High blood pressure kills. It really does. Since we started aggressively treating hypertension, we have dropped the risk of stroke by almost 75 percent and premature heart attacks by just as much (statins figure in there, too).
I’ve received lots of questions about the recently updated blood pressure guidelines — are they necessary? Why do I need to take another pill when this one is working? Can’t you doctors just make up your mind? Who is the “who” who decided this anyway?
First of all, the “whos ” involved here are the American Heart Association and the American College of Cardiology. These esteemed organizations recently recommended that treatment for high blood pressure should begin at levels of 130/80 instead of 140/90 for many patients — I’ll fill you in on who the “many” are by the end of this column.
So let’s go into Mr. Peabody’s Wayback Machine (a nod to all you fans of the 1960s “Rocky and Bullwinkle Show”) to a time when an article in the Journal of the American Medical Association said we were making too big a fuss about blood pressure.
Yes, this came from JAMA, that prestigious publication, saying there was no credible evidence that a systolic pressure of 160 or above should be treated. They said, and I quote here, “The observation that many persons with high blood pressure live to old age suggests that undue significance is frequently attached to the degree of hypertension.”
Uh, huh. Boy, were they wrong!
Now, we do go back and forth as to what blood pressure level we should consider high enough to be treated because we get information from studies and then alter what we’re doing. The last time the blood pressure guidelines were changed was when you were still using a flip phone. That was 2003 — a good four years before Steve Jobs introduced the iPhone.
My, oh, my, the world has changed a lot since then, and so have our guidelines. More data means better guidelines. It’s as simple as that with any technology from a cell phone to medical care.
The American Heart Association and the American College of Cardiology aren’t your flashy-pop-star, trendy-fashion-fad doctors. They are the steady and reliable experts you want in your corner telling you when there is a different strategy that’s better. Just like you wouldn’t go back to using a 2003 computer or cell phone, don’t go back to the old blood pressure standards.
The new guidelines are driven by a mammoth study of nearly 10,000 people over age 50, which found that those who followed the new blood pressure levels lowered their incidence of heart attack, heart failure and stroke by one third and death by 25 percent. Wow!
Yes, there will be more people on pills — we’ll double or triple the number of people under 45 who need blood pressure medications. And those already on meds will need higher doses or another pill. But the blood pressure drugs these days that nearly everybody is on are cheap generics, less than the cost of buying this newspaper every Sunday.
If you’re not interested in stepping into the new age of blood pressure treatment, then put my column down and go grab some pork rinds. They’re high-salt, high-fat, mighty good to taste — and mighty bad for you to eat.
Let’s delve into these new guidelines a little further. The new number of 130/80 or greater is for anyone with a “significant risk” of heart attack or stroke. What’s significant? Risk factors include being overweight, family history, previous heart problems, diabetes, high cholesterol, peripheral vascular disease, being a smoker, senior citizen — the list goes on and on.
If you want to check your risk, go to cvriskcalculator.com. It will take you to the American Heart Association calculator. People with a heart attack or stroke risk of less than 10 percent can stick to the more lenient standards of 140/80.
Nearly half of all American adults and 80 percent of those over 65 will find they’ll probably need to take steps to control their blood pressure.
Next up, what are those steps? How about getting up right now, putting down the newspaper and walking for 10 minutes? That will help. Shed some pounds if you need to, and that also will help. Cut down the salt, eat a more Mediterranean diet, that will help.
Why not go to lifestyle changes first? And if that fails then consider the pills. That’s a non-drug way to tackle the problem.
But if you’re a conspiracy theorist thinking the medical establishment is just there to push you toward more doctor visits and more medications, then you should return to the 1960s when high blood pressure was untreated, rampant and killed.
President Franklin D. Roosevelt died when he was 63 from high blood pressure complications, heart failure and stroke. His final pressure was 240/130.
Just imagine, for an instant, that he knew what we know today about high blood pressure and had the medications you can get from your local drug store. If we put them in the Wayback Machine and gave them to FDR, then he might have lived longer, our post-World War II negotiations with Stalin may have turned out differently, and the Iron Curtain might not have ever existed.
When it comes to your blood pressure, be smart. And stay well.