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What do you think of the new BP recommendations?- My MD's response in OP

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November 14, 2017, 10:26 AM
MNSIG
What do you think of the new BP recommendations?- My MD's response in OP
I've been in the "pre" stage for quite a few years, but these new recommendations put a lot of my readings into the Stage 1 level.

I'm 52, BMI 25, rarely add salt to anything, don't smoke, don't drink. Not sure there's a whole lot more to be done with lifestyle that would make much difference. I suppose I'll be starting meds at my next check up. Dang!

My physician responded to my question today and suggested doing nothing different. She indicated that the guidelines are an AHA position paper and not a true recommendation for treatment. She said she wouldn't even consider meds unless I was CONSISTENTLY in the high 130s-140s.

This message has been edited. Last edited by: MNSIG,
November 14, 2017, 10:32 AM
Elk Hunter
quote:
Originally posted by MNSIG:
I've been in the "pre" stage for quite a few years, but these new recommendations put a lot of my readings into the Stage 1 level.

I'm 52, BMI 25, rarely add salt to anything, don't smoke, don't drink. Not sure there's a whole lot more to be done with lifestyle that would make much difference. I suppose I'll be starting meds at my next check up. Dang!


What are those recommendations?

Have not seen anything on it.


Elk

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-Thomas Jefferson

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FBHO!!!



The Idaho Elk Hunter
November 14, 2017, 10:36 AM
Poacher
They dropped the numbers from 140 and 90 to 130 and 80. Overnight half the population now has high BP.




NRA Life Member

"Do what you can, with what you have, where you are." Teddy Roosevelt
November 14, 2017, 10:37 AM
12131
Every few years or so, they come out with new recommendations this and new guidelines that. And, folks will argue. I personally do NOT put too much stock into it. Do not freak out. You are fine.

quote:
Originally posted by MNSIG:
I suppose I'll be starting meds at my next check up. Dang!

I hope you're not serious.


Q






November 14, 2017, 10:38 AM
Chris17404
Saw this on the news last night. The medical lady said they think it will only cause a 2% increase of people going on meds. Yeah right. Roll Eyes



November 14, 2017, 10:41 AM
12131
quote:
Originally posted by Chris17404:
Saw this on the news last night. The medical lady said they think it will only cause a 2% increase of people going on meds. Yeah right. Roll Eyes

I'll tell you, it's a racket.


Q






November 14, 2017, 10:45 AM
MNSIG
quote:
Originally posted by 12131:
Every few years or so, they come out with new recommendations this and new guidelines that. And, folks will argue. I personally do NOT put too much stock into it. Do not freak out. You are fine.


As I recall, you are a physician, so I'm interested in your opinion. I've monitored at home for years and shared the data with my physician. Typical home reading will be 115-125/75-85. At work, I will frequently be in the 130s/80s.

I'm a bit more obsessive about it because my dad had a severe stroke at 60. Of course, his BP was WAY higher(untreated and ignored) for years before that.
November 14, 2017, 10:45 AM
sjtill
I’m no longer involved in hypertension guideline development so have not been involved in discussions leading up to the new guidelines by American Heart Association and American College of Cardiology.
The new guidelines are much more complex and treatment guidelines are based on other risks of cardiovascular disease. Whether physicians and patients understand and follow the subtleties of this remains unknown.
If the guidelines were followed accurately, there would be much more confirmation of BP readings with home and ambulatory BP readings.
I have not seen a cost-effectiveness analysis of significantly lowering the BP treatment thresholds. As BP is lower, the benefit of treatment is less but not insignificant.

So that’s a long-winded way of saying: I don’t know yet what I think of them, but thanks for asking!


_________________________
“ What all the wise men promised has not happened, and what all the damned fools said would happen has come to pass.”— Lord Melbourne
November 14, 2017, 10:48 AM
esdunbar
When I stopped eating refined sugar and simple carbs (still eat complex carbs...fruits, veggies, etc), my blood pressure dropped. Not sure if it was related, just something I noticed.

My blood work in general got really good!
November 14, 2017, 10:50 AM
MNSIG
^^^^^

Was there significant weight loss associated with the dietary change?
November 14, 2017, 10:54 AM
shovelhead
Not a medical professional, my EMT license expired the end of '87.

We were taught as a baseline that adult males systolic numbers should be age plus 100 over 80 and adult females should be 10 points less on systolic and 8 diastolic. Of course we were not diagnosticians, we just used that as a rule of thumb for monitoring and reporting.

Systolic varies greatly by activity, position of cuff, which arm,stress, etc. Seems a bit aggressive to treat with medication at a range that I would consider normal. My normal range is 120-134 systolic and have been treated for hypertension since 1991.
,


-------------------------------------——————
————————--Ignorance is a powerful tool if applied at the right time, even, usually, surpassing knowledge(E.J.Potter, A.K.A. The Michigan Madman)
November 14, 2017, 10:55 AM
esdunbar
quote:
Originally posted by MNSIG:
^^^^^

Was there significant weight loss associated with the dietary change?


Sure was. Body fat % dropped quite a bit too. I went from 227 lbs to 185 lbs. I'm 6' 1" FYI.

The first month or two was the majority of weight. Then it kept creeping down slowly over time. I've settled in around 190 lbs.

February 1, it will 2 years since I changed. I started working out religiously about a year ago, so my weight actually sent up, but I'm trimmer than before working out.
November 14, 2017, 10:57 AM
229DAK
quote:
Originally posted by MNSIG:
I've been in the "pre" stage for quite a few years, but these new recommendations put a lot of my readings into the Stage 1 level.

I'm 52, BMI 25, rarely add salt to anything, don't smoke, don't drink. Not sure there's a whole lot more to be done with lifestyle that would make much difference. I suppose I'll be starting meds at my next check up. Dang!

How about exercise - cardio and strength? You didn't mention it.


_________________________________________________________________________
“A man’s treatment of a dog is no indication of the man’s nature, but his treatment of a cat is. It is the crucial test. None but the humane treat a cat well.”
-- Mark Twain, 1902
November 14, 2017, 11:03 AM
V-Tail
quote:
Originally posted by shovelhead:
We were taught as a baseline that adult males systolic numbers should be age plus 100 over 80
Am I reading this correctly? Age plus 100? I am 80, almost 81 years old.



הרחפת שלי מלאה בצלופחים
November 14, 2017, 11:03 AM
blueye
Good revenue stream for the pharma's. Holidays around the corner and they need better bonuses. But the medical community new that the old numbers where just not cutting it, everyone felt that 138/80 was a good number but in reality you had high blood pressure.
November 14, 2017, 11:05 AM
bahs11
You really need cardio and weight training. Also , try to avoid any BP meds-They all have potential side effects (you will not like the side effects)
All things in moderation is still sound advice-
November 14, 2017, 11:06 AM
MNSIG
quote:
Originally posted by 229DAK:
How about exercise - cardio and strength? You didn't mention it.


My exercise is primarily walking. On a typical work day, my Apple Watch records about 8,000 steps. On weekends, between 12,000-15,000.

I sure can't deny that weight lifting is generally a good thing (until you end up in the orthopedic clinic Smile), but not sure that it has any direct effect on BP.
November 14, 2017, 11:30 AM
mike28w
I'm old enough to remember a time in the late 1970/1980 's when they wanted to aggressively treat high blood pressure..... Lot's of docs got on board and everyone thought they were doing good things for the patients.

A few years later some studies started noticing that there were more people passing out and falling over ( and possibly more strokes) due to low blood pressures....then the claim was that docs were treating blood pressure too aggressively. Said they were getting "kickbacks" from the drug companies....sometimes you just can't win.

In the meantime...." Everything in moderation" jmo, mike
November 14, 2017, 11:32 AM
nhtagmember
sounds like a real money-maker for big pharma...

wait six months, they will change their minds again



[B] Against ALL enemies, foreign and DOMESTIC


November 14, 2017, 11:40 AM
12131
quote:
Originally posted by MNSIG:
quote:
Originally posted by 12131:
Every few years or so, they come out with new recommendations this and new guidelines that. And, folks will argue. I personally do NOT put too much stock into it. Do not freak out. You are fine.


As I recall, you are a physician, so I'm interested in your opinion. I've monitored at home for years and shared the data with my physician. Typical home reading will be 115-125/75-85. At work, I will frequently be in the 130s/80s.

I'm a bit more obsessive about it because my dad had a severe stroke at 60. Of course, his BP was WAY higher(untreated and ignored) for years before that.

If I were in your shoes, and my doc pushes BP med on me, I would politely decline. And, if he continues to insist, I'd find another PCP. Just me.

You're doing the right thing with keeping a diary of your BP measured away from the doc's office. You ought to be commended for this. Keep exercising and eating "right", and stay away from OTC meds that can raise your BP, and I bet you'll never have to swallow a BP med.

Your dad's case is a completely different scenario. Known uncontrolled HTN and a noncompliant patient. Yeah, that will eventually stroke you out. Same thing happened to my dad. Roll Eyes


Q