March 19, 2016

Blood Pressure Measurements in Question

Another controversy has erupted around blood pressure measurement and this has been created by doctors. Doctors have done this by creating a 'one-size-fits-all' program for hypertension treatment. Most are prescribing blood pressure medications to those that really don't need the medications and others are over prescribing the medications to lower blood pressure levels to those of the guidelines.

These doctors do not care that it may lower blood pressures too low for the elderly and cause them falls that may be very serious. All they care about is the levels and issuing the prescriptions. They do not take into consideration the person's age and other comorbid conditions, in other words the patient is not properly assessed.

Blood pressure readings vary, but most people with diabetes should have a reading of no more than 140/80. The first, or top, number is the "systolic pressure," or the pressure in the arteries when your heart beats and fills the arteries with blood. The second, or bottom, number is the "diastolic pressure," or the pressure in the arteries when your heart rests between beats, filling itself with blood for the next contraction.

There is some “expert” disagreement with the above numbers and some groups feel that BP readings should be 130/75-80. When it comes to preventing diabetes complications, normal blood pressure is as important as good control of your blood sugar levels.

A small reduction as the primary composite outcome may not justify the increased adverse events and costs associated with an intervention targeting systolic blood pressure (BP) less than 120 mm Hg, according to an Ideas and Opinions piece published online Feb. 23 in the Annals of Internal Medicine.

Eduardo Ortiz, M.D., M.P.H., from Washington D.C., and Paul A. James, M.D., from the University of Iowa in Iowa City, discuss the results of the Systolic Blood Pressure Intervention Trial (SPRINT), which were promoted before publication. The results showed a risk reduction in the primary composite outcome with a lower target systolic BP.

The researchers note that based on the results, for 1,000 persons treated over 3.2 years with a systolic BP target of less than 120 mm Hg versus 140 mm Hg, 16 persons would benefit, 22 would be seriously harmed, and 962 would experience no benefits or harms. In addition to a small decrease in event rates, the aggressively treated group more frequently had serious adverse drug events, which were possibly or definitely related to the intervention.

"We do not believe that the small absolute benefit seen in SPRINT provides convincing evidence that large segments of the population should be treated with additional drugs to a systolic BP goal less than 120 mm Hg, especially when the adverse events, costs, and burden of such treatment are considered," the authors write.

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