The Real Story Behind the AMA New Blood Pressure Guidelines

[Ed. note: This is Day 5 of Stephen’s special five-part series for Tomorrow in Review readers called “The Truth About MD Warnings,” in which he exposes the truth about 2014’s wacky new health recommendations and what do about them. Expect a full review of this series Friday. Miss the other four parts?]

[On Jan. 26, Stephen exposed the truth about new sodium recommendations from your doctor. Should you really eat less salt? On Jan. 28, he blew the lid off a scandal in the world of sweeteners. On the 30th, he revealed a shocking connection between arthritis and red meat… Monday, he navigated the controversial world of statins. And today, he closes with startling news about your blood pressure — it might not be as bad as you think.]

There is no question that if you could control only one thing about your health, blood pressure is probably the most important. It’s the most important component of having heart disease later in life — especially when it comes to having a heart attack or stroke.

Ever since the Framingham Heart Study decided 30 or 40 years ago that blood pressure was a big deal in heart disease, physicians have been extremely worried about people’s blood pressure.

A month ago, any cardiologist would have told you — and probably still will, despite the new evidence — that a healthy level is 130/80.

But recently, that’s all changed.

New guidelines published in December say we shouldn’t worry quite as much as we used to. If you’re 60 and older, you can have blood pressure up to 150/90. And if you’re younger than 60, you can have blood pressure up to 140/90. This new study has doctors scratching their heads.

What do you think?

I myself started developing higher blood pressure. My doctor prescribed a blood pressure pill for me.

“Do I have to take it?” I asked.

“Well, no, if you’ll exercise and lose some weight and be religious about it,” she said.

“Well, why wouldn’t I?” I asked.

“Because no patient I’ve ever had has actually done it,” she responded.

After that conversation, I did bring my blood pressure down significantly thorough diet and exercise.

But it didn’t last. It lasted for about 10 years and then my blood pressure started creeping up again as I got older. For many different reasons, but mostly genetics — your blood pressure goes up as you get older.

So who’s on the other side of the fence? Nephrologists, or the doctors who treat kidney disease. As you get older, they want you to have a little more blood pressure to push your blood through the kidneys. The kidneys aren’t quite as good as they were when you were younger, and higher blood pressure means your kidneys can be more efficient.

But there’s someone else on the other side of the fence. Drug companies. It’s something we need to always keep in mind.

If I use these new recommendations, will it get me off blood pressure medications?

Personally, I think the cardiologists are probably right. I shouldn’t have blood pressure that’s higher than 130 over 80, no matter how old I get.

But there’s kind of a bottom line to all of this that is interesting.

My interpretation of this study is the American Medical Association doesn’t like the drugs being prescribed for high blood pressure.

The study, I think, in some ways is trying to find a balance between when you really have to take drugs and when you should bring your blood pressure down with lifestyle changes.

They’re trying to balance the side effects of the drugs — and all of these drugs have side effects — versus the risk of death. And they’re saying that everybody is probably better off if we push these limits up.

Basically, if we push the blood pressure recommendations up, fewer people end up on blood pressure drugs.

Because the way I interpret this study, they believe everyone is better off if we push the guidelines up. Some people may die with these new blood pressure guidelines, but the side effects of these drugs might kill a lot more people.

I’ll tell you what I’m going to do.

Keep exercising.

And watch my numbers. I’m sticking to the lower guidelines.

To a bright future,

Stephen Petranek
for The Daily Reckoning

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Stephen Petranek

Stephen Petranek’s career of over 40 years in the publishing world is marked by numerous prizes and awards for excellent writing on science, nature, technology, politics, economics and more. He has been editor-in-chief of the Miami Herald’s prestigious Sunday magazine, Tropic, and has covered a wide range of topics for Time Inc.’s Life magazine. His...

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