The National High Blood Pressure Education Program estimates that 42.3 million people in the U.S. have been diagnosed with high blood pressure. About 25 million of them regularly take at least one prescription drug to control it. But, according to a growing body of research, the current mainstream approach is failing miserably.
A recent study published in the Archives of Internal Medicine reports that only about 30 percent of those being treated for hypertension are “well controlled.” The others are still in a dangerous zone, despite regular treatment with drugs and regular checkups with their doctors. Why? Of course, the answer is complex. But the study suggests that the signs of remaining risk are plainly visible – if only their doctors knew what to look for.
Even a “mild” increase in systolic pressure can DOUBLE your risk of death
I’m sure you’re familiar with a blood pressure reading; it’s been standard medical practice for generations. Blood pressure is represented as a fraction; systolic pressure, the top number, represents the pressure of the blood against the artery walls when the heart contracts, while the bottom number represents the diastolic pressure, or the pressure against the artery walls when the heart relaxes between beats. Generally, the threshold for high blood pressure is 140/90 – anything above that mark is characterized as hypertension.
Traditionally, most doctors have focused their attention on the diastolic pressure, both in diagnosis and in treatment. Although more and more research has supported the importance of the systolic pressure over the past several decades, many mainstream doctors have still not caught up. And as this latest research suggests, that lack of understanding could mean the difference between life and death.
In a study of 4,714 French men currently under treatment for hypertension, the men with systolic blood pressure (SBP) values between 140 and 160 were two and a half times more likely to die from cardiovascular disease than men with SBP values under 140. As the authors note, a great proportion of people under treatment for hypertension fall into this category; in this cohort, about 45 percent of the participants had SBP values in that range, despite their drug treatment. And, under current guidelines, that 20-point jump would most likely be considered a “mild” increase – even though the data indicates it more than DOUBLES your risk of death.
“Effective” drug treatment can still leave you at risk
The scientists also report that this increased risk was independent of the men’s diastolic blood pressure (DBP) values; even after they adjusted for high DBP, the risk remained the same. On the other hand, the increased risk of high DBP did NOT remain after adjustment for high SBP. As the authors wrote, “After adjustment for SBP, DBP levels lost all predictive value.” And while previous work suggested that SBP might be a better indicator of cardiovascular risk in patients over 60, most research still supported diastolic as the best marker for younger patients. But in this study, the role of SBP was not influenced by age – and in fact, the average age of the participants was 51.
Of course, most conventional doctors prescribe antihypertensive medications to their patients with high blood pressure. Many call the treatment a success once the diastolic pressure has gotten down below 90, even if the systolic is still above 140. But as this study shows, even with treatment, SBP values above 140 are still too high – and may require even more aggressive treatment.
If you have hypertension, you should be well aware of your systolic and diastolic numbers – and have a comprehensive plan to bring BOTH of them down. There are many ways to do that: through diet, exercise, stress management approaches, supplements and other natural remedies – and in some cases, prescription drugs. In past issues of the HSI Members Alert newsletter, we’ve written about natural ways to address blood pressure, like the Chinese “immortality herb” jiaogulan, which has been proven to regulate blood pressure (July 2000 issue) and the Ayurvedic herb arjuna, which has been shown to offer “significant cardioprotection.” (June 2001 issue).*
And if you’re working with your doctor to address your blood pressure concerns, ask him what your goals are – and make sure those goals don’t downplay the importance of your systolic pressure. You may even want to ask your doctor to read this study – see the source information at the end of this e-Alert for the complete citation.
Source: Archives of Internal Medicine 2002;162:582-586
Copyright 1997-2002 by Institute of Health Sciences, L.L.C.
