Blood Pressure Guidelines
Dr. Bruno’s Original Post: Will Dropping Blood Pressure to 130/80 Cause Polio Survivors to Drop?
My concern is that doctors will follow the guidelines, and not treat the patient. Doctors will prescribe anti-hypertensive medications, for example beta blockers -- which drop polio survivors' heart rates and blood pressures and can cause fatigue -- the goal being a "perfect" blood pressure of 130/80 without considering other issues.
For example, autonomic dysfunction in polio survivors -- or anyone over 60 -- can itself cause orthostatic hypotension, especially in the middle of the night, causing people who get up quickly to go to the bathroom to fall down when their blood pressure drops.
Please talk to your doc if he/she wants to medicate you for blood pressure issues. This is the type of headline that raises my blood pressure to dangerously high levels -
Under New Guidelines, Millions More Americans Will Need to Lower Blood Pressure
“For years, doctors were told to aim for a systolic blood pressure of less than 140. (The first of the two blood pressure numbers.) Then, in 2013, recommendations were relaxed to less than 150 for patients age 60 and older. Now they have been tightened, to less than 130 for anyone with at least a 10 percent risk of heart attack or stroke in the next decade. That means that nearly half of all adults in the United States are now considered to have high blood pressure. I bet I’m not the only doctor whose blood pressure jumped upon hearing this news. Disclosure: I’m an advocate of less medicine and living a more healthy life, and I worry we get too focused on numbers. But to make that case I’ll need to use some numbers.”
“The new recommendation is principally in response to the results of a large, federally funded study called Sprint that was published in 2015 in The New England Journal of Medicine. Sprint was a high-quality, well-done study. It randomly assigned high blood pressure patients age 50 and older to one of two treatment targets: systolic blood pressure of less than 140 or one of less than 120. The primary finding was that the lower target led to a 25 percent reduction in cardiovascular events — the combined rate of heart attacks, strokes, heart failures and cardiovascular deaths.”
“Serious falls are common among older adults. In the real world, will a nationwide target of 130, and the side effects of medication lowering blood pressure, lead to more hip fractures? Ask your doctors. See what they think.”
“Let me be clear: Using medications to lower very high blood pressure is the most important preventive intervention we doctors do. But more medications and lower blood pressures are not always better for everyone.”
“So focusing on the number 130 not only will involve millions of people but also will involve millions of new prescriptions and millions of dollars. And it will further distract doctors and their patients from activities that aren’t easily measured by numbers, yet are more important to health — real food, regular movement and finding meaning in life. These matter whatever your blood pressure is.”