What Is the Best Goal Blood Pressure in Hypertension

Not a bad monitor

First, remember that blood pressure is reported as two numbers: systolic and diastolic. E.g., 135/92. The first number is the systolic number. A systolic pressure goal of under 120 mmHg may be better than the traditional goal of under 140, at least if you’re “at increased risk for cardiovascular disease.” The study at hand excluded folks with diabetes or prior stroke.

We randomly assigned 9,361 participants who were at increased risk for cardiovascular disease but did not have diabetes or previous stroke to adhere to an intensive treatment target (systolic blood pressure, <120 mm Hg) or a standard treatment target (systolic blood pressure, <140 mm Hg). The primary outcome was a composite of myocardial infarction, other acute coronary syndromes, stroke, acute decompensated heart failure, or death from cardiovascular causes. Additional primary outcome events occurring through the end of the intervention period (August 20, 2015) were adjudicated after data lock for the primary analysis. We also analyzed post-trial observational follow-up data through July 29, 2016.

RESULTS

At a median of 3.33 years of follow-up, the rate of the primary outcome and all-cause mortality during the trial were significantly lower in the intensive-treatment group than in the standard-treatment group (rate of the primary outcome, 1.77% per year vs. 2.40% per year; hazard ratio, 0.73; 95% confidence interval [CI], 0.63 to 0.86; all-cause mortality, 1.06% per year vs. 1.41% per year; hazard ratio, 0.75; 95% CI, 0.61 to 0.92). Serious adverse events of hypotension, electrolyte abnormalities, acute kidney injury or failure, and syncope were significantly more frequent in the intensive-treatment group. When trial and post-trial follow-up data were combined (3.88 years in total), similar patterns were found for treatment benefit and adverse events; however, rates of heart failure no longer differed between the groups.

Steve Parker, M.D.

PS: Exercise and loss of excess weigh helps control and prevent high blood pressure. Let me help.

Biden’s New COVID Control Plan Already Working!

It was a mere four days ago that Joe Biden announced his new plan to fight COVID-19. And it’s working like a charm. He scared that virus and it’s on the run. Way to go, Dear Leader Joe!

Here are the CDC’s daily case numbers since the start of the pandemic:

By my reckoning, the recent downtrend in daily cases started around August 31. Biden announced his new plan on September 9.

Steve Parker, M.D.

It’s a Small Club and You Ain’t In It: Biden Exempts Special People From Vax “Requirement”

The patient is wise to look away. If you watch the needle go in, it’ll hurt more.

From The Epoch Times:

On Thursday evening, President Joe Biden unveiled two executive orders that could mandate vaccinations for the CCP (Chinese Communist Party) virus for millions of working Americans in both the public and private spheres. But absent from these mandates are similar requirements for members of Congress, federal judges, or their staffers.

Biden’s executive orders would unilaterally require vaccination for federal employees, the military, and government contractors. The president also asked Occupational Safety and Health Administration (OSHA) to require that firms with over 100 employees either mandate vaccination or weekly CCP virus tests. In total, these mandates could affect over 100 million American workers, making it one of the widest-reaching vaccine mandates in world history.

Steve Parker, M.D.

9/11: An Alternative History You’ve Never Heard Of

Israeli flag

From Ron Unz, who is smarter than you and me:

The widespread doubts about the reality of the official story provided by our government and almost universally promoted by our media has severely diminished popular faith in the credibility of those two crucial institutions, with consequences that are still very apparent in today’s highest profile issues.

Over the years, diligent researchers and courageous journalists have largely demolished the original narrative of those events, and have made a strong, perhaps even overwhelming case that the Israeli Mossad together with its American collaborators played the central role. My own reconstruction, substantially relying upon such accumulated evidence, came to such conclusions, and I am therefore republishing it….

I recommend that you RTWT.

Before it’s disappeared by TPTB.

Steve Parker, M.D.

Stop Worrying So Much About Delta Variant of COVID-19

A few days hence, the Biden administration will be announcing their plan to get the delta variant of COVID-19 under control. But look at the graph of “cases” published by the CDC and you’ll see that delta variant has already peaked. The fed.gov will be taking credit for the decline a couple weeks from now. That’s called leading from the rear.

Also from the CDC, this graph of deaths from March 1, 2020, through Sept 4, 2021. Either the virus is less virulent or we’re learning better how to treat it.

This virus is endemic now. The vaccines will not result in herd immunity because vaccinees catch the virus and spread it to others. That is, vaccinees are not immune. At best, the vaccines still prevent severe disease and death, but I await clinical proof of that. (Israel, Iceland, and Gibralter: share your numbers!) Expect another viral peak in December-January 2021-2022 in the U.S. We may even see a bump after the Labor Day gatherings.

Steve Parker, M.D.

h/t William M Briggs

QOTD: Solzhenitsyn on Resistance

And how we burned in the camps later, thinking: What would things have been like if every Security operative, when he went out at night to make an arrest, had been uncertain whether he would return alive and had to say good-bye to his family? Or if, during periods of mass arrests, as for example in Leningrad, when they arrested a quarter of the entire city, people had not simply sat there in their lairs, paling with terror at every bang of the downstairs door and at every step on the staircase, but had understood they had nothing left to lose and had boldly set up in the downstairs hall an ambush of half a dozen people with axes, hammers, pokers, or whatever else was at hand?… The Organs would very quickly have suffered a shortage of officers and transport and, notwithstanding all of Stalin’s thirst, the cursed machine would have ground to a halt! If…if…We didn’t love freedom enough. And even more – we had no awareness of the real situation…. We purely and simply deserved everything that happened afterward.

-Aleksandr Solzhenitsyn, author of The Gulag Archipelago and other books

Ivermectin for COVID-19: What’s the Dose?

Photo by Anna Shvets on Pexels.com

Critics of the use of ivermectin for prevention or treatment for COVID-19 point out potential flaws in the supportive scientific studies. A few of these critiques are:

  • small size of experimental and control groups
  • lack of a reasonable control group; e.g., if everybody in the U.S. is vaccinated for COVID-19, we won’t have a control group to help us determine true long-term consequences of vaccination or lack thereof
  • not accounting for changes concurrent with the experiment; e.g., lockdowns, mask-wearing compliance, natural waxing/waning of viral surges
  • excessively complicated study design; e.g., using doxycycline or azithromycin or a steroid along with the ivermectin
  • the chosen doses of ivermectin are all over the map

The non-standard doses of ivermectin are maddening, but understandable. We’re trying to re-purpose a drug that’s already FDA-approved for several indications. Physicians already prescribe numerous drugs where the dose depends on age, weight, renal function, liver function, etc. Big Pharma spends millions of dollars per drug to figure this out when a drug is patent-able. But who’s going to pay for that when the drug is off-patent, like ivermectin? It’d be nice if the CDC or FDA did. We’re already a 18 months into this pandemic.

If ivermectin works at all for COVID-19, the dose for prevention may be different than for treatment. The following are some oral doses I’ve run across, mostly from positive clinical studies. “Kg” means body weight in kilograms. “Mg” means milligrams. If you can’t convert between milligrams and micrograms in your head, do it here. Many ivermectin proponents recommend starting treatment early, especially if there are co-morbidities.

Prevention of COVID-19

  • at least 150 microgram/kg per week
  • 12 mg (~150 microgram/kg) monthly or every 42 days

Treatment of COVID-19 Whether or Not Hospitalized

  • 200 to 1200 microgram/kg daily for three to seven days
  • 0.2 mg/kg (200 microgram/kg) on Day 1 and Day 3 (plus Days 6 and 8 “if not recovered”)
  • 400 microgram/kg (max of 24 mg) on Days 1 through 4 (Caution: study by Elgazzar et al is under investigation for misconduct)
  • 18 to 36 mg daily or every other day for between 1 and 5 doses (Drs Orient and Vliet with help from McCullough)
  • 0.4-0.6 mg/kg daily for five days or until recovered (I-MASK+ and MATH+)

Treatment of COVID-19 in Hospitalized Patients

  • 200 microgram/kg on Day 1 (plus 200 microgram/kg on Day 7 at physician’s discretion) (Broward Health hospitals study)
  • single dose of 0.15 to 0.4 mg/kg
  • 200 microgram/kg single dose
  • 400 microgram/kg (max of 24 mg) on Days 1 through 4 (Caution: study by Elgazzar et al is under investigation for misconduct)

See, doses vary wildly. And don’t ask me if dose should be based on ideal rather than actual body weight.

You probably know that you can often get ivermectin without a prescription. Many countries have decided it’s safe enough to sell over-the-counter.

I’m not recommending ivermectin to you or anybody else. I’m not your doctor. Only your personal physician who knows you, your lab results, your physical exam, and your medical history is in a position to recommend drug therapy.

Steve Parker, M.D.

Ohio Judge Compels Hospital to Give Ivermectin to COVID-19 Patient on Ventilator

intubation, mechanical ventilation, ventilator
Not Mr Smith

For Details, see Ohio Capital Journal on Aug 30, 2021:

A Butler County judge ruled in favor of a woman last week who sought to force a hospital to administer Ivermectin — an animal dewormer that federal regulators have warned against using in COVID-19 patients — to her husband after several weeks in the ICU with the disease.

Butler County Common Pleas Judge Gregory Howard ordered West Chester Hospital, part of the University of Cincinnati network, to treat Jeffrey Smith, 51, with Ivermectin. The order, filed Aug. 23, compels the hospital to provide Smith with 30mg of Ivermectin daily for three weeks.

A number of taxpayer-funded state authorities would not comment on the case. But don’t worry, they won’t miss a paycheck.

The article has a graph showing the number of ivermectin prescriptions dispensed from retail pharmacies in the U.S. from March 2019 to mid-August 2021. A large spike in prescriptions started in early July 2021, leading to almost 90,000 prescriptions in the weak of Aug 13.

Some pharmacists refuse to fill ivermectin prescriptions for COVID-19.

Steve Parker, M.D.

COVID-19: Disappointing Vaccination Results in Israel

The various available vaccines likely have different efficacy and adverse effect profiles

Israel has a very high COVID-19 vaccination rate: 78% of those 12 and older are fully vaccinated, nearly all with the Pfizer/BioNTech product. Yet they’re having a major surge with the delta variant.

Remember, the EUA vaccines were sold to us originally as preventing severe disease and death. We know they don’t prevent much infection, if any.

An article at Science notes that: “As of 15 August, 514 Israelis were hospitalized with severe or critical COVID-19, a 31% increase from just 4 days earlier. Of the 514, 59% were fully vaccinated. Of the vaccinated, 87% were 60 or older.”

Why the surge? One theory is that immunity conferred by the vaccine is waning over time. Israel is recommending a booster shot for those over 50 and six months past the original 2-shot vaccination.

The article concludes:

Yet boosters are unlikely to tame a Delta surge on their own, says Dvir Aran, a biomedical data scientist at Technion. In Israel, the current surge is so steep that “even if you get two-thirds of those 60-plus [boosted], it’s just gonna give us another week, maybe 2 weeks until our hospitals are flooded.” He says it’s also critical to vaccinate those who still haven’t received their first or second doses, and to return to the masking and social distancing Israel thought it had left behind—but has begun to reinstate.

Aran’s message for the United States and other wealthier nations considering boosters is stark: “Do not think that the boosters are the solution.”

Given the known and unknown risks of the vaccines, if I were one of the tyrants mandating vaccination I would rescind my order.

Steve Parker, M.D.

1976 Swine Flu Debacle: Any Parallels to the Current Pandemic?

It’s probably just a matter of time before YouTube disappears this video since it is subversive to the MSM and political narrative. Don’t focus too much on Guillain-Barre Syndrome. The important points are misleading propaganda, the hasty roll-out of the swine flu vaccine, government malfeasance, and apparent lying by a former head of the CDC. Enjoy!

I thank WordPress for not censoring me. I hope it’s not because my readership is so minuscule that I’m not on their radar screen!