If you are being treated by a mainstream doctor for any condition right now, chances are good you’re being overmedicated.
And if you’re being treated for high blood pressure, you are definitely being overmedicated.
I’ve been saying that for years. And yet the medical establishment just keeps marching along with its needless and harmful prescriptions. It seems the American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) are finally speaking up, though. Is it too optimistic to hope mainstream docs will take heed?
The ACP and AAFP teamed up to dig into the research on blood pressure and figure out whether current guidelines are really in the best interests of patients.
A little background … Back in 2013 and into 2014, the Journal of the American Medical Association (JAMA) updated its recommendations for high blood pressure. Instead of treating everyone up to age 80 for blood pressure levels above 140/90, the new rule was to give older people a little more leeway. The systolic threshold (the upper number) was raised to 150 mm Hg for anyone over age 60.
Of course, that was met with backlash. The American Heart Association insisted that everyone up to age 80 should have systolic pressure below 140 mm Hg. That left a lot of doctors confused about what to do. And of course, when in doubt, they usually choose to medicate.
But the ACP and AAFP have looked at all the research, and they have found that trying to keep blood pressure under 140 in the over-60 set isn’t just unhelpful, it’s harmful. While there’s a very small reduction in adverse events (we’re talking less than 20 events for every thousand high-risk patients over 5 years), those benefits aren’t worth the downsides. Namely excessive cost and greater risk of low blood pressure and fainting.
So why do some in the medical establishment continue to push for more aggressive blood pressure reduction? Well, most of the research comes from one single trial. It was called the Systolic Blood Pressure Intervention Trial (SPRINT), and it found that very low systolic blood pressure (under 120 mm Hg) was linked with substantial drops in cardiac events.
The problem is, subsequent studies couldn’t replicate those findings. So if you take that trial out of the mix, the research just doesn’t support the lower blood pressure targets.
Now let me be perfectly clear: I’m not advising that you discontinue blood pressure medication without talking to your doctor. They can be life-saving — for certain people. For instance, if you have high cardiovascular disease risk (diabetes, vascular disease, metabolic syndrome, or chronic kidney disease), you should still keep your systolic blood pressure under 140. The same is true if you have a history of stroke or transient ischemic attack.
So what should you do if you’re currently being medicated for high blood pressure? A few things…
First, make sure you actually have high blood pressure and not just “white coat syndrome.” (Some people have a blood pressure spike just because they’re nervous at the doctor’s office.) Check your blood pressure a few times — in both arms — in a low-stress setting and factor those readings into your discussion with your doctor.
Second, make sure you’re addressing your blood pressure through diet and lifestyle. Eat right, exercise, and support your adrenals.
And finally, if you are on blood pressure meds and you need to stay on them, make sure you’re not lining Big Pharma’s pockets any more than you need to.
Your doctor may have bought the line that the newest drugs are the best ones. But that’s often just marketing, not science. I always choose the older drug if there’s one that does the trick. In part, that’s because we know the side effect and safety profile of older drugs. They’re also cheaper, which my patients without prescription drug plans appreciate.
So, bottom line—if you are on blood pressure medications, now is probably a good time to have a check-in with your doctor.
My hope is that these less aggressive guidelines — if we can get anyone to pay attention to them other than me — will make it so that only the people who truly need blood pressure medicines will be on them.