Anti-Hypertension drugs?

[DonTickles]

Theoretically, they are incongruous products [to be found] in an environment where people are in good health," said Michel Rieu, the AFLD's scientific expert, according to AFP. "It seems abnormal to me to be finding anti-hypertensive drugs. Their aim is to ensure that the athlete keeps a low blood pressure. Why

From the Cyclingnews story here.

Like the guy in the quote asks, why? If not performance enhancing, could they possibly be masking, or to offset side effects of other doping products? My first thought was that it might do something for the folks transfusing. Does anyone with a medical background have any insight?

 

[python]

old stuff

a well known side effect of a blood transfusion is high blood pressure. same when injecting saline sol. or plasma to dilute for masking. they expand blood vessels by relaxing smooth muscle around them. even when not accompanying a transfusion hypertensive drugs may increase cardiac stroke and oxygen delivery.

 

[poupou]

All those medicines discovered in hotel garbages shows that doping needing assistants were done. Bordry and AFLD know it, Mc Quaid and UCI cannot ignore it too so McQuaid UCI self-congratulations are rubbish.

 

[DonTickles]

a well known side effect of a blood transfusion is high blood pressure. same when injecting saline sol. or plasma to dilute for masking. they expand blood vessels by relaxing smooth muscle around them. even when not accompanying a transfusion hypertensive drugs may increase cardiac stroke and oxygen delivery.

I thought it would be something like that and I know nothing about the subject. So why does the AFLD's "science expert" act like he has no clue?

What about the other drugs mentioned?

In addition to substances designed to treat hypertension, French police forces also allegedly discovered Sitagliptin, an oral drug normally used by diabetic patients, as well as Valpromide, an anticonvulsant used in the treatment of epilepsy and psychiatric disorders.

They don't mention quantities so I suppose it could just be a diabetic mechanic and epileptic soigneur. Any idea what nefarious effects these products could have on the riders if they were in fact found in excessive quantities?

 

[RhodriM]

All these allegations are sure to raise riders' blood pressure.

And just think what poor old Bruyneel's must have been like on the Astana bus.

 

[richwagmn]

From the Cyclingnews story here.

Like the guy in the quote asks, why? If not performance enhancing, could they possibly be masking, or to offset side effects of other doping products? My first thought was that it might do something for the folks transfusing. Does anyone with a medical background have any insight?

What are the quantities? It's not possible that someone not racing but on the team has diabetes for hypertension? Maybe the found tampon boxes too!

 

[Cobber]

What are the quantities? It's not possible that someone not racing but on the team has diabetes for hypertension? Maybe the found tampon boxes too!

That might explain why Lance was whining so much during the Tour...

 

[kelvedon wonder]

It's the sitagliptin that amazed me...it inhibits the conversion of stored liver glycogen into glucose. About the last thing you would want for a professional cyclist. If you wanted to find who was abusing sitagliptin you would look for the rider with a rucksack full of energy bars - or someone who was constantly falling off their bike.

Whichever team it was either has a diabetic swannie or an idiot for a doctor.

 

[Mellow Velo]

A common side effect of having an enlarged heart, is high blood pressure.
Basic engineering.
Now, do we know if any Tour riders has one?

 

[kelvedon wonder]

I was always led to believe that it was the high blood pressure that caused the enlarged heart in the first place (owing to the strain of pumping against hardened blood vessels). The heart is the only muscle in the body which generally becomes less effective as it enlarges, so I don't think an enlarged heart would cause hypertension. I can't see how antihypertensives would work, except to counteract a rise in blood pressure caused by an increase in blood volume.

 

[slcbiker]

All you have to do is look at the post in the Gear forum about supposedly performance-improving mouthguards.

People desparate for results will try almost anything, particularly if the substance in question isn't banned. Scientific validation of improvement is often not a huge consideration.

 

[sgreene]

All these allegations are sure to raise riders' blood pressure.

And just think what poor old Bruyneel's must have been like on the Astana bus.

Again, why trash people you don't know without any evidence? You folks waiting for the demise of Johan Bruyneel are going to be waiting a long, long time.

 

[RhodriM]

Again, why trash people you don't know without any evidence? You folks waiting for the demise of Johan Bruyneel are going to be waiting a long, long time.

It was a joke.

 

[DonTickles]

A common side effect of having an enlarged heart, is high blood pressure.
Basic engineering.
Now, do we know if any Tour riders has one?

I heard that increasing your cadence, losing weight, training specifically for just one event, and adjusting your position based off wind tunnel testing can actually embiggen your heart, which we all know the heart is where courage comes from, so a larger heart equals more courage, and a big bag of courage is required to accelerate in the big mountains like l'alpe d'huez, which of course is where the tour day french is won! (deep breath)

It all makes sense now! Blood pressure medicine is necessary to keep all the courage from seeping out of the eyes and ears!

 

[franciep10]

I heard that increasing your cadence, losing weight, training specifically for just one event, and adjusting your position based off wind tunnel testing can actually embiggen your heart, which we all know the heart is where courage comes from, so a larger heart equals more courage, and a big bag of courage is required to accelerate in the big mountains like l'alpe d'huez, which of course is where the tour day french is won! (deep breath)

It all makes sense now! Blood pressure medicine is necessary to keep all the courage from seeping out of the eyes and ears!

great post but you forgot the increased pain tolerance.

 

[David Suro]

The antihypertensive drugs for which evidence was found act as vasodilators. Vasodilators act to increase the internal diameter of a blood vessel by blocking the mechanisms that stimulate the musclular wall of the blood vessel to contract. In short, they help to increase blood flood to organs, including the muscles.

Increased blood flow to muscles has obvious advantages for both performance and recovery.

The other comments regarding increased blood pressure following transfusions or secondary to an enlarged heart are true. An enlarged heart is commonly seen in patients who have abused anaboplic steroids.

Increased blood pressure is also commonly seen in patients who have a low resting heart. Given that a certain amount of blood must be supplied to the organs to sustain life, if a person's heart rate is low then more blood must be moved with each beat. If more blood is moved for each beat, then the amount of pressure required is greater.

Another possible reason for the administration of vasodilators is reduction of stroke risk. Remember that death due to stroke was the red flag that led to investigation into EPO use in the first place. EPO causes the blood to become thicker (higher concentration of cells int he plasma), so does dehydration. Thicker blood has a higher level of resistance to flow, this blood pressure becomes elevated in the absence of dehydration for those with thicker blood. vasodilators would serve to reduce the workload on the heart and reduce risk of stroke in individuals with higher hematocrit.

It is possible that the antihypertensives were administered for theraputic reasons, but more likely that they were used as performance enhancers or recovery enhancers.

The roots of pharmaceutical manipulation for improved performance run very deep in cycling. Bummer. I wonder what will come next.

 

[RTMcFadden]

A common side effect of having an enlarged heart, is high blood pressure.
Basic engineering.
Now, do we know if any Tour riders has one?

FYI. A recent study by Dr. Francois Carre of the Centre Hospitalier Universitaire de Rennes, France, found that almost all cyclists competing in the Tour de France had enlarged hearts. The size increase was on the order of 20-40% larger than normal! He thought it would interesting to see whether the cyclists' hearts are large to begin with or expand to accomodate the rigors of training (probably both). A bigger heart translates to more blood-pumping ability which in turn translated to increased oxygenation of blood and tissues.
In his study, Carre tracked seven former professional cyclists through their final year of competition and three years of retirement. Once a year, the cyclists took tests to check the size and function of the heart. They were also tested on their fitness levels. Carre found that the athletes' hearts shrank nearly a quarter in size after they finished riding professionally. Still, the cyclists remained in excellent physical condition.

 

[RTMcFadden]

A common side effect of having an enlarged heart, is high blood pressure.
Basic engineering.
Now, do we know if any Tour riders has one?

I found this article to be very interesting.


More than half of elite professional cyclists apparently have an enlarged heart chamber, a new study from France indicates.

Although endurance athletes are known to develop large hearts, the finding that such a high percentage of top-class cyclists are affected could have implications for screening elite athletes for heart conditions, researchers say.

Dr. Eric Abergel of the Hopital Europeen Georges Pompidou in Paris and colleagues examined the hearts of 286 cyclists who competed in the Tour de France in 1995 or 1998 or both years. The researchers used echocardiography, which uses ultrasound to create an image of the heart, to examine cyclists’ hearts two days before the race.

As a comparison, 52 non-cyclists also underwent echocardiography.

The dimensions of the left ventricle, the heart’s main pumping chamber, were much greater in cyclists than in non-athletes. A little more than half of cyclists had a substantially enlarged left ventricle, the researchers report in the Journal of the American College of Cardiology.

In about 12 percent of cyclists, the left ventricle was so enlarged that it had an effect on heart function, according to the report.

Typically, the heart wall thickens when a chamber enlarges, but the researchers noticed something unusual when they compared cyclists who competed in 1995 with those who competed three years later. Cyclists in the 1998 race tended to have a larger left ventricle, but the walls of the chamber were thinner than in 1995 cyclists.

Abergel and his colleagues are not sure why the 1995 and 1998 cyclists differed. Although performance did not vary significantly between the years, the variations could reflect excessive training or the use of steroids or other performance-enhancing drugs, the authors suggest.

“This modification could be due not only to intensive physical training but also to pharmacological training - drug abuse,” Abergel told Reuters Health.
…….
SOURCE: Journal of the American College of Cardiology, July 7, 2004.

 

[Martinello]

Enlarged left ventricles do not lead to hypertension but hypertension can cause enlarged left ventricles and ultimately congestive heart failure.
Increasing circulatory volume by infusions shouldn't by itself increase blood pressure. It would merely increase preload (basic Frank-Starling circulatory physiology) whereas arterial bloodpressure would be downregulated by carotid baroreflexes, decrease in vasopressin and increase in natriuretic peptides released from the myocardium.

My best guesses to why some use antihypertensive drugs are:
Acellular Haemoglobin based oxygen carriers work as NO-scavengers, increasing blood pressure
Infusion "old autologous blood" (+40-50 days) causes increased haemolysis of the old erythrocytes resulting in free haemoglobin (the NO-scavenger again)
Roids
Cocaine/ephidrine/amphetamines
Testosterone

 

[RTMcFadden]

Enlarged left ventricles do not lead to hypertension but hypertension can cause enlarged left ventricles and ultimately congestive heart failure.
Increasing circulatory volume by infusions shouldn't by itself increase blood pressure. It would merely increase preload (basic Frank-Starling circulatory physiology) whereas arterial bloodpressure would be downregulated by carotid baroreflexes, decrease in vasopressin and increase in natriuretic peptides released from the myocardium.

My best guesses to why some use antihypertensive drugs are:
Acellular Haemoglobin based oxygen carriers work as NO-scavengers, increasing blood pressure
Infusion "old autologous blood" (+40-50 days) causes increased haemolysis of the old erythrocytes resulting in free haemoglobin (the NO-scavenger again)
Roids
Cocaine/ephidrine/amphetamines
Testosterone

Would you care to elaborate on th elast three?

 

[Martinello]

Would you care to elaborate on th elast three?

Long term androgen supplementation will probably increase blood pressure by regulating vascular tone and promoting atherosclerosis. Conversion of testosterone to estrogens may aggrevate the risk of metabolic syndrome and cardiovascular morbidity. (http://www.ncbi.nlm.nih.gov/pubmed/...nel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum)

The classic stimulants of the CNS (caffeine, amphetamine, ephedrine, cocain) all increase vascular tone with cocain being the ultimate badboy. Myocardial infarctions have been reported in 30 y-o's coke abusers. Betablockers may also be handy to alleviate the effect of these stimulants, ie. after training on amphetamines on a rainy day in Belgium.

Steroids cause increased systolic blood pressure and atherosclerosis.

So if you don't want to end up like Flo-Jo, take good care of your heart and arteries. Diuretics are on the no-no list, but in cycling you're good to do betablockers, ang-II antagonists, ace-inhibitors, anti-coagulants etc.

 

[brianf7]

brianf7

We train many hours a week for many years so the Left Ventricle gets big that causes cardiac output Vo2 max or some would say a big engin.

I know many Doctors who try to reduce the volume only to cause tachycardia because the LV dosnt fill up every stroke.

What happens naturaly is best left alone.

 

[Martinello]

Hypertension in the non-doped endurance athlete is not a big concern. The bodybuilders are the ones putting their hearts at risk in the long run. The steroids combined with heavy weight lifting produce an enormous increase in afterload (intermittent systolic BP of over 300mmHg and permant hypertension) leading to severe congestive heart failure. I've had patients, barely 30 years old, with practically no EF (20-25%) and extremely low performance (walking distance 25m) because of steroid/bodybuilding induced cardiomyopathy - scary stuff.

Atrial fibrillation in former endurance athletes is however more common, probably because of an enlarged myocardium combined with minute inflammatory changes ultimately leading to increased risk of distorted electrical impulse propagation across the atriae. I've seen several ex-pro's (pre-epo era) with this particular phenomenon.

 

[python]

Martinello, u sound like a cardiologist. are you. would you care to put yourself in the shoes of a hematologist advising a cheater and speculate on the least detectable mode (added/withdrawn quantities, timing, prep etc) of blood transfusion ? it’s all hypothetical of course.

 

[Animal]

Atrial fibrillation in former endurance athletes is however more common, probably because of an enlarged myocardium combined with minute inflammatory changes ultimately leading to increased risk of distorted electrical impulse propagation across the atriae. I've seen several ex-pro's (pre-epo era) with this particular phenomenon.

What's atrial fibrillation? What are the symptoms? I've gone from massive training volume with some super high intensity work, to just riding to and from work, and I've noticed that my heart rhythm seems to "get it wrong" every now and again.