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It is very unclear whether or not high blood pressure truly matters.
I’ll show you in this newsletter why having high blood pressure may be a good thing.
It turns out that the definition of “high blood pressure” has changed a great deal over the years.
Also known as hypertension, it used to be something like over 160/100.
But since then, the definition of hypertension has gradually been reduced.
The result is millions and millions of men now “need” medication to have “normal” blood pressure.
However, there was really very little study on whether or not using drugs for blood pressure is a good idea.
The drug companies and the doctors ended up essentially working together to determine what a “good” blood pressure is.
They’ve worked to ensure that more and more people need medication.
And that they need more and more of the medication to lower their blood pressure ever lower and lower.
The gold standard for determining if any treatment is effective, or even needed, is a good idea is a randomized trial.
This is a trial where some are given a treatment and others are not, while neither patient or doctor knows which is which.
Ideally, a randomized trial would be the best way to determine whether or not lowering your blood pressure is a good thing.
Some patients would be given medication to fix their high blood pressure.
Other patients would not receive medication — they would receive a placebo instead.
And then researchers would wait and see who lives longer.
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The real key is “all-cause mortality.”
In other words, researchers would track how many people from the medicated group die versus the unmedicated group.
And they would track all deaths, regardless of cause, to see if more deaths occur in one group than the other.
This is the all-cause mortality measure.
And the reason that it’s the key is that everything happens to the entire body.
When you take any medication, it doesn’t just lower your blood pressure.
It impacts all of your other organs.
Even if the medication does lower blood pressure, it could impact something else that causes death.
But such a study would require being able to study people who do not take blood pressure medication.
It’s difficult to study people who are not in treatment for hypertension today.
But there was a good Chinese study that had some interesting data in it.
The study looked at large numbers of men and women.
The researchers sliced and diced the data of whether treating high blood pressure is good or bad.
The treatment was with typical drugs.
The study is fairly recent, so the drugs are the current crop of ACE inhibitors.
I’ll show you the graph that demonstrates death from stroke.
The same message is basically repeated with all of the factors studied — which are heart attacks and strokes:
In every case, almost everyone treated with medication had a worse outcome than those were not treated with medication.
The only exception were people with severe high blood pressure in both numbers.
They were excessively high in both the systolic (top) and diastolic (bottom) numbers.
These patients could not be controlled easily at all and are the SDH group.
Other than these extreme cases, the untreated, unmedicated people with high blood pressure generally fared better.
And they lived longer.
Another study shows that treating blood pressure is not beneficial.
In fact, medicating high blood pressure may actually be harmful to older people.
This is a huge study done in Europe.
They attempted to focus on whether or not treating blood pressure resulted in lower numbers of strokes and heart attacks.
Which it does.
If you treat a lot of high blood pressure with medications, you do get fewer strokes and heart attacks among those patients.
But the problem is that even with large numbers of people there is no difference in all-cause mortality.
There are the same number of deaths between medicated and nonmedicated patients.
So even though stroke and heart attack deaths were reduced, other causes made up for those numbers.
This may be one of the last studies that will be done with placebo patients.
It’s getting harder and harder to find candidates who qualify for the study, but who are not already taking blood pressure medication.
So we’ll get what we can from this study.
All-cause mortality was not influenced.
There is evidence that high blood pressure is even protective for older people.
The study attempts to put a positive face on the problem.
Treatment of 1000 patients for 5 years with this type of regimen may prevent 29 strokes or 53 major cardiovascular endpoints,
In other words, to treat 1000 people in five years, you would prevent 29 strokes or 53 heart attacks.
But you wouldn’t actually save a life.
And you would have a thousand people treated year after year with an expensive drug that has loads of side effects.
So how does this affect you?
There are a lot of dangers of blood pressure medications.
One of the biggest dangers is ejaculatory problems and erectile problems.
These problems affect at least 30% of men taking the medications, and I believe the number is higher.
Also, there is a huge problem with postural hypotension.
Postural hypotension when you get up suddenly after sitting a long time, you black out and fall.
And very often, you end up in the hospital.
These are just some of the dangers of today’s blood pressure medications.
Unless you have extremely high blood pressure, you may want to consider not treating the blood pressure with drugs.
Or, you may want to discuss a different medication, perhaps a much older medication, with your doctor.
The oldest medications did not have the side effect of causing erectile problems.
They also did not cause postural hypertension.
In fact, we may be better off with higher blood pressure in any event.
As we get older, our blood pressure naturally goes up.
And when we’re elderly, higher blood pressure actually is predictive of a longer life.
http://circ.ahajournals.org/content/118/15/1558.short
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