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New Hypertension Guidelines: Same Old Song

On Tuesday, November 14, 2017, the front page of the New York Times was headlined, “New High Blood Pressure Norm to Affect Millions.” Similar headlines were plastered across the internet and in every major news outlet.

The NYT article explained, “…the nation’s leading heart experts issued new guidelines for high blood pressure that means tens of millions more Americans will meet the criteria for the condition and will need to change their lifestyles or take medicines to treat it.” The new guidelines were based on an ongoing analysis of the 2015 Sprint study.

The Big Pharma Cartel must be celebrating as they now have millions of more customers.

When I was in medical school, we were taught that blood pressure naturally goes up with age. Guess what? That is still true. The elderly have stiffer arteries than they did when they were young and they generally require a higher blood pressure to pump their blood from the head to the toes. I was taught to add 100 to a patient’s age and the resulting number is a normal systolic blood pressure.

Since medical school, there have been many changes to what I was taught. First, the Powers-That-Be tightened the systolic (the higher number) blood pressure to read as anything less than 140 mmHg. In 2013, surprisingly, the recommendations were relaxed to less than 150 mmHg for patients 60 years and older. I wrote about this change here: http://www.drbrownstein.com/blood-pressure-and-lipid-guidelines-for-the-elderly-useless/. I wrote that I was pleased the blood pressure recommendations were relaxed.
Now, I am not so pleased. In fact, I think my blood pressure is rising as I read the new recommendations!

According to the NYT, “In formulating the guidelines, the expert committee reviewed more than 1,000 research reports. But the change is due largely to the convincing data from a federal study published in 2015. That study, called Sprint, explored whether markedly lower blood pressure in older people… might be both achievable and beneficial.”

So, as my blood pressure is still rising, let me examine Sprint. Sprint was a study of 9361 persons with systolic blood pressure of 130 mm Hg or higher and an increased cardiovascular risk. The subjects were randomized to either a blood-pressure target of less than 120 mm Hg (intensive treatment)or less than 140 mmHg (standard treatment). The outcomes measured were myocardial infarction, other acute coronary syndromes, stroke, heart failure, or death from cardiovascular causes. In the abstract of the paper, the authors state that they stopped the trial early because there were less events in the intensive-treatment group. The conclusion of the article (in the abstract) stated, “Among patients at high risk for cardiovascular events but without diabetes, targeting a systolic blood pressure of less than 120 mm Hg, as compared with less than 140 mm Hg, resulted in lower rates of fatal and nonfatal major cardiovascular events and death from any cause, although significantly higher rates of some adverse events were observed in the intensive-treatment group.”

Before my head explodes, let’s look at the results. The primary outcome is the first occurrence of a heart attack, acute coronary syndrome, stroke, heart failure or death from cardiovascular causes. For the primary outcome measured, 6.8% of the standard group suffered an incident compared to 5.2% of the intensive treatment group. This amounts to a 1.6% absolute difference between the two groups. In other words, as compared to those treated with the standard protocol of maintaining blood pressure less than 140 mmHg, you need to treat 62 people (1/1.6%) with multiple blood pressure medications to lower their blood pressure to 120 mmHg or lower to benefit one person. In other words, 61 out of 62 in the study received no benefit. That also means the treatment failed to show protection in 98.4% of those treated intensively.

Oy vey. THIS is what the new treatment guidelines were largely based on?

You gotta be kidding me!!

And, because now I am feeling a little chest pain and shortness of breath, I am not going to delve into the side effects suffered by the participants in the study. Those treated in the intensive-therapy group suffered significantly more hypotension, dizziness, emergency room visits, and acute renal failure as compared to the standard-treatment group.

I have now told myself that I am done with these ridiculous recommendations. My heart is slowing and I am feeling better.

Do I recommend following the new guidelines?

No way.

DrB

Author Info

David Brownstein, M.D.

Comments ( 23 )

  • Lisa

    I am Sooo grateful for your articles and blogs, Dr. B!! It helps me have a clue when my 86 year old dad says he is suffering from daily migraines, and vertigo that sent him to the ER. I asked him what his blood pressure was and he said 105/55, In the ER!!! An 86 year old! (My B.P. goes through the roof just writing about this, too.) The Dr.’s and nurses had the gall to say it was Parkinson’s related and sent him home with head exercises for the vertigo, and never once mentioned he was practically dead from low BP! I am appalled at their gross negligence and lack of knowledge about the human body, which is what they are “trained” to know about. Thank you, again, for helping us help others with real information.

  • Carol in USA

    Thanks for this article Doc. I have about 8 autoimmune diseases, and my B/P ran 130/70 most of the time. I don’t need meds for any condition BUT AI conditions.. Until, that is, NOW of course. Now they will be convinced that I need B/P meds. Unless something else happens, they can prescribe them, and I can fill the scripts. But if my B/P is still my normal, I will not be taking the drugs. I just despair sometimes with all of this stuff going on.

  • D. Smith

    I wondered if anyone else has been watching the docu-series called Vaccines Revealed? I just watched episode 3 where RFK, Jr. speaks with Dr. Gentempo (? I think that’s his name!) for over an hour and they discuss mercury and they discuss the collusion between the CDC, the FDA and BIGPHRMA. Really interesting. You have to sign up to watch it and I really hope they offer it free again sometime later. To show it now, during the busiest month of the year, hasn’t been a good time for me to see it. I missed the first 2 episodes but #3 was really really good. I think if you just search vaccines revealed it will take you to the right place. Share the message all over the place, too!

  • D. Smith

    @ Dr. Brownstein: I wondered if you’d read, and have an opinion yet, on the latest article by Bill Sardi concerning high blood pressure and the possibility of zinc being helpful in reducing it? The article was printed at the Lewrockwell.com web site on November 29th (the title of the article there was something about a miracle mineral, or something to that effect). Bill Sardi’s web site is Knowledge of Health and he has a blog as well, but I don’t know the exact name of it nor do I have a link to it. If you read the article, I would love to know your opinion. It’s quite a long article, so possibly you could write something about it when you’ve finished analyzing it? Thanks so much!

  • Sally Seaver

    Dr.B, On this day of Thanksgiving I read another blog from you. I cannot truly express my gratitude for your extremely trust worthy & precious information you send our way. I deeply appreciate all your tiring efforts to help all of us willing to listen! My life has changed since I’ve been coming to CHM. All the doctors at CMH are extremely bright lights on this earth!

  • I have a very short story in my book, Toxic Staple, about a woman whose blood pressure was sky high and she was on mega drugs to control it. She discovered she had celiac disease, followed the GF lifestyle absolutely, and her blood pressure normalized.

  • Shasha

    Gluten may cause swelling/inflammation. Dr. Davis Wheat Belly….gluten/grains may hurt people. Gluten may also hurt glands and nutrients absorbed like Mg that helps deal with sugar which may cause swelling. Progesterone is lower due to stress/age etc so blood pressure may go up as a person swells due to it being low. Giving Statin drugs instead of fixing the root cause only covers symptoms and causes more problems. People can use blood pressure as an indicator to fix their health, but not if it is lowered artificially by Statin drugs and more.

  • You always say it so well, Dr. B! After years of taking blood pressure meds, my wonderful intergrative care doctor has helped me get of the ARB I had taken for 20 years. Guess what- my BP readings DROPPED! Now we are starting the process of getting me off the calcium channel blocker. My reaction to this “news” about the new standards was the same as a lot of other people- what a great way for Big Pharma to make more money!

  • Annie

    My BP has been low until it started creeping up in the last few years (I’m 62). It would be like 105/63 after the gym at 6 am, so when I’d get a 146/79 at the doctor’s office, I didn’t believe it. Then at a routine eye exam, my opthamologist used new high-tech equipment that examines retinas (no dilation) and found “mild hypertensive retinopathy.” Even though he said it was normal and not at all bad for someone 60+, it was enough motivation to start supplementing (aged garlic, grape seed extract, Niacin B-3, etc) , monitored my BP more closely and saw that in the comfort of my living room, it tended to go up later in the day.
    I finally went to a PCP with a month of readings and asked for an Rx. I now have the 12.5mg HCTZ on hand “when I need it,” and was told to “keep it under 130.” Some days I don’t take any.
    I generally do not hold PCPs in high regard these days, but am grateful for the Rx and glad to have a little help when nature’s pharmacy doesn’t do the job. I don’t want my eye doctor telling me MODERATE hypertensive retinopathy on the next visit.

  • I was in the SPRINT study for 4 years. I’m 75 years old and have white coat hypertension. I was given large doses of ARB’S along with lasix and various strong diuretics. The result after complaining over and over again – a severe case of eczema and nummular eczema. I finally stopped the meds myself and it took nearly a year to get rid of the rashes. I also got rid of an autoimmune disease called lichen planus. It was horrible. I am now on a simple diuretic low dose and doing great. Stop the insanity. Thank you Dr. Brownstein. We need so many more doctors like you.
    Patty Koch –

  • Eglus

    I agree completely, 100% with you doctor. The big pharma are celebrating. I am 66 yrs old and I feel a relief when you say for my age 160 is normal, adding 100 to my age. I am in the range between 140-159 and I was worried with these values because I do Not want to live with a bag of medications to take for high blood pressure and stomach issues & muscles pain as consequences of medications. Thank you doctor for your article.

  • John Wright

    The medical community is out of touch with what healthy blood pressure is or what to do about it when it is “high”. What blood pressure should we be aiming for? My research shows something around 90 systolic / 60 diastolic is optimum. If yours (or your patient’s) is higher the answer is NOT pharmaceutical drugs! Eat healthy, be physically active, use nutritional supplements, meditate… As others have said, “Just say NO” (to artificial drugs).

  • Grammy G

    Dr. B-Thank you! I saw that in the news the other night and just laughed! They continue to find ways to keep the revenue stream going and keep patients returning, or keep them sick. Sasha above said it well-We can’t eat the foods we do and expect our bodies to miraculously operate with precision. We must do the work necessary to keep it tuned and be logical about it. It’s our responsibility, yet many get sick after long term poor decision making and rush to go to the doctor expecting the doctor to fix the problem. Out comes a pill, or referral for tests upon tests and a revenue stream is generated. Fee based medicine will always work this way. Outcome based medicine in the early 1900s is long gone. The Opiod issue should have found doctors held responsible who prescribe them. They know what will happen, but they can keep the patient sick, and coming back. What happened to “Do no harm?” Thank you for being a caring, compassionate doctor who treats the whole patient! You are a blessing!

  • Mary McIntire

    Thank you Dr. B. Your blog posts give me the courage (and the ammunition) to confront my doctors when I know they are wrong–or just following orders from their puppeteers, big pharma. I appreciate what you are doing!

  • Michelle

    Unfortunately, not surprising, big Pharma wins again ? But I am always ever so grateful for your good blogs/posts. Thank you for your amazing teachings through your writing!!

  • Tikvah

    Thanks, Dr. Browbstein. I have discovered at age 61 I have high bp 165/95 with a migraine. I began magnesium, a banana a day and I’m going to begin digestive enzymes. I refuse to bow to big pharma. Between them and Monsanto, can you say corrupt? Read “Seeds of Change” for an eye-opener into genetically modified seeds, crops and the food industry. I do wonder how these folks sleep at night or how they look at themselves in the mirror. Appalling! Thanks, again! I appreciate your insight.

  • Marie N.

    I am a 2 year old too….NO WAY! Thanks for the information. Makes it easy to share!

  • Ron

    The drug companies must like this, more money in there pockets. Just don’t agree.

  • Bravo Dr Brownstein. I calculated the identical numbers in trying to talk my previously-unworried-now-unnecessarily-worried patients off the ledge. The insanity never stops when you follow the money. Whatever happened to old fashioned common sense? 5 years ago the cardiologists tried to get my now 91 year old mother’s blood pressure down to 130/80 and she was miserable from side effects like fatigue, dizziness and low energy. I backed her down to a reasonable goal of 160/90 and she has been doing great ever since. I agree with the doctor who said “drugs do not have side effects – they are all real effects of the drug.” Subjecting our aging parents and others to these new standards would be a disaster in massive side effects and diminished quality of life. I’m with you. No way.

  • Mary

    Pretend you are a 2 year old and JUST SAY NO!

    I saw that on Peoples Pharmacy Newsletter. Guess what I thought about it then?

    NO WAY.

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