Something shocking is happening in the world of “healthcare” right now. There’s the medical equivalent of a catfight going on among “experts,” and it’s all centered on who should be put on blood pressure drugs.
That there’s an argument over who’s right going on is no surprise—this happens all the time. Many medical “guidelines” are something that doctors viciously disagree about. “Guidelines” are often created by the most vocal “leaders” in the field, and often these leaders have an axe to grind.
No. That there’s a catfight isn’t surprising. What is unheard of is that this one is happening in open sight of the public.
So how high is YOUR blood pressure? Are you on medication? Has your doctor piled on more and more drugs in an effort to get it “low enough”? Do you feel like you were pushed into treatment? This post is a handy guide to the argument going on right now. I’ll explain what the disagreement is all about, what the science says, and what you can do to take control of your own health when it comes to your blood pressure.
Here’s what doctors are arguing about
The prevailing wisdom about blood pressure has changed dramatically over the years. As recently as the 1970s, normal blood pressure was defined as “100 + age.” So a 60-year-old with a BP of 160/90 would have been considered within normal range. All through the 1980s and 90s, blood pressure of 140 was considered totally normal. “Ideal” blood pressure was 120/80.
Then in 2003 new “guidelines” came out. These guidelines changed the definition of hypertension—high blood pressure—and created a new malady: “pre-hypertension.” Suddenly blood pressure between 120/80 and 140/90 was bad. Very bad. Downright dangerous, in fact. Overnight, people who had been perfectly healthy found themselves labeled “sick” and given drugs.
Doctors were urged to treat people with lower and lower blood pressure. And they were advised to use more powerful drugs. Instead of using diuretics, which were cheap and effective for most people with true high blood pressure, they were pushed to prescribe newer, more expensive, more dangerous blood pressure drugs.
Not surprisingly, most of the authors of the “guidelines” had ties to Big Pharma.
Since then the picture has only gotten darker. The mantra has been that everyone, regardless of age or health, should be on medication if their blood pressure is 140 or above. The original goal was to get blood pressure below 140. But the goalposts keep moving. The game has been to keep adding medications and pushing blood pressure lower and lower—from 140 to 130, 130 to 120—no matter how many drugs it takes or what their side effects are. Some strident voices are even claiming that 120/80 is “prehypertension” and we should be aiming for a mere 115/75!
This is where the catfight starts.
Many doctors have seen this trend for what it is—another money grab by Big Pharma. One that doesn’t make us healthier and might even make us sicker.
Here’s what the science says
The newer blood pressure drugs didn’t have to show they were safer or more effective than the older diuretics to be FDA approved. They’re no more effective, for the most part. They do have more side effects—and a much, much bigger price tag. But the argument goes far beyond the question of which drugs we should be using, and instead questions whether many people on medications should be taking them at all.
The most recent shot fired in this ongoing war for your health was a study called HOPE-3. It was a large study that included nearly 13,000 people, and it followed them for nearly six years. Because the argument is that pushing blood pressure numbers ever lower cuts the incidence of cardiovascular disease, every person in the study had at least one cardiovascular risk factor.
Blood pressures at the beginning of the study were all over the place, from less than 132 to over 150. The average blood pressure of the group was 138, well within the range that current guidelines say should be treated, and treated aggressively.
This study shot that “guideline” full of holes.
Here’s what the study showed: While medication did lower blood pressure across the board—by about 6 points on average—what it didn’t do was lower the rate of cardiovascular disease.
That’s right. A six-year study of almost 13,000 people found that forcing blood pressure ever lower made no difference in the number of cardiovascular problems. No reduction in heart attacks, strokes, or other problems. And it’s important to note that there was nothing special about this group of people. They had an average age of 65. Nearly all were overweight. A quarter of them were smokers. And the group was split fairly evenly between men and women. This is the perfect picture of the average person with high blood pressure.
After “exploring the data further”—because after all, this goes against many different versions of the “guidelines”—researchers did find a tiny risk reduction for people whose blood pressure was 154 or over. However, even this effect was negligible.
Of course these results have the Pharma-backed guideline-makers, including those at the World Health Organization and the NIH, rolling on the floor in a kicking, screaming tantrum. Meanwhile, the rule-followers are finally beginning to question how much stock we should put in “guidelines” aimed at lining Big Pharma’s pockets. It’s an argument So bitter that it has leaked out of the medical back room and onto the front pages of the papers.
Now here’s what YOU can do
Here’s the bottom line: no matter how many sets of “guidelines” come out, there’s no proof of any benefit in drugs for people with blood pressure of 140 or less—unless you own a pharmaceutical company, that is. If you’re 65 or over, 150 might be a more reasonable goal. And though everyone agrees that very high blood pressure needs to be managed, they also agree that diet and lifestyle should be the first treatment option.
Some of the most effective things you can do to lower your blood pressure without drugs are:
- Drop the extra pounds if you’re overweight
- Get some physical activity every day
- Eat real food, and make sure to include foods high in potassium such as bananas, tomatoes, and sweet potatoes
- Limit your alcohol to 1 drink per day
- And cut your stress levels
These steps alone can lower your blood pressure by several points—and we’ll look at more specific tips for managing your blood pressure naturally in an upcoming post. In the meantime, don’t be fooled into thinking that the medical world is united on what constitutes “prehypertension,” or even on whether it actually exists. They aren’t. The current public argument proves that beyond a doubt.