Now the latest study emphasizes more severe blood pressure reductions as beneficial

You may recall a study we talked about here last week that showed blood pressure control did not produce the benefits expected, and if individuals required more drugs for Blood Pressure control, their rate of events was higher, so now a big study says lower blood pressures than the current guidelines should be the goal.

blood pressure posts at JS


7 responses to “Now the latest study emphasizes more severe blood pressure reductions as beneficial

  1. @john1282
    I would love to see Dr. Curtis’ take on this latest study.

  2. It’s always difficult to comment intelligently on this sort of “science by press release” although the mere fact that they engaged in this sort of thing does raise the level of my suspicion. The problem is that almost none of the really important information is given and the journalists who write these articles are rarely capable of providing a decent critical analysis. With that caveat I would bet the farm that the 1/4 to 1/3 reductions in heart attacks, strokes, and death are relative risk reductions and that when one sees the actual figures it is likely that the numbers are very low e.g. a 3% incidence for the <140 group and 2% for the under 120 group. No doubt they torture the statistics to prove a "statistically significant" difference but anyone with common sense knows that the real world significance of this kind of difference is nonexistent.
    The article says that these blood pressure levels were "targeted" so it is not clear whether they were actually achieved. The two experimental groups were drawn from people over 50 years of age with a "high cardiac risk" and others with, apparently, established kidney disease. This seems like an odd apples and oranges mix but perhaps the author stated it incorrectly.
    There are decades of studies showing that aggressive blood pressure control measures do very little in terms of reducing mortality sand morbidity. This is especially so when discussing systolic hypertension. The only data with any marginal scientific credibility showing benefit from blood pressure reduction showed that the only people who benefited (and the degree of benefit was rather modest) were those who had sustained diastolic pressures greater than 105 mm/hg. Not even marginal benefits have been demonstrated for reduction of systolic levels which are well known to be considerably more labile than diastolic pressures. So the alarm bells on my BS meter start clanging loudly when so called "federal health experts" claim to come up with dramatic findings that contradict this experience.

    • That would seem to be slim justification for halting the trials.

    • @Ernest–
      Thanks. My BS detector also went off when I noted that, yes, this is certainly science by press release with few details; and the fact that we are talking about systolic BP. It has been known for more than 50 years that “essential” hypertension with respect to systolic is caused by less elasticity in the vessels as we get older.

      That’s why it was taught that the really important number is the diastolic—the denominator in the BP.

      Then, there’s the little matter of such studies essentially implying that everyone over 50 needs to be on meds. Amazing how so many docs are still drinking all the Kool-Aid.

      Finally, I am sick to death of the underlying nonsense of all this: The most important thing in medicine is that the patient NOT die of heart disease. Any other cause of death, no prob. Your tax dollars at work, friends.

  3. of course, once you hit 0 blood pressure you’ll never have another heart attack or stroke because you’ll be dead…

    So the ultimate goal to have everyone at 0 blood pressure will mean no more strokes and heart attacks. Which is of course a magnificent achievement…

  4. lower bloodpressure is less blood per beat to your organs when your arteries stiffen with age. Personally i rather keep my brain/other organs well oxygenated as long as possible and take the ‘risk’ as just that’s the way the cookie crumbles.

  5. I knew Ernest would help with this. Petrossa, unintended consequences, excessive blood pressure meds can cause circulatory compromise. Harder, less elastic blood vessels make for less tolerance to low blood pressure.

    Rick/Hard Place. Moreover, some blood pressure meds have side effects that make people unhappy, particularly the beta blockers.

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