A new study has shown that blood pressure goals for people with high blood pressure should be much more aggressive than previously thought.
The study randomly assigned people over 50 with high blood pressure to a goal of under 120 systolic, or under 140 systolic. It was supposed to continue through 2017, but the interim results were so big and dramatic that the study was stopped early. Assigning people to the lower goal lowered their risk of death by almost a quarter. That’s huge.
To achieve the lower goal, patients typically have to take several drugs.
Let’s see…the “federal health officials” are trying to drive more and more folks into unnecessarily taking blood pressure medications while the experts have an entirely different opinion. Knock me over with a feather…
and otherwise focuses mainly on the use of drugs to lower blood pressure, it has a picture at the top of an older physician (not involved in the study, but who commented on it in the article) trail running. Perhaps it would have been better if it had discussed exercise as well.
I’m usually not so cynical. But I had heard about this new recommendation a while back. Combine this with the ever lowering cholesterol goals and accompanying recommendations to take statins, I’m thinking we all are going to be told to be on medicines starting in childhood.
I have hypertension. In April, I took up cycling in a very committed fashion. My BP lowered from 160s/90s to 116/60s, and I began having incidents of being lightheaded and dizzy, especially when rising from a seated position. My doc cut my dose in half, and now I’m hanging out in the low to mid 120s/70s, with no further dizzy spells. My goal is to get off the med completely. I don’t know that I could realistically expect to maintain at less than 120 systolic without any meds at all. I’m already riding an hour minimum each day. I don’t want to feel the need to go more than 2 hours a day in order to keep my systolic in the teens.
I can certainly see a down side to keeping blood pressure very low. I think it could indeed put people at risk if they cannot get the BP to such a precise low.
Read more carefully, Wolverine. The experts are the ones who halted the study because the results were so obvious that it was unethical to continue to assign patients to the higher target.
There was a controversy. Doctors didn’t know whether the result of lowering blood pressure more was worth the side effects of the drugs. That’s why the study was done. Doctors who thought that higher blood pressure goals were correct are now revising their expert opinion.
Interesting. I have naturally low blood pressure. And sometimes I have “postural hypotension:” dizziness when rising from a seated position. Decades ago, my mother reported those same symptoms to her doctor. He told her that’s a problem she’ll still be worrying about in her 90s, when her contemporaries are gone. Sure enough, she’s 91. So I don’t worry about my low blood pressure or my occasional dizziness when standing.
The important point appears not to have been mentioned: this isn’t for people with high blood pressure but people at “high risk of heart disease or had kidney disease”. The study questions whether reducing systolic pressure more has greater therapeutic benefit for people with these specific issues and the result was soundly yes - though I haven’t read the paper. But this doesn’t mean people who are not at “high risk of heart disease or had kidney disease” should do anything differently. A simple guess is that if you are sick or a strong predisposition to heart disease, then you need more care. That’s eminently sensible: it says that sick people were not being treated enough, not that healthy people need to do anything different.
You could be a participant in the study if you were over 50, had high blood pressure and had a >15% chance of heart disease in the next ten years (using Framingham risk score). Anyone with high blood pressure who was 75 or over was eligible.
We’re not talking here about people with one foot in the grave, just people who smoke or who have high cholesterol. In other words, we’re talking about a lot of people over 50. Plenty of parents on CC would have qualified for this study.
NRDsb, I had similar issues and have gotten rid of my BP medication. Lightheaded, so reduced the dose myself, then was chastised for being “non compliant”. I felt a danger to myself when driving. Working in cardiology, I see more BP variations on a daily basis than most family practice docs. Whatever-I do respect their opinions. My new doc took me off the medication last year, and I was 115/70s when last checked a few days ago.
However, there are many many things that can be done to reduce BP naturally. Exercise is number one to keep those blood vessels flexible rather than stiffening with age. Reduce stress-meditation was what did it for me alone with weight loss. I’ve been walking fast and biking for years, but weight loss really helped. Slowing the breath drops the HR and BP. Google for techniques on line. Salt restriction in a certain percentage of the population. The DASH diet, which I follow for the most part.
But…some folks with a family history of hypertension are going to need meds no matter what. Taking meds does not mean you have to take them forever, as you see with two of us here who have stopped them due to lifestyle changes. If your BP is high, take the meds, work on your lifestyle issues and see how things go. Taking meds is not a sentence, rather a way to stay healthy.
I used to think teas are ok. My eye doctor pointed out there’s plenty caffeine in green tea. My drinking list is a bit boring but to me the trade off is worth it. I didn’t like the blood pressure meds.
I’m even more concerned about the new study that also came out saying people who don’t sleep well are at an increased risk of heart disease and stroke. I’m outta luck on that one for sure.