The medical profession did it again, another decade and another new lower blood pressure target.
Now, this is not something of great surprise to most U.S. doctors. We have known for 20 or 30 years that when it comes to blood pressure, the lower, the better.
What we start with – a blood pressure reading – has gotten a lot more realistic after the recent joint guideline changes by the American Heart Association and American College of Cardiology.
Is a single reading in a doctor’s office enough to commit a person to blood pressure treatment? No. People get bad readings in a doctor’s office all the time. Yet they don’t live, sleep, or eat in a doctor’s office.
People need multiple blood pressures measured at home and work, and at various times and stress levels. A person’s average blood pressure is what needs to be considered.
Moving the action level from 140/90 to 130/80 – as these guidelines have done – will mean about half of the U.S. adult population suffers from hypertension. That initially strikes everyone as an alarming number, but it is no coincidence considering that the rate of obesity and diabetes are similarly climbing.
For solutions, we are looking at lifestyle modifications first, which can help blood pressure as well as obesity and diabetes.
These are harder than taking a pill, but a more advisable method for addressing the problem. For people who are overweight, a diet and attention to reducing excess salt can be all one needs. Exercise burns calories and produces sweat, another good approach to shedding pounds and sodium.
Doctors used to pay lip service to reducing blood pressure with lifestyle changes, then typically put patients on medication anyway because they didn’t expect people to actually change their habits.
Doctors were communicating that medication could cancel out harm from bad lifestyle decisions. However, it can’t. It can reduce the risk, but addressing the underlying problem is far more effective.
For those with more risk of disease, doctors will start medication sooner and use a target of below 130/80, instead of below 140/90. Just taking the average blood pressure from 140/90 to 130/80 cuts the heart attack risk in half.
Blood pressure medications have been inexpensive, clean, and highly effective for years. Most are taken only once or twice a day and don’t have bothersome side effects. Generic brands are easily found and can be ridiculously cheap. The pills are not addicting and you can always stop, though your blood pressure will just go back up.
The new guidelines tell us to make sure we are treating a real blood pressure number, and to pick from a whole palette of lifestyle modifications and medications.
This is a good thing. We need to change some hearts and minds in the approach to health.
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic