body to maintain a suitable BP through the stretch sensors. If your BP or salt levels decrease then the Carotid Bodies in your neck can start a process by which angiotensin and aldosterone are produced which stiffen and tighten the walls in order to put up the BP too and it’s a hard system to switch back off again once activated. Apparently by taking diuretics and advice to cut salt (sodium) this system gets switched on overriding the HPA axis that should normally control BP? I think that blood nutrient density is also sampled by the Carotid Bodies and if the consistency is overly dilute then that too can increase BP? However I’ve also heard that mineral deficiency can lower BP but that may be to balance pH of blood? I’ve started taking a collagen and vitamin C supplement and making sure not to take iron (I think I probably get enough in my food) but also 1mg of copper just in case. I will let you k ow how it goes though I have decent to low BP even being heavily overweight so maybe have to check my wrinkles instead ha ha or I might make my brother my guinea pig for this with his AF and slightly raised BP-that would make more sense 🥴🫣
I know that did also occur to me ha ha along with some research into farming methods using copper wires etc in soil. I had previously poo-pooed the idea however there are increased yields and better pest resiliences reported using these methods that had me thinking that I shouldn’t reject ideas out of hand without finding out myself 👍😂
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