Monday, January 13, 2014

New Blood Pressure Guidelines

Fewer people should take medicine to control their high blood pressure, a new set of guidelines recommends.
Wednesday, Dec. 16, 2013

Adults age 60 or older should only take blood pressure medication if their blood pressure exceeds 150/90, which sets the bar higher than the current guideline of 140/90, according to the report, published online in the Journal of the American Medical Association.

The guidelines also recommend that diabetes and kidney patients younger than 60 be treated at the same point as everyone else that age, when their blood pressure exceeds 140/90. Until now, people with those chronic conditions have been prescribed medication when their blood pressure reading topped 130/90.

Blood pressure is the force exerted on the inner walls of blood vessels as the heart pumps blood to all parts of the body. The upper reading, the systolic pressure, measures the force as the heart contracts. The lower reading, the diastolic pressure, measures the residual as the heart relaxes between contractions. The normal adult blood pressure is 120/80.

The recommendations are based on clinical evidence showing that stricter guidelines provided no additional benefit to patients, explained guidelines author Dr. Paul James, head of the department of family medicine at the University of Iowa Carver College of Medicine.

“We really couldn’t see additional health benefits by driving blood pressure lower than 150 in people over 60,” James explained. “It was very clear that 150 was the best number.”

The American Heart Association (AHA) and the American College of Cardiology (ACC) did not review the new guidelines, but the AHA has expressed reservations about the panel’s conclusions.

About one in three adults in the United States has high blood pressure, according to the U.S. National Heart, Lung, and Blood Institute.

These new guidelines are a step in the right direction. Although the existing guidelines from both the AHA and ACC call for lifestyle changes in additional to medication, the reality is most physicians just place their patients on medication with little or no attempt at reversing the cause of high blood pressure.

I loved the quote from Dr. James about no additional health benefit from driving the blood pressure down below 150. That’s what beta blockers, calcium channel blockers, and ACE inhibitors do, drive down blood pressure.

One in three Americans has high blood pressure. Seventy-five percent remain undiagnosed, just treated with medication. Kidney, lung, and liver dysfunction are the most common causes. High blood pressure is also one of the indicators for metabolic syndrome.

High blood pressure is not a disease. It is not even a symptom, although symptoms are associated with it. Blood pressure is a test. Treating the test is not the answer. Finding out why the blood pressure is elevated and correcting the health problem causing this abnormal test is the real solution.

If you have high blood pressure find a doctor who will investigate the cause and help you to reverse the problem. Take a good look at your lifestyle – Are you overweight? Do you exercise on a regular basis? Don’t settle for just medicating the test.