[h=2]Did Obamacare Save 50,000 Lives?[/h]Posted by Joseph Becsey 5sc on April 03, 2015
Graham Kessler at the Washington Post argues that Obamacare really did prevent 50,000 statistical deaths. How, by insuring people? No. By changing the way some hospitals provide outpatient care. Kessler writes that the problem was to establish causality between the Partnership for Patients program and the claimed reduced deaths:
The 50,000-number is derived from a study, released on Dec. 2, 2014, by the Agency for Healthcare Research and Quality, an arm of the Department of Health and Human Services.
The study looked at the impact of the Partnership for Patients, a $460-million program funded by the health law which ties together 3,800 hospitals in 27 “health engagement” networks, with the goal of reducing ten categories of “patient harms,” such as adverse drug events, pressure ulcers and catheter-associated urinary tract infections. The networks work together to identify possible solutions to common problems and then circulate those ideas among the various hospitals, with the goal of reducing preventable hospital-acquired conditions (HACs) by 40 percent and 30-day hospital readmissions by 20 percent.
The study admits that “the precise causes of the decline in patient harm are not fully understood,” but notes that “the increase in safety has occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events” though programs like the Partnership for Patients. So a key question is whether the impact is coincidental or the result of the ACA.
The majority of the preventable deaths arose from two categories of possible mismanagement: “it turns out pressure ulcers and adverse drug events are responsible for nearly 65 percent of the reduction in estimated deaths—20,727 fewer deaths from pressure ulcers and 11,540 from adverse drug events. So can we draw a straight line from the Affordable Care Act to those saved lives? Administration officials argue that is correct.”
So under the ACA’s Partnership for Patients, greater scrutiny of supposedly low risk drugs and better patient management was implemented in hospitals.
Similarly, to thwart pressure ulcers, hospitals began paying closer attention to repeatedly turning patients, providing more appropriate mattresses, applying moisture barriers and repeated toilet assistance and keeping track of nutrition and hydration. …
As our colleagues at PolitiFact noted, in-patient deaths were already declining before the Affordable Care Act was implemented. The Centers for Disease Control and Prevention found a 60,000 decline in patient deaths in the decade before 2010. This is not quite the same statistic, but it indicates that before the ACA was passed into law, progress was already being made in reducing deaths from conditions acquired in hospitals.
But officials say there is also little question that the half-billion dollars in ACA funding sparked significantly greater cooperation among thousands of hospitals
That is hardly a straight line. That there is any line at all is disputed by others. First, as to the money. According to Dan Diamond of California Healthline, the true figure is a billion dollars, not $460 million. That billion dollar figure is echoed by Modern Healthcare. Secondly, according to an article in the New England Journal of Medicine, the causality cannot be supported. Peter Pronovost, M.D., Ph.D., and Ashish K. Jha, M.D., M.P.H. address the issue directly in the article, “Did Hospital Engagement Networks Actually Improve Care?”
Everyone with a role in health care wants to improve the quality and safety of our delivery system. Recently, the Centers for Medicare and Medicaid Services (CMS) released results of its Partnership for Patients Program (PPP) and celebrated large improvements in patient outcomes.But the PPP's weak study design and methods, combined with a lack of transparency and rigor in evaluation, make it difficult to determine whether the program improved care. Such deficiencies result in a failure to learn from improvement efforts and stifle progress toward a safer, more effective health care system.
CMS launched the PPP in December 2011 as a collaborative comprising 26 “hospital engagement networks” (HENs) representing more than 3700 hospitals, in an effort to reduce the rates of 10 types of harms and readmissions. The HENs work to identify and disseminate effective quality-improvement and patient-safety initiatives by developing learning collaboratives for their member facilities, and they direct training programs to teach hospitals how to improve patient safety. In a February 2013 webcast, CMS announced that the rates of early elective deliveries had dropped 48% among 681 hospitals in 20 HENs and that the national rate of all-cause readmissions had decreased from 19% to 17.8%, though it is unclear which HENs were included for each measure and what time periods were the pre- and post-intervention periods.
These numbers appear impressive, but given the publicly available data and the approach CMS used, it's nearly impossible to tell whether the PPP actually led to better care. Three problems with the agency's evaluation and reporting of results raise concerns about the validity of its inferences: a weak design, a lack of valid metrics, and a lack of external peer review for its evaluation. Though the evaluation of many other CMS programs also lacks this basic level of rigor, given the large public investment in the PPP, estimated at $1 billion, and the strong public inferences about its impact, the lack of valid information about its effects is particularly troubling. …
Beyond using a poor design, CMS did not use standardized and validated performance measures across all participating hospitals — further hampering inferences about the program's effects. To support engagement, CMS allowed each HEN to define its own performance measures, with little focus on data quality control. …
CMS also required HENs and participating hospitals to submit a large number of process measures of unknown validity. … CMS also required HENs and participating hospitals to submit a large number of process measures of unknown validity.
Graham Kessler gives the Obamacare claim a coveted “Gepetto” in its Pinocchio scale, which means the claim is “the truth, the whole truth, and nothing but the truth” even though this view does not appear to be shared by a prestigious medical journal. Note that the NEJM uses the billion dollar figure in evaluating the cost of this Obamacare success story -- and point out what massive waste of resources it was to blow a billion on something which cannot even be accurately measured.
The PPP involved an investment of nearly $1 billion to improve care — three times the annual budget of the AHRQ, the lead federal funding agency for implementation science, which often lacks resources for promising projects. With such a sizable investment, CMS could have supported a better evaluation. It could have randomized HENs or hospitals to receive interventions earlier or later; used standardized, validated measures across the HENs; built in basic data quality controls; and independently collected qualitative information alongside quantitative data to learn not just whether the interventions worked but also how and why they did, thereby advancing our understanding of the mechanisms and context of improvement science. These changes would have allowed the country to learn so much more.
The Washington Post “fact checking article” is of dubious value. It may be the case that the Patient Protection program has benefited patients, but the methodology used makes it difficult to state the case. Even if the claims are true it cost $20,000 per life saved to induce hospitals to be more careful about outpatient care. While every life saved is something to be treasured Obamacare’s PPP is a helluva way to run a railroad.
Graham Kessler at the Washington Post argues that Obamacare really did prevent 50,000 statistical deaths. How, by insuring people? No. By changing the way some hospitals provide outpatient care. Kessler writes that the problem was to establish causality between the Partnership for Patients program and the claimed reduced deaths:
The 50,000-number is derived from a study, released on Dec. 2, 2014, by the Agency for Healthcare Research and Quality, an arm of the Department of Health and Human Services.
The study looked at the impact of the Partnership for Patients, a $460-million program funded by the health law which ties together 3,800 hospitals in 27 “health engagement” networks, with the goal of reducing ten categories of “patient harms,” such as adverse drug events, pressure ulcers and catheter-associated urinary tract infections. The networks work together to identify possible solutions to common problems and then circulate those ideas among the various hospitals, with the goal of reducing preventable hospital-acquired conditions (HACs) by 40 percent and 30-day hospital readmissions by 20 percent.
The study admits that “the precise causes of the decline in patient harm are not fully understood,” but notes that “the increase in safety has occurred during a period of concerted attention by hospitals throughout the country to reduce adverse events” though programs like the Partnership for Patients. So a key question is whether the impact is coincidental or the result of the ACA.
The majority of the preventable deaths arose from two categories of possible mismanagement: “it turns out pressure ulcers and adverse drug events are responsible for nearly 65 percent of the reduction in estimated deaths—20,727 fewer deaths from pressure ulcers and 11,540 from adverse drug events. So can we draw a straight line from the Affordable Care Act to those saved lives? Administration officials argue that is correct.”
So under the ACA’s Partnership for Patients, greater scrutiny of supposedly low risk drugs and better patient management was implemented in hospitals.
Similarly, to thwart pressure ulcers, hospitals began paying closer attention to repeatedly turning patients, providing more appropriate mattresses, applying moisture barriers and repeated toilet assistance and keeping track of nutrition and hydration. …
As our colleagues at PolitiFact noted, in-patient deaths were already declining before the Affordable Care Act was implemented. The Centers for Disease Control and Prevention found a 60,000 decline in patient deaths in the decade before 2010. This is not quite the same statistic, but it indicates that before the ACA was passed into law, progress was already being made in reducing deaths from conditions acquired in hospitals.
But officials say there is also little question that the half-billion dollars in ACA funding sparked significantly greater cooperation among thousands of hospitals
That is hardly a straight line. That there is any line at all is disputed by others. First, as to the money. According to Dan Diamond of California Healthline, the true figure is a billion dollars, not $460 million. That billion dollar figure is echoed by Modern Healthcare. Secondly, according to an article in the New England Journal of Medicine, the causality cannot be supported. Peter Pronovost, M.D., Ph.D., and Ashish K. Jha, M.D., M.P.H. address the issue directly in the article, “Did Hospital Engagement Networks Actually Improve Care?”
Everyone with a role in health care wants to improve the quality and safety of our delivery system. Recently, the Centers for Medicare and Medicaid Services (CMS) released results of its Partnership for Patients Program (PPP) and celebrated large improvements in patient outcomes.But the PPP's weak study design and methods, combined with a lack of transparency and rigor in evaluation, make it difficult to determine whether the program improved care. Such deficiencies result in a failure to learn from improvement efforts and stifle progress toward a safer, more effective health care system.
CMS launched the PPP in December 2011 as a collaborative comprising 26 “hospital engagement networks” (HENs) representing more than 3700 hospitals, in an effort to reduce the rates of 10 types of harms and readmissions. The HENs work to identify and disseminate effective quality-improvement and patient-safety initiatives by developing learning collaboratives for their member facilities, and they direct training programs to teach hospitals how to improve patient safety. In a February 2013 webcast, CMS announced that the rates of early elective deliveries had dropped 48% among 681 hospitals in 20 HENs and that the national rate of all-cause readmissions had decreased from 19% to 17.8%, though it is unclear which HENs were included for each measure and what time periods were the pre- and post-intervention periods.
These numbers appear impressive, but given the publicly available data and the approach CMS used, it's nearly impossible to tell whether the PPP actually led to better care. Three problems with the agency's evaluation and reporting of results raise concerns about the validity of its inferences: a weak design, a lack of valid metrics, and a lack of external peer review for its evaluation. Though the evaluation of many other CMS programs also lacks this basic level of rigor, given the large public investment in the PPP, estimated at $1 billion, and the strong public inferences about its impact, the lack of valid information about its effects is particularly troubling. …
Beyond using a poor design, CMS did not use standardized and validated performance measures across all participating hospitals — further hampering inferences about the program's effects. To support engagement, CMS allowed each HEN to define its own performance measures, with little focus on data quality control. …
CMS also required HENs and participating hospitals to submit a large number of process measures of unknown validity. … CMS also required HENs and participating hospitals to submit a large number of process measures of unknown validity.
Graham Kessler gives the Obamacare claim a coveted “Gepetto” in its Pinocchio scale, which means the claim is “the truth, the whole truth, and nothing but the truth” even though this view does not appear to be shared by a prestigious medical journal. Note that the NEJM uses the billion dollar figure in evaluating the cost of this Obamacare success story -- and point out what massive waste of resources it was to blow a billion on something which cannot even be accurately measured.
The PPP involved an investment of nearly $1 billion to improve care — three times the annual budget of the AHRQ, the lead federal funding agency for implementation science, which often lacks resources for promising projects. With such a sizable investment, CMS could have supported a better evaluation. It could have randomized HENs or hospitals to receive interventions earlier or later; used standardized, validated measures across the HENs; built in basic data quality controls; and independently collected qualitative information alongside quantitative data to learn not just whether the interventions worked but also how and why they did, thereby advancing our understanding of the mechanisms and context of improvement science. These changes would have allowed the country to learn so much more.
The Washington Post “fact checking article” is of dubious value. It may be the case that the Patient Protection program has benefited patients, but the methodology used makes it difficult to state the case. Even if the claims are true it cost $20,000 per life saved to induce hospitals to be more careful about outpatient care. While every life saved is something to be treasured Obamacare’s PPP is a helluva way to run a railroad.
so Obamacare is so bad that Obama admitted he lied. Everyone save for some Pauls are worse off, the medical profession hates the regulations and paperwork, the insurance industry dislikes the quagmire although they're doing better than ever (oh the fucking irony, A?), Peters are paying more than ever and politicians have a new political pawn to use on the village idiots
so the critics were essentially right about everything, yet libtards thinks the critics have to eat crow
do libtards like eating crow? that would explain a lot. Maybe they think eating crow is a good think. I'm not exactly knowledgeable in the dietary habits of Pauls. I think they like spam and the 69 cent hodog sold by some towelhead, maybe they be liking crow too.
so the critics were essentially right about everything, yet libtards thinks the critics have to eat crow
do libtards like eating crow? that would explain a lot. Maybe they think eating crow is a good think. I'm not exactly knowledgeable in the dietary habits of Pauls. I think they like spam and the 69 cent hodog sold by some towelhead, maybe they be liking crow too.
The claim that Obamacare “saved 50,000 lives” came from a government (AHRQ) report. Note the report said: It’s not possible to literally count the number of deaths prevented in the same way you can count actual deaths. So the authors of the report had to use a complicated set of estimating techniques to come up with the 50,000 figure.
And:
The authors of the report that Obama cited also hedged a bit on the causes for the decline, writing that "the precise causes of the decline in patient harm are not fully understood."
So the 50,000 figure they are claiming is “fact” is an estimate derived from “complicated estimating techniques” about an event that is not fully understood and precise causes are not known. Additionally, the estimates about this are “due in part to initiatives woven into the Affordable Care Act.” What % of patients were saved due in part? Oh, nobody knows.
It is so comical how leftist "facts" are always convoluted bullshit.
And:
The authors of the report that Obama cited also hedged a bit on the causes for the decline, writing that "the precise causes of the decline in patient harm are not fully understood."
So the 50,000 figure they are claiming is “fact” is an estimate derived from “complicated estimating techniques” about an event that is not fully understood and precise causes are not known. Additionally, the estimates about this are “due in part to initiatives woven into the Affordable Care Act.” What % of patients were saved due in part? Oh, nobody knows.
It is so comical how leftist "facts" are always convoluted bullshit.
http://www.ibtimes.com/rising-cost-...remiums-increase-state-exchanges-face-2027758
[h=1]Rising Cost Of Health Care: Obamacare Insurance Premiums To Increase As State Exchanges Face Losses, Even Closure[/h]
- - -
Americans continue to make out like bandits on that annual $2,500 savings.
[h=1]Rising Cost Of Health Care: Obamacare Insurance Premiums To Increase As State Exchanges Face Losses, Even Closure[/h]
- - -
Americans continue to make out like bandits on that annual $2,500 savings.
pulling numbers out of their asses, totally meaningless unfounded numbers, but bullshitting is what they do best, it's the only thing they're really good at
Clinton hired 200,000 teachers
not to be outdone, he then hired 200,000 law enforcement officers (we know Barry would never want that)
Obama created or saved 2,000,000 jobs
obamacare saved 50,000 lives
not a shred of credibility on anything, words have no meaning with them, I wouldn't trust them to run a $ 5 office pool. They're dishonest to a fault
No government in the history of civilization has ever made any product or service cheaper without screwing over someone else to do it. It isn't possible. There is no magic government wand they wave...all government interference accomplishes is to create inefficiencies and price distortions.
Funny how those who get steamrolled (ie the cost) never seem to matter.
Take food stamps for example. The recipients get "free" food...but at what cost? Someone has to pick up the tab, right? So the poor slobs who work and pay taxes need to pay a little more just so Mr and Mrs Welfare Fucks can get their free food. Same goes for rent (section 8 housing), health care, etc. We hear the trumpets of "Obamacare has enrolled SOOOOO many people who didn't have health care before it became law!" Except what about the people who lost their health insurance with which they were perfectly happy, and sometimes surviving based on it? I posted stories here about people who died because their health insurance was no longer ACA-compliant, and there was no other specialist they were seeing for whatever condition they had anywhere near them.
That doesn't matter to dimpcraps. Just a little collateral damage en route to an imaginary Utopia that will never occur.
http://www.truthrevolt.org/news/obamacare-co-op-insurers-tanking
According to a Health Department watchdog report, almost all of the Obamacare "co-op" health insurers are losing money, a fact that threatens to leave a large portion of their $2.4 billion in federal loans unpaid.
Under the increasingly ironically-named Affordable Care Act, the government gave start-up loans to nonprofit co-ops that were intended to be sustainable in the healthcare market. As it turns out, not so much.
The report, released Thursday, found that 21 of the 23 co-ops nationwide were hemorrhaging money, with only one actually making a profit.
#toldyouso
According to a Health Department watchdog report, almost all of the Obamacare "co-op" health insurers are losing money, a fact that threatens to leave a large portion of their $2.4 billion in federal loans unpaid.
Under the increasingly ironically-named Affordable Care Act, the government gave start-up loans to nonprofit co-ops that were intended to be sustainable in the healthcare market. As it turns out, not so much.
The report, released Thursday, found that 21 of the 23 co-ops nationwide were hemorrhaging money, with only one actually making a profit.
#toldyouso
TN 36.3% rate hike
KY 25.1% rate hike
OR 25.6% rate hike
OH 14.5% rate hike
[h=1]Insurers Win Big Health-Rate Increases[/h]
A totally epic beclowning thread.
KY 25.1% rate hike
OR 25.6% rate hike
OH 14.5% rate hike
[h=1]Insurers Win Big Health-Rate Increases[/h]
A totally epic beclowning thread.
[h=1]Blue Cross and Blue Shield pulling out of New Mexico exchange[/h]
ALBUQUERQUE (KRQE) – Blue Cross and Blue Shield of New Mexico announced on Wednesday it “will not offer individual on-exchange health insurance products on the New Mexico Health Insurance Exchange in 2016.”
They had only been offering health insurance in the state for 75 years.
Obamacare working!!!
ALBUQUERQUE (KRQE) – Blue Cross and Blue Shield of New Mexico announced on Wednesday it “will not offer individual on-exchange health insurance products on the New Mexico Health Insurance Exchange in 2016.”
They had only been offering health insurance in the state for 75 years.
Obamacare working!!!
Another big win for the Obama Administration and ObamaCare
[h=1]Contraception opt-out violates religious freedom: U.S. appeals court[/h]
A U.S. appeals court has ruled that President Barack Obama's healthcare law violates the rights of religiously affiliated employers by forcing them to help provide contraceptive coverage even though they do not have to pay for it.
Parting ways with all other appeals courts that have considered the issue, the 8th U.S. Circuit Court of Appeals in St. Louis on Thursday issued a pair of decisions upholding orders by two lower courts barring the government from enforcing the law's contraceptive provisions against a group of religiously affiliated employers.
[h=1]Contraception opt-out violates religious freedom: U.S. appeals court[/h]
A U.S. appeals court has ruled that President Barack Obama's healthcare law violates the rights of religiously affiliated employers by forcing them to help provide contraceptive coverage even though they do not have to pay for it.
Parting ways with all other appeals courts that have considered the issue, the 8th U.S. Circuit Court of Appeals in St. Louis on Thursday issued a pair of decisions upholding orders by two lower courts barring the government from enforcing the law's contraceptive provisions against a group of religiously affiliated employers.
I cannot tell you guys exactly what would have happened had I gone through my recent and ongoing health issues under my old plan. I can tell you that under my old plan I rarely was sick so I didn't use it much. But I will say that when I needed tests or bloodwork they hardly paid for shit. I am still with the same company Blue Cross (Keystone Silver) but I registered through the ACA.
I've been billed over 15K so far with a lot more on the way since my nose bleeds started fucking with my life in August, including 3 ER visits I haven't even been billed for yet. For the first hospital bill, 12,000 Blue Cross declined NOTHING and every doctor except one accepted what my insurance paid. He billed me for 17 bucks.
I've had a few post-op visits to doctors with copays ranging from 10-30 dollars. My surgery was outpatient and I had to lay out $150 co-pay there. Haven't seen what the full bill is for that (arterial ligation) but my portion is paid.
My at home sleep study was turned down as I was third tier with the lab. I laid out $300 bucks there. Wish I had not because it turns out I die 34 times an hour every night and now they want me to wear an alien on my face that whispers in my ear all night while I fight to sleep on my back, a position I loathe. A machine that ends up in the back of everyones closet who tries it. No Thank You!!!
But anyway you guys all know I hate Obama. But I'm very pleased with my new health insurance. As a world famous internet forum fella more than once exclaimed..... "Not gonna lie!"
I've been billed over 15K so far with a lot more on the way since my nose bleeds started fucking with my life in August, including 3 ER visits I haven't even been billed for yet. For the first hospital bill, 12,000 Blue Cross declined NOTHING and every doctor except one accepted what my insurance paid. He billed me for 17 bucks.
I've had a few post-op visits to doctors with copays ranging from 10-30 dollars. My surgery was outpatient and I had to lay out $150 co-pay there. Haven't seen what the full bill is for that (arterial ligation) but my portion is paid.
My at home sleep study was turned down as I was third tier with the lab. I laid out $300 bucks there. Wish I had not because it turns out I die 34 times an hour every night and now they want me to wear an alien on my face that whispers in my ear all night while I fight to sleep on my back, a position I loathe. A machine that ends up in the back of everyones closet who tries it. No Thank You!!!
But anyway you guys all know I hate Obama. But I'm very pleased with my new health insurance. As a world famous internet forum fella more than once exclaimed..... "Not gonna lie!"
AHI above 30 is severe, my friend. Not good. Significant increased risk of disease with no treatment. Compliance with CPAP , as you noted, terrible-- once study reports after year one, as high as 70% will not use it. IT IS effective, and will get that number way down-- its the Gold Standard. However there are other options.
that all said, your AHI number will decrease with weight loss. In fact, weight gain (overweight/obese) is a risk factor for OSA. Of course, no idea if you're overweight or not, thought i'd share
You forgot to mention .... Sleep Apnea not only obstructs sleep. It prevents weight loss, grrr.
Some good news the cardio guy discharged me today. No heart issues. Pressure still nuts though. Can be 120/65 and 15 minutes later 155/100. And no, not because somebody throws a pick6 lol! Added metoprolol 25 to the Irbesartan 300 and HydroChorothiazide 25. Also, swelling is down in ankles, below first level on the scale. ENT on 22nd.
who told you this? That statement is not substantiated by data/research.
quality sleep is critical for overall health ; healing, body repair, proper hormonal balance. Lack of quality/reparative sleep (getting into stage 3 of sleep, so called deep sleep ) can adversely affect levels of leptin and ghrelin. These two hormones help regulate body weight/metabolism.
Your statement is that sleep apnea prevents weight loss. Ergo if we STOP sleep apnea then the patient will lose weight. Right? By establishing proper ghrelin/leptin levels during sleep then metabolic rate will normalize and the person loses weight. Now, is there data to support this? NO...NO.....NO. The relationship between weight gain/loss and sleep is not black and white. Clearly other factors play a role
http://www.ncbi.nlm.nih.gov/pubmed/25432944ain
Effects of CPAP on body weight in patients with obstructive sleep apnoea: a meta-analysis of randomised trials
Abstract
INTRODUCTION:
The impact of obstructive sleep apnoea (OSA) treatment with CPAP on weight is not clear. This meta-analysis was designed to assess whether OSA treatment with CPAP promotes changes in body mass index (BMI) and weight.
METHODS:
We searched PubMed, SCOPUS and Cochrane Central Register electronic databases through 1 October 2013 (including papers in press at that time), without language restrictions. We identified randomised trials of CPAP versus controls with a minimum treatment duration of 4 weeks that objectively measured BMI. Data were independently abstracted and reviewed by two investigators using a standardised protocol.
RESULTS:
We included a total of 3181 patients from 25 randomised trials that measured BMI and weight. All studies enrolled mainly overweight and obese patients. The fixed-effects meta-analysis revealed that CPAP promoted significant increase on BMI (Hedges' g=0.14, 95% CI 0.07 to 0.21, I(2)=16.2%) and weight (Hedges' g=0.17, 95% CI 0.10 to 0.24, I(2)=0%). The funnel plot revealed low risk of publication bias. Meta-regression analyses including age, gender, baseline BMI, baseline weight, OSA severity, CPAP compliance, use of sham CPAP, study duration, study design (crossover/parallel), study origin (Western/Eastern), recommendation for dietary changes or physical activity, revealed that no single predictor influenced the main outcome for weight. Baseline weight was a predictor of increased BMI after CPAP.
CONCLUSIONS:
OSA treatment with CPAP promotes significant increase in BMI and weight. Additional therapies for body weight reduction must be recommended for overweight or obese patients with OSA initiated on CPAP.
weird conclusion, eh? In other words-- OSA treatement with CPAP INCREASED WEIGHT!!!!!!!!!!!!!!!!!! LOL!!!!!!!!!!!
hence when someone says sleep apnea prevents weight loss , um, well then why does CORRECTING the apnea not result in decrease of body weight? Establishing healthy levels of leptin/ghrelin is a good thing. But other factors also play a role in weight loss.
i'm sure your cardiologist advised of the following, i'll post so as to reietrate ;
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666153/
Abstract
Obstructive sleep apnea (OSA) is increasingly being recognized as a major health burden with strong focus on the associated cardiovascular risk. Studies from the last two decades have provided strong evidence for a causal role of OSA in the development of systemic hypertension. The acute physiological changes that occur during apnea promote nocturnal hypertension and may lead to the development of sustained daytime hypertension via the pathways of sympathetic activation, inflammation, oxidative stress, and endothelial dysfunction. This review will focus on the acute hemodynamic disturbances and associated intermittent hypoxia that characterize OSA and the potential pathophysiological mechanisms responsible for the development of hypertension in OSA. In addition the epidemiology of OSA and hypertension, as well as the role of treatment of OSA, in improving blood pressure control will be examined.
Scott, the sentence in bold is HUGE. It says the CAUSE of your hypertension may have been your long standing sleep apnea. To not FIX the apnea (AHI down from 34 to under 5) would be ill advised. Basically the medications are an attempt to CONTROL the problem, while ignoring its CAUSE. However, if its not causal in your case, the apnea most certainly adds fuel to the fire , so to speak, in the management of your hypertension. In other words, controlling the apnea will go a long way to controlling your BP
