Sounds like Big Pharma lobbyists got their way. Expect bigger profits soon.
4
No surprises here; they did this first with WEIGHT in the Clinton era, about 1998. One day, average people went to bed thinking their weight was normal but woke up the next morning to discover they had been "reclassified" as overweight or obese. The government had lowered the standard for BMI from 27.5 (where it had been for many years) to UNDER 25.
Then they did it with blood pressure, and now have lowered it AGAIN. And they are after blood glucose levels, trying to define "pre diabetes" now as any reading over 100 (previous was 140, then 126).
Cholesterol too -- with completely artificial guidelines of under 200 as ideal -- but this number was literally picked out of a hat, and has no basis in scientific or medical research.
We are being ruled by "numbers" from "tests" and this is NOT GOOD MEDICINE.
I have had elderly relatives, who were put on high doses of BP meds to bring their pressure down to an "ideal" of 110/70....which resulted in dizziness and falls. One elderly aunt broke a hip and ended up in a wheelchair. Was it worth it to have super-low blood pressure?
They are trying the hardest to MEDICALIZE perfectly healthy ordinary people! and put them on lifetime drug regimens. This is very troubling.
30
How did my grandfather live to be 101 without this guideline?
37
The blood sugar level for pre-diabetes was reduced to 100, which made millions of Americans pre-diabetic.
The total cholesterol that was considered high was reduced to 200, giving 10 to 20 million Americans high cholesterol.
High blood pressure was reduced to 130 over 80, giving tens of millions of Americans high blood pressure.
And all three were total scams.
And some have claimed this has nothing to do with Big Pharma because there are generic medications. Don't kid yourself. Novartis and I believe Pfizer recently came out with "better" drugs for blood pressure. Soon the news programs will be inundated with ads for them.
67
Another scam by the medical industrial complex. More appointments with doctors. More prescriptions drugs. They already have 91% of Americans age 65 and over on a prescription drug. 69% age 45 to 64. Not enough people in their clutches, I guess.
Dig deeper into the data about blood pressure if the charlatans have the guts to release their data sets.
Read this from 4 years ago:
http://www.nytimes.com/2013/11/18/health/risk-calculator-for-cholesterol...
Last week, the nation’s leading heart organizations released a sweeping new set of guidelines for lowering cholesterol, along with an online calculator meant to help doctors assess risks and treatment options. But, in a major embarrassment to the health groups, the calculator appears to greatly overestimate risk, so much so that it could mistakenly suggest that millions more people are candidates for statin drugs.
27
Why is it that diet is mentioned twice but no specifics are given? The science is quite clear that most of us could lower our blood pressure without drugs by switching to a plant-based, low sodium diet: https://nutritionfacts.org/topics/blood-pressure/
22
I am troubled by readers' skepticism of this guidelines. America's leading health experts and cardiologists have developed these guidelines based on decades of scientific research and evidence. Leading medical societies endorse the guidelines. Why are so many Readers' Picks and NYT Picks dismissive of the guidelines?
To me, readers' skepticism of the ACC/AHA guideline is in many ways analogous to many Americans' denial of climate change. NY Times readers (rightfully) bemoan climate change deniers' disregard for science, yet I expect many of the same people are questioning the validity of this guideline, despite the overwhelming body of scientific and medical evidence to support it. Yes, Big Pharma stands to benefit from the new guidelines, but - as the evidence shows - so do patients! Just because the green energy sector stands to profit from climate-conscious policy doesn't make the evidence supporting climate change and the benefits of green energy any less valid! Do NYT readers really believe that America's leading physicians and researchers are ALL "in on it" (i.e., devising some plan to make money for Pharma at the people's expense)? Absurd!
Those who point out that the focus of blood-pressure lowering (and health in general) should start with a healthy diet (e.g., DASH or plant-based diet) and exercise are absolutely right. And this guideline recommends those changes first and foremost (before medical therapy)! So why all the science denialism?
27
There are plenty of blood pressure drugs to fund the drug companies especially when every Tom, Dick, and Harriet is taking one. Half of Americans woke up with an illness which they don't have. I have NEVER seen blood pressure taken properly. The patient comes in, sits down, the tech starts a conversation, tucks the patient's hand under her arm and inflates the cuff very tightly. Then she tries to measure the pressure. People have anxiety about coming to the doctor, the patient is supposed to sit for five minutes without talking, and the arm is supposed to be parallel to the ground but not dangling. How many people have accurate readings. By my calculations none.
Twenty-five years ago diabetics were told to keep their numbers low or risk the consequences. After years of research, they have found that sticking to artificially low numbers was actually detrimental to the person's health. I am not talking about crazy and lax control but a long-term study found that those who were micromanaging their glucose levels were actually dying sooner. The stress of worrying was detrimental to their health. This is the new glucose control or Is this the new statin? Beware the drugs for all approach to medicine. "May the cure not be worse than the disease." (a quote from Man of La Mancha)
24
Why do none of these articles ever mention eliminating salt from one's diet? A long time ago, I used to take ballet lessons 6 days a week for close to to 2 hrs. each. Then when I was 51, I moved making it impossible to get there.
Little by little, I gained weight so that over the next 10 years I put on about 60-70 lbs. Eventually, it went to 80-90 lbs.
I went to my doctor for a physical about 10 years ago and was astounded to find out that my BP was 140/? (don't remember). I was horrified. When I was taking ballet, my BP had been around 105/50-55, despite the stress of teaching math in a high school in NYC.
I immediately decided to omit salt as much as possible and lowered my BP to about 115/60-65. While I was wondering why my BP had gone up, I remembered an algebra problem from a 9th grade text I had used in my classes.
Essentially, the result was that for every 25 lb of body weight, the body has 1 liter of blood. So my 75 lb weight gain at that point meant that my heart had to pump an extra 3 liters of blood. I am happy that I was able to lose 25 lb since last April but not pleased that I stalled in the past two months. I have recently started once again in my efforts to lose another 25, a little at a time. After that, the next campaign and so on until I am back to a healthy weight.
So while this article and many others correctly counsel weight loss + exercise, I feel that eliminating or sharply reducing salt is also crucial.
12
I recently had a high blood pressure crisis after years of having slightly high BP. I don't know why it escalated suddenly but I was lucky to live through it. Consequently, I have had to go on a low salt diet. I already watched my salt intake, avoiding canned soups, fast food, etc. Now, I started reading every package. To my shock, many items I never thought of contained huge quantities of salt. Even fresh chicken and pork are shot up with saline to increase weight and improve the taste. So, people who are salt sensitive, as I am, get a lot more salt than they realize. It is really difficult to make everything from scratch and I don't know what to eat anymore.
12
Those medicines to reduce blood pressure have side effects that are not good. Losing weight is the best way to lower blood pressure, and plant based diet is best for that.
18
I'm sick of being told everything I like to eat or drink will kill me. This is a bald play to put a huge percentage of Americans into the big Pharma money pit. Why does the Times continue to put out this nonsense?
I'd like to know how much the study staff was paid.
15
Sorry, guys, I have to let this go. Fake medicine!
12
Reading comments on NYT is always a joy, until I get to an article on public health. Then I feel sure we are all doomed. Your FEELINGS on a scientific subject are irrelevant, yet so many comments are pure opinion or fear-based. Keep your BP down and you won’t have to worry about it. Have high BP and feel fine? There’s a reason it’s called a silent killer. Question mortality with your mind, not your heart. There’s a 100% chance you will die one day, do yourselves a favor and try to use logic in the face of science.
-an irritated nurse
19
@MV - Don't let yourself get irritated....I hear it's bad for your blood pressure.
Low blood pressure is not the answer to everything. My doctor told me about a middle aged patient who had moderately high blood pressure who finally went on medication. Her numbers were "became", however several months later she stroked out, even with clean arteries & perfect BP.
5
Sorry - should be "Her numbers became "perfect" .
2
The marketing department is about to get a big bonus !!
5
Another multi-billion dollar opportunity for the pharmaceutical companies. What a nerve!
14
Sounds like a homerun for Big Pharma!
10
These guidelines were publicized over a year ago.
4
Jeesh, a lot of conspiracy theorists and anti-medical establishment types commenting. Perhaps reducing the levels of overweight and obesity, increasing exercise, changing diet a bit, limiting alcohol and incorporating so many other incremental, lifestyle remedies will get that last bit of BP to the new acceptable range. For those who still believe this is a big pharma scam, enjoy your stroke.
19
Systolic blood pressure is the second most valuable biomarker you need to lower your all-cause mortality risk, so you should track it. Number one is iron accumulation and overload - so track your GGT and ferritin levels and get them down to 50. Donate blood every two months to get your iron down.
As much as I rant about MD's as Malpractice Doctors and shills of Big Pharma and parasites on sick people, this new blood pressure guideline is a good thing.
Every one point decrease in BP is a one percent decrease in your all-cause mortality, and this holds all the way down to a systolic of 90.
The problem are the drugs. These are very risky drugs because, like all pharmaceuticals, they block natural processes and thus cause collateral damage - they do not actually fix the underlying cause. Big Medicine is entirely built on band-aids.
In theory, unless your BP is over 140, drugs are not supposed to be prescribed due to their risk not being worth the benefit.
You don't need any drugs. Reducing alcohol is good for 5 points, exercise is 8 points, drugs average 12 points but at a high cost, sodium restriction (down to 2 grams) is 16 points (particularly if your BP is very high), low-salt plus vegan plus exercise gets you 17 points, but the number one way to lower blood pressure by 37 points (and fix every other health problem), is water-only fasting.
Check out the youtube videos by Longo or Goldhamer if you are serious about health, or if you have serious health issues.
5
My BP went down when I increased my Vit D level to mid normal from low normal( 30.5 ng/ml to ~ 50ng/ml). Now 126/76
5
So who ran the trials? Big Pharma? But look at the profits to be made!! Profits not only from selling more blood pressure medication but even more profit from selling the medications to combat acute kidney injury...that being twice as high when you're taking all those blood pressure medications. A win/win for the Medical/Pharmaceutical cartel.
9
We are now surrounded by full of info about a better lifestyle and are getting healthier. Good for most of us but a big problem for some sectors. Maybe the same fate as the iron industry....
I didn't have high blood pressure yesterday, but I do today.
9
Change the danger numbers. What a great new way to create a new target audience for certain drugs. I have no horse in the race personally as my numbers at the age of 54 are still below the new warning line. But I can't help but feel my blood pressure rise a bit at what seems like a cynical ploy.
6
So, last week half of us were addicts. Is this multiple choice?
3
if memory serves a year or so ago (if that) another study/med assn said the 130/80 bar was too low and had raised it to 140/90 in the older crowd such as moi. think this might be a reversal of that.....prob, if not certainly, the answer lies in individual consult with one's physician. but the plans will push it as will pharma. and the rule is prob "better safe than sorry anyway."
2
A few weeks ago, the American Diabetes Association changed their guidelines for H-A1c, including "pre-diabetes" with recommendations for diet and exercise, and "possibly" Rx medication. Now, the American Heart Association is following suit. If only ADA and AHA would provide guidelines on reducing root causes like poverty rather than kowtowing to pharmaceutical companies!
6
I wonder how many people had the reaction I did: our numbers turned problematical overnight, if this is to be believed.
4
A study from 2007 published in the Journal of American Medicine compared the low-carb Atkins/Keto diet with the vegan/low fat Ornish diet over a 12-month period for various health benefits including blood pressure.
Atkins/Keto (carbs under 50 grams) won, lowering BP much more than the vegan low fat diet; 8 points systolic versus 2 points systolic.
The Keto diet also beat the vegan diet on every other biomarker of health.
3
Nearly every one commenting blames the pharmaceutical industry for the new guide lines. Maybe so I have my own conspiracy theories and like everything else there's more to it than some monolithic entity ike the illuminati behind all this. I get confused with theories i'm sad to say. During the 70's it was evil Oil that conspired to drive up prices. Now they conspire to keep prices down. Different times but there's a little more to it. My guess Kidney failure is much more profitable at least to some people.
Another thing that confuses me, is statistics a science? Climate science has a profit motive like just like oil companies and big pharma. At least alot of jobs are at stake. So how come a majority of skeptics here weighing in against big pharma
don't turn a jaundiced eye to the Climate change industry. We all know statistics aren't always reliabable. At I have a hard time believing them.
And to the response that blood pressure medications are generic these days and off patent.... just wait. Big Pharma will tweak the existing formulations under some guise enough to win a new patent.
3
I find the guidelines and the comments very interesting. First to the comments. All the major drugs used for treatment of HBP are generic. There has not been any promotion of HBP drugs for years so it seems virtually implausible that Big Pharma is behind this. Which takes me to the next issue. The difference in total events in SPRINT between the high intensity and low intensity groups was around 0.5%. To subject so many more people to treatment for what appears a marginal difference sounds difficult to believe. I wonder if other alternatives would result in better outcomes than mandating more intensive treatment. The authors say that they have to treat 172 more people for 3.3 years to prevent one CV death. There were also many subgroups, large ones, where standard treatment did better than intensive treatment.
After all, life is a sexually transmitted disease with 100% mortality.
And, if society manages to reduce this minimal increase in death rates due to HBP, people will have a resulting increase of deaths due to cancer or dementia. Maybe dying in your sleep of sudden death is a more peaceful option.
People should be able to choose rationally what they want done to them.
4
Hi Carlos. I'm confused by your SPRINT summary: Here is the key finding: Initial Study Results: Intensive management of systolic blood pressure to a target of <120 mm Hg reduced rates of complications of high blood pressure (including heart attacks, heart failure, and stroke) by 30% and lowered the risk of death by almost 25% as compared to a systolic blood pressure target of <140 mm Hg.
The trial was stopped by the independent safety review board so that the control group could be treated to the same targets - for ethical reasons. Also, VERY FEW people will see a new medication under this new guideline, since uncomplicated Stage 1 hypertension is only indicated for diet/lifestyle changes - not medication. Most people are missing this point completely!
2
Joseph Roch - Percentages mean very little without context.
2
For those on blood pressure medicines now, this is a time to ask your doctor whether it makes sense to shift at least one of your blood pressure medications, preferably an ACE-inhibitor OR an Angiotensin blocker from the am to bedtime. With that shift one gets about 75% better protection from a stroke or heart attack AND there is more likely to be better 24 hour blood pressure control by taking a bedtime dose, believe it or not.
Also if one is on hydrochlorothiazide (HCTZ) one can get better 24 hour blood pressure control and greater protection against strokes by switching from HCTZ to indapamide.
In both of these examples one will be making use of a principle of therapy known as "chronotherapy". Taking a blood pressure med at bedtime and taking a much longer acting anti-hypertensive diuretic (indapamide versus the much shorter acting HCTZ) are two prime examples of using chronotherapy to your benefit. And most all blood pressure medications that fit into the "chronotherapy mode of action" are generics so one in general is not switching from generic to brand name drugs.
Ask your doctor:
Should I be taking one of my blood pressure medications at bedtime instead of in the morning?
Would it benefit me to switch from a shorter acting diuretic - antihypertensive to a 24 hour acting one?
Look up in pubmed.com the concept, "chronotherapy". You will be surprised by the variety of maladies to which it applies.
4
After 4 decades of borderline high blood pressure with a heart rate in the mid 40s and heavy physical activity, I was told I now have high blood pressure. A blood pressure medication was immediately recommended with no mention of the DASH diet. A hand-out could have been so easy. What is wrong with our health and medical system such that only drugs and surgery are in the tool box?
14
Use the calculator to determine risk? Really? I'm 63. My Cholesterol is 170, HDL is 85, now for the kicker; LDL is 69, based on my last checkup. But it only lets you put in a minimum of 80. Then it finally tells me i'm at medium risk and I should see a doctor; possible therapies are exercise (just ran a 15k at a 7:40 pace), statins (cross that one off), diet ( I eat a mostly meatless diet, with very little sugar and alcohol). Maybe I should buy stock in a Pharmaceutical company.
13
Many comments here are every bit as skeptical as the overall coverage of this "announcement" in the European media today. In summary: it's good news for American Big Pharma, not so great news for ordinary Americans who are already overprescribed with meds. In European countries with better health outcomes and life expectancy than ours -- and that's most European countries in 2017 -- even cholesterol readings are one of many criteria that doctors review with patients. Here, the readings are so important that a 77-year-old friend of my family with "low high" cholesterol was told by her physician that she should never touch ice cream.
Much of U.S. health care is driven more by factors of dogmatic Puritanism and profits and less by common sense. And now we have yet another definition of high blood pressure to update the new one of two years ago. America -- we have "the greatest health care in the world."
12
Unfortunately, lowering blood pressure targets to <135/85 (or less) has not been proved a useful strategy, even in case of cardiovascular high-risk individuals. Our recent Cochrane systematic review (please, see http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010315.pub2/abstract) states clearly that no differences were detected in total numbers of deaths, heart or vascular deaths or serious harms between lower and standard blood pressure goal approaches.
Moreover, based on very little information, we found more dropouts due to drug-related harms in the lower blood pressure target group. The only significant benefit among people in the lower group in the studies analyzed was a slight decrease in total heart or vascular problems, but there was no overall health benefit. Thus, the best available evidence does not support lower blood pressure goals over standard goals in people with elevated blood pressure and heart or vascular problems.
10
Sorry, the previous link does not work. Here is the fixed one: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010315.pub2/abstract
There's a lot of skepticism about this change. At the same time high blood pressure is connected to deaths from heart disease,, stroke, and diabetes. That's one third of all deaths, almost twice as many than those resulting from cancer. To protects us against cancer, we try not to smoke, to stay out of the sun, to undergo regular mammograms, prostate exams, and colonoscopies. We expect the government to protect us against carcinogens. We are vaccinated against HPV. Don't take extraneous x-rays. And examine yourself for unusual growths.
To avoid heart-related problems. don't overeat, get regular exercise, and watch your blood pressure. Those are the basics. Other stuff helps, but much less.
I'd say that, all things considered, heart-related precautions don't measure up. And more aggressive Preventive treatment makes sense.
2
As Jan Black said, this test is baloney. It asked me no questions about my weight or my diet or my exercise habits all of which are excellent. I tweaked the values one at a time and the only variable that really mattered was my age, which I obviously cannot do anything about. Yes somebody my age does have a 10% chance of a cardiovascular event in the next decade. But this test simply labeled me as a high-risk individual and told me to run to a doctor.
13
It's because of Trump.
5
Q. Who is in charge of your health care?
A. You are! Still.
Educate yourself and, if your doctor is bought and paid off by Big Pharma, get another doctor. (Here's a clue: suits and skirts with sample cases are usually parading through the office.)
8
This is not only Big Pharma, but Big Lawsuits. For example:
Plaintiff's Lawyer: "Doctor, the treatment guidelines, which MUST be obeyed, CLEARLY state that a Hasenpfeffer Ratio of 1.2 means you must proscribe these 5 medications. My client's ratio was 1.21. She died of this multi-cause condition. Why did you not do it?
Doctor: "She's 97, and the likely side-effects would have drastically curtailed her quality of life."
Jury: "The patient's survivors win the lawsuit lottery. The doctor must pay $5 gajillion dollars"
All doctors after that day: Proscribe the pills regardless like Pez.
4
With what is going on in this country, we would all have high blood pressure without the new guidelines........
13
As a pharmacist I say this is good news.......;...job security.
13
What have other countries decided in regards to this? It would be an interesting comparison to see, and valuable in deciding whether the new
Standard is inline with a first world consensus. It is hard to trust American drug companies who are
Killing many with opioids deciding that the vast majority of Americans need what they’re offering.
Science long ago left the stable for Drug Companies. We know that they throw out studies they don’t like. American medicine has at the highest levels replaced science with unbridled greed. So no, one should not trust this, but neither should one ignore it.
Maybe some reporting that was more than of the press release could do the job. Seems like something a newspaper would do with giving context, but that’s probably just crazy talk.
Oh yummy for Big Pharma!! Aided and abetted by their buddy docs and med associations, they stand to make yet another fortune since "half" of us have high blood pressure, according to them. What's next? Will they now have the go-ahead to lower the BP requirements willy-nilly until we're all fainting from lack of proper BP? Sure they will, but then they'll get the imprimatur to force us to buy medication for that specific side effect. There's no end to their glee! I can hear them chuckling all the way to the bank. Shame on all those in the medical field who contribute to this pandering. I was recently told my a doc that I should be taking BP meds because my BP is 120 over 80. Her comment was, "Oh, but the standards have changed." Silly me, here I was thinking that at my grand old age I was doing really well not needing any meds. BTW it's insidious. They start you off with one med, then you end up with another med for the side effects, then another for side effects to the additional med, then another med...ad infinitum. What's the difference between them and drug dealers? Not a thing. They should all be in jail along with those who aid and abet them. Would someone please tell those TV "docs" that nobody takes them seriously? If they were worth their salt, they wouldn't need to be peddling voodoo medicine on TV, would they?
6
Probably a good idea. My SO had systolic blood pressure in the 130s, and ended up with a heart attack. Doing much better now and on beta-blockers for the blood pressure.
2
Exactly how your blood pressure is measured and under what circumstances can significantly impact the outcome, a physician told me. The simple matter of the stress many feel being in a hospital or medical setting can raise the numbers. I use a major health care center that has medical and nursing schools attached but I have yet to have my pressures checked after a "quiet period" of several minutes before the reading is taken. Instead, you plop down and off they go. Also, various departments use different kinds of devices, from the traditional cuff to fully automated machines. My advice is to not panic if your numbers are a bit high under those circumstances.
11
"The nation’s leading heart experts on Monday issued new guidelines for high blood pressure that mean tens of millions more Americans will meet the criteria for the condition..."
Thanks experts! Now tens of millions more Americans will be handed a pre-existing condition. So helpful considering where we're headed with healthcare. Big pharma may not have thought this study thru. You probably can't sell more drugs to an uninsured population.
5
Isn't high blood pressure a result of sickly kidneys? Blood pressure meds merely treat those symptoms and eventually stop working as the kidneys get sicker.
Aren't sickly kidneys are a result of poor diet (not enough potassium and other nutrients) and lack of exercise? Are we really going to get people to do better? I guess it drives up Medicare costs but lowers the Social Security costs. I wonder if that is a wash.
4
I'd like to see what other countries with universal health care have as their model. I know of some instances where blood pressure meds have caused falls (serious in seniors) and kidney disease. Why am I suspect? It doesn't help that this country is in the grip of Big Pharma.
5
This is a great way to write off more people as having existing medical conditions.
6
big pharma lobbyists moved the goalposts closer to market.
8
I agree entirely with the writers below who believe research doctors are being bought by pharmaceuticals. Going on all the time. The companies sponsor drug tests in the university medical colleges and reward the "researchers" for their cooperation. I can't believe much of anything as to what they say they "find" about old drugs or new.
5
I always had a healthy diet, always have been active, however not so long ago I was diagnosed with high blood pressure. I just could not believe it... I did pay attention to the Nutrition tables before but now I start paying even more to breads which I kind of was ignoring before... I was so surprised when I discovered that the bread I usually buy at Whole Foods contains 12 -14 % of Sodium in 1 or 2 slices! I stopped buying their bread. The sodium is in almost everything... If we are talking about hypertension we should as a society talk about the sodium content in our breads, cereals, cheeses, some meats, canned food, juices.. In some ways Food industry is partially responsible for it... We should talk how easy it can be preventable and not how easy to take a pill..
5
Per the results of the online calculator mentioned in the article, I have a low risk (1.2%) of having an event. HOWEVER, also per this calculator, my blood pressure of 120/70 is elevated and I should see my physician soon. Seriously?
10
"Simply being age 65 or older brings a 10 percent risk of cardiovascular trouble, and so effectively everyone over that age will have to shoot for the new target."
This is a strange social mandate. Wondering if the lifestyles of the cohort that was studied to collect this 10% data mark reflect a spectrum of lifestyles or anything like what a doctor would consider healthy? For example what percentage of the study came from areas of the country where there is more smoking and large portions of fried foods are a dietary staple?
5
Quite frankly, if you want to lower the blood pressure of the greatest number of Americans, quickly remove Trump from office.
33
These guidelines are promulgated by corrupt physician committees who are paid stooges of the pharmaceutical industry.
16
And disease creep continues. I recall the Cochrane review which reported no benefit from lowering blood pressure to less than 140/90, and several problems with side effects. Some doctors at the time dismissed it, one saying, "We won't change prescribing guidelines because of a single study." I recall thinking that I'd bet they would be happy to change prescribing guidelines if that study had leaned toward more meds. Here we have a single study which contradicts mounds of evidence to the contrary, and prescribing guidelines have been changed. What a surprise.
12
Maybe the BP baseline is being changed because this administration is rising the BP of millions of its citizens. Perhaps the President is trying to control those poll numbers too!
6
Too many people here see a conspiracy in everything, it is big pharma or the insurance companies trying to create people with preexisting conditions et al. The fact is that most Americans are overweight and they have lousy diets and they don't exercise. If you check all the boxes above, the easy way out is to take a pill a day. Sure it makes you feel like a patient, but that is exactly what you are, not a healthy person. Most of the major blood pressure medicines are off patent so big Pharma is not exactly enamored with Blood Pressure. The fact is that high Blood Pressure is a warning sign and it is up to you how to react. You can do nothing and may live to regret it or be one of the ones that beat the odds, smokers do that every day, but sometimes their luck runs out.
4
As someone who has been treated for hypertension for five years now, I find the hysteria over this article both amusing and distressing. Even though I am thin, run 40 miles a week and have a vegan diet, I still have hypertension so it is not all about life style changes. I take a generic hypertension drug that costs me less then $5/month. My biggest expense is the six month visit to my doctor which costs me about $200 with the high deductible plan I have.
Instead of getting worked up over these articles and blaming the medical/pharmaceutical complex for hatching a plot to take more of your money, stay informed about your health. I know it is hard, but find a doctor that you can develop a good relationship with; especially as you enter middle age. Hypertension is common and the cost to treat and control it is insignificant to the cost of having a stroke.
9
If you truly are "...running 40 miles a week and have a vegan diet," I suggest you see another doctor. You're being taken for a run.
5
I am a family doctor and I am concerned about these new guidelines for several reasons.
The people who created them are saying that the guidelines have not been updated since 2003, however an updated version of the guidelines, which set the standard at 140/90 and was known as JNC-8 came out in 2014. Why would the American Heart Association and the American College of Cardiology be misleading about this?
The 2014 updated guidelines were widely accepted and provided evidence based recommendations on the approach to treatment. What new evidence is available that say the 130/80 standard is better for patients?
How much longer can an individual expect to live if their blood pressure is 130/80 vs 140/90? What medication side effects come with that increased longevity? How many people would need to be treated for 1 individual to experience the benefit of treatment? (the Number Needed to Treat) How many people will experience negative effects from this more aggressive treatment?
With this more aggressive target, I expect more prescriptions to be written and, as I've seen in the comments thus far, I will sadly continue to see trust in the medical profession erode.
45
As a family doctor, I assume you have the freedom to discuss these issues with your patients and write prescriptions when both of you agree that they are needed balancing that need against potential side effects.
Thanks for doing your part to uphold trust in the medical profession.
3
Hi Travis
The JNC-8 committee split, ceased to exist, and a group of them published a non-consensus recommendation. It was not adopted by NHLBI.
The new evidence is the SPRINT trial - which showed compelling evidence for treating to lower targets in higher risk patients.
The increased CV risk from 130/80 to 140/90 is about double. More supporting data is available in the guideline document.
The guideline does not call for medication therapy below 140/90, unless there are multiple risk factors. It does call for diet and lifestyle changes.
You would not know any of this by reading this comments section! Again, the guideline is published and free to download for anyone who wants the facts.
3
Wonder how much it cost the pharmaceutical industry to convince them to lower the "high" blood pressure numbers? How many more people will be paying for blood pressure medicine?
8
As people age, keeping BPs too low can contribute to orthostatic hypotension--sudden lowering of pressure when rising from a sitting or lying position. Falls are frequently the precipitating event for rapid decline in the elderly. My 6'2" father's BP medication kept his pressures 105/55 at 77. He fell after standing up, breaking a hip, then declining in rapid order from independence to needing assistance to requiring full care to death.
One size does not fit all.
31
105/55 is the BP I had after being thrown and dragged by a horse. I felt weak and woozy until my BP went up again. Your father must have felt the same way.
3
No they don't "need" to do anything, it might be a good idea. You "need" to pay your taxes there is no law about how you manage your health care, and hopefully you never will.
3
It is all in the measurement. I have my own digital machine and I can get any number I want depending on the time of the day, my activity level and the number of readings I do. Even when I sit for the recommended five minutes, which you never get to do in the doctor's office, the readings vary all over the place. So to me 140 is no different from 130. And remember it wasn't that many years ago when systolic wasn't even a concern it was only the diastolic that mattered.
8
The guidelines call for self-measured blood pressure and the use of averaged blood pressure over time to make a proper diagnosis or treatment decisions. Again, I get the feeling nobody wants to read the actual guidelines. Too bad!
1
Regarding the hilarious argument that pharmaceuticals don't have skin in this game: $4/day/week/or even a month x 103 million patients is quite a surfeit of tasty profits.
Regarding the kind of horrors that high blood pressure visit upon one, such as kidney failure and loss of vision, this is a result of much, much higher blood pressure than 140/90. Scare tactics.
The point of most of these comments is not that high blood pressure is something to be ignored, but that the guidelines are set so artificially low that the ultimate overall effect will do more harm than good--starting with the absurdity that half of Americans now have a disease they didn't have the day before, not because their blood pressure is higher but because the goal posts have been moved.
Finally, when I read these comments, I hardly get the idea that these new guidelines are by themselves lowering blood pressure. Quite the contrary, in fact.
18
Which big pharma company is behind this one? Who's paying for the research? Maybe the cardiologists will start reselling the drugs themselves like the oncologists. 100% of Americans are going to die of something.
5
Why do Americans need to take more pills? Why not cut Big Pharma off at the knees by losing 25 pounds and exercising? This I will never understand.
9
No need and of course one is way easier than the other. And your doctor usually indicates that loosing weight and exercising are to be done first if you will or can.
Three quarters in the US have high blood pressure since 2016 election.
There, fixed it for you.
21
Deja-cholesterol.
4
Shut up and take your pills like we tell you. We'll worry about your *access* to dialysis at a later date. We're working on drugs to ameliorate the side effects of this drug so you may not need it. It's a win, win! For us.
6
Take another PILL, America! Go Pharma and the colluders at FDA and CDC! Can't wait to hear how much these urgently-needed high blood pressure tabs are going to cost. And, yes, to the previous comment about the damage the heart organizations will do to those of us struggling to pay for medical insurance and now, suddenly, have to explain a brand-spanking new (out of nowhere, truly) preexisiting condition. Shame on you, wreaking all of this havoc and damage. May your actions be met with misfortune. Terrible, terrible corruption roils through your medical industry right now--and these crimes lie at your doorstep. Do something about it. Do something about: too many vaccines; conjured and exaggerated conditions that undermine children and ruin peoples' lives; and a drug for everything. You are not being good nor is this a cautious step. Ask yourselves, "Why? Why this? Why now?"
5
Or don't take the pill. Weight loss, exercise, and diet seem to have some effects on blood pressure.
1
Getting trump and his minions out of the WH will lower the blood pressure of many of us!
20
Big Pharma's newest money making venture reminiscent of having everyone on cholesterol drugs.
8
"Doctors reported today that saliva . . . causes stomach cancer, but only if swallowed in small amounts over a long period of time." - George Carlin, 1973
If doctors, who are paid by drug companies to do certain things all the time, redefine "normal" so as to make half of the population "abnormal", I think they need to restore their credibility by re-acquainting themselves with the definition of the word "normal".
11
Thanks for the chuckles, Mtnman. That Carlin quote was spot on. I do miss his honest appraisal of cultural "mores."
3
The greed of the AMA and big pharma knows no bounds. What do you call an entity that is willing to hurt people's health with drugs for profit? Sociopathic.
My high blood pressure went away 25 years ago after changing my diet to natural and authentic foods i.e. no processed food. Corporate America which includes healthcare, big pharma, politics, the processed food industry, big tobacco, the chemical companies and the junk food industry are all in the business for their own self interests and that revolves around money and power. They don't care about the good of the citizens, the health of the planet or the well being of humanity. This numbers ploy with high blood pressure is just one more sign of how low people will go to manipulate society for their own benefit. The ama wants customers, they don't want people healed of these problems in fact the AMA will sue you to shut down your evidence if you come up with a cure for anything. These are sick people.
8
Doesn't this sound like the cholesterol alarm several years ago? If your reading is over 200...or heck even 195...you should be on statins. Collusion with the Big Pharma industry?
7
Actually, more recently they claim that everybody should be taking statins regardless of cholesterol levels. They really do believe we're that dumb.
3
After reading the scary events described in the headlines in today's Times, I am not surprised that half of Americans have high blood pressure!
4
Sounds to me like and excuse for people to buy more drugs.
America has truly become the Ferengi Alliance.
5
Big pharma strikes again. No increase in the rate of heart attacks and yet....
2
"Indication creep"? And - if my BP's up a little, at least I know my brain's adequately perfused.
2
More lies from the medical-industrial complex designed to increase their profits.
5
Great---even more money for big pharma.
3
Why blame pharma for the news that the AHA has finally acknowledged the outcome of a study that clearly showed increased survival of individuals with lower blood pressure? Most BP lowering drugs are generics and inexpensive. There doesn't appear to be a huge profit in this for big pharma. And why not point a finger instead at big food for loading our diet with unnecessary salt? If you can get to target zones with exercise and diet, go for it. If you can't, a pill is better than death. Those darned pharma companies have invented vaccines, pills and chemo drugs that have saved millions from premature death. Let's vilify them as a reward! It goes well with our current inverted value system here in the USA!
3
Big Food's sins in this country don't cancel Big Pharma's sins. Your comment would seem to infer that those of us expressing our skepticism toward the latter are totally naïve of, even indulgent toward, the former. That's a fallacious argument.
Another money making idea from drug companies everywhere.
3
Let's undermine people's confidence in medical science. Shall we?
Lower the numbers that qualify for hypertension so that people take medicines with dangerous long term side effects.
Now you blood presure is down to 130/80 and you take blood pressure medicine for ten to twenty years, and your kidneys or your liver fail as a side effect from the blood pressure medicine, alhough your previous pressure of 140/90, you could have lived with until you were over 100.
Absolute nonsense likely to undermine confidence in medical science.
5
This is another example of big pharmas influence on our daily lives ! Troubling that on their quest to achieve the perfect bp number MDs will put some patients on higher doses or several bp meds risking falls, other side effects and kidney damage . What is more expensive? No brainer here continued care for someone who has had a heart attack or a sentence of life long dependence on dialysis (which is very costly) and a shortened life span with no quality of life. Disgusting intrusion under the guise of we know better and it's for your own good!
3
You don't have to take the drugs if you don't want to. Our country is far from perfect, but at least one can't be forced to take drugs they don't want to.
1
@ JTCheek, You must not be on medicare and their guidelines obviously. And yes you don't have to take drugs if you don't want to but there are plenty of elderly that are prescribed unnecessary drugs and I'm not disparaging our country,
1
I consider American Heart Association and American College of Cardiology are nothing more than labor unions. They want to enhance the revenue of cardiologists. Remember the days that they use to advocate visit Doctor once a year, now they say go see the doctor when you are sick, just plain commonsense. Just practice healthy living and stay away from the doctor, unless you are sick.
3
And with trumpcare next year, if u don't meet the new guidelines you will have a preexisting condition - but not to worry, they won't be able to deny you insurance, because how would they make money? They'll just double your premium for every 10 points over.
1
Gotta love those "new guidelines". Ka-ching, Ka-ching. More $$ into Big Pharma's pockets. One of the amazing things here is that so far, every commenter I've read feels the same as I do about this. Doesn't it remind you of the time (just a few years ago) when They suddenly announced that most Americans over a certain age needs to be on a statin. One day they didn't and the next day they did.
Such a business! Need more revenue? Let's just move the 'goal posts' so we can scoop up more non-discerning customers and their harried prescribers. So simple. Ka-ching, ka-ching.
Just say no!
5
Right! Don't take the meds recommended by your physcian. Let's stick it to big pharma!
1
NYT needs to stop pandering to conventional US medicine which, in most cases, seeks only to create more illnesses and required drugs to treat them.
A look at US mortality/morbidity and healthcare financials compared to other first world countries undeniably shows our system is not about public health but about money.
NYT needs to cover all branches of healthcare, not just those involving drugs, surgery or poisoning (radiation, chemotherapy).
3
Only half? I confess I'm surprised. I would have thought it should be closer to 90 to 95%, given our mainstream eating habits - SALT SALT SALT AND MORE SALT; FAT FAT FAT AND MORE FAT, ad nauseam.
1
Some number of years ago, I think at least ten, I learned from my primary about a medical syndrome known as "white coat anxiety." The victim of this psychological malady is so worried he or she has high blood pressure just the thought of having one's BP taken causes the systolic pressure reading to rise, often falsely indicating hypertension. My then doc learned of this condition while doing his residency at a Los Angeles hospital. He asserted that many people suffering WCA are taking medication they don't need. Sorry, I can't cite the study or the hospital, but I believe the condition is well documented. I was so concerned not to be falsely diagnosed that I purchased my own sphygmomanometer and use it conscientiously every time I expect to visit my current provider, since his nurse always takes my BP. I suffer from WCA. My BP when I take it shortly after rising in the AM averages 118/70 and my resting pulse rate is typically 54-58 (I'm an interval runner: uphill fast walking followed by sprinting on my treadmill) while when my nurse takes it, it can be 140/80 or even as high as 150/85 the day I was expecting to receive bad news. We joke about WCA and I always give her the three BP readings I took that very morning. She dutifully ads them to my medical history. Articles such as this one, though useful and informative, lead inevitably to WCA in some. Just how many I can't say.
6
Most doctor's offices do a bad job of taking blood pressure.
5
So, no mention of the primary cause of all this increased blood pressure, which, by the way, is not found in indigenous hunter-gatherer clans living in their traditional environments and according to their traditional life-ways. In fact these H-G peoples have NONE of our diseases of civilization. Thus, as we all have essentially the same genes, the cause must be environmental, what I have coined "population density stressors". Stress reduction is impossible if we choose to continue our current high stress life-ways and all of our "diseases of civilization" are increasing dramatically. We already consume 4.3 billion Rx per year, which is enough for every man, woman, and child for all but one month of the year. Population density stress is the underlying cause of ALL of our health problems and the only solution is voluntary one-child families to bring down our numbers, as well as reducing our consumption of non-renewable natural resources in the wealthy Western world. How much more are we willing to spend in fending off these killer diseases before we face the real problem? I'm a retired physician. Stress R Us.
4
The problem with the one child families, you recommend, is that there will be no one to care for our elderly. The one child might not even survive or if he does have the burden of parental care he/she have no one to share the load.
1
When I go to my doctor, the nurse straps on the blood pressure cuff with me sitting down. The readings generally come in as around 145/80. She will try a second time and still get a similar (or slightly higher) reading. Then she asks me to stand up and takes the readings again and this time I might come in at 135/78. She congratulates me and records the lowest reading on my record. We joke about this subterfuge to get the BP readings into what must be the "approved" zone for the doctor to see.
Just to see what happens, I have tried taking a micro dose of marijuana (estimated by knowledgeable friends as being less than 1 mg equivalent THC) an hour before my doctors visit. My blood pressure is then typically 120/70 and the nurse is delighted! Absolutely no symptoms of the old college experiences of being high.
4
According to the article, the study in question focused on systolic readings. What then is the basis for lowering the recommended diastolic level?
1
This change will only add to MORE confusion to things related to cardiology , including, but not limited to:
1. Blood pressure - So if a non-diabetic person has a resting BP of 132/82, does this person now need BP meds...
2. cholesterol levels - what's the most important number: HDL, LDL, trigelcerides?....I can probably find different articles that will say different things...
3. Calcium scoring - This one takes the cake.....There is so much confusion on this one your head will spin.....While a ZERO score is clearly best, what is impact of low scores?....And what is a low score < 10, <100, etc?....
I'm sure the cardiology community means well, but they sure know how to confuse people.....
2
I am astounded at the number of seniors with high blood pressure I see who still eat , per person, half a pizza several times a month, eat salami and lunch meat, consume the regular high salt popular soup brands.
The denial of how much excess salt is in prepared foods is astounding.
5
Given that a good number of us will work until we die, stoking out sooner may not be such a bad thing; we’ll finally get to retire.
3
What happen? big PHARMA found someone not on their drugs? It reminds me of the announcement of the bmi which changed the definition of normal weight to overweight in a day. One day you are okay and the next with no change in your weight you are fat. I am happy to see so much skepticism in the comments to the article.
10
Dust off and lubricate the old stationary bike. Take a hike. Biggest take from this article is the danger to other organs from increased dosages for newly defined hypertension. Same thing was done with cholesterol several years ago. What are the benefits of increased levels of medication for that? Don't mean to sound cynical, but the drug culture directed at us baby boomers continues, now from corporate funded MDs in lab coats rather than sleazy guys in surplus army fatigue jackets. Turn on, tune in, and drop dead.
2
Snake oil salesmen all.
The trust towards doctors and all medical providers is deteriorating with types of guidelines. And next week it will be something else.
It's bad, it's good, no now it's bad for you again. Don't drink, smoke or eat anything at all. Consume rice cakes and water only.
Can't we acknowledge the fact that we all age, then we wear down and out and eventually die?
We can't all be octogenarian tri-athletes either.
7
If you just eat rice cakes and water you won't get enough fiber.
2
Great, now another reason to see a doctor that so many people still can't afford to do!
5
Who are these so-called "leading heart experts?" On the pharmaceutical industries payrolls by any chance? Several years ago the independent medical research org. - The Cochrane Collaborative, published a meta-study that demonstrated that for otherwise healthy individuals (not obese, diabetic, etc) older people could have regular BP readings of up to 160-100 without impacting their longevity. The blood pressure racket, whereby doctors prescribe 3-5 meds daily to keep you at 130-80, also makes you feel low-energy and lethargicl. I've decided to go with a higher BP reading and enjoy my remaining life.
10
Sounds like a big Pharma conspiracy to me folks!
Last Friday at the GP's office my blood pressure was 140/90 then 130/90 and finally 110/80. At the eye doctor's it was 104/ 78.
Clearly I have white coat syndrome!
4
Lowering the scale is a great way to expand the potential customer base and sell more product -drugs to Americans
Just another way to increase profits
2
As patients/consumers we need to check additional items (in regards to potential conflict of interests). Research the history of those who sit on the panel making this recommendation....how many have been on PHARMA advisory boards, have research funded by pharmaceutical companies, and/or have been compensated by same for one effort or another, etc.?
7
Score another one for the Pfizer drug company. Take a look at this article from 2005, referring to the previous lowering of the standards for hypertension:
https://www.seattletimes.com/seattle-news/health/new-blood-pressure-guid...
As long as the medical industrial complex is based on signifcant profits, the credibility of studies such as this one will be questionable.
13
Whatever happened to promoting a healthier diet and exercise instead of creating new guidelines and promoting pills? These new guidelines will place millions into the risk category and the beneficiaries are the pharmaceutical companies. Adding insult to injury are the risks of using these drugs and damaging the kidneys. How backwards and insane is that?
The pharmaceutical companies do a great job marketing their drugs to the public with their never ending drug commercials. How wonderful it would be if these commercials were replaced with commercials on healthy diets, exercise and managing one’s health.
9
For many people, such as myself, diet and exercise could not lower BP to acceptable numbers. While I continue watching diet and exercising, I take a minimal dosage of BP med, and it does the trick.
11
AAF, could you describe "managing one's health" in greater detail? Certain types of diets (DASH, Mediterranean) and exercise have been shown to provide robust improvements in blood pressure. I'm interested to learn what other options you are aware of.
The guideline calls out lifestyle and diet changes as a first line recommendation for Stage 1 hypertension. It does not recommend these patients be put on medication. Please read the guideline and then offer input.
1
This is actually good news for millions of Americans. High blood pressure causes thousands of deaths, strokes, heart attacks, heart failure, kidney failure, loss of eyesight and hospitalizations each year. Almost half of all Americans have high blood pressure and most of those people have uncontrolled high blood pressure.
All in all, this means that high blood pressure is quite bad.
A large body of research has proven that lowering blood pressure is beneficial. This research is highlighted by the SPRINT trial, a federally funded research program that demonstrated a blood pressure goal of <120/80 prevents more badness than a goal of <140/90.
The fact that independent heart and blood vessel societies are now advocating for and putting their weight behind a lower blood pressure goal means better health for all of us.
Large pharmaceutical companies have no skin in this game. All high blood pressure medications are generic and $4 at most pharmacies. High blood pressure is not profitable and for researchers it is not sexy like genomics. The only reason guidelines such as these exist is to help people with high blood pressure.
Certainly, controlling high blood pressure is neither easy nor fun. But it is beneficial. We all take part in plenty of other things that are good for us but time-consuming, such as working long hours or volunteering, because we know that these things are beneficial in the long run. It's time that we consider our high blood pressure in the same category.
6
What concerns me is that there are equally compelling studies showing that anti-hypertensive drug treatment for those with mild stage one hypertension has NOT been demonstrated to reduce mortality or morbidity. See the link to the 2012 study regarding this topic. Perhaps more research has transpired in the intervening seven years that has shifted consensus? It is hard for lay people to make sense of the ever shifting sands of medical research. http://www.cochrane.org/CD006742/HTN_benefits-of-antihypertensive-drugs-...
2
Say 10 million patients x $50/year - $500 million. Not exactly chump change for almost no effort.
1
This decision is based on a flawed and discredited study, which was discontinued before it had achieved its original objectives. Clearly, this is a victory for big pharma. It is amazing how this administration persistently works against our common good.
3
Recommend plant-based diet and exercise.
6
There is also evidence that using pot helps.
1
Studies show that a vegan diet does not do much for BP. On the other hand an Atkins/Keto diet does wonders. Absolutely no need for drugs.
If Trump names former Eli Lilly executive Alex Azar to be Secretary of the U.S. Department of Health and Human Services, we will have yet another fox guarding yet another hen house. Trump repeatedly chooses to fill government department head positions with executives from industries that stand to benefit most from their leadership, and this is a prime example. The nod is given to improving lifestyle choices, but it's really going to mean "open wide and take more meds."
15
More good news for big pharma and a reason for them to sell more drugs and make more money. I suppose they lobbied for this change or provided the research money behind it. Of course they don't say that almost any medication, including bp meds have side effects, but oh they have another drug for those side effects... Big medicine does not look at each person individually but only looks at averages. Medicine and doctors are now being trained by the pharmaceutical industry as a marketing ploy.
3
The WHO has a slightly higher levels with much more flexibility in treatment. What these guidelines seem to absolutely require is taking drugs. I have to agree with the comments that this all about drug companies making money. You can see it in the number of vaccines that are now being pushed by retail pharmacies. Blood pressure seems to vary based on any number of slight changes in person, their age, the immediate environment, their exercise level, etc. It should never be taken once, a moment in time, like in a noises doctor's office. Establishing guidelines without any flexibility seems to ensure that drug companies will make money, and of course, physicians will get their kickbacks. I would recommend that people make their own judgements and avoid physicians that push drugs, and make sure it's taken over a long period of time before you get forced to take drugs.
The only thing this new declaration will create is a windfall for the pharmaceutical companies. It would be interesting to see who finances both the American Heart Associations and the American College of Cardiology, for no doubt both of them have associations with big pharma and the industrial food complex.
Please forgive my cynicism, but both groups have a vested interest in supporting the status quo. Not to solve this problem.
What they should be talking about is how the American lifestyle is poisoning us and creating the conditions for Metabolic Syndrome, which is the root cause for diabetes, hypertension and a host of other related diseased.
Providing us with a pill will not solve this epidemic. Providing people with the guidance and tools to make healthier choices will be far more helpful that just declaring a larger portion of America ill. Walk through any mall in America, and it is obvious that we are in the middle of an epidemic that needs to be attacked, not by pills, but by exercise and greatly reducing our sugar intake.
And as a byproduct do much to keep down the rapidly growing healthcare costs in this country.
3
The guideline recommends diet and exercise and only medication after those regimes have failed, or for stage 2 hypertension. Please check out the actual guideline before condemning it. Get the facts, THEN put out an opinion.
1
Diet and exercise are the key, but most will turn to a pharmaceutical solution for a faster and easier result.
Watch the stock market for a surge in pharmaceutical companies that make A.C.E. Inhibitors, Beta Blockers, Statins, etc..
As the article mentions, the heart benefits of bringing down blood pressure will often be offset by kidney damage.
Ultimately, health in the United States is driven by money first and foremost. That’s why we spend far more on health per capita than any other nation in the world, yet our results are nowhere near the top.
An ounce of prevention is worth a pound of cure. Exercise and diet are the only legitimate long term solution, yet programs to focus on them, are routinely mocked (Michele Obama’s scholastic diet program).
It’s just not as profitable to prevent disease as to market and sell designer drugs to consumers.
78
I didn't see anything in the article saying that high cholesterol causes high blood pressure, so there should be no increased use of statins to lower blood pressure. So, too with A.C.E. inhibitors, beta blockers or other random drugs. Cutting salt, maybe, but many of us already have, so Morton's stock shouldn't go down. High health costs are largely caused by medical insurance admin costs, doctors, hospitals and others gaming the system, Congress blocking Medicare from negotiating prices with drug makers, and if you really want some granular analysis, read the book "An American Sickness". What I do agree with is that articles like this should include include good analysis on the reasons blood pressure is up in the first place, which this one doesn't do, or even link to, and provide other insight on the preventive side.
1
They are all generic. No one promotes them. They cost pennies a day.
Please note that the way that levels of risk are being calculated here, as I found when clicking to the short quiz about one’s cholesterol and blood pressure, depends almost entirely on age and somewhat on gender.
It states in the article that simply being over 65 puts you in the high-risk category. When I tested this, it was frighteningly true. In other words with the same numbers at age 64 or at age 71, where my husband and I are now, we go from low risk to high-risk. (I tested this by in putting our current actual numbers with the younger age and by changing the gender listed for my husband, which changed his risk level from low to very high.)
Really what has changed is not the lab test numbers but our age—which is not something we can influence. In effect, this means that as we cross the invisible barrier of 65 years, suddenly all of these measurements would need to decrease dramatically in order for us to remain at the same level of risk. This seems highly likely to simply make older people anxious and worried about their health rather than to contribute to them being healthy.
I choose to post this comment because I don’t see this issue being addressed in the comments, nor in the article.
10
It's a conundrum. I am 59 and have had hypertension since my twenties. I suffered many years of severe dizzy spells, nystagmus and one crossed eyes. In 1996 moving to Savannah Ga a kindly old fashioned doc suspected I had hypertension because my readings were always elevated whenever I saw him. He put me on Zestril (now generic Lisinopril) 20mg and all the problems ceased. The medication is free and my blood pressure has been a model ever since.
I'm 5' 9" 160LBS no fat, long distance runner/gym workouts/swimming/no drinking or soda/ watch sugar and salt etc eat whole foods no meats. But if I stop the medication my BP will spike within 48 hours. Nobody has an answer why.
3
My BP fluctuates significantly during a day even though I try to keep the measurement conditions fairly consistent. Average BP? Average of what?
In the report, is there any definitive BP measurement procedure which GOES WITH the recommended BP such as 130/80 or 140/90? Without that, it seems pretty meaningless to come up with any specific recommended single set of BP. Even I would say pretty UNSCIENTIFIC!
7
i have been an ER nurse for 30 years. and as an earlier commenter stated: it is the methodology.
bp cuffs are sized for arm size. arms should be uncovered, if a reading seems too high or low i always retake it a bit later, and i check the other arm. i would say that MOST of the time, the first reading in not indicative of the patient's actual blood pressure.
the new guidelines are suspicious, especially if the person taking and recording bp readings are not nuanced in the procedure.
25
What difference is noted in your experience when BP is taken digitally VS the older manual method?
My results always always are significantly higher on digital monitors.
Thanks if you can respond!
1
Great comments about proper BP measurement. These issues are addressed in the new guideline - a big improvement over the last guideline published way back in 2003 (JNC7). For those who have time, it is always beneficial to read the source material before forming an opinion. To read the actual guideline recommendations, go here:
http://hyper.ahajournals.org/content/early/2017/11/10/HYP.0000000000000065
1
"If there is any good news here it is that most of the drugs used to treat blood pressure are generic." The concomitant observation is that, in order to be prescribed these medications, a patient must be under the regular care of a physician, requiring frequent office visits. Therefore, lowering the standards for diagnosis just created countless new patients, especially those with good insurance, for a medical practice's business model to milk for payment. The same thing happened some years ago for the diagnosing standard of diabetes. Thousands of new paying patients (indeed, perhaps hundreds of thousands) were created instantly, though they were no more ill than they were before. And all the scary news articles about these "findings" eventually generate the public' skepticism about medical research.
12
I went to see a new doctor after relocating to another state because of a health scare related to moving stress. I spent more than 30 minutes in an overcrowded waiting room, then walked several hallways with the nurse to an examination room where she slapped a cuff on my arm the moment I sat down. I was already anxious from the wait and the reason for my visit, and my blood pressure was just over 130 over 80. It is normally under 110 over 65. This doctor ordered all kinds of blood tests for my health scare and commented on my high blood pressure. I went back 2 weeks later for a follow up and the nurse again slapped the cuff on just as I sat down. On this day the reading was 122 over 76, but the doctor suggested that since my blood pressure was "elevated", he needed to keep a close watch on it. All of my blood work was normal and I said my blood pressure is fine and I left and will never return to that doctor. Don't doctors and their staff know to let a patient sit quietly for a minute or two before they slap the cuff on? Or are some doctors actively seeking blood pressure patients? I wonder if some patients are needlessly on blood pressure medication because of hastily taken readings.
36
On days when my blood pressure was high, my doctor always took my blood pressure again later during the visit, when I'd had time to relax. It was always good then. He has retired and I will have a new primary care doctor. If necessary, I will tell him to follow that procedure. I don't need BP meds and have no intention of starting to take them because I got a high reading from being stressed.
6
Patients are indeed, needlessly taking all sorts of medication because they say ok instead of "none for me thanks" or "let's wait six months and see if my life-syley changes don't make a difference."
It's hard for so many to question authority, especially when it presents itself in white coat. But question we must.
3
Yes, blood pressure is very poorly measured in usual care. The situation is terrible.
This is borne out in many clinical trials. This issue is addressed in detail in the new guidelines, which incorporate self-measured blood pressure and call for using only well-validated devices in diagnosis and follow up. You would not know it from this comment section! It's too bad the article could not cover all the issues addressed in the guideline publication. It's available free online for those wishing to read it, and it is a big step forward for promoting quality care in hypertension.
So the goalposts just got moved - in order to accomplish what? This is not a call to improve health. It is a guarantee of higher revenues for health insurance conglomerates and pharmaceutical companies.
I am skeptical at best and contend that the underlying causes for higher blood pressure are many, and are frequently from the sedentary lives and poor foods that are pervasive in our society.
14
A significant step in the WRONG direction. If you have a 10 pct probability of heart failure above 130/80, then 90 pct do NOT need to have treatment. But because numbers are easy targets, a large number of people will be over-treated. It is a waste of resources, and a significant percentage may suffer from debilitating side effects from the treatment they do not need.
16
My husband just received a letter from our health ins. provider that his hypertension program, which he itilized for six hrs, would be discontinued as of 2018. No reason was given. This program provided free generic meds for BP, zero copay during dr. appts related to BP and a healthcare coach phone call four times a year. We saw this as a very helpful perk in proactive care. Reading this article makes me believe the onslaught of new candidates for such a program would have quickly created a cost issue my ins. co. was no longer willing to carry. I wish they had considered a copay specific to the program rather than cancel it. I sure as heck hope there is a critical basis for changing the BP baseline with plans to offer a new program soon because people like my husband are trying to be forward thinking about their health and appreciated the program that addressed it.
4
I am a metrologist - a scientist that studies how to make measurements.
A sphygmomanometer applies air pressure to your arm sufficient to stop blood flow in a major artery. By releasing the pressure, the nurse, doctor or computer detects the point where the pulse again gets past the cuff. The air is released until the cuff no longer affects the blood flow.
The signal is your artery, buried under skin, muscle and fat, causing pressure fluctuations in a fairly large air bladder. It is read as a twitch in a needle (or electronic pressure transducer for automated systems). The accuracy of this system is about +/- 10 mm of Hg, and depends on:
the size of the cuff, it's placement on the arm, how hard it's strapped on, whether the patent is anxious (white coat high blood pressure), exerting to lift the arm, squeezing their fist in response to the discomfort, have taken medicines that elevate blood pressure, whether they've had coffee that morning . . . .
In other words, the doctors on this esteemed panel don't seem to realize that, because of the inherent inaccuracy of their measurements, 130/80 and 140/90 are quite often THE SAME EXACT CONDITION.
197
They can give precise guidelines, just not accurate ones...
1
Thank you for this analysis! My BP fluctuates a lot at different offices, different times of day, if I’d had caffeine, and most especially on different monitors. The digital ones always measure a significantly higher BP than the manual ones.
3
And because doctors are obscenely numbers-driven, once you get a couple of sloppy measurements in your record, you are dubbed "elevated BP" for all time - never to be revisited, always to be medicated.
4
I, like many other commenters, think the big pharma companies must need some new revenue. They are worried about the future of their huge profits. The biggest irony is that many in our federal government don't think there is any issue at all with the cost of staying healthy in this country. This will just be more medicine that so many people cannot afford.
19
Hate to be so jaded, but Mary, that thought was exactly what crossed my mind as I read this article!
2
Looking at the comments here I see a consistent theme that that this is all a Pharma conspiracy. Skepticism of Pharma is not a bad thing. However, in this case it doesn't hold up. There are almost no medications still on patent for blood pressure lowering - nearly all are generic. As the article stated, most people treated for BP pay literally pennies per day for their treatment. The data from the SPRINT trial are not fudged or invented by big pharma - in fact big pharma is not too concerned about Blood Pressure - there are no profits in it. If you want to understand why this guideline came about, or how many strokes/heart attacks can be prevented, google "Sprint blood pressure trial". The evidence is strong - be careful throwing around conspiracy theories. Don't kid yourselves, hypertension kills.
12
There would be fewer conspiracy theories if we didn't now have an epidemic of opioid abuse arising from inappropriate use fostered by Pharma and a generation of Science Times writers and Physicians fooled by Pharma. I recall reading NYT support for better, stronger pain treatment that came right out of Pharma land. Hey, fooled this reader too!
There would also be fewer conspiracy theories if science writers routinely detailed who funded the "science." In a setting in which only "positive" results are published, we are all left to wonder about the studies that differed.
If all studies were triple blind -- funding was blind to grantees, meds were blind to doctor and patient - then we could have some faith. If you routinely reported on the research history and funding history of the "experts" making policy, we could have faith. Are drug researchers or clinicians better at determining what works with patients? Who funded the cardiologists who head the groups supporting this change? Is their research above suspicion?
There should be more science in the science and more evidence in the reporting.
10
@Joseph: You are right that the meds are cheap - but the side effects from BP meds are very real. Worse, defining people into a "disease" condition by moving the goalposts this way will result in MANY more people being labeled as having a "pre-existing condition" - and if you know anything about American health insurance coverage, you know what that means: people who will NOT be able to get coverage, or who will have to pay far more to get coverage. THAT is a conspiracy all on its own, IMO.
People have very good reason to look upon these new "guidelines" with skepticism!
7
I'm having serious doubts about the calculator recommended in the article. I entered the requested info, and got back a page saying that I was at high risk of a heart attack or stroke, and should see my doctor immediately. However, below the scary scale at the top, I saw something saying that my blood pressure was completely normal, and telling me "Good Job!" Since my cholesterol levels have always been great, and those were the only numbers I entered, other than blood pressure levels, this thing doesn't make any sense.
6
Another money-making idea by doctors. More people will need to undergo profitable procedures done by doctors. More drug companies will be able to push their blood pressure medications.
Everyone wins, but the patients.
24
The federal study indicates a reduction is possible with the new guidelines, and do not explain the situation for participants well. This is broad brush science with very limited context. Not impressed.
3
Unfortunately we can no longer look at any new government guidelines without wondering how much big business (in this case big Pharma) has lobbied to push regulations that will lead to more drug use. So now millions more Americans will be told that they need medications. And who is going to pay for those? Without insurance and drug coverage, those most in need (if indeed they are in need of medications) will be forced to pay high prices for unregulated drugs. And future insurance will be higher due to 'pre-existing conditions.' At this point, I have to wonder if the new guidelines are just another 'game' being played by the Trump millionaires' club to impoverish even more Americans.
41
I have essential hypertension. I was diagnosed at 21 and have tried everything - weight loss, exercise, diet, no sodium - to reduce my blood pressure. At 53 I'm on a three pill a day regimen that keeps my blood pressure between 125/72 and 138/86. My risk of a heart attack is less than 5%. I am extremely adherent after working closely with my cardiologist to develop a regimen that works for my life. Recommendations such as these don't look at the complete picture of the people they will affect and are destined to fail. Until we encourage everyone to develop a relationship/partnership with their health care team, we will not achieve optimum control of blood pressure or anything else. Until we make sure that everyone has a health care team, we will not achieve optimum control of any chronic conditions. The study mentions risk to kidney health - are we going to have more people on dialysis now, too?
11
What's a health care team? My doctors are like the three blind men and the elephant.
1
Reading the collection of comments to the article is enlightening. Obviously there is a great deal of initial cynicism in response to this study, and it's not hard to understand why. So many measurements of what is considered healthy seem to change periodically, and we all know that pharmaceutical companies and the medical profession generally profits from them. As a result, it is difficult to credit studies like this as being completely objective, even when undertaken by the American Hearth Association. How can a typical reader trust these reports?
26
Read Carl Elliott's book: "White Coat, Black Hat: Adventures on the Dark Side of Medicine" and it will be easy; you won't have to worry about trusting those reports because you simply won't.
What I don't understand is why we aren't addressing what is in the blood that is causing the increase in pressure in the first place. Setting aside the discussions about Big Pharma and qualifying for insurance. I understand that lower blood pressure is healthier, but what is it that we are putting in our bodies that make the pressure go up? Its like pipes and water pressure, what is changing to make the pressure go up and why.
One might be told plaque or high cholesterol, ok...so what is creating that plaque or high cholesterol? Our bodies make 80% of our cholesterol...why are our bodies making so much extra? It makes it in response to bad food.
One might be told high blood sugar increases blood pressure, ok...so where does excess sugar come from? Bad FOOD!
That's what these articles should be about: The quality of our food! Food is medicine. Food first.
89
So so true about food. My blood pressure started climbing 7 years ago (also cholesterol, blood sugar, LDL, triglycerides). I was told that I would be diabetic in 10 years (as if that was a foregone conclusion) unless I started taking this pill (metformin). I was given a glucose meter to measure my BG 1 hour after meal and 2 hrs after meal. I realized that the glucose meter gives me a snapshot of my metabolism, which in the end defined my health. Using the meter, it turns out that the healthiest diet was one with low carbs (100 g or less per day), lots of vegetable and healthy fats. My BP is 106/65 to 110/75; cholesterol of 180, triglycerides of 55; HDL of 60. No pills needed.
3
Or move to a greek island or high protein Okinawa. Eating rice, tofu and fish wont work for everybody in this increasingly stressful and dirty world. It is good however, that more organic food, fresh or packaged can be found in food stores and produce farm trucks are brought to impoverished areas. People were slimmer back in mid century.
1
There is a standard statistic we clinician look for when considering guidelines such as this. It's called "the number needed to treat," or NNT. For example, how many patients do we have to treat to lower blood pressure from 140/80 to 130/70 in order to prevent one bad outcome? 10, 100..?
If I ask my patient, "Sir, if you and 99 other people take these medicines, one of you won't have a heart attack, do you want to take it? What do you think the response will be?
I believe the "number needed to treat" should be noted and explained in articles such as this. It translates aggregate data into something understandable to the patient.
128
I think you mean "one of you won't have a heart attack who otherwise might have." Big difference.
2
Thanks, Doc!
I'm 77, and broke a tooth last night.... at the dentist today, they took my blood pressure, and it was 150/?? (I'm 77!) Since I've never had high BP before, I'm suddenly interested.... and yours is the first comment that actually provides helpful info!
1
I understand perfectly well that lower pressure on the walls of blood vessels will reduce damage to important organs. Nevertheless, have the studies considered the blood pressure history of the participants over a life span? I would assume a difference between someone, who started out on low blood pressure and very gradually ended up around 140/90 Hg in her seventies and someone whose blood pressure hovered around that mark throughout her adult life. Considering that blood pressure medications create their own kind of problems like dizziness resulting in an increasing the risk of falls, shouldn't there be more studies that assess benefits and risks for different classes of patients?
28
I agree. I fall into this category. My father's blood pressure was in the 140/90 range his entire adult life. Mine has been around that range since I was in my early 30s. I am 63. My siblings are the same. Along with it, we all have the "white coat" syndrome when our blood pressure is taken at the doctor's office. My father lived to 96. Fortunately, my doctor took family history and life style, which is very active, into account. My mother, on the other hand, was treated for high blood pressure and suffered from the side effects -i.e. the dizziness. She still lived to be 80. But her last 10 years challenging. I seriously question these guidelines.
13
The number ONE cause of MY elevated BP resides in the Oval Office. This is NOT a joke, I'm serious. HE is the actual joke. Beware.
43
It's way past time that the connection between HBP guidelines and drug sales are made transparent. Every time the guidelines tighten the sale of drugs soars. I'm a skeptic. Shouldn't more of us be? And our journalists too?
10
This is just horsefeathers.
ALL blood pressure meds have SIDE EFFECTS. I don't care how cheap the pills are, they come with SIDE EFFECTS.
I told my own cardiologist several years ago that I will NOT chase a moving target re: blood pressure. My blood pressure is fine, and I refuse to be defined INTO a class of people who have a medical problem when I *don't* have that problem.
12
I have no side effects to mine, which keeps my BP at 120/80. Without it, my BP skyrockets. My friend scoffed at BP meds and has had three strokes in the last six months. Age 66. Is now a believer with a great Neurology team.
I see where the horse feathers live. The fact that you have a cardiologist already tells me you are in denial.
2
The actual report from JNC7 listed lifestyle change as first line of treatment of the new category of hypertension (SBP > 130 mmHg or DBA >80 mmHg). Lifestyle change includes reduce sodium in the diet, DASH diet, increase physical activity, smoking cessation, weight loss if needed, and be judicious with alcohol consumption.
The conclusions and recommendations were based on extensive review of the medical literature.
(I, nor any of my family, do not work in the pharma industry.)
4
This is nothing more than a push by BIG pharmaceutical companies to force their wares on a HEALTHY segment of society.
17
That's one way to sell more drugs and increase big pharma profits.
11
Perhaps life should be thought of as a disease too, after all it is sexually transmitted and associated with a 100% mortality.
The bottom line is, we all die from something. If not from consequences of high blood pressure, then perhaps from cancer or Alzheimer's.
How do I live life to the fullest till the last moment, that is my question. I do not believe that taking BP meds when my BP is 135/80 is the answer.
Please ask the researchers the following question: what is the number needed to treat to avoid one stroke, one heart attack, one kidney failure or one congestive heart failure when the BP is 130-140/80-90. We may find out that dozens of people will take meds for one individual to have a benefit. It may be statistically significant, but is it meaningful?
Which basically means the big pharma is the one with the real benefits.
40
"Perhaps life should be thought of as a disease too ... sexually
transmitted and associated with a 100% mortality."
Wonderfully put!
1
Virtually every comment has noted the hucksterism involved in the study. The real question is: why is hucksterism the "American way of government" and why do we tolerate it?
74
It pays some to lie. The rest are too busy to notice.
1
Hucksterism is pervasive throughout the culture in forms of religion, education, advertising, entertainment, and their permutations. Parting the sucker from his dollar is part of the American way of life. Teaching personal finance, nutrition, and cooking skills in schools would help if critical thinking cannot be conveyed. No advertising of prescription drugs.
1
How convenient for the pharmaceutical companies. Let's not forget setting so many more up for future pre-existing condition insurance denials. Everyone rejoice!
27
How much is Big Pharma driving this new assault on our bodies?
11
If you need to drum up more business in the medical and pharmaceutical arena just invent a new danger zone or preventive bar that the paranoid public has to meet and sell more tests, more drugs and more services. A twisted form of genius that we all seem to play right into all in the hopes we will live past a hundred and run a marathon at eighty.
18
This announcement must be taken with a grain of salt since so many medical research studies are funded by the pharmaceutical industry. Looking at sources for funding research at the NIH, one learns that 45% of the funding is provided by "industry". That creates the potential of serious bias in the findings of the research.
98
Ridiculous. Everyone is supposed to have the blood pressure of a twenty year old athlete. The medical establishment is off their meds.
101
I'll live with the 140/90 standard, and a healthy lifestyle, over the medication side effects, thank you.
35
Me, too. That's what I've been doing for five years.
1
Just a ruse to classify more people as having pre-existing conditions.
52
A very sad day for civil liberties and human rights in this country. The UN has long considered forced psychiatric "treatment" torture and yet the US continues to let pharmaceutical companies and psychiatric guild interests take the reigns over not just individual rights but also outcomes -- Abilify has pitiful long-term outcomes and only has worsened endemic, chronic disability due to mental health conditions that on their onset need not be chronic. Shame on the FDA.
6
One can always refuse the treatment. It is not against the law to do so. One can also shop for MDs that will work with you to interpret the guidelines and adapt them to personal needs and wishes.
3
Two comments. I do not dispute that lower blood pressure is a good thing in general so the new guidelines may be a good thing. On the other hand, my older personal physician, now retired, used to say blood pressure is always highest at the doctor's office because you are at the doctor's office.
Secondly, the first thing that I thought of reading this was when the standards for weight changed in 1996 from normal BMI of 18.5 to 28 to 18.5 to 25. There was no new data that caused the change, but suddenly 55% of Americans were obese or overweight. Why did the change occur? This was done by a board of people and every single one of them had ties to either the diet or pharmaceutical industries, or both. Hmmm. Does make one wonder, especially when every longitudinal health study ever done shows longest life span in the 25 to 30 BMI range, not the "normal" weight range.
25
Thyroid test numbers have been revised such that many more are included in the take the pill zone~for life! These values fluctuate. If one is diagnosed with hypothyroidism and doesn’t have Hashimoto’s, taking the MDR of iodine as kelp daily for a month, then retesting, and if the values are okay, continuing supplementation at three times a week can get the thyroid hormone number in the normal range.
If 130/80 is going to be the trigger for drug treatment, it is important to fully assess the patient's blood pressure. Blood pressure responds to many factors, including physical or emotional stress, time of day, recent activity, and also needs to be taken accurately with the patient relaxed and the cuff at heart level and preferably not over tight clothing. Variations in real or assessed blood pressure are normal, and even the stresses of visiting a clinic can increase blood pressure. Perhaps patients need to become educated regarding the many factors involved, and should record their own blood pressure over a period of time using readily available home equipment before making treatment decisions.
146
How will BP be measured in the doctor's office? Will it be: walk 100+ feet to the examining room, sit on the edge of the examining table with feet dangling, answer a few rapid-fire questions and then the cuff goes on for a single, ten-second reading? That is sure to have a higher than normal reading.
My experience has been that the home self-inflating devices overstated my BP compared to my physician's reading (not similar to the above). Patients should bring their device to compare to a clinical reading.
2
My BP has gone up 10 points since I started reading this article and the comments.
1
Reading even one news article within two hours of a blood pressure test would get me up to 130/80.
1
I took the quiz on the link. According to the results I am at high risk. 66 yo, Bp 115/70. Heart rate of 52. Bmi of21. Low total and Hdl, very good levels of good cholesterol. Lung function tests by my doctor shows the lungs of a 40 yo. Yet my smoking just twice a day disqualify my health.
12
It sounds to me that you have great cardiovascular health. Do you get many hours of activity a day..maybe you're an athlete or a laborer? I recommend you throw out all the statistics.
Because it's the truth, whether you can handle it or not.
Smoking is the worst thing you can do to yourself, period.
You don't have to take any meds. Stopping smoking will be more beneficial to you than any of them.
2
So smoking twice a day is as bad as a pack a day? BTW., a complete scope investigation of my lungs showed none of the effects normally seen for actual smokers.
1
Sounds to me like BigPharma wants to increase its profits.
Instead, lose weight, exercise, take Magnesium, eat a plant based diet (think Mediterranean), and find ways to lower your stress (e.g. meditate, change jobs if necessary, shorten commutes, create community, help others).
Note: Some common side effects of high blood pressure medicines include:
Cough
Diarrhea or constipation
Dizziness or lightheadedness
Erection problems
Feeling nervous
Feeling tired, weak, drowsy, or a lack of energy
Headache
Nausea or vomiting
Skin rash
Weight loss or gain without trying
See: https://medlineplus.gov/ency/article/007484.htm
14
The side effects of Magnesium include:
Dizziness or fainting
Flushing
Muscle paralysis
Troubled breathing
Diarrhea
drowsiness (severe)
Increased or decreased urination
Slow heartbeat
spelling "windfall" for Big Pharma makes my blood pressure go up.
14
I know this sounds crazy, but it is true: After seeing my parents die in a (higher end) warehouse for the aged (aka: a "skilled" nursing facility), I am envious of people who are likely to die of a heart attack. I have low blood pressure, and a low risk of having a heart attack. Given my family history, I am likely to die of cancer, or end up in a warehouse for the aged .
A heart attack -- that sounds like a sweet way to go.
36
Could we please talk about ways to lower blood pressure that involve drugs?
Big Pharma profits!
2
Just reading articles in the Health section of the NYT's, it sounds like Americans are in really bad shape. We drink too much which is going to cause cancer, we are obese leading to diabetes and other illnesses and now most of us have hypertension. It might be less depressing to go back to the front page and read another article about Trump
21
Half of American adults have hypertension? Fake news?
11
Co-Q10 reduces blood pressure. Also beets and hibiscus tea. Skip the meds. Try other things first.
5
Where are the scientific tests verifying the efficacy of COQ10? Where are the notices of its risk factors?
And where are the standards re: the various COQ10 preparations?
Also, take a look at the cost - COQ10 actually costs more than off-patent BP meds. Who is raking in those profits?
I'm not against COQ10 per se, but how come people like you don't hold it to the same standard as you would prescribed mediations?
3
"New Guidelines" always seem to indicate that more people need medical intervention.
8
My bp was just fine until nov 2nd of last year and then it skyrocketed. Maybe the fda should try to remove the current administration and their crooked appointments and see if the nations bp reduces before subscribing more meds.
166
What's the difference between a doctor and a drug dealer?
The drug dealer doesn't charge a consultation fee.
34
And going forward destructive pharmaceuticals continue to be the treatment of choice. Talking about a giant shakedown and fraud. Targeting symptoms, the allopathic method, is like trying to put fingers in a collapsing dike. But there is sure a lot of money in it.
5
I went to the website listed and took the test for heart attack/stroke risk, entering all my legitimate numbers. My risk was said to be very high:26%! I needed to call my doctor immediately! Then I started changing the input values one at a time to see what was causing the high risk. Reporting a lower cholesterol, lower LDL, lower BP one at a time made no difference. Reporting these all at once gave me a 20% risk. BUT, restoring all values to their correct numbers and dropping my age from 77 to 67 dropped my risk to 1.5%! This test is baloney.
122
Yes ... and age is your most important risk factor. There is no medication to reduce age.
3
Add me to those who wonder if this is not another example of the medicalization of the normal in order to drive patients to doctors' offices and sell pharmaceuticals. If you look up the Sprint study online, you will see that the investigators hail from the specialist community devoted to treating even mild hypertension with medication.
The issue here is relative risk. It tells us nothing when a doctor quoted in the article, a member of the Sprint guidelines committee, says that geriatric patients had "half the rate of disability" with the studied medications. If the risk is X percent, and even if the medications truly lower the risk to 1/2 of X, the question is whether X is big or small to start with.
This article and what I can find posted by the Sprint study group online -- the study itself is behind a paywall at the New England Journal of Medicine -- give no way of judging the actual risk decrease.
The history of hypertension studies (see UNC-Chapel Hill professor of medicine Nortin Handler's WORRIED SICK: A PRESCRIPTION FOR HEALTH IN AN OVERTREATED AMERICA) is that a very small potential benefit for the individual has to be weighed against quality of life issues.
16
This new standard is a grossly incompetent misapplication of medical idealism which will force millions of healthy people to become patients, dependent on doctors and medications they really don't need, along with the side-effects of those meds and the additional meds needed for the side-effects. It's nothing less than a colossal scam that enriches doctors and pharmaceutical corporations, while harming patients. It is a fundamental violation of the Hippocratic oath which says, "Do no harm...."
If the medical community is at all serious about hypertension they should begin by taking patients' blood pressure the correct way: the arm resting on a table at heart level. Almost no one in the medical community currently follows that prescribed method. More than 80% of doctors currently take blood pressure readings incorrectly more than 90% of the time and many do not even know the correct way to take a patient's blood pressure. Consequently patient's often receive erroneous readings and prescriptions. The new standard will further amplify such erroneous prescriptions and the harm that will cause will far outweigh any benefits derived.
16
What doctors take blood pressure readings? I don't believe they even remember how any more. It is all done by nurses, half of them using machines, that at least on me always report pressures 10-15 pounds higher than on a conventional sphygmomanometer.
1
Excellent point John. My BP is usually very good, and then some med tech slips one of those portable, battery powered BP cuffs on, and it comes back with some crazy BP number. I always ask them to redo my BP check with a real BP cuff, manually. And every single time my BP measured the old fashioned way (the correct way), comes back normal. And within the recommended BP level.
It's not just that they don't know how to measure a persons BP correctly, they use the wrong technology/equipment to do it.
And a patients BP reading, measured incorrectly, is going to put them on drugs they don't need? Wonderful.
A perfect example of how the US for-profit medical scam harms Americans while professing to help them. Can anyone say: "Oxycontin and Vicodin are safe! We can prescribe them to millions of Americans for pain, they won't get addicted!"
3
For a historical perspective check out this article entitled "New blood-pressure guidelines pay off — for drug companies" http://community.seattletimes.nwsource.com/archive/?date=20050626&sl...
At the time diuretics were as effective without the side effects of the newer drugs. They were, however not profitable for BigPharma.
6
Any excuse for big Pharma to get people on statins and other unnecessary drugs that have bad side effects...like kidney disease.
How can we trust medicine anymore given that hundreds are dying daily from drug overdoses caused by big Pharma drug pushers and their distributors?
(See 60 minutes/Wapo story).
11
If we really wanted to lower the blood pressure and risk of heart disease for millions of Americans this country would give them real, good paying jobs with medical benefits and take away all of the infuriating roadblocks companies set up to limit access......to everything. And get rid of the lying sociopathic conman who is POTUS.
Nice to see so many comments here seeing this for what it really is - moving the goal posts on yet another disease so the medical community/drug manufacturers can sell even more drugs to people who don't really need it (because now they are classified as "sick") while allowing insurance companies to deny coverage to millions more Americans with this newly created phantom "preexisting condition". Remember when they did the same by reclassifying what a Vitamin D deficiency was? Over night Americans went from having perfectly normal Vitamin D levels to needing Vitamin D supplements? Yeah, right, sure.
Remember what Vince Lombardi said about the medical establishment, the insurance companies, and the drug manufacturers. "When the going gets tough, the tough change the rules."
54
People are jumping to the conclusion that this guideline was created by Big Pharma. However, if you know any doctors, they will be the first ones to take BP medicine because they see the effects of high BP: early death, from strokes and heart attacks.
The new guidelines will hopefully help to diminish thousands of early deaths. Think of the unexpected deaths we see on a yearly basis of famous people in the news…or of our family and friends. I can think of a lot, and it's been a huge loss for their families, to their communities, to the world of entertainment and music.
A doctor from the Cleveland clinic on the news today said that high BP is very corrosive on blood vessels, and believed that only 2% of those under the new guidelines will have to take medication. The other 98% are encouraged to reduce their BP in four ways:
1. Reduce your weight.
2. Exercise regularly.
3. Reduce sodium intake.
4. Reduce alcohol intake to one drink day for women/2 for men.
5
No my doctor does not take BP meds - he says the guide is wrong. So there.
One suspects that the pharmaceutical industry has a lot to do with this.
14
Just want to put this out there...(Credit WBUR for direct quote)
"The National Academy of Medicine (formerly the Institute of Medicine), came out with a report on diagnostic error in 2015 identifying diagnostic error as the most harmful and most expensive of medical errors. It is estimated that between 40,000 to 80,000 deaths occur in the U.S. from diagnostic error and that as many as 17 percent of diagnoses are inaccurate."
Let's not read too much into this new statistic.
14
So Big Pharma is redefining "normal" so as to put tens of millions of Americans into the "... and take this tablet twice a day" bucket. Oh, and please pay attention to the ads that encourage you to "... ask your doctor if {fill in the name brand} is right for you" every 20 minutes during the football game. Do we think there may be a connection between the two? We are being had. This is why among all Western countries the US population pays by far the most for health care, and has by far the worst health outcomes.
238
Asking if the drug advertised on TV wastes part of the 10-minute doctor interaction, which is mainly devoted to typing at a monitor.
1
Big Pharma certainly seems devilish
on this issue, especially after learning about the hoax the Sacklers sold to American doctors about Oxycontin not being addictive.
3
Thanks Martin. Ask your doctor if NFL football is right for you. I can only surmise that watching football causes hypertension. The salty snacks and the junk-food. The physical inactivity if you're couch-potato'ing it at home. The alcohol. The cigars. I think football is bad for everybody except maybe for the highly-overpaid Commissioner (rumoured to be $50 million/year and a lifetime use of a private airplane? Huh?) and the billionaire owners, most of whom probably hold Big Pharma stock in their portfolios. And then there's the chronic traumatic encephalopathy. It's all enough to make your blood pressure go up, I tell ya.
1
The new standards will probably need more pills or higher doses. Each pill or higher doses will increase more side effects or risks to other organs. I want pharmaceutical companies to do more research and decrease the side effects in each medicine. Our aim should be not just a longer life but a good and healthy life.
8
So we have more people categorized as having HBP yet there are not enough primary care providers to over see or help them. Nor do they have the insurance that gives them access to that care and the prescription medication needed.
We can make all sorts of medical conditions appear by changing the goal posts but bottom line where is the availability for preventable care in this country?
Similar to the drug ads on TV very few people have access to them due to lack of insurance that covers them. What good are they?
9
Answer: Socialized medicine
UK, to my knowledge, is the only truly socialized healthcare system
Compare outcome: UK vs. USA Very instructive
http://www.commonwealthfund.org/publications/fund-reports/2017/jul/mirro...
Health is the result of the impact of a rather few variables. Pushing medications is not the way to go; remove the gigantic junk on the shelves of our groceries, give people incomes they can live on without having to buy junk and teach children in school about healthy living.
Need to google how UK monitors the quality of medications
3
These guidelines are 2 years in the making. I have been recommending similar blood pressure goals for my high-risk patients since the SPRINT trial came out in November 2015 (which is the basis for these new guidelines). This all came on the heels of previous guidelines that loosened BP goals due to lack of evidence for strict control (no one had ever performed a study like this). It was a well done study with impressive outcomes; far fewer patients with the lower BP goal had heart attacks during the study period than usual care (goal <140/90), forcing them to stop the trial early (because it would be unethical to allow the usual treatment group to continue on with higher BP’s once it was statistically clear that the lower BP goal was the cause for fewer heart attacks).
I’m always skeptical of pharmaceutical companies, but as this article points out, all BP meds are now generic. Their opportunity to reap huge profits from these guidelines passed a long time ago.
Patients in the SPRINT trial had their BP monitored away from staff with multiple pressures to reduce the risk for over-treating those with white coat hypertension or treat one BP that was too high.
My initial concern would be that they included diabetics in the guidelines to be treated with the more strict goals, even though these patients were excluded from the SPRINT trial.
5
Many generic drugs are manufactured by the same companies that produce the more expensive non generic drug, the only difference being the name and the price. Just because a drug is generic doesn't mean big pharma won't profit from increased sales. In fact, "making it up in volume" may well be the best income optimization strategy for a pharmaceutical company once a drug goes generic.
10
@Ben Curran: I'm interested in knowing if you yourself take blood pressure medications. And if you do, how do you like the side effects?
Or do you, like many doctors, prescribe drugs whose effects you have never experienced and wonder why your patients might not be compliant?
I'd also like to know your response to this: If next year, we get told the new "guidelines" are now 120/70, will you just blindly accept that as being optimal for your patients and put even more of them on blood pressure meds?
BTW, many of us would rather die of heart disease than live long enough to develop dementia and end up warehoused in a nursing home.
8
Check out 'LUPIN' lisinopril recalls.
Lupin is an Indian manufacturer.
https://www.medprodisposal.com/lisinopril-recall
Can anyone please comment on medication quality control, especially in the case of generics?
Should every batch get quality-contolled? [I think, yes]
Can we trust manufacturer assurances [I think, no]
As long as there is money, and lots of it, to be made, beware of the dog.
Healthcare is no exception.
3
Thank you, American Heart Association and the American College of Cardiology. Under your new guidelines, half of all Americans will be diagnosed with a preexisting condition. Taking into account the current relentless assault on the protections provided by the ACA, these diagnoses will likely impact Americans' ability to buy health insurance, needed to access health care, in a negative way. So yes, Dr. Carey, these numbers are "scary." But not for the reasons you suppose. They're scary because they will be used to tether people to a health care system they can no longer afford. That's madness.
289
yes...it easy for well to do and doctors living in their towers.
6
It will also tether them to jobs they may want to leave, but can't because they may be now uninsurable because of a "preexisting condition". Grab your Obamacare while you can!
1
Nice increase in profits for the drug companies. Interesting that it's drugs that are emphasized here and not addressing the underlying reasons for high blood pressure.
61
the first thing that came to mind...how much profit the drug companies will make.
2
Is this similar to the rooster thinking that he makes the sun come up? After this therefore because of this?
People with lower blood pressure are found not to have as many strokes, etc. But does lowering blood pressure create that result or were the people with the lower incidences of strokes, etc. doing something that at the same time gave them both results?
I am suspicious of the drug companies involvement in the research behind this. I remember going to my doctor to check my long acting blood sugar when he suddenly announced, in effect, "We've moved the goal posts!" Same thing, now people are given pills for pre-diabetes.
And yet schools everywhere are cutting back on recess and Phys. Ed. programs, and the sugar/corn syrup industry is not taxed. There is so much society could do to encourage more exercise & better eating habits.
104
This appears to be a ploy by big pharma to fatten their wallets, much like when the guidelines for statin consideration were eased recently. If it is ever discovered and disclosed that these drugs actually do more harm than good then the stocks in many large pharmaceutical companies will plunge.
42
"This appears to be a ploy by big pharma to fatten their wallets"....All the important blood pressure lowering drugs went off patent several years ago. The large pharmaceutical companies do not spend much time engaged in the sale of generic drugs.
3
First thoughts exactly.
Never fear WA Spitzer, they'll find a way to create newer BETTER blood pressure meds, no doubt at exorbitant cost.
1
Sorry, but this is something we need to take with a grain of salt, especially when one looks at categories being doubled or tripled simply by virtue of a change in the numbers of an acceptable level.
Yes, hypertension is a potentially serious threat, but we again seem to be looking at a problem that will, in most cases, be "handled" with ever more prescription medications, along with the high individual and national costs, and the often serious complications associated with many of these drugs. Harried doctors, as they have done with antibiotics or the psych industry with their penchant for mind altering pills versus counseling, will often be rushed (or pushed by patients seeing more TV ads for "ask your doctor about...") into writing evermore scripts.
If we couple this effort with a change of the law back into banning direct to consumer drug advertising we might be able to control it, but I am pessimistic that will happen or that we will be able to control this new drive.
66
Unfortunately, I agree.
3
These drugs can damage your kidneys and liver, and there is no guarantee you won't get heard disease anyway.
I would prefer to stick with diet and exercise,thank you. Simple interval training 3 times a week can lower your blood pressure, and provides many other health benefits.
91
Look into Magnesium supplementation and stress reduction as well.
13
The new guidelines create millions of people with new "pre-existing conditions" that may well not be covered by whatever replaces the ACA. Even standard employer-subsidized health insurance looks at the old guidelines as a pre-existing condition. Millions of people will shift from employable to high-risk, and less desirable employees. This includes young people.
Moreover, drug companies stand to benefit enormously. Takingi bp meds is a lifetime proposition--precisely what pharma wants. This reeks.
386
Not only do the new guidelines categorize millions of people with "pre-existing conditions" they didn't know they had, they virtually define old age as a pre-existing condition. "Nearly 80 percent of those aged 65 and older" will find they have problematically high blood pressure. What can be more absurd than defining the vast majority of the elderly as having a pathological condition? When do they start saying that the 80% must take blood pressure medication or be seen as "non-compliant"? And what will be the consequences of being "non-compliant"?
14
Normally I read an article and reader comments before forming my opinion on a given article. However, in this case, my suspicion was raised starting with the article title. Could this change in the standard have been driven by Big Pharma? Is this an attempt to throw out a more stern warning to the general public in order to ward off their likely descent into bigger trouble? I'm all for greater awareness and stronger encouragement to change behaviors but I fear that most people will choose to pop a pill. Just as the cardiologist has surmised at the end of the article.
153
@Cindy - Agreed. It's similar to the supposed danger of higher cholesterol, even though there is no basis for that conclusion. The majority of people who have heart attacks have "normal" or "low" cholesterol levels, yet statins are pushed on everyone as a miracle drug (and that target continues to move down periodically too). And all blood pressure medications have side effects, they just vary in severity.
1
This really sounds bought and paid for by Big Pharma to increase the pool to sell Statins and other drugs to. I no longer believe any of the so-called experts and studies anymore. "Regulatory Capture" has taken over all of them. We are on our own and the only real path to health is a plant-based diet. Everything else is marketing by someone seeking to profit off of you.
320
As is a plant based diet.
Except these drugs can be purchased as inexpensive generics.
1
blood pressure guidelines are based on averages. some people have "high blood pressure" normally. (like myself) Doctors have freaked out at my blood pressure and ordered me to admit myself to the hospital immediately. But, i exercise everyday; i'm very fit; i'm vegetarian, i don't drink alcohol or smoke tobacco, and my blood pressure is just fine. when they tell me i have to take meds, out they go. nature takes care of our bodies, if we do.
62
Perhaps high blood pressure is a symptom of quite different underlying conditions which in your case are relatively benign or not in the way of normal functioning.
1
actually, i would be a bit concerned re: consistently high diastolic ( bottom reading) pressure. years of high bp can be asymptomatic, until.. they are not and you develop kidney disease.
Yep...like you I have had high blood pressure since I was 18 or so...my first real doctor somehow new this was normal for me.
Has anyone investigated the possibility that many blood pressure readings are simply wrong? Machines mounted on a wall that give radically different from numbers from a doctor in an office. Poorly trained medical assistants. Having radically different readings from one office to another. Taking the pressure on top of clothing. The methodology is not reassuring.
200
The medical field updates rather quickly, in some instances, compared to some industries. Taking BP over clothing has not really shown a clinically significant change in recordings for BP. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368310/
Feb 2017, most BP studies were done back in 2008 or 2010, but yes there are many factors that play into an accurate BP.
Get your own monitor. Battery powered, with a digital readout. Much less room for operator error. Available in most drugstores, or Target. Or Walmart, if you must. Take your own measurements, at home, record in a cheap, spiral notebook. Take with you to your medical appointments.
A really worthwhile investment in your health. Also, a really great and useful gift for Family, especially older relatives. Happy Holidays.
4
You may have something there, Pamela. In the rush to shorten time spent in the examining room, blood pressure is usually taken by a nurse before the patient is ushered into the exam room. These days, this is done hurriedly, usually without removing the shirt or rolling up the sleeve, even if multiple layers are being worn. I've taken my blood pressure both ways and found the numbers to differ fairly widely. They also will vary depending on which arm the reading is taken from, but nurses never take it in both arms unless asked to. The equipment varies from simple manual machines and stethoscope to fully automated digital instruments -- the numbers CAN'T be precise from office to office, or maybe even from exam room to exam room. One last point: most instructions for taking blood pressure readings specify that the patient sit quietly for about ten minutes before the resting value is taken. Never happens, today. I would expect scientific studies to use standardized, properly calibrated equipment and procedures, but did they?
Still, I agree with the findings based on their uniformity. I recently told my PCP that, as a 68-year-old male, I had a resting BP goal of 120/80, down from the mid 130s over high 80s) and he heartily agreed. I now take two medication which, other than the occasional swimming head when I rise too quickly, I am dealing with quite nicely. But I'm also asking him to keep a close eye on my renal numbers. That does worry me.
1