New Blood Pressure Guidelines

[candrew]

New Blood Pressure Guidelines Mean Yours Might Be Too High Now

https://www.nbcnews.com/health/heal...idelines-mean-yours-might-be-too-high-n820456

"Heart experts released new guidelines for blood pressure on Monday and that means millions more Americans will now be diagnosed with high blood pressure.

"Anyone with blood pressure higher than 130/80 will be considered to have hypertension, or high blood pressure, the American Heart Association and American College of Cardiology said in releasing their new joint guidelines."

Here are the actual guidelines from the ACC that should help anyone determine whether or not a drug regimen would be appropriate for elevated BP based on the new criteria. According to data from the ACC, a diagnosis of stage 1 hypertension is not necessarily cause for taking BP lowering drugs. An individual’s risk factor(s) must first be assessed.

High Blood Pressure Guidelines Hub | JACC: Journal of the American College of Cardiology

If you know them, you can input your own numbers for total Cho, HDL, LDL, systolic BP, etc. into the calculator to determine if your risk factors would indicate drug therapy as a treatment.

ASCVD Risk Estimator +

Obviously, YMMV!!

 

[braumeister]

Interesting stuff, but I was glad to see some opposing viewpoints in the NYT article about this:

But more intensive drug treatment in so many more patients may increase rates of kidney disease, some experts fear. In the Sprint trial, the incidence of acute kidney injury was twice as high in the group receiving drugs to reduce their systolic pressure to 120.

“Although the lower goal was better for the heart, it wasn’t better for the kidney,” said Dr. Townsend of Penn Medicine, who is a kidney specialist. “So yeah, I’m worried.”

Lifestyle changes like diet and exercise can help many patients lower blood pressure. But many of the newly diagnosed are likely to wind up on drugs, said Dr. Harlan Krumholz, a cardiologist at Yale University.


“This is a big change that will end up labeling many more people with hypertension and recommending drug treatment for many more people,” he said.

The current treatment strategy has not been so successful for many patients, he noted.

Under New Guidelines, Millions More Americans Will Need to Lower Blood Pressure

 

[Sojourner]

When I saw this yesterday in my news feed and read a detailed article about it, I realized that I'm pretty likely to fall into the Stage 1 category now. My top-line number is sometimes over and sometimes under 130, but my bottom-line number is always over 80. I don't think I've had a single BP reading in the past 10 years where it's been under 80. Sigh. Well, I guess I'll see what my doc has to say about it when I check in with him next month for my physical.

...

Just noticed the link to the ASCVD Estimator tool and plugged my numbers in. My 10-year ASCVD risk is 2.8%, which is under the 5% risk threshold for recommending treatment. That's nice to know. Thanks for the link!

 

[Geld ist Freiheit]

I remember seeing a commercial for blood pressure medicine a few years ago where they mentioned the criteria were under review and "millions more may be at risk".

I thought to myself "Yep. That's the whole point isn't it?"

Need to drive sales? Change the rules so suddenly a whole new pool of customers exists.

 

[candrew]

My 10-year ASCVD risk is 2.8%, which is under the 5% risk threshold for recommending treatment. That's nice to know. Thanks for the link!

The JACC 10 year CVD threshold is actually > 10%. Your margin appears to be a bit wider than you thought!

 

[candrew]

I remember seeing a commercial for blood pressure medicine a few years ago where they mentioned the criteria were under review and "millions more may be at risk".

I thought to myself "Yep. That's the whole point isn't it?"

Need to drive sales? Change the rules so suddenly a whole new pool of customers exists.

+1

My first thought upon reading this news was that it would be greeted with applause by big Pharma.

 

[Alan]

FWIW here are the guidelines that the NHS here currently follow.

https://www.nhs.uk/conditions/high-blood-pressure-hypertension/treatment/

Your doctor will carry out some blood and urine tests, and ask questions about your health to determine your risk of other problems:

if your blood pressure is consistently above 140/90mmHg (or 135/85mmHg at home) but your risk of other problems is low – you'll be advised to make some changes to your lifestyle

if your blood pressure is consistently above 140/90mmHg (or 135/85mmHg at home) and your risk of other problems is high – you'll be offered medication to lower your blood pressure, in addition to lifestyle changes

if your blood pressure is consistently above 160/100mmHg – you'll be offered medication to lower your blood pressure, in addition to lifestyle changes

 

[braumeister]

The same technique worked well for the statin makers, so why not?

OTOH, in both cases the majority of medications is generic, so there wouldn't be a big cost to patients.

I just tend to bridle when I see the mindset of "everything out of what we call the normal range should be treated, even if it isn't doing any harm."

 

[ripper1]

What happened to the new guideline that said 60 yr olds acceptable BP could be 150/90.

 

[tfudtuckerpucker]

+1

My first thought upon reading this news was that it would be greeted with applause by big Pharma.

Indeed. After the statin overprescription saga I would do my homework before taking any meds, despite how much I trust my dr. Some interesting excerpts:

"A number of experts who worked on the ACC/AHA guidelines had financial links to drug companies, which they disclosed publicly."

"The ACC did not follow its own conflict of interest guidelines,"

""If you don't ask about muscle weakness in a study, you're not going to report it,"

 

[MRG]

What happened to the new guideline that said 60 yr olds acceptable BP could be 150/90.

I don't know.

I was recently educated about that. Last year after over a year off BP meds mine went higher(140/90). After taking the BP meds I had been on, my BP crashed. I'm on the floor passing out and DW calls paramedics who keep me going till it got up to 70/35?

They educated me to 120/80 is a joke don't worry until >150/90. I'm on 100mg metoprolol now and I'm still above the new guidelines. My doc says my weights perfect, we eat low sodium, exercise regularly..... I don't want to add more metoprolol as my heartrate is perfect, more beta blocker will make it too slow.

 

[Chuckanut]

Any new patented blood pressure drugs near the end of the pipeline?

 

[UnrealizedPotential]

Just checked mine. 119/81. I'll take it. High blood pressure was a factor in me leaving my job early and ever since I left my blood pressure is much better. No blood pressure medication for over a year now. My blood pressure has been fine.

When I was working my blood pressure was not good. It was 140/102! So clearly the job was hurting my BP. I am kind of high strung sometimes as well. Much, much less since I quit working. Sometimes it's just like that.

 

[athena53]

+1

My first thought upon reading this news was that it would be greeted with applause by big Pharma.

Same here. Fortunately, mine is at the very low end of normal; I have to be careful I don't fall over after donating blood or blood products.

 

[Big_Hitter]

my mom is 88 and sometimes her BP goes over 200/130; done that for years

 

[razztazz]

Since the wheels have been coming of the cholesterol wagon for years now, they need a new FEAR conduit to your wallet. Ten, 20, 30 years from now it will be shown that none of this affects actual mortality any. (Actually it is shown already but will not be discussed until they make their money)

 

[ripper1]

Since the wheels have been coming of the cholesterol wagon for years now, they need a new FEAR conduit to your wallet. Ten, 20, 30 years from now it will be shown that none of this affects actual mortality any. (Actually it is shown already but will not be discussed until they make their money)

+1.....All about the Money.

 

[candrew]

Since the wheels have been coming of the cholesterol wagon for years now, they need a new FEAR conduit to your wallet. Ten, 20, 30 years from now it will be shown that none of this affects actual mortality any. (Actually it is shown already but will not be discussed until they make their money)

Reminds me of a scene from Woody Allen's movie, "Sleeper".

Dr. Melik: This morning for breakfast he requested something called "wheat germ, organic honey and tiger's milk."

Dr. Aragon: [chuckling] Oh, yes. Those are the charmed substances that some years ago were thought to contain life-preserving properties.

Dr. Melik: You mean there was no deep fat? No steak or cream pies or... hot fudge?

Dr. Aragon: Those were thought to be unhealthy... precisely the opposite of what we now know to be true.

 

[RunningBum]

oooo, this makes my blood boil!


Oops, that doesn't help, does it?


I'm lucky that I have a doc who tries to keep me off meds if at all possible. Even if he didn't, all he can do is advise me. It's up to me whether or not to take the meds.


I will use this as a motivation to try harder with diet/exercise/lifestyle choices to keep my BP lower.

 

[4legsgood]

When I saw this I thought I'll bet that makes for a whole lot more people with preexisting conditions.

 

[MRG]

When I saw this I thought I'll bet that makes for a whole lot more people with preexisting conditions.

+1 My first thought.

 

[GravitySucks]

+1

My first thought upon reading this news was that it would be greeted with applause by big Pharma.

My first thought was it had been funded by Big Pharma

 

[audreyh1]

Wow - after they had just lowered them for the over 60 since they had found no benefit for treatment.

I need to learn more about this SPRINT study.

I get terrible readings at the doctor's - all over the map. The last couple were in the low 120s. But I've sometimes had much higher. Some visits I'm anxious due to a medical issues or waiting to hear test results. Most of the time it's super rushed and right after you've walked down the hall and during questions!

At home where I monitor weekly to twice a month I am rarely above 105/70 or thereabouts. But I keep records just in case some doctor decides I've got a problem.

 

[CRLLS]

What happened to the new guideline that said 60 yr olds acceptable BP could be 150/90.

Does anyone else remember the first guidelines that "BP should be 100+ your age"?

A few years back, there were a few studies that found there was no significant differences in strokes for those with pre-hypertension taking BP reducing medications. I can't seem to find if these studies have since been found to be discredited or not.

For me, my BP has been ~138/80 +/- 7 for many, many years. This new recommendation does not "increase" any "real" risk to me. If there is/was a risk, it has been there long before this new guideline came out. I won't be taking drugs to lower my BP anytime soon just because of this new guideline.

 

[audreyh1]

Any new patented blood pressure drugs near the end of the pipeline?

Who knows? All the remaining ones are generic.