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Rethinking Blood Pressure
Old 12-29-2013, 09:22 AM   #1
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Rethinking Blood Pressure

The subject will hit the health news today...
A new study questioning the current blood pressure guidelines, especially for older persons and people with diabetes or kidney disease.
It could lead to a mini revolution in the pharmaceutical and medical profession, and initiate the kind of controversy that theories on diet have generated in the recent past, or the more recent study the on the value of vitamins.

Being in the "older class" the thought that artificially low BP readings are always good... may have to change. Is low blood pressure possibly harming the system? Stay tuned....
New blood-pressure guidelines raise concern among heart-health groups - The Washington Post
Quote:
Raymond R. Townsend, a kidney specialist at the University of Pennsylvania who helped write the new guidelines, said the group’s work is based on the best available evidence from high-quality clinical trials. Published last week in the Journal of the American Medical Association, the recommendations allow people over 60 and those with diabetes and kidney disease to have slightly higher blood pressure than current standards, a change that could mean having to take fewer pills.
... more...
Whaddya think?
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Old 12-29-2013, 10:27 AM   #2
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This is really great news - if it sticks.

Once upon a time, doctors weren't that concerned if a patients blood pressure increase a bit as they aged.

Then came new guidelines that were very aggressive, and many folks were considered "pre-hypertensive" because they weren't under a very low level. It sure looked like a setup to put a bunch of healthy people on blood pressure medication. $$$$$

Glad to see the pendulum swinging back a bit.
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Old 12-29-2013, 10:55 AM   #3
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Thanks for posting the article, and I agree with Audrey that it is good news.

These days my BP is usually in the 130-140 range, sometimes over 140 but nearly always below 80. I wondered how significant this is since in every other aspect I am very very healthy (not counting the bodywork which is rusting away)

I hope these suggested ranges become the new normal
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Old 12-29-2013, 11:16 AM   #4
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I think all these changes in medical recommendations - fewer mammograms, higher cholesterol readings, higher BP readings, etc, are based on the gov't trying t kill off all us old fat people. It will make medical treatment cheaper for everyone else, open up jobs for the young'uns, redistribute wealth through estate taxes, and overall get things more in the order "they" want them. That's what I think.
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Old 12-29-2013, 11:21 AM   #5
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Originally Posted by harley View Post
I think all these changes in medical recommendations - fewer mammograms, higher cholesterol readings, higher BP readings, etc, are based on the gov't trying t kill off all us old fat people. It will make medical treatment cheaper for everyone else, open up jobs for the young'uns, redistribute wealth through estate taxes, and overall get things more in the order "they" want them. That's what I think.

That trend is not confined to geriatrics. It is happening in pediatrics too. There is a general swing of the pendulum towards "less is more" as the impact of doing too much becomes apparent.
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Old 12-29-2013, 12:02 PM   #6
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Originally Posted by Alan View Post
Thanks for posting the article, and I agree with Audrey that it is good news.

These days my BP is usually in the 130-140 range, sometimes over 140 but nearly always below 80. I wondered how significant this is since in every other aspect I am very very healthy (not counting the bodywork which is rusting away)

I hope these suggested ranges become the new normal
Sounds like you are doing very well with your BP, Alan, since you feel it is at a healthy level for you.

I don't know what I think about BP for Alan or for people in general, but I know what I think concerning myself.

My doctor has me on generic BP meds at a negligible cost. I like the fact that my resting BP is about 120/70 with these meds, even though I am age 65 and pre-diabetic. I would be pretty unnerved and concerned if my resting systolic was over 140.

The meds he has me on right now do not cause me the side effects that some have in the past, and I am not suffering any ill effects from them at all. So, I completely agree with his decision to keep my BP down a little like this. Maybe keeping my BP down will help me to live longer.
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Old 12-29-2013, 12:07 PM   #7
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I might add that the DASH diet has been shown to be as effective as medication in controlling BP. Damn hard diet to follow, though. Losing a few pounds helps a lot, too.
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Old 12-29-2013, 12:10 PM   #8
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That trend is not confined to geriatrics. It is happening in pediatrics too. There is a general swing of the pendulum towards "less is more" as the impact of doing too much becomes apparent.
Also, ther were only so many insured patients for a pretty good number of Docs with high professional overheads, big loans, and strong expectations of an upper middle class lifestyle at minimum.

Patient visits had to come from somewhere, so without easily expandable patient count, the doc is left with visit frequency and billable tests and ministrations. Ergo universities manufactured results, and committees more or less distilled and simplified and codified and publicized them to create demand for new or more services, and the troops fulfilled the mandate. Now with ACA and more Medicare, truly sick people are coming out of the woodwork so there is less need to manufacture illness.

Some Docs may be a bit surprised at the social differences they are about to encounter!

Ha
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Old 12-29-2013, 12:50 PM   #9
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Originally Posted by audreyh1 View Post
This is really great news - if it sticks.

Once upon a time, doctors weren't that concerned if a patients blood pressure increase a bit as they aged.

Then came new guidelines that were very aggressive, and many folks were considered "pre-hypertensive" because they weren't under a very low level. It sure looked like a setup to put a bunch of healthy people on blood pressure medication. $$$$$

Glad to see the pendulum swinging back a bit.
I recall that in the 1950s the top number was supposed to be 100+your age for example.
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Old 12-29-2013, 12:55 PM   #10
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Originally Posted by harley View Post
I think all these changes in medical recommendations - fewer mammograms, higher cholesterol readings, higher BP readings, etc, are based on the gov't trying t kill off all us old fat people. It will make medical treatment cheaper for everyone else, open up jobs for the young'uns, redistribute wealth through estate taxes, and overall get things more in the order "they" want them. That's what I think.
+1 , not a conspiracy theorist, but that thought did come to mind. Now if that will ever translate into lower insurance costs
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Old 12-29-2013, 01:00 PM   #11
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As I said above, although my systolic figure has risen I have been oddly reassured that the diastolic figure has remained below 80, even though I had little idea if this meant anything. The article suggests that the lower figure is the more significant of the two.

From the article, the intention is really to give an alternative to those who are responding badly to BP meds.


Quote:
Townsend said the evidence is strong for keeping diastolic pressure under 90. There was not enough evidence that older people benefit from reducing systolic pressure from 150 to 140, and no evidence that people with diabetes or kidney disease need to be at 130.

His group never intended for doctors to take people off blood pressure medicines that are working without problem, he said. But this might keep doctors from writing more prescriptions for patients already taking multiple drugs.
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Old 12-29-2013, 01:00 PM   #12
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Even though it's great we can educate ourselves on health issues by researching the net, there's a possibility we will believe what we want to believe as there are many conflicting articles.

I think we need to stay in tune with what our bodies tell us. ...and get a yearly checkup to make sure all is well. If there are problems, we need to discuss treatments/alternatives to become healthier.

I believe if we trust our doctor, we should follow his/her guidelines.
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Old 12-29-2013, 01:28 PM   #13
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Originally Posted by bbbamI View Post
Even though it's great we can educate ourselves on health issues by researching the net, there's a possibility we will believe what we want to believe as there are many conflicting articles.

I think we need to stay in tune with what our bodies tell us. ...and get a yearly checkup to make sure all is well. If there are problems, we need to discuss treatments/alternatives to become healthier.

I believe if we trust our doctor, we should follow his/her guidelines.

Except that some doctors don't trust guidelines, and some are just confused, or behind the times. I don't trust doctors, even though I am one. 😷
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Old 12-29-2013, 01:32 PM   #14
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I believe if we trust our doctor, we should follow his/her guidelines.
I find these articles interesting and I have mailed articles to my doctor when I have felt the need to challenge her advice (cholesterol medications for example). I don't believe anyone person will always provide correct advice and I want to play an active role in my healthcare.

No one will ever care about my health as much as I do.
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Old 12-29-2013, 01:51 PM   #15
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Except that some doctors don't trust guidelines, and some are just confused, or behind the times. I don't trust doctors, even though I am one. 😷
Ooooo lawdy...we're all doomed!
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Old 12-29-2013, 01:57 PM   #16
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I find these articles interesting and I have mailed articles to my doctor when I have felt the need to challenge her advice (cholesterol medications for example). I don't believe anyone person will always provide correct advice and I want to play an active role in my healthcare.

No one will ever care about my health as much as I do.
Absolutely.

That's why I said....

Quote:
If there are problems, we need to discuss treatments/alternatives to become healthier.
There's nothing wrong with being an educated patient. If we have questions or concerns, we need to discuss them with our doc. If we can't talk to our doc openly, we need to move on.
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Old 12-29-2013, 02:12 PM   #17
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Except that some doctors don't trust guidelines, and some are just confused, or behind the times. I don't trust doctors, even though I am one. 😷
Thank you for saying this, meadbh. I have nothing against doctors in general, but I would never blindly trust my health to any doctor, either. Just as I would not hand over all of my retirement money to any investment advisor and let them invest it for me, as they see fit. If you have a doctor that you think is pretty good, that's great....consider his/her advice, but by all means, do your own research also. I know many doctors that are great at trauma care, but know very little about treating many of the chronic "lifestyle" diseases that plague many of us. Or, they think they know a lot about these things, but haven't kept up with the latest literature, so their advice may be badly outdated. I find this to be true with regard to nutrition, in particular......I have several friends who have received badly outdated diet/nutrition advice from doctors, which could actually do them more harm than good. I know that doctors don't receive much in the way of diet/nutrition education in med. school (unless things have changed recently), so it is only the doctors that have an interest in it that keep up with the literature that provide good information in this area.
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Old 12-29-2013, 03:19 PM   #18
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IMOLDERNU, you continue to amaze me with the topics you start on the forum. This one included. You are in invaluable member of this community and I just want to say Thanks.


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Old 12-29-2013, 03:59 PM   #19
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Interesting stuff...
Time for a little introspection. Have been taking BP medication for 10 years, and BP is usually 120/72... Now I wonder... On the times when I forget for a few days, it goes up to 135/80, the same as it was when Lisinopril was prescribed.

Now, on the distaff side, DW has been taking BP medication and has a w/medication BP of 110/65 or less, and receives the ususual "great", "keep it up" from the doctors. She experiences some dizziness and light headedness, and has had a few stumbles and falls... no damage, but now I wonder.

Since we're both in our later 70's wondering if the normal hardening of the arteries may require a higher BP to service the brain and the extremities.

Don't guess that this would be an earthshaking decision, either way, but will be watching for more on the subject.

Some experiences along the way:
On Cholesterol, stopped Lipitor years ago because of muscle problems... Switched to phenophedrine and LDL and Triglycerides went down.
On diabetes... took Metformin for Metabolic Syndrome, as a pre-diabetic.
Four years later, glucose level, now w/o the medication is at 90.

Nothing to be proved either way, but as we learn more and more about the long term effects of different medications and nutrition it certainly gives pause for thought about what to take or do, to stay ahead of the game.
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Old 12-29-2013, 04:43 PM   #20
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This may have been posted here before since it is from 2009. Dr Malcomb Kendrick also questions the conventional dogma on healthy BP levels.

Does Treating High Blood Pressure Do Any Good? Part 1 of 2
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