Antihypertensive drugs reproduce carcinogens, and three drugs have been recalled. Do domestic patients need to stop taking them？

Recently, Xiao Jiu backstage received such a private letter:

"I am 56 years old. I have been diagnosed with hypertension for 6 years, and I have been taking antihypertensive drugs. Yesterday, my old friend shared an article with me and told me that four batches of antihypertensive drugs were recalled because of carcinogens. The antihypertensive drugs I just ate are one of them. What should I do? Should I stop taking the medicine? What should I do if I eat cancer again? "

In fact, it is not the first time that antihypertensive drugs have been recalled because they contain carcinogens. As early as 2018, sartan drugs were recalled. What about this antihypertensive drug recall that fans privately wrote?

01

Reproduced carcinogens, 4 batches of antihypertensive drugs were recalled.

On December 21, 2022, the US Food and Drug Administration (FDA) issued a recall announcement, which stated that Lupin Pharmaceuticals voluntarily recalled four batches of quinapril tablets because nitrosamine impurities, a possible carcinogen, were detected in these drugs, which exceeded the maximum acceptable daily dose stipulated by WHO. The FDA believes that if people are exposed to nitrosamine impurities above the maximum daily intake for a long time, it may increase the risk of cancer.

Quinapril tablet is an angiotensin converting enzyme inhibitor, which is mainly used for the treatment of patients with hypertension to reduce the risk of cardiovascular events caused by hypertension.

Can I continue to take this medicine? According to the company’s announcement, no adverse event report related to this time has been received. And they suggest that patients who take this medicine contact doctors or medical service providers to find out whether to continue taking the medicine or whether to consider other treatment methods before returning the medicine.

In fact, it is not the first time that antihypertensive drugs have been recalled because of nitrosamine impurities:

On March 4th, 2022, Pfizer Canada completely recalled the antihypertensive drugs Accuretic tablets (quinapril hydrochloride and hydrochlorothiazide tablets) in the Canadian market.

On March 21st, 2022, Pfizer voluntarily recalled 11 batches of products in the United States, including 6 batches of Accuretic tablets, 1 batch of quinapril/hydrochlorothiazide tablets and 4 batches of quinapril hydrochloride/hydrochlorothiazide tablets.

On October 24th, 2022, Aurobindo Pharma USA voluntarily recalled two batches of quinapril and hydrochlorothiazide tablets.

The reason for the above three recalls was that the content of nitrosamines containing potential carcinogenic impurities exceeded the prescribed standards. Why do nitrosamine impurities with such high risks often appear in antihypertensive drugs?

Jin Pengfei, deputy director and chief pharmacist of the Pharmacy Department of Beijing Hospital, said that nitrosamine impurities in drugs are related to many reasons, such as process generation, degradation pathway and pollution introduction. In the process of drug synthesis, amine compounds may react with other reagents to produce nitrosamine impurities; Inadvertently using materials contaminated by nitrosamines in the production process of raw materials may also be risky; In addition, some drugs may degrade to produce nitrosamine impurities under special circumstances. He also said that if we want to control the generation of such impurities, we should adopt the strategy of avoiding first and controlling second.

02

Get rid of those rumors about antihypertensive drugs

1. Does hydrochlorothiazide increase the risk of skin cancer?

In 2017, a research article published in the Journal of the American Academy of Dermatology showed that people who use hydrochlorothiazide frequently increase the risk of skin cancer; Coincidentally, an article in the Danish National Demography and Health Registry shows that the use of thiazide diuretic hydrochlorothiazide may increase the risk of skin cancer and lip cancer. So is this really the case?

In this regard, Qin Xiuchuan, chief physician of Beijing anzhen hospital Emergency and Critical Care Center affiliated to Capital Medical University, said that all these so-called studies have great limitations and did not include the main risk factors of skin cancer, such as ultraviolet exposure and skin type. The skin differences between different races are not taken into account, so there is no causal relationship between hydrochlorothiazide and skin cancer. Patients who are taking drugs must not stop taking them without authorization.

2, antihypertensive drugs are dependent, don’t eat?

Many people think that once antihypertensive drugs are taken, they can’t be thrown away. They need to be taken for a lifetime and will be dependent. But in fact, taking antihypertensive drugs is not dependent. Moreover, hypertension itself is a chronic disease that cannot be cured. If you want to control blood pressure in a stable range, you can only take medicine for a long time according to the doctor’s advice to avoid cardiovascular accidents.

3. You don’t need to take medicine without symptoms?

Many people think that no discomfort is a sign of normal blood pressure, so there is no need to continue taking drugs. In fact, this idea is not correct. Many hypertensive patients have no obvious discomfort when their blood pressure rises to nearly 200. Stopping drugs without authorization will lead to excessive blood pressure fluctuation, which is easy to induce cardiovascular accidents.

4. The lower the blood pressure, the better?

Excessive blood pressure drop in a short period of time will easily lead to an increase in the risk of diseases such as cerebral apoplexy. And the lower the blood pressure, the better. For patients with hypertension, what needs to be pursued is to reduce the blood pressure smoothly and control the blood pressure at about 140/90mmHg.

03

Lower blood pressure and put away the summary of Mayo Clinic in America.

Five "depressurization methods"

Mayo Clinic, a non-profit medical institution in the United States, has won the international hospital competition for seven consecutive years. Regarding how to lower blood pressure, Mayo Clinic provides five life suggestions for patients with hypertension:

Eat less salt.

Patients with hypertension should pay attention to eating more fruits and vegetables, grains and low-fat dairy products in their daily diet, and reduce the intake of high-fat and high-cholesterol foods. At the same time, attention should be paid to limiting salt intake, and it is suggested that the daily salt intake should be kept below 5g.

Restrict alcohol and tobacco

Alcohol and tobacco will cause abnormal vasoconstriction after entering the body, and will reduce the efficacy of antihypertensive drugs. It is necessary for hypertensive patients to quit smoking and limit alcohol if they want to control their blood pressure better.

Stick to exercise

It is recommended to maintain at least 150 minutes of moderate-intensity exercise every week, and the time of each exercise is not less than 30 minutes. You can choose aerobic exercise such as walking, jogging, cycling and swimming, and pay attention to long-term exercise.

Lose fat

Obesity is one of the main causes of high blood pressure. It is necessary to lose weight in order to control blood pressure better. Want to lose weight, nothing more than six words-shut up, take your legs, lose weight in a scientific way, and don’t blindly diet.

Learn to decompress

Being in a state of excessive pressure for a long time will lead to sympathetic nerve excitement and easy to cause blood pressure to rise. Pay attention to adjust your emotions in life and don’t let your spirit be too tight.

In short, it is the key for hypertensive patients to take antihypertensive drugs for a long time if they want to control their blood pressure. Hypertensive patients should never stop taking drugs without authorization, and they need to discuss with their attending doctors before making a decision. In addition to taking antihypertensive drugs, we should maintain a healthy lifestyle, eat a balanced diet, eat less salt and exercise more, so that blood pressure will be stable.

References:

[1] Where do the carcinogens that exceed the standard in the "recall door" of Pfizer antihypertensive drugs come from? Phoenix Net Health. 2022-03-27

[2] "Don’t eat antihypertensive drugs! 6 Misunderstandings of Drug Use to Know. Dr. Lilac. 2019-09-05.

[3] "Mayo Clinic in the United States summed up 10" life-lowering methods ",insisting on doing blood pressure can be lowered a little bit". Life Times .2021-04-19

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